Glue ear
- Dr Mohamed Hariri, Consultant in Audio-vestibular Medicine
- Mr Nicholas Clifton, Consultant Ear, Nose and Throat Surgeon
Glue ear is when your middle ear contains a build-up of sticky fluid (or glue). This can affect your hearing. It usually goes away on its own without treatment. But sometimes you may need an operation to put tubes called grommets into your ear.
How glue ear develops
Glue ear | Watch in 2:02 minutes
This animation explains what glue ear is. Glue ear is most common in children.
This animation explains what glue ear is.
Glue ear is most common in children.
To understand the cause of glue ear, it's helpful to know how the ear works.
Your ear consists of three parts: the outer ear, the middle ear and the inner ear.
These all work together to pass the sound from your ear to your brain.
Here in the animation, we show how the sound waves pass through your ear.
First, the sound waves pass through your ear canal, to your eardrum.
Your eustachian tube controls the pressure in your middle ear, to make sure that your eardrum can vibrate properly.
Your ossicles amplify the sound, which then passes through a small window into your cochlea.
In the cochlea, the sound waves are converted into electrical signals that travel to your brain.
Sometimes, the eustachian tube becomes blocked.
This may happen because of an infection or an allergy.
It's most common in children.
A blocked eustachian tube can cause fluid to build up in the middle ear.
This is often known as 'glue ear' because sometimes the fluid is sticky like glue.
The fluid makes it much more difficult for the sound waves to pass through your ear canal.
It also prevents the eardrum and ossicles from vibrating properly.
So, a child with glue ear may have some hearing loss.
Glue ear will usually get better on its own.
If it doesn't, your doctor will advise you on the best treatment for your child.
This is the end of the animation.
About glue ear
Glue ear is very common in children. It’s most common in children aged between six months and four years. Up to 8 in every 10 children will have had an episode of glue ear by the time they start school. Adults can sometimes get glue ear too.
If you have glue ear, sticky fluid collects inside your middle ear. Your middle ear is normally kept ventilated (filled with air) by a tube running between your middle ear and the back of your throat. This is called the Eustachian tube. Glue ear can happen if this tube becomes blocked or inflamed. The fluid can’t be cleared from inside your middle ear. The fluid inside your ear can affect your hearing.
Glue ear usually gets better over a few months. But sometimes it carries on for longer and can cause hearing loss. This can affect children’s education, language development and behaviour.
Glue ear isn’t very common in adults. So if you think you may have glue ear, contact your GP.
Causes of glue ear
Doctors aren’t completely sure why some children get glue ear. But the condition often follows a middle ear infection – especially in young children. Glue ear is more common during the winter months.
Other possible causes of glue ear in children include:
- problems with the Eustachian tube – the tube between the middle ear and the back of the throat
- an infection (a virus or bacteria)
- an inflamed middle ear
- infected or enlarged adenoids
Your child is more likely to get glue ear if they:
- live with someone who smokes
- keep getting colds and throat infections
- have allergies
- are bottle fed or regularly suck on dummies
- have contact with lots of other children, such as at nursery
- have a cleft palate or Down’s syndrome
Glue ear in adults may be caused by a viral infection, such as a cold or sinusitis. But sometimes it may be due to a blockage of the Eustachian tube.
Symptoms of glue ear
The most common symptom of glue ear is hearing loss. This can be easily missed in very young children and babies. If your child has hearing loss caused by glue ear, you may notice some of the following signs.
- Mishearing what you say.
- Asking for things to be repeated.
- Not responding when you call or talk to them, especially from behind.
- Not being able to hear or communicate well in a group.
- Having the television volume up high.
- Having trouble concentrating.
- A change in behaviour.
Glue ear symptoms in adults and children may also include:
- a feeling of fullness inside the ear
- mild earache
- crackling or popping sounds in the ear
- problems with balance
If your child’s hearing loss is severe, or they’ve had it for a while, they may have problems with speech and language. Their listening skills can also be affected. This can affect how well they’re doing at nursery or school.
Contact a GP if you notice these symptoms in yourself or in your child. You wouldn’t usually have discharge from your ear with glue ear. Contact a doctor straightaway if you have this symptom.
Diagnosis of glue ear
If you see a GP, they’ll ask about your, or your child’s, symptoms and medical history. They’ll look at your eardrum (or your child’s) using a device called an otoscope.
