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Glue ear

Thousands of children experience hearing difficulties because of glue ear. Though it can be successfully treated, it's often overlooked and, as a result, a child may become withdrawn and experience learning difficulties.

Glue ear is one of the most common causes of hearing problems in children, affecting most children at some point before the age of six. But in some, it becomes a long-term problem and, if undetected, a child can end up with learning difficulties and at worst be labelled 'difficult'.

Glue ear is a condition in which sticky fluid collects behind the ear-drum, blocking the middle ear and interfering with hearing The fluid may come and go of its own accord, so the child's hearing may be affected some of the time, or it may be present all the time, causing more serious problems, including painful infections.

The condition often gets worse in winter when children have more coughs, colds and runny noses In about ten per cent of children, it becomes a long-term problem requiring medical treatment.

WHY DOES IT HAPPEN?
The eustachian tubes that connect the ears with your throat help to drain fluid and mucus from the middle ear. In children, these tubes are still growing and can easily become blocked, for example if they become infected, or as a result of an allergy to substances like pollen or certain foods.

If this happens, fluid builds up in the middle ear and eventually thickens, making it much harder for sound to penetrate through it.

Glue ear can be rather like listening with both fingers in your ears. This obviously makes hearing hard work, so children with the condition often become easily tired, irritable and withdrawn.

HOW IS IT DETECTED?
Unfortunately, studies have shown that glue ear is easily overlooked despite being so common. With a young baby, a health visitor will carry out a routine hearing test, during which the baby is given a visual stimulant to hold his attention while something such as a rattle is shaken behind his head.

If the baby fails to look round in the direction of the noise, it may mean he has hearing difficulties. It's not a very reliable test, but if he fails to respond on two or three separate occasions, he will probably be referred to your doctor.

SIGNS TO LOOK FOR
If glue ear develops in a child, signs can include bad behaviour, learning problems or constant requests for people to repeat what they say. If you think your child has a hearing problem, talk to your doctor or school nurse as well as your child's teacher or carer.

WHAT THE DOCTOR WILL DO
Your doctor can check your child's ears by looking into them with an otoscope, a special torch magnifier that shines a light through the membrane of the eardrum. If the drum appears dull, cloudy, inflamed or infected, or if your doctor can see fluid on the other side of the drum, then it's likely your child has glue ear and, if the problem is serious, you should be referred to a specialist.

TREATING THE PROBLEM
Where there is obvious infection or inflammation, your doctor will probably prescribe antibiotics. However, these won't get rid of the `glue' itself, so he is also likely to prescribe decongestants, which help reduce mucus and fluid production, or 'mucolytics' which thin the glue to help it drain away.

If he suspects a food allergy is the cause, he may suggest cutting out certain foods from your child's diet to try and identify the culprit.

If your child sees a specialist, he will be given a number of quick painless hearing tests to see how well the middle ear is working, if fluid is present and if there are hearing problems.

The specialist may prescribe steroid nasal drops to clear up the problem. If glue ear persists, your child may need surgery to insert 'grommets' in his eardrums. These tiny tubes maintain a steady air flow into the middle ear, encouraging fluid to drain down the eustachian tubes into the back of the throat.

INSERTING GROMMETS
Under a light general anaesthetic, the specialist will make a small hole in the eardrum and drain out the 'glue' - a procedure known as myringotomy. Then a grommet will be inserted into the hole.

Some grommets stay in for up to a year, after which they should fall out naturally. By then, the child should have outgrown the problem. It is generally thought that children with grommets shouldn't swim, as water pressure changes can interfere with them, but studies have shown that this is not the case.

In the case of a young child, the surgeon may recommend waiting to see if the condition clears by itself. He may also recommend that your child's adenoids be removed, as this can often help, provided the child is at least four years old.

     
     

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