For the first three months after glue ear is diagnosed, it's likely that your child won't receive any treatment.
However, your child's condition will be monitored by your GP. This is known as "active observation" or "watchful waiting".
Treatment for glue ear isn't usually given during the first three months after diagnosis, because over half of all cases resolve within three months, and there's no medication that shortens the length of time the symptoms last.
Medications such as antihistamines, decongestants and antibiotics have been tested for treating glue ear, but evidence shows they have little effect in shortening the duration of symptoms. They can also cause side effects.
When treatment is required
If your child still has fluid in their ear(s) after three months, active observation may still continue. This is because 9 out of 10 cases of glue ear resolve within a year.
Treatment is usually only recommended if your child has:
Glue ear is unlikely to get better by itself in children with Down's syndrome or a cleft palate, and hearing loss could make existing communication problems worse.
In these circumstances, you will probably be referred to your local ear, nose and throat (ENT) department for further assessment and treatment.
Hearing aids and grommets are the two main treatment options for glue ear.
The various treatments for glue ear are outlined below. You can also read a summary of the pros and cons of the treatments for glue ear, allowing you to compare your treatment options.
Hearing aids are often recommended for children with Down's syndrome, because surgery can have unpredictable results.
Hearing aids can also be used when your child is unable to have surgery or you're unwilling for surgery to be carried out.
A hearing aid is an electronic device that consists of a microphone, amplifier, loudspeaker and battery.
Modern hearing aids are very small and discreet, and some can be worn inside the ear. The microphone picks up sound, which is made louder by the amplifier.
Hearing aids are also fitted with devices that can distinguish between background noise, such as traffic, and foreground noise, such as conversation.
A grommet is a very small tube that's inserted into your child's ear during surgery. It can help drain away fluid in the middle ear and maintain air pressure.
Grommets are inserted during an operation called a grommet insertion. The procedure is carried out under general anaesthetic (your child will be unconscious and won't feel any pain). The procedure takes about 15 minutes, so your child should be able to go home the same day.
During the first few days after surgery, your child may find that noises sound much louder than they're used to. This is normal and should pass as your child gets used to having a normal level of hearing.
A grommet will help keep the eardrum open for several months. As the eardrum starts to heal, the grommet will slowly be pushed out of the eardrum and will eventually fall out. This process happens naturally and shouldn't be painful. Most grommets will fall out within 6-12 months of being inserted. Around 1 child in 3 will need further grommets.
Grommet insertion is generally a simple and safe procedure, but as with all types of surgery, there's a risk of complications. These include developing an ear infection or a small hole in the ear drum (perforated ear drum).
See complications of glue ear for more information.
You can also watch the animation above that shows how grommets are inserted.
There are a number of less commonly used treatments for glue ear, which are listed below.
Autoinflation involves your child blowing up a special balloon using their nose. It helps to open up the Eustachian tube, making it easier for the tube to drain fluid from the middle ear.
This will need to be done regularly, until all the fluid has drained away. Autoinflation can be difficult for young children to do and isn't always suitable.
If autoinflation causes your child pain, treatment should be stopped. Autoinflation should also not be carried out if your child has a cold, chest infection, throat infection or flu.
An adenoidectomy is a surgical procedure to remove the adenoids. The adenoids are small, soft glands at the very back of the nose. They help to detect germs and notify the immune system. It's thought that after around the age of three, the adenoids aren't needed any more, because the body is able to fight germs without them.
The adenoids are usually only removed if they're causing problems. For example, if your child's adenoids are swollen and enlarged, they can sometimes block the Eustachian tube. Removing them can help the Eustachian tube to work better.
An adenoidectomy is carried out under general anaesthetic and your child will usually be able to go home the same day. The procedure is often carried out at the same time as a grommet insertion or removal of the tonsils (tonsillectomy).
As with grommet insertion, an adenoidectomy is a relatively simple procedure and the risk of complications is very low. However, there's a small chance of problems, such as bleeding and infection.
Read more about the risks of an adenoidectomy.