Glue Ear is a common childhood condition in which the middle ear becomes filled with fluid. The medical term for glue ear is otitis media with effusion (OME).

It’s estimated that one in five children around the age of two will be affected by glue ear at any given time.

Causes of Glue ear

While it is not known exactly what causes glue ear, several things have been identified that may increase the risk of children developing the condition.With glue ear, the Eustachian tube seems to lose the ability to drain away the mucus. The mucus builds up inside the ear, which leads to glue ear.
The reasons for this loss of function are still unclear, but some suggestions include:
  • changes in air pressure inside the ear that lead to a blockage in the Eustachian tube
  • inflammation of the Eustachian tube caused by allergic rhinitis, infection or irritants such as cigarette smoke, which causes the tube to narrow
  • gastric fluids from the stomach that leak up through the throat and into the Eustachian tube
  • inflammation and swelling of the adenoid glands (small lumps of tissue located at the back of the throat that form part of a child’s immune system).
Other reasons for glue ear include:
  • being bottle-fed rather than breastfed
  • having contact with lots of other children, such as at a nursery (this may be because of a higher risk of infection)
  • cleft palate, (a birth defect where a child has a split in the roof of their mouth)
  • Down’s syndrome (a genetic disorder that causes learning difficulties and disrupts physical development)
  • cystic fibrosis, (agenetic condition that causes the lungs to clog up with thick, sticky mucus)


Glue ear is often not obvious and it usually goes undetected. Often the first thing a parent notices is hearing loss.

Signs that your child may be having problems hearing include: 
  • struggling to keep up with conversations and seems inattentive
  • becoming aggravated because they are trying harder to hear
  • regularly turning up the volume on the TV
Other symptoms that may occur include:
  • ear pain
  • disturbed sleep
  • a feeling of fullness in the ear (this is unusual for young children to articulate)
  • ringing in the ear (occasionally mentioned by older children)
  • balance problems
  • speech delay
  • recurrent acute otitis media superimposed on underlying glue ear.
Whether or not fluid is present can be confirmed by an ear examination.
Glue ear.ent

Glue ear


Otoscopy and ear microscopy is used to evaluate the changes in the external ear canal and eardrum.
Other tests, such as tympanometry, may also be used to examine the middle ear.
Tympanometry measures pressure differences between the middle ear and outer ear by measuring how easily the eardrum vibrates back and forth.
To measure whether the fluid is causing hearing loss, a separate hearing test or audiometry is necessary.

Treating Glue ear

Most cases of glue ear don’t require treatment as the condition will improve spontaneously, usually within three months.

Grommet insertion.ent

Grommet insertion

Treatment is normally only recommended when symptoms last longer than three months and the hearing loss is thought to be significant enough to interfere with a child’s speech and language development.

In these circumstances, glue ear can usually be treated using minor surgery, which involves placing small tubes (grommets) in the ear to help drain away the fluid.

Sometimes adenoid hyperplasia may cause obstruction of the Eustachian tubes and therefore be the reason for glue ear. In these cases adenoidectomy is performed and very often at the same time as a grommet insertion.