Glue ear that most common of childhood conditions may be caused by allergy, according to a growing body of opinion.

London's Royal National Throat Nose and Ear Hospital reports that it has monitored more than 200 children aged between 3 and 8 suffering from chronic or recurrent glue ear in the last two years (The Lancet, 2 January 1993). More than 80 per cent were found to be suffering from rhinitis (inflammation of the mucous membranes of the nose); 35 per cent from asthma; and 20 per cent from eczema. When these children's allergies were treated, their hearing improved. Only 11 per cent needed grommets.

A Derbyshire hospital identified a link 10 years ago between glue ear and hypersensitivity in 36 out of 89 children attending for treatment, reports The Lancet.

Both these findings follow an announcement by Effective Health Care (WDDTY, vol. 3, no. 12) that most cases of glue ear will recover without the need for surgery. Nevertheless, in one third of cases, surgeons make an immediate decision to operate at the first consultation with no further assessment and glue ear continues to be the most common reason for children to have operations.

The insertion of grommets poses serious risks. These include tympansclerosis (hardening of the ear drum), chronic perforation, and cholesteatoma (a middle ear cyst).

"A very restrictive policy regarding the insertion of grommets is necessary," says the BMJ in an editorial (2 January 1993).

"Ideas about the [cause] of glue ear are changing," the BMJ added. "In some perhaps most cases [glue ear] may be a normal reaction to an upper respiratory tract infection. Surgical intervention would therefore be unjustified."