The ear is a complex and sensitive organ, helping us with both hearing and balance. From earwax build-up to a perforated eardrum, damage to the ear can cause anything from mild inconvenience to serious medical problems.

A condition which is very common, especially in young children, is glue ear. Eight in 10 children will experience glue ear before they reach their 10th birthday. While it’s not typically serious, it can cause temporary hearing loss which, with children, can sometimes result in a misdiagnosis relating to speech or behaviour.

Usually, it will clear up within three months, but prolonged problems may require treatment.

What is glue ear?

Also sometimes known as otitis media with effusion (OME), glue ear is a condition which usually occurs in young children, although it can develop at any age. It is caused by the build-up of a sticky fluid in the middle ear, located behind the eardrum. Essentially, this means it is harder for sound vibrations to pass through to the cochlea in the inner ear, resulting in a deadening sound or total loss of hearing.

It is possible for glue ear to affect just one or both ears at the same time.

How does the ear work?

The ear itself is made up of three parts: the outer ear, middle ear, and inner ear. Sound waves enter the outer ear and hit the eardrum. This then sends vibrations to the middle ear, where they meet small bones – ossicles – which transmit these vibrations through to the cochlea within the inner ear. Here, the vibrations are converted to electrical signals and sent on to the brain, which interprets them as sound.

What causes glue ear?

As mentioned previously, glue ear is caused by the middle ear filling with a sticky fluid. This is usually as a result of the Eustachian tube – which connects the middle ear with the back of the throat – not functioning correctly. Normally, the tube is closed but will open when we yawn, chew or swallow, enabling air into the middle ear and any fluid to drain out. For the middle ear to work properly, it must be filled with air.

If the Eustachian tube becomes blocked, or is too narrow or doesn’t open correctly, air cannot enter the middle ear. And this is where the issues with glue ear begin. A lack of air causes the cells within the middle ear to produce fluid. As it fills the middle ear, it can become thicker, eventually blocking the middle ear and making it difficult for the vibrations – sent on by the eardrum – to pass through.

Often, glue ear can occur following a cough, cold or ear infection. Passive smoking and allergies can also contribute, while children with a cleft palate or Down’s syndrome are more susceptible to glue ear as they often have narrower Eustachian tubes.

What are the symptoms of glue ear?

Dulled hearing or temporary hearing loss – though not complete deafness – are the main symptoms of glue ear. Sometimes, mild earache may be experienced and in some cases with children, there may be knock-on behavioural or developmental effects.

In half of cases, glue ear will clear up on its own within three months and within a year in nine out of 10 cases. Some children may also experience several short bouts of glue ear.

How do you treat glue ear?

There is currently no medication which successfully treats glue ear. In most instances, glue ear will clear up by itself within a few months. In prolonged cases, you may require seeking help from an ear specialist or an Ear, Nose and Throat (ENT) department. They will likely be monitored for a period of time (watchful waiting), after which, several treatment options may be explored. One option is a special balloon which children inflate with their nostrils, with the pressure sometimes helping to open the Eustachian tubes. Grommets are a second option. These small ventilation tubes are inserted into the ear as part of a small operation, allowing air into the middle ear. Hearing aids present a further solution.