Glue ear (Also known as otitis media with effusion/OME) is a common childhood condition characterized by the accumulation of fluid within the middle ear, without signs of acute infection.

The presence of fluid behind the eardrum (tympanic membrane) adversely affects the efficiency of movement of the 3 bones (ossicles) of hearing in the middle ear. The sound signal is not carried as well to the sensory organ in the inner ear (cochlea) and as a result the sound is heard as a quieter noise than it ought to be.

There are 2 peaks in the incidence of glue ear around 3 and 5 years of age. Glue ear is very common and 80% of children have been affected by 10 years. Hearing loss is the commonest presenting feature but sometimes the hearing difficulty can go unnoticed.

Less frequently glue ear may present with poor educational progress, clumsiness, ‘the wobbly child’, abnormal noises in the ears (tinnitus) and intolerance of loud noise (hyperacusis). Glue ear may resolve naturally and therefore a period of 3 months of ‘active monitoring’ following diagnosis is recommended. If the glue ear persists for over 3 months with accompanying hearing difficulty then intervention should be offered. Medicinal treatments have not been shown to be effective in the management of glue ear.

This intervention can take the form of surgically draining the fluid and inserting grommets (ventilation tubes) to ventilate the middle ear. Grommets prevent the development of the negative pressure in the middle ear that is thought to lead to the development of glue ear. Hearing aids are an option to amplify the sounds sent into the ear to counter-act the inefficient sound transfer. They allow the child to hear better, whilst waiting for the natural resolution of the glue ear, that can take months to a few years.