Understanding Glue Ear in Adults: The causes, symptoms, complications, preventions, and treatments

What is Glue Ear?

Understanding glue ear in adults and its complexities

Glue ear

Glue ear, also known as otitis media with effusion (OME), is a condition of fluid accumulation in the middle ear without signs of acute infection. It usually affects children, although adults can also experience it. The term "glue ear" stems from the thick, glue-like consistency of the fluid that builds up in the middle ear.

In this article, we discuss the causes, symptoms, complications, preventions, and treatments available.

Causes of glue ear in adults 

Although less common, glue ear can also affect adults.  Understanding the causes, symptoms, diagnosis, treatment, and potential complications of glue ear in adults is important for effective management and future hearing health.

Glue ear can be a result of allergies, infections, or even just the way our ears are shaped.  However, dysfunction of the eustachian tube, which connects the middle ear to the back of the nose and throat, is one of the main causes of glue ear in adults. 

Allergic rhinitis or sinusitis are other causes that can lead to inflammation and swelling of the eustachian tube, impairing fluid drainage from the middle ear and contributing to glue ear.  

Similarly, structural abnormalities of the eustachian tube or middle ear, such as a deviated septum or enlarged adenoids, can also cause eustachian tube dysfunction and glue ear in adults.

Symptoms of glue ear in adults

The most common symptom of glue ear in adults is mild to moderate hearing loss, which may affect one or both ears. Hearing loss associated with glue ear can fluctuate in severity and may be more pronounced in noisy environments. 

Ear fullness can also be experienced when adults have glue ear.  The sensation of fullness or pressure in the affected ear(s) is similar to the feeling of having water trapped in the ear.  Plus, sounds might seem a bit muffled during this time.

Some adults, with glue ear, may experience ringing, buzzing, or other sounds in the affected ear(s), known as tinnitus.  When there is a buildup of fluid in the ear, the balance organs in the inner ear can be affected and create dizziness problems.

Glue Ear in Adults

How is it diagnosed?

Glue ear diagnosis

Diagnosing glue ear in adults involves looking into medical history, a physical examination, and diagnostic tests by your local GP and/or ENT specialist.  They will ask you about your symptoms, medical history, and any recent allergies or illnesses that could contribute to eustachian tube dysfunction.

Using an otoscope, they can examine your ear canal and eardrum for any signs of fluid buildup and assess eardrum functionality.  There may also be a tympanometry test which measures the movement of your eardrum in response to shifts in air pressure.  This provides information about your middle ear function and if there is any fluid present.

A hearing test can also evaluate the type and degree of hearing loss that may be present, associated with glue ear, helping to confirm the diagnosis and assess hearing function and treatment needed.

What is the treatment for glue ear?

Treatments for glue ear, in adults, aim to reduce symptoms, promote fluid drainage, and prevent further complications.  If your glue ear is mild with minimal symptoms, a "watch and wait" approach may be appropriate at first.

This means you can continue to monitor your symptoms over time to see if they improve spontaneously.  If the symptoms persist, further action needs to be taken.  Such treatments may include:

• Medication: If allergies or inflammation contribute to glue ears, medications such as nasal corticosteroids may help reduce inflammation and improve eustachian tube function.
• Autoinflation: This technique involves using devices like the Otovent or Politzer balloon to help equalise pressure in the middle ear by forcing air through the eustachian tube.
• Ear tube surgery: In persistent or severe cases of glue ear, particularly when hearing loss is significant, ear tube insertion (tympanostomy) may be necessary. During this minor surgery, a tiny tube is placed through the eardrum to allow fluid drainage and equalise pressure.
• Hearing aids: For those with significant hearing loss, associated with glue ear, hearing aids may be prescribed to amplify sounds and improve communication.

What are the complications of glue ear?

Untreated or chronic glue ear in adults can lead to several complications.  For instance, if you leave it untreated, it can cause problems with your hearing and speech.   Here are some common complications of glue ear:

• Persistent hearing loss: Chronic fluid buildup in the middle ear can result in persistent hearing loss, affecting communication.
• Speech and language difficulties: Hearing loss from glue ear can interfere with speech and language comprehension, leading to communication difficulties and potentially impacting social and professional interactions.
• Social and emotional impact: Adults with hearing loss may experience social isolation, depression, and anxiety due to communication challenges.
• Balance problems: Severe or chronic glue ear can affect the balance organs in the inner ear, leading to balance disturbances or vertigo.

Can you prevent glue ear?

While it may not be possible to prevent all cases of glue ear in adults, certain measures can help reduce the risk.  Such as managing allergic rhinitis or sinusitis through medications may help reduce inflammation and eustachian tube dysfunction.

Smoking and exposure to secondhand smoke can increase the risk of respiratory infections and eustachian tube dysfunction.  This is why avoiding smoking and secondhand smoke is advisable.