Glue ear

[Springforward]

Sorry if this has been up before, I searched but couldn't find an answer to my question.

My 3 year old DS was diagnosed with Glue Ear yesterday (history of ear infections, right drum perforated twice but healed, left drum looking like it might go same way soon apparently). We have a follow-up appointment in 3 months which will decide whether an ENT referral is necessary or not.

I'm OK with all that - I wasn't surprised, we stopped swimming because of his ear infections - but I don't know whether he's got a big hearing loss or not, and it's bugging me. His loss seems to be around 30 dB (but only 10 dB via bone conduction) - is that a big loss, or not?

He seems to be able to hear us most of the time (I'm pretty sure there's some selective ignoring going on as well as not hearing me when I speak more softly!) and nursery have never raised any concerns about his speech, even when I asked for advice with a bit of stuttering which started over Xmas and now seems to be resolving.

Does anyone know about this kind of thing? Would be grateful.

My disclaimer is I'm not a medical person this is just my understanding of glue ear and hearing difficulty

I understand that normal converstaion is 40-60dB and a whisper is around 30dB
Mild hearing loss was defined to us as 25-40dB where you might have difficulty following a conversation if the speaker is more than 6 foot away or if there is noise in the background (you can see why this 'mild' loss becomes huge once a child starts School although it is still classed as 'mild' )
Hearing loss over 40dB is usually around the point they would use a hearing aid

Glue ear is conductive hearing loss so your ds's hearing may have fluctuated so he has acquired his speech ok - the glue would have also cleared when his ears naturally perforated with an infection.

This website Deafness Research UK has a lot of information and some fact sheets for teachers which I think you should give to nursery as well, they may well pick up on some of his hearing difficulty once they realise,its amazing how well children compensate and cope with hearing loss.

These are the [[www.nice.org.uk/nicemedia/pdf/CG60publicinfo.pdfSimilar
NICE guidelines for managment of Glue Ear]] which may also be useful (I've assumed you are UK and using the NHS ) The 3 month wait you have now is to see if the glue ear clears by its self which for some children it does

hope that helps

Incy, that's brilliantly helpful, thank you!

I told his nursery when I dropped him off this morning and the manager said that they would do things like sit him next to his nursery nurse etc., so I'm feeling reasonably confident that they'll be on it now.

Hi spring both myself and my DD have had glue ear . I had grommetts inserted twice when I was young. My DD has them in now . Have they mentioned grommets to you ? My advice would be to get them in before school as it will impair his ability to learn . If he can't hear the teacher his mind will wander then even when his hearing is improved he will still be in the habit of not listening . I'm nearly 26 and I still say "pardon?" a million times a day even although I have heard the majority of things said to me it's just a habit I have carried through to adulthood . I'm sorry I don't know about exact db or anything but I do know how frustrating it is living with glue ear .

I remember thinking some of my DDs behaviour was selective also , but then I started to notice things like sitting right up at the tv with the sound blaring . When I would be speaking to her she would pull my face round so we were square to one another so he could watch exactly what I was saying .

I know any kind of surgery is scary but I would honestly recommend it especially if he is in pain a lot with infections .

HTH

I totally second what MrsC says, if ds needs grommets then do them before School, my ds had them done towards the end of reception, he finished the year barely reading because he had no idea what phonics where (couldn't hear them or distinguish between the sounds) plus other social difficulties but thats a whole other thread along with how because hearing difficult is invisible School don't acknowledge it and constantly forget what you've told them... I could go on.... and on...

Would you consider a few sessions of cranial osteopathy?
(I know some consider it woo - so feel free to ignore this post :))
It really helped ds and meant he didn't need grommets.

Hi MrsC, thanks for the tip. If surgery were offered I would take it - in truth I was kind of hoping for an ENT referral yesterday so we could just get on with it.

The audiologist seemed to suggest that if he'd had less than 5 infections in last year then watch-and-wait was right for now. He's only (only!) had three that I've taken him to docs for in that time, so fair enough for now, I guess.

