Glue Ear

As a paediatric ENT surgeon, I see and treat hundreds of children affected by Glue Ear every year. Glue Ear (also known as otitis media with effusion or OME) is a really common condition, especially in children aged 1 to 6 (though it can sometimes affect older children too).

Glue Ear happens when the middle part of the ear fills with a thick, sticky fluid instead of air. Air normally comes from the back of the nose via the eustachian tube. In children, this tube can be prone to blockage, leading to negative pressure within the ear and the ear drum is sucked in. In susceptible children this may lead to thick mucus fluid being secreted into the ear – this is commonly called glue ear.

Glue Ear & Hearing Loss

Glue ear is the commonest cause for hearing loss in children. The fluid within the middle ear makes it harder for sound to pass through, which can cause hearing problems.

While many young children might have poor ‘listening ears’ when it comes to instructions from parents or carers, a child with glue ear may not hear being called for dinner all the time, they may be saying “what?” more often when in conversation with friends and may appear to turn the TV or their personal devices very loud.

For toddlers with Glue Ear, they may ignore instructions completely, mispronounce their words or suffer from speech delay.

Glue Ear & Ear Infections

Glue Ear can develop after a cold or ear infection (known as otitis media). When a child has a cold or upper respiratory infection, the Eustachian tube—which helps drain fluid from the middle ear—can become blocked or inflamed. This blockage prevents normal drainage, allowing fluid to build up behind the eardrum. Over time, this fluid can become thick and sticky, leading to Glue Ear.

While Glue Ear doesn’t usually cause pain or fever like an active infection, the fluid that collects can become a breeding ground for bacteria. This means children with Glue Ear are more prone to recurrent ear infections, especially if the fluid remains for a long time.

Many parents will be in a cycle of seeing their GP with a child experiencing ear pain and fever, their child having antibiotics and appearing better, only for another ear infection to start a few months later. Sustained hearing loss could indicate Glue Ear and an ENT doctor can conduct a more in-depth assessment of the ears.

Hearing is essential for your child’s speech, language and social development. That’s why it’s important to have your child assessed by a specialist if you have any concerns.

Diagnosis

When I see your child in clinic, I start by listening carefully to what you’ve noticed at home. I then examine your child’s ears using a light or special microscope to look at the ear drum. This is quick, completely painless and can be done in my office.
I will also organise a quick hearing test with an audiologist that can help us understand how well sound is travelling through the middle ear. There are paediatric experts who have different techniques for babies, toddlers and children. These tests are designed to be fun and engaging, and they usually take 10 to 20 minutes depending on your child’s age and attention span.
Tympanometry is also used for most patients. This is a safe, gentle test that takes less than a minute. It measures how well the eardrum moves and helps confirm if there’s fluid behind it. It’s suitable for most children.
If I suspect that other issues in the back of the nose might be contributing to the problem, I might perform a flexible naso-endoscopy. I use a very slim camera to get a clear look at your child’s nasal passages and adenoids. The procedure is quick (about a minute) and can be done while your child is awake with a gentle numbing spray in the nose. Some children are fascinated to see the inside of their bodies, which can really help to overcome any nervousness.

Getting an accurate diagnosis early means I can monitor things properly and avoid unnecessary delays in your child’s speech, learning, social skills and confidence.

Treatments

Treatment depends on the type and cause of hearing loss.

In many children, Glue Ear resolves naturally within a few months. If your child’s hearing is only mildly affected, I may recommend a period of watchful waiting, monitoring their hearing and conducting a second consultation a few months later.

However, if Glue Ear persists beyond three months or is significantly impacting your child’s hearing, speech, or learning, we can explore treatment options together.

Non-surgical options
Glue Ear surgery

Before considering surgery, we may try:

Hearing aids: For children who aren’t ready for surgery or have additional needs (such as Down syndrome), temporary hearing aids can be helpful
Medication: While there’s limited evidence that medications resolve Glue Ear, I may consider:
- Antihistamines or nasal steroid sprays if your child has associated nasal allergies.
- Antibiotics if there’s an active ear infection.
- Decongestants or mucolytics are sometimes tried, though they’re not routinely recommended.

Often by the time parents come to see me, they have already tried different medications and their child is still struggling with poor hearing.

Auto-inflation: This involves your child blowing up a small balloon (otovent device) through their nose to help open the Eustachian tube and drain fluid. It’s most suitable for children over age 3
Allergy assessment: If allergies are suspected (especially if your child has hay fever, eczema, or asthma) I may work alongside an allergy specialist. Addressing underlying allergies can sometimes reduce the frequency or severity of Glue Ear episodes.

Grommet insertion (ventilation tubes)

If Glue Ear is persistent and affecting your child’s development, I may recommend a short surgical procedure to insert grommets (also called ventilation tubes) into the eardrum.

This is a very common and safe procedure:

It’s done under general anaesthetic and usually takes about 15 minutes.
A tiny incision is made in the eardrum to drain the fluid, and a small tube is placed to keep the middle ear ventilated.
Most children go home the same day and can return to normal activities within 24–48 hours.
Grommets usually fall out on their own after 6–18 months as the eardrum heals.

Adenoidectomy

In some cases—especially if your child has large or infected adenoids—I may also recommend removing the adenoids (adenoidectomy) at the same time. This can improve the long-term success of grommets and reduce the chance of Glue Ear returning.

Make an Enquiry

If you’re concerned your child may have Glue Ear, getting expert advice can make all the difference. As an experienced ENT surgeon, I can support you with thorough diagnostics and assessment of your child’s ears and help you navigate the best treatment options. Clear hearing is important for everyone, but it is particularly important for the language and social development of babies, toddlers and children.

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