How to spot if your child has glue ear
If there is hearing loss in the presence of persisting glue ear, the first line of treatment is grommets – these small tubes are inserted into each ear drum, during a short operation usually performed under general anaesthetic.
My gorgeous 5-year-old niece recently had an operation for ‘‘glue ear’’. This involved inserting grommets into her ears – a procedure that took less than half an hour, but has resulted in a miraculous improvement in both her hearing and the clarity of her speech.
Apparently she is now able to watch television without the entire street having to hear as well, and she can focus and listen to the teacher in class without needing to sit right at her feet. Needless to say, my sister is thrilled.
As I told my partner and kids about this, it became apparent that none of them had any understanding around what a grommet was, or indeed what glue ear was – in fact one (who shall remain nameless) thought a grommet was a type of worm placed in the ear to eat ‘‘bugs’’, kind of an ‘‘ear leech’’. What a horrible thought.
Here are some basic facts about glue ear and grommets:
❚ Glue ear is also known as otitis media with effusion (or OME). It occurs when there is an effusion or build-up of fluid in the middle ear and Eustachian tube. This thick fluid prevents the ear drum from vibrating properly and processing sounds.
❚ Glue ear is really common in early childhood, and in fact is the commonest cause of acquired hearing loss in this age group. We think the incidence of glue ear is as high as 20 per cent, or one in five, of all 2 year olds, but this decreases after the age of 5 to a rate of around 8 per cent. It does occur in adults but is much less common.
❚ Glue ear usually occurs after an acute ear infection, known as otitis media. As ear infections are often caused by one of the normal ‘‘cold’’ viruses , they are more likely to occur over winter.
❚ Risk factors that make glue ear more likely include: smoking within the household, attendance at day care (or an older sibling that attends day care), enlarged adenoids, frequent respiratory tract infections (colds), and lower socioeconomic status including poor housing. Glue ear is also associated with other medical conditions, including craniofacial abnormalities, Down’s syndrome and allergic rhinitis (or hayfever). ❚ The symptoms of glue ear will vary from child to child, but often it goes completely undetected as it appears ‘‘normal’’ to that child. Hearing loss is the most common complaint, and this can present in a variety of ways: struggling to hear conversations at home or school, needing the television or music up really loud, slow language development or speech that is hard to understand, poor performance or behaviour at school or home. Some children may complain of intermittent pain in their ears, or a sensation of fullness there, and occasionally balance may be affected. As it can be really hard for children to recognise and verbalise what is going on, as a parent it is a good idea to be proactive if you have any concerns – getting checked by your GP or practice nurse should be a really easy process, and can save months of difficulty for your child. Testing for glue ear is straightforward – your doctor will look in your child’s ears, and may see signs of fluid behind the ear drum.
They can also do a test called a tympanogram which helps assess how the ear drum is moving in response to a pressure wave. This test simply involves the child sitting still for a minute or two and is pain-free. If the tympanogram shows that glue ear is a possibility, your doctor will talk you through what needs to happen next.
The best thing to do initially if glue ear is detected is to wait – in the majority of cases, it will resolve within three months on its own with no further intervention needed (except perhaps some extra parental patience as you care for a child that isn’t hearing clearly).
If the repeat test in three months shows that glue ear is still present, it is important to be referred for a hearing test – glue ear on its own doesn’t necessarily need treating if your child’s hearing is perfectly normal.
If there is hearing loss in the presence of persisting glue ear, the first line of treatment is grommets – these small tubes are inserted into each ear drum, during a short operation usually performed under general anaesthetic.
The grommet creates a passageway for the fluid to drain out from behind the eardrum, and stays in place for several months or years until it falls out. Hearing improvement is almost instantaneous, but the benefits may only last a year or so.
Sadly non-surgical options haven’t been shown to be effective, although treating any underlying medical conditions such as allergic rhinitis can make some difference to the symptoms.
For more information, visit healthnavigator.org.nz.
❚ Dr Cathy Stephenson is a GP and mother of three.