DH and I are starting to wonder about some other behavioural stuff now, in view of yesterday's news. If I leave him to visit his aunty alone while I go off and do chores and the telly's on, when I get back the telly is always massively louder than I have it on - aunty always lets him have his own way, so perhaps she's putting it to a volume he hears better? The ignoring thing, I now see, might not always be just wilfulness. He's often excessively tired and grumpy by the end of the day, and the only time I can reliably have a properly extended conversation with him is when we're having a cuddle or I'm reading to him in bed - it's less likely to happen, say, in the garden where there is quite a bit of road noise, or in the kitchen which is kind of echoey. Hmm.

To be totally honest (if a bit of a hypochondriac) I'm now wondering about my own hearing - I couldn't hear all of the test tones myself, and I drive my DH nuts with the "pardon?" thing.... Might check that out too.

You have a bit of time as your ds is only 3, although i know you will want the infections gone sooner. My DD was nearly 5 when she was diagnosed so I pushed for the op asap and it was done the month before she started school. I would keep persevering I'm sure at your next appointment you will be referred to ENT and if not push to be referred . Tell them you are not willing to leave your child to be constantly getting ear infections . Three a year is a lot for anyone let alone a 3 year old !!

Favorells - cranial osteopathy is not that woo imo - all 3 of mine had grommets in the end (family history) and I asked ENT consultant if there was anything I could do whilst 'watchful waiting' (which they like to call 'active monitoring' now!) and he suggested - no smoking (we don't), cutting out dairy as its muscus producing (which we've now done for all inc dh and I because its just easier) and getting cranial osteopathy (we did only start this after grommets - we needed to get them back on track, ds3 (2) has speech delay and ds1 (5) is still struggling at school - but I'm hoping they won't become the 30% of children that need additional sets before they grow out of it)

Incy - did you cut out dairy, and did it help? Ditto the CO?

We don't smoke (both ex-smokers, long before DS was conceived - DH has laspes very occasionally but never at home, always at work), and don't take him any places where other people do, so nothing more to do on that one.

MrsC - one was too many for me. He was so, so miserable and so were we.... Also a bit freaked that last time he didn't respond to first set of ABs and path lab swabs noted he was growing something resistant to everything except gentamicin, which is ototoxic (low risk but not one I wanted to take, really) - infection was on the wane by then however so I guess he demonstrated that some infections can resolve themselves.

I used to work as an ENT secretary and grommet insertion was the norm. I do not recall a single case where you had to have five infections prior to referral!

Get your GP to refer you to the Paeds ENT surgeon at your local hospital and you'll be seen before school starts in September.

We have managed it a bit differently from everyone lese on the thread, DD and DS2 both have glue ear and are hearing aided. It wasn't automatically offered, however glue ear is something that a child may grow out of and DS1 had glue ear and grommets and had an awful experience with them so this has somewhat put me off that route unless absolutely neccesery.

curlywurly, what happened with your DS1?

curlywurly - did/do your ds2 and dd suffer with ear infections along with glue ear?

springforward - I think the dairy has really helped ds1, just started with ds2 and 3 so prob too early to tell. Again early days with CO - I guess I won't know properly until grommets are out and we see if they get a build up of glue ear again, if they don't then I will most likely put it down to diet and CO intervention as I know we have genetic marker for Otis Media (part of genetics study) and dh had several sets as a child. curlywurly is right that most children do grow out of it by the time they are 7 yrs.

Hello op your ds sounds very much like how my dd was before she had gromits, she has had 2 sets now, her first set was when she was about 2.6yo and it was very dramatic the difference to her hearing, she heard birds in the trees for the first time, traffic, the washing machine totally freaked her out!!!

We had tried co but tbh it didn't do a lot of good, and the co lady in the end conceded defeat and said my dd was a bad case

Her 2nd set was just before she started school and was done at the same time as having her adenoids and tonsills out, her hearing improved but she then had problems with her right ear and constant infections, that gromit has now come out (dd now 6yo) and I would not want her to have any more, I would rather hearing aids. I did get something from amazon called octovent (I think) that was recommended by mn - haven't tried it yet but might help.

Hmm. I wonder if it's relevant that DS has also had several bouts of tonsilitis. I feel a trip back to our GP coming on.

I have a friend who is trying this with her ds due to reoccuring infections - antibiotics do tend to wipe out the system so suppliments and probiotics help

girlie our ENT consultant said on Monday he doesn't reccomend Otovent for bad/severe cases of glue ear. Apparently nasal balloons have been around since 60's and have limited success rate, sometimes they can cause damage

Thanks for the tip Incy, i'll look into it.

