MESHGuides

Studies into the incidence of Glue Ear in pre-school children were carried out in the 1980s and 90s.  It is now well documented that a large number of children will have Glue Ear at least once before the age of four and as such there has been little recent research.

There is a high incidence of Glue Ear in the early years and studies have shown that for most children this will clear without intervention.  Glue Ear has been shown to improve in 78-88% of ears and as a result of this finding, guidance arose to wait 3 months before surgical intervention (Tos et al. 1982).  

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A grommet is a small ventilation tube that is surgically inserted into the eardrum to ventilate the middle ear.  The insertion of grommets for the treatment of Glue Ear is one of the most common operations performed under general anesthetic in childhood (Department of Health 2015).  Glue Ear normally resolves itself so guidelines state that there should be a 3 month period of persistent Glue Ear before surgical intervention should be considered.

Glue Ear is most common between the ages of 2 and 4 years.  During a critical period for language development, the frustration of not understanding or being misunderstood, can result in behavioural problems.  Wilks et al. (2000) found that 55% of pre-school children who had Glue Ear for 3 months or more, presented with behavioural problems.

A baby’s hearing is tested shortly after birth as part of the Newborn Hearing Screening Programme.  Children are not born with Glue Ear but it is common in the first year of life.

The two tests that may be used in the Newborn Hearing Screen are oto-acoustic emission and Automated auditory brainstem response.  Both of these tests are objective tests and do not require the baby to respond in anyway.  The auditory brainstem response test needs the baby to be asleep (either under natural sleep or sedated).

Acute Otitis Media is when the fluid in the middle ear is caused by an infection.  The pressure on the eardrum caused by the infected fluid is very painful.  Sometimes the pressure on the eardrum is so great the drum ruptures or perforates.  A doctor may be able to diagnose an ear infection by inspecting the ear using an otoscope.  Compared to a healthy eardrum it will look red and it may be possible to see evidence of fluid behind the ear drum.

ADHEAR is a new bone conduction aid developed by MED-EL.

It consists of two parts: an adhesive adapter, which sticks on the skin behind the ear and a small bone conduction device, which attaches to the adhesive adapter.

In the past various treatments have been tried but NICE's latest recommendations (2023) state that the following treatments are not recommended for the management of OME:​

• homeopathy
• cranial osteopathy
• acupuncture
• dietary modification, including probiotics
• massage.

  The Ottis media with effusion in under 12s NICE Guideline (2023) states:

Spoken language is acquired by hearing speech.  It is heard, copied, practised and then perfected.  Children with Glue Ear may not overhear conversations which provide the necessary repetition to learn speech.

Glue Ear can impact on speech intelligibility.  Some speech sounds will be clearer than others, resulting in speech that is muffled and difficult to understand.  For this reason Glue Ear can cause delays in speech and language.

Tympanometry is the only method, which can give reliable information about the existence of middle ear fluid and has been used in various studies to try to assess the prevalence of Glue Ear.