Glue ear:
Glue ear or middle ear effusion is a condition where sterile mucous gets stuck behind the ear drum. This dampens the sound vibrations in the eardrum, causing a significant hearing loss.
The part of the ear behind the ear drum (middle ear) is an air-filled chamber. For a continuous supply of the air, it is connected to the nose via a tube called eustachian tube. There are a lot of moving parts in the middle ear (ear drum and tiny bones which carry the sounds to the inner ear). Extra mucous usually drains out of the middle ear via eustachian tube. When that draining process is interrupted by blocked tube, mucous gets stuck behind the eardrum, causing glue ear.
Eustachian tube can get blocked due to various reasons. Cold and congestion are perhaps the major reasons although it can happen without an apparent congestion. This happens more frequently in younger children because their eustachian tube is still developing to take the adult shape in later years. Also, with developing immunity, younger children pick up more germs causing Cold from the nurseries and schools.
When the eustachian tube is blocked, the mucous collects in the middle ear chamber, which affects the movement of ear drum. Hence, the sound transmission is affected. So, Glue ear is essentially a drainage issue for the middle part of the ear.
By some account, Glue ear is the most common issue why parents take children to their GP’s, throughout the world. 90% of us suffer with it at least once before the age of 4. Chances of having glue ear reduce sharply above six years of age. So, you tend to grow out of it. However, some of us go on to have this in the adulthood. Adult Glue ear is rare and often pathological, needing medical attention.
Luckily, for most of us, Glue ear is a rather temporary issue. It affects the hearing significantly when present. If a child already has other developmental issues such as speech and/or language development delay, reading/writing issues, attention deficit or a pervasive developmental disorder etc- glue ear may affect the child more than someone who has otherwise normal range of development. There is a group of individuals where glue ear is more frequent or persistent e.g. children with Down’s syndrome or cleft palate, children with hayfever or allergies etc.
Once the eustachian tube congestion goes away- glue ear disappears. As discussed above, this happens spontaneously in most children. However, a small percentage of children either have a persistent glue ear or more frequent episodes than others, affecting their hearing, speech/language, academics and behaviour. If the hearing issues diagnosed in a series of audiological tests (puretone audiometry, speech audiometry, tympanometry/reflexes and otoacoustic emissions) show a significant deterioration along with the accompanying symptoms (speech, behaviour or learning issues)- it is perhaps a good reason to actively seek help for glue ear. One of the treatment options is something called ‘grommet insertion’. Grommet is a tiny little tube (you can perhaps fit 3-4 of those on your little finger nail), that is fixed in the eardrum by an ENT surgeon, after sucking the glue/mucous out of the ear with a special suction device. It is a rather successful operation with reports of 98% success rates. Please speak to your audiologist, GP or ENT surgeon, if you are worried about your child’s hearing. Your audiologist will perhaps monitor your child’s hearing for a few time, before discharging them from the service.
Support at school:
Glue ear is a medical condition. There are guidance and laws operating in various different parts of UK that require the schools to take steps to support children with medical conditions. Your audiologist can recommend certain measures to be in place for children identified with hearing and/or listening issues.
Links:Our paediatric assessment service:
https://audiologyplanet.com/our-services/paediatric-audiology/
Glue ear information
http://www.ndcs.org.uk/family_support/glue_ear/
http://www.nhs.uk/conditions/glue-ear/pages/introduction.aspx
Video animation:
https://www.youtube.com/watch?v=gYrEh025hqU
NICE guidance on Glue ear (profesisonal resource)
Information on speech and language development
https://ican.org.uk/i-cans-talking-point/
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