What it is
Behind the eardrum is a small air-filled space, the middle ear. It is kept ventilated by a narrow tube to the back of the nose, the Eustachian tube. In young children this tube is short and works less well, especially during colds or when the adenoids are large.
An acute ear infection (otitis media) is an infection of that space, usually with pain and fever. Glue ear (otitis media with effusion) is sticky fluid that stays behind the eardrum, often after an infection, usually without pain.
Signs to look for
An ear infection usually causes ear pain, fever, pulling at the ear, poor sleep and irritability. Sometimes the eardrum bursts, discharge runs from the ear and the pain eases.
Glue ear is quieter and easy to miss. A child may turn up the television, not answer when called, seem inattentive at school, have unclear speech or be a little clumsy. Adults can get it too, often after a cold or a flight, and fluid on one side in an adult should always be examined.
When to see an ENT surgeon
Most ear infections clear within a few days, and most glue ear clears within three months. Referral is worthwhile when infections keep coming back, when glue ear lasts three months or more with reduced hearing, when speech or schooling is affected, or when an ear keeps discharging.
Seek urgent care if there is swelling, redness or tenderness behind the ear, the ear is pushed forward, one side of the face droops, or your child is very drowsy, has a severe headache or a stiff neck.
How it is treated
Pain relief is the first treatment for an ear infection; antibiotics are used for some children, depending on their age and how unwell they are. For glue ear, a period of watching with a repeat hearing test is usual, because it so often clears by itself.
When it does not, grommets, tiny ventilation tubes placed in the eardrum through the ear canal, let air into the middle ear and usually restore hearing straight away. If the adenoids are large, they may be removed at the same time. A hearing test by the audiologists in the same rooms comes first.
Common questions
Does glue ear cause permanent hearing loss?
Usually not. The hearing loss from glue ear is generally temporary and improves when the fluid clears or grommets are placed.
Are hearing aids an alternative to grommets?
For some children, yes, while waiting for the glue ear to clear. Dr Kana will talk through the options with you.
Can my child swim with grommets?
Ask Dr Kana for advice for your child. Many children can swim on the surface; diving and dirty water are usually avoided, and ear plugs are sometimes suggested.
This page is general information, not medical advice for your situation.
