A Sticky Situation: How Surgical Grommet Insertion Can Treat Glue Ear In Young Children
Otitis media with effusion, commonly abbreviated to OME but usually referred to as ‘glue ear’, can be a distressing and uncomfortable condition to deal with for any child. However, the good news is that the condition is largely self correcting, with most cases resolving themselves without treatment. However, if your child’s glue ear lingers for several months, or your child has suffered from several bouts of the illness in a short time, surgical insertion of ear grommets may be the best way to protect your child’s health and hearing.
What is glue ear, and what causes it?
Glue ear refers to a specific type of ear infection that occurs in the middle ear, between the tympanic membrane (eardrum) and the ossicles (the three small bones that transmit sound vibrations to the cochlea). When this part of the ear becomes infected, the tissues within become inflamed, causing pain and temporary healing loss.
Middle ear infections generally clear up by themselves, but if the infection recurs or lingers the middle ear may begin to fill up with a sticky fluid — hence ‘glue ear’. This sticky fluid prevents the eardrum and ossicles from vibrating properly, reducing the child’s ability to hear from the affected ear. If left untreated for long enough, this ‘glue’ can build up to dangerously high levels, rupturing the eardrum and potentially causing severe damage to the structures of the inner ear.
Most ear, nose and throat specialists believe glue ear is related to dysfunction of the Eustachian tube, the small canal that links the middle ear to the back of the throat, and ordinarily allows drainage of any fluid caught in the middle ear into the throat. The Eustachian tube also allows air flow into the middle ear, regulating the internal air pressure of the ear — when the tube stops working correctly, air pressure inside the ear drops dramatically, drawing the fluid from the surrounding tissues.
What are the symptoms of glue ear?
Because glue ear often affects very young children who have not yet learned how to communicate effectively, diagnosing a case of glue ear can be challenging. Look for the following symptoms and unusual behaviours from your child:
- Noticeable hearing loss — This can be signified by lack of surprise at loud noises or inability to hear the TV or radio at normal volumes. Your child may also become understandably irritable due to hearing loss, and may become sensitive about having the infected ear touched. If your child is old enough to attend a school or nursery, they may have particular trouble keeping up with lessons and tasks, and may become more quiet and withdrawn as a result. Some children with glue ear may also experience tinnitus.
- Pain — The pain of OME is not the same as the pain caused by acute ear infections, and usually occurs in spells.
- Discharge from the ear — If the eardrum bursts, visible discharge may be seen seeping from the child’s ear.
- Balance problems — This is caused by the fluid interfering with the structures in the inner ear that control equilibrium.
How can grommets help treat my child’s glue ear?
Surgical intervention is naturally not an option to be taken lightly. However, if your child has repeated bouts of glue ear, or doesn’t respond to less invasive treatments, the surgical insertion of a grommet into your child’s ear may be the most effective way to counter the problem.
Grommets are essentially small, cylindrical tubes that act as internal supports for your child’s middle ear. Once inserted, the hollow tubes keep the middle ear open and work to normalise internal air pressure, promoting drainage of the ‘glue’ and providing a channel of clear air through which the eardrum can transmit sounds to the ossicles normally. These grommets are usually made from soft plastic or rubber to minimise irritation to the delicate skin inside the ear.
If you and your doctor decide that grommet insertion is the best way to tackle your child’s enduring glue ear problem, your child will be referred to an ENT surgeon to have the grommet(s) surgically implanted. In some cases this can be done under local anaesthetic, and your child will be able to leave the hospital the same day, but many ENT surgeons, particularly those who work closely with children, will recommend administering a general anaesthetic. This ensures that your child does not move around or become fidgety during the operation, potentially causing inadvertent damage to the delicate structures inside the ear.
Once your child’s grommet is inserted, they may be distressed by the sudden return of their hearing, and ordinary noises may seem unbearably loud to them. Be patient, as their normal hearing will return in time as the eardrum readjusts to normal function.