Download Hearing loss caused by fluid in the middle ear

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Hearing loss caused by
fluid in the middle ear
Information for parents and teachers
Children’s Hearing Assessment Centre
The Trust endeavours to ensure that the information given here
is accurate and impartial.
This document can be provided in different languages and
formats. For more information please contact:
Children’s Hearing Assessment Centre
Ropewalk House
113 The Ropewalk
Nottingham NG1 5DU
Tel: 0115 948 5591
Claire Benton, Children’s Hearing Assessment Centre © April 2015. All rights reserved.
Nottingham University Hospitals NHS Trust. Review April 2017. Ref: 1202/v2/0415/AM.
Public information
Aim of the leaflet
More information
This leaflet is aimed at parents and carers of children with
hearing loss that has been caused by congestion in the middle
ear. It aims to provide information on how we hear and how
having fluid in the middle ear can impair hearing. It also aims to
provide guidance on how this will affect the child and offer some
tactics to help them.
How the ear works
When we hear sound, the signal travels down the ear canal and
then vibrates the eardrum, making three bones in the middle ear
move. When the bones move they stimulate the cochlea in the
inner ear and then the signal is sent up the auditory nerve to the
brain.
The National Deaf Children’s Society (NDCS)
www.ndcs.org.uk
Action on Hearing loss
www.actiononhearingloss.org.uk
Children’s Hearing Assessment Centre
Tel: 0115 948 5591 Monday to Friday 8.30am - 5pm
Email: [email protected]
www.nuh.nhs.uk/audiology
For ears to work properly the middle part of the ear containing
the three small bones needs to be kept full of air. The
Eustachian tube, which usually does this, runs from the middle
ear to the back of the throat.
What is fluid in the middle ear?
The Eustachian tube is not as efficient in children as it is in
adults, because it is not as vertical or wide as it will be when
they are older.
If the tube becomes blocked air cannot enter the middle ear. If
this happens, the cells lining the middle ear begin to produce a
fluid and this fluid can fill the whole middle ear space.
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How can you help your child?

It is important that you are aware that your child may have a
problem with their hearing and that you inform the people
who are involved with your child e.g. nursery and school.

Get your child’s attention before you start talking and speak
in a clear voice, without shouting. It will help if the child can
see your face when you speak to them. Move closer to your
child rather than speaking to them from a distance.

Make sure all background noise is reduced to a minimum turn off the television if you are not watching it.

In school, it is important that the child is as close as possible
to the speaker. They should also be on the better side if one
ear is affected more than the other. The child should not be
made to feel awkward if they ask for something to be
repeated.

Remember to be patient if your child misunderstands things.
If they didn’t understand what you said the first time, try to
say it in a different way.
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Fluid in the middle ear causes hearing loss because it makes it
more difficult for the eardrum to vibrate. It is more difficult for
sounds to travel through into the inner ear, and sounds need to
be louder to make the middle ear system move.
The fluid in the middle ear that causes the congestion is called
middle ear effusion or ‘glue ear’.
The amount of fluid in the middle ear can vary and this can
mean that your child’s hearing can fluctuate. You will often find
that your child’s hearing is worse when they have a cold.
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How do we know your child has middle ear fluid?
How will it affect your child?
In clinic we will have carried out a test called a tympanogram.
This involves putting a small tip in the ear which records how
well the ear drum is moving. If the ear drum doesn’t move
(shown by a flat line on the screen), this is because there is a
problem in the middle ear.

It is important to understand that the problem is not due to
the child’s lack of awareness of sound but more of speech
clarity. Some parts of speech may be heard less well than
others and this can mean your child may misunderstand
what you say. Some words may be missed altogether. If you
put your fingers in your ears this helps to simulate what your
child may be experiencing when they have fluid in their
middle ears.

The child’s hearing problem will be much greater in noisy
surroundings or in situations where more than one person is
speaking at a time. They may have problems at home if
there is a lot of noise, or in a school playground.

Their hearing levels may fluctuate from day to day. Some
days the child’s hearing may appear to be normal and on
bad days the child may have considerable difficulty.

If your child is not hearing speech correctly it is possible that
they may mispronounce words.

A child with a degree of hearing loss may have been
accused of being inattentive, when they actually have a
genuine problem in making sense of what is said.

If one ear is affected more than the other, the child may have
difficulty working out where a sound is coming from.
How common is it?
Fluid in the middle ear is very common in children and
approximately 80 per cent will have fluid in their middle ear at
some point in their childhood. As children grow, their Eustachian
tube becomes more vertical and works more effectively, making
it less likely to become blocked. However some adults do still
get fluid in their middle ear.
How long will it last?
It is not possible to predict how long it will take for fluid in the
middle ear to clear. It may clear when your child’s cold has
gone. In some cases it can persist and you may need to be seen
by an ear, nose and throat doctor. This decision will be made
jointly by you and your audiologist.
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