Glue ear - Treating glue ear

For the first three months after glue ear has been diagnosed, it's likely your child will receive no treatment but their condition will be monitored by your GP.

This is known as "active observation".

This is because more than half of all cases of glue ear resolve within three months and there is currently no medication that shortens the length of time the symptoms last.

Medications such as antihistamines, decongestants and antibiotics have been tested for treating glue ear, but evidence shows they have little effect in shortening the duration of symptoms. They can also cause side effects.

When treatment is required

If your child still has fluid in their ear(s) after three months, active observation may still continue. This is because 9 out of 10 cases of glue ear resolve within a year.

Treatment is usually only recommended if your child has:

• severe hearing loss
• hearing loss causing significant problems with their learning, development and social skills
• Down's syndrome or a cleft palate

Glue ear is unlikely to get better by itself in children with Down's syndrome or a cleft palate and hearing loss could make existing communication difficulties worse.  

In these circumstances you will likely be referred to your local ear, nose and throat (ENT) department for further assessment and treatment.

The two main treatment options for glue ear are hearing aids and grommets (a grommet is a very small tube that is inserted into your child's ear during surgery).

Hearing aids

Hearing aids are often recommended for children with Down's syndrome as surgery can have unpredictable results.

Hearing aids can also be used when your child is unable to have surgery or you are unwilling for surgery to be carried out.

A hearing aid is an electronic device that consists of a microphone, amplifier, loudspeaker and battery.

Modern hearing aids are very small and discreet, and some can be worn inside the ear. The microphone picks up sound, which is made louder by the amplifier. Hearing aids are also fitted with devices that can distinguish between background noise, such as traffic, and foreground noise, such as conversation.

For more information about hearing aids, see treating hearing loss.

Grommets

A grommet is a very small tube that is inserted into your child's ear through a small cut in their eardrum. Grommets can help drain away fluid in the middle ear and maintain air pressure.

Grommets are inserted during an operation called a grommet insertion. This procedure is carried out under general anaesthetic (where your child is asleep and doesn't feel any pain). It usually only takes about 15 minutes, so your child should be able to go home the same day.

During the first few days after surgery, your child may find that noises sound much louder than they are used to. This is normal and should pass as your child gets used to having a normal level of hearing.

A grommet will help keep the eardrum open for several months. As the eardrum starts to heal, the grommet will slowly be pushed out of the eardrum and will eventually fall out. This process happens naturally and should not be painful. Most grommets will fall out within 6-12 months of being inserted. Around one child in three will need further grommets.

Although grommet insertion is generally a simple and safe procedure, as with all types of surgery there is a risk of complications. These include developing an ear infection or a small hole in the ear drum (perforated ear drum). See complications of glue ear for more information.

Watch an animation showing how grommet insertion surgery is performed. 

Other treatments

There are a number of less commonly used treatments for glue ear.

Autoinflation

Autoinflation involves your child blowing up a special balloon using their nose. It helps to open up the Eustachian tube, making it easier for the tube to drain fluid from the middle ear.

This will need to be done regularly until all the fluid has drained away. Autoinflation can be difficult for young children to do and is not always suitable.

If it causes your child pain, you should stop this treatment. Autoinflation should also not be carried out if your child has a cold, chest infection, throat infection or flu.

Adenoidectomy

An adenoidectomy is the surgical removal of the adenoids.

The adenoids are soft mounds of tissue at the very back of the throat. They are part of the body's immune system, which helps to fight infection.

If your child's adenoids are enlarged and swollen, they can sometimes block the Eustachian tube. Having them removed can help the Eustachian tube work better.

The procedure is carried out under general anaesthetic and your child will usually be able to go home the same day. An adenoidectomy is often performed at the same time as a grommet insertion.

As with grommet insertion, an adenoidectomy is a relatively simple procedure and the risk of complications is low. However, there is a small chance of problems such as bleeding and infection.

Read more about the risks of an adenoidectomy.