Did any of your children have a tendency to sleep with a hand over either ear? Ask as DS has a habit of doing this and now i'm wondering about its significance.

Thanks to all who've posted, this really has been incredibly helpful.

Just wanted to add our experiences.

Dd was diagnosed at 3 with glue ear, some speech impairment and general daydreaminess were the clues.

She had her first set of grommets at 4 whilst in reception. They made a huge difference - until the came out. Referred back at age 5. Consultant talked about hearing aids then or repeating the grommet procedure. I was reluctant to go down the hearing aid route as wear them myself and find them a PITA tbh and as we had had no complications with the grommets we went for them again.
So at just turned 6 DD had a second set of grommets. Again hearing improved remarkably until they started to work their way out.

Now at just turned 7 dd's hearing is at an all time low and we have (yesterday) been back to the hospital to see the ENT specialist again. The doctor was quite amazed that dd's hearing was so bad.
This time they have recommended permanent grommits as she has had no infections or complications previously we have opted for them. They will basically be left in until she is in her late teens.

I think there is a large percentage of children whose glue ear resolves by this age but dd's hasn't.

It has been a struggle to get the school to give her the help she needs. She has been slow to read. The most obvious sign now is her lack of friendships in her peer group. I think she is so used to being in her own world (not hearing other people's conversations properly) that she has struggled to form close friendships. She is not being bullied though.
Today I have to talk to the class teacher again and try to emphasize how difficult things can be for people with hearing impairment.

Wish me luck.

whyme your poor DD so sorry she is having such a bad time . It's such a shame going through that op for them to come out so quickly . Hope you get on well at the school , good luck !!

Regarding the octovent, DD was given it to try before being booked in for the op . When they did the vibration test, there was so much mucus pressing against her eardrum it did not vibrate at all . So when I think back I can't believe They actually expected that to work !!

Good luck Whyme. So sorry to hear DD is having a hard time.

I am worried about DS leaving his lovely nursery.... He's not due to start school until Sep 13, and now I'm kind of rethinking my choices as it seems like the school are going to have to be really on the ball with this kind of think to support him through it. sigh.

Thing, not think - sorry!

Faverolles, how did the CO work for your DS? I guess we could try it while we wait for an ENT referral.

I think with school you have to keep pulling them up on it. Another poster mentioned this but it is an invisible disability so often gets forgotten by staff so keep reminding them often .

When dd went into year2 the teacher made some negative remarks about dd's struggle to read. I did find it difficult to make him understand the problems dd faced. He was almost blaming me for not practicing enough reading at home. I suggested she read in a quiet/seperate room at school which really helped her as it cuts out background noise.

Amazingly dd thinks it is all fun and games all these trips to the hospital and the ice cream after each visit she is apparently not bothered by having to undergo another op.

Permanent gromits? Have never heard of them, how do they stay in then? I would be worried about dds eardrum being too weak to cope with anymore gromits now so really hope her hearing doesn't tail off again as at the moment its not too bad, although she is complaining recently of her ear feeling itchy on the inside?!! I'm hoping thats a good sign

Incywincy I only got the otovent as it was recommended on here!!! Like I said haven't needed to try it yet but do find that it helps generally to clear her ear when it feels 'bubberly' (dds words!) to blow her nose hard!!!

Dd has also struggled with reading in particular with distinguishing between sounds like 'ch' and 'sh' dd came home tonight with another IEP which is really as I feel she is quite bright but misses a fair bit of what is being said to her.

girliefriend - I saw Otovent recommended here too which is why I asked our consultant about it (I was hoping if he thought it was good I'd get it on prescription as I have 3 with glue ear) but was supprised that he wasn't keen after how positive everyone was, I guess it wasn't suitable for my ds's.

whyme - how was school? does your LEA have a hearing team that can support you? I found ours did a great job at explaining the audiograms to class teacher (I think they had more credability than me as a parent ) up to then his IEP contained 'listening' as a target ffs - still a battle tho, parents evening tomorrow and dreading it

springforward - don't worry about School just yet I'd recommend getting copies of audiograms for your reference and asking if your nursery has a SENCO type that can help/advise you, ours has been brilliant with ds3 (due to start school same time as your ds)