Glue Ear

• The eustachian tube connects our middle ear to the nose and equalises pressure in the ears.
• This tube does not function adequately in younger children, leading to a negative ear pressure that draws in fluid (glue).
• Large adenoids at the back of the nose can also hinder the function of this tube.

• Glue ear causes hearing loss in children (the severity of this is similar to putting your fingers in your ears).
• This can lead to speech and language delay, poor listening skills and affect educational progress.

• Examination of your child.
• Hearing tests and pressure tests to check for fluid behind the ear drum.

• Most children will clear the glue on their own over a period of 3-6 months.
• Children are usually monitored during this period with repeat hearing tests.
• In this surveillance period the Otoventâ device can be used to improve your child’s eustachian tube function. This is a balloon that your child blows up with their nose twice a day. The video demonstrates this.
• In children with persistent glue and hearing loss and speech delay the options include a hearing aid or surgery (insertion of grommets).
• In children with evidence of large adenoids (nasal blockage/ frequent upper respiratory infections), an adenoidectomy can also be beneficial.

• Grommets are small plastic tubes that are inserted into your child’s ear drum.
• Grommets improve the function of the middle ear.
• Grommets remain in the ear for 12 months after which they fall out on their own.

• The procedure removes glue, improves middle ear function and allows your child to hear normally.
• Children’s hearing usually improves soon after the procedure.
• Grommets also reduce the number and severity of ear infections.

Grommets are a quick and straightforward day case procedure involving a general anaesthetic. Recovery is usually painless and children can return to school within a few days.

Overall, grommets are a very safe and short procedure. The risks are as follows:

• Infection (usually precipitated by water entering the ears).
• Persistent leaking from the ears (otorrhea) can occur in children with recurrent ear infections. This can be treated with short course of antibiotic ear drops.
• Occasionally the grommet falls out earlier than expected, however usually this causes no issues.
• Rarely grommets do not come out on their own and can cause recurrent infections in the long term and may need to be removed.
• A hole in the ear drum that does not heal (1% risk)- this can lead to infections and may require repair when the child is older
• Scarring of the ear drum (tympanosclerosis)- this does not usually cause any problems

• Hearing aids
• A medium term course of a low dose antibiotic (for ear infections)
• Watch and wait approach to see if the glue clears

• Recovery is quick and children can return to school soon after the procedure.
• We suggest a short course of ear drops to prevent the grommets becoming blocked in the first few days.

• I usually suggest that children avoid swimming for the first 2 weeks following grommet insertion to allow the ear drum to heal.
• In this period it is also useful to minimise hair washing and use ear plugs or cotton balls soaked with Vaseline in the ear during baths.
• After this period, swimming usually causes no problems.
• Use of a moulded ear plug with a swimming cap can be considered if there is concern regarding ear infections.
• Diving should be avoided as it is associated with a higher pressure and thus may lead to water being forced in to the middle ear and subsequent infections with grommets.
• If your child has any pain, ear discharge or fevers then we suggest seeing your GP or emergency doctor as antibiotic drops may be required.