Glue ear occurs when thick, sticky fluid collects in the middle ear—the small air-filled space behind the eardrum. The name "glue ear" describes the consistency of this fluid, which can be as thick as glue.

This condition often develops after a middle ear infection (otitis media), but it can also occur without a preceding infection. Unlike acute ear infections, glue ear doesn't usually cause pain or fever, but it can significantly affect hearing.

How glue ear differs from ear infections:

• Acute otitis media (ear infection): Painful infection with fever, caused by bacteria or viruses
• Glue ear (OME): Painless fluid accumulation without active infection, primarily causing hearing difficulties

Why it's more common in children:

Children are particularly susceptible to glue ear due to their smaller, less developed ear structures:

• Their Eustachian tubes (which connect the middle ear to the throat) are shorter, narrower, and more horizontal
• These tubes don't drain as efficiently as in adults
• Children experience more frequent colds and respiratory infections
• Their immune systems are still developing
• Enlarged adenoids (common in children) can block the Eustachian tube opening

Prevalence:

• About 8 out of 10 children will experience at least one episode of glue ear by age 10
• Most commonly affects children aged 2-5 years
• Usually resolves naturally as children grow and their Eustachian tubes mature
• Less common in adults, but can occur, especially after severe colds or sinus infections

Understanding glue ear is the first step to ensuring timely care and support for affected children and adults.

The most noticeable symptom of glue ear is temporary hearing loss in one or both ears. Because the thick fluid prevents the eardrum from vibrating properly, sounds don't transmit effectively to the inner ear.

Common symptoms in both children and adults:

• Hearing loss: Mild to moderate, often fluctuating (better some days, worse others)
• Earache or discomfort: Usually mild, not as severe as with acute infections
• Tinnitus: Hearing sounds like ringing, buzzing, or humming in the ears
• Feeling of fullness: A sensation that the ears are blocked or "underwater"
• Balance problems: Occasional dizziness or clumsiness (less common)

Important considerations:

• Symptoms can come and go, making glue ear harder to identify
• Children may not realize they have hearing difficulties and won't necessarily complain
• Hearing loss may be subtle enough that it's not immediately obvious
• One ear may be more affected than the other

If you or your child show these signs, consult your GP to confirm whether glue ear is the cause. A simple examination with an otoscope and potentially a hearing test can diagnose the condition.

Glue ear develops when sticky fluid builds up behind the eardrum and fails to drain properly through the Eustachian tube—a narrow passage connecting the middle ear to the back of the throat.

How glue ear develops:

1. The middle ear normally contains air, which is replaced regularly through the Eustachian tube
2. When the Eustachian tube becomes blocked or doesn't function properly, air cannot enter the middle ear
3. The cells lining the middle ear continue producing fluid, but it cannot drain
4. This fluid accumulates and becomes thick and sticky over time
5. The accumulated fluid prevents the eardrum from vibrating normally, causing hearing loss

Common triggers and contributing factors:

• Following ear infections: After acute otitis media, fluid may persist even after the infection clears
• Colds and respiratory infections: Cause inflammation and swelling that blocks the Eustachian tube
• Flu and sinusitis: Upper respiratory infections can lead to Eustachian tube dysfunction
• Enlarged adenoids: These tissues at the back of the throat can physically block the Eustachian tube opening
• Allergies: Allergic rhinitis causes inflammation and mucus production
• Passive smoking: Exposure to cigarette smoke significantly increases risk
• Bottle-feeding while lying down: In infants, can allow milk to enter the Eustachian tube
• Childcare attendance: Increased exposure to colds and infections
• Down syndrome or cleft palate: These conditions affect Eustachian tube structure and function

Risk factors in adults:

While less common, adults can develop glue ear, particularly if they:

• Have chronic sinus infections or rhinosinusitis
• Suffer from severe seasonal allergies
• Experience sudden pressure changes (flying, diving)
• Have nasal polyps or structural abnormalities
• Smoke or are regularly exposed to secondhand smoke

In adults, glue ear may indicate an underlying issue that requires investigation by an ENT specialist.

The good news is that glue ear often resolves on its own without treatment, especially in children. However, proper monitoring and, in some cases, intervention may be necessary.

1. Watchful Waiting (Active Monitoring):

For most children and adults, the first approach is to monitor the condition:

• Your GP will recommend regular check-ups every 3 months to track progress
• Hearing tests may be conducted to assess the degree of hearing loss
• In most cases, glue ear clears naturally within 3 months
• Even persistent cases often resolve within 6-12 months without intervention

During the monitoring period:

• Ensure teachers or caregivers are aware of the child's hearing difficulties
• Seat the child at the front of the classroom for better hearing
• Face the child when speaking and speak clearly (not necessarily louder)
• Reduce background noise during conversations
• Check that the child has understood instructions

2. Grommets (Ventilation Tubes):

If symptoms persist beyond 3 months and cause significant hearing loss or impact on learning and development, an ENT specialist may recommend grommets:

After grommet insertion:

• Keep ears dry—use earplugs or cotton wool coated with petroleum jelly when bathing
• Avoid swimming or use special earplugs if swimming is permitted
• Attend follow-up appointments to monitor healing
• Some children require a second set of grommets if glue ear returns

3. Hearing Aids:

In cases where surgery isn't suitable or appropriate, hearing aids may be recommended:

• Useful for children with other health conditions that make surgery risky
• Temporary solution while waiting for natural resolution
• Can support learning and development during the glue ear period
• May be preferred for recurrent glue ear to avoid multiple surgeries

4. Other Potential Interventions:

• Adenoidectomy: Removing enlarged adenoids may help if they're blocking the Eustachian tube
• Autoinflation: A technique using special balloons to open the Eustachian tubes (limited evidence, but may help some children over age 3)
• Treating underlying causes: Managing allergies, avoiding smoke exposure, treating chronic sinus problems

Treatment for adults:

For adults, glue ear is less common and may indicate an underlying issue. Your GP will likely refer you to an ENT specialist to:

• Investigate potential causes (chronic sinusitis, nasal polyps, allergies)
• Rule out more serious conditions
• Recommend appropriate treatment, which may include grommets or addressing the underlying cause

What doesn't work:

• Antibiotics don't help glue ear (it's not an active infection)
• Decongestants and antihistamines have limited benefit unless allergies are a factor
• Steroid nasal sprays may help in some cases but aren't routinely recommended

At Clear Ear Cheer, we're passionate about making ear care accessible and positive for everyone, from young children experiencing their first episode of glue ear to care home residents who may struggle to communicate hearing difficulties.

Our mission includes:

• Providing clear, evidence-based information about ear conditions like glue ear
• Raising awareness of how hearing difficulties affect learning, communication, and quality of life
• Supporting families and caregivers in managing ear health challenges
• Offering professional mobile ear care services across Essex and Suffolk
• Campaigning for better access to ear health services across the UK

Advocacy for better services:

We're actively campaigning for improved access to ear health services, particularly in areas like Mid & South Essex and Suffolk & North East Essex, where NHS support may be limited or waiting times are long.

We believe every child deserves timely assessment and support for glue ear to prevent impacts on learning and development. We also recognize that older adults in care homes need accessible ear health services to maintain their communication, dignity, and connection with others.

Working together:

While glue ear diagnosis and treatment decisions rest with GPs and ENT specialists, Clear Ear Cheer supports the broader ear health journey by:

• Helping identify potential hearing issues that warrant GP assessment
• Providing ongoing ear health monitoring and maintenance
• Ensuring earwax build-up doesn't compound hearing difficulties
• Supporting families and care homes with education and guidance