The GP may arrange a hearing test. There are two main types of hearing test:
- tympanometry checks how well the eardrum reacts to sound
- audiometry tests hearing
If your child has glue ear, your GP will usually refer them to a community audiology clinic. If your child fails two hearing tests several months apart, the community team will usually refer them to an ear, nose and throat (ENT) specialist. This will depend on what community audiology services are available in your local area. If your child has Down’s syndrome or a cleft palate, they’re likely to be referred to a specialist straightaway.
If you have glue ear as an adult, your GP may refer you to an ENT specialist straightaway. But this may depend on your symptoms and history. They may want to run some tests to check whether there’s an underlying reason for your glue ear.
Self-help
If your child has hearing loss due to glue ear, there are lots of things you can do to help them. Try to:
- get your child’s attention before you talk to them
- speak to your child clearly, slowly and face-to-face
- cut down background noise such as music or TV
- read with your child every day to help develop language skills
- work with your child’s nursery or school to make sure they get the right support
Treatment of glue ear
In children, glue ear usually gets better on its own without any treatment. The GP will usually monitor your child for three months to see whether the glue ear goes away by itself. If it hasn’t cleared up after three months, your GP will discuss glue ear treatment.
Glue ear in adults also usually clears up on its own. Your GP may refer you to a specialist for further investigation and treatment if it doesn’t.
There’s no evidence that certain medicines, such as antibiotics, antihistamines, mucolytics, steroids and decongestants, can treat glue ear. There’s also no evidence that complementary therapies, such as homeopathy, acupuncture, cranial osteopathy and special diets, will help.
Non-surgical treatment
Hearing aids
If your child has hearing loss in both ears, they may be offered hearing aids while they’re waiting for surgery, or instead of surgery. This might be an option if your child is unable to have surgery for some reason, or if you’d prefer them not to. Your child can wear hearing aids until the glue ear clears up on its own, or until they have surgery.
Autoinflation
Your doctor may suggest a technique called autoinflation to help your child’s symptoms. Your child may be able to do this while they’re waiting to see if their glue ear clears up, or while they’re waiting for surgery.
In autoinflation, your child blows up a balloon using a nose-piece attached to one nostril. They close their mouth and the other nostril. This can help to open their Eustachian tube and let air into the middle ear so fluid can drain out.
Older children may be able to do this without using a balloon. They pinch their nostrils and close their mouth while they forcibly blow out. Check with your doctor whether they think this would be helpful for your child. You should never do it if your child has a cold or other virus.
Surgery
Grommets
Surgery for glue ear involves placing tiny plastic tubes called grommets into your ear drum. These help to ventilate your middle ear after your surgeon has removed all of the fluid. Your doctor may offer your child surgery if:
- their glue ear is no better after three months
- they have severe hearing loss in both ears
- their learning or development is significantly affected
You can have grommets as an adult too, depending on what’s caused your glue ear.
Grommets are usually put in with a general anaesthetic in children. This means your child will be asleep during the procedure. Grommets can be put in with a general or local anaesthetic in adults. Your surgeon makes a tiny cut in your ear drum and drains away the fluid in your middle ear. Then they put in the grommets.
Grommets can improve hearing while they’re in the ear, but eventually they fall out as the eardrum heals. You or your child may need more grommets put in if the glue ear comes back.
Adenoid removal
Sometimes surgeons recommend that children have their adenoid(s) out (anadenoidectomy) at the same time as having grommets put in. The adenoids are lumps of soft tissue at the back of your child’s nose. A large adenoid can block the opening of the Eustachian tube. An infected adenoid can contribute to glue ear. Removing the adenoid may mean glue ear is less likely to come back.
Living with grommets
You’ll usually need to keep your (or your child’s) ears dry for a few weeks after the operation. This helps to stop water getting into the ear and causing an infection while it’s healing. After the first few weeks, you’ll usually be able to swim or bathe as normal. Use ear plugs if you swim underwater a lot or if you’re swimming on holiday in other countries. It may be best to avoid diving, though. It’s fine to fly if you have grommets.
If you have any discharge from your ear while you have grommets, see a doctor. You may have an infection that needs treating with antibiotic ear drops.
Adults can get glue ear. But glue ear is far less common in adults than it is in children. If you have glue ear as an adult, you may see a specialist to check for an underlying cause. Adults can have grommets for glue ear.
You may not need any treatment. Glue ear often gets better on its own within a few months. If it doesn’t get better, your doctor may suggest surgery with grommets. These tiny tubes help to ventilate the inside of your ear.
See our treatment of glue ear section for more information.
In children, untreated glue ear may affect their hearing and lead to problems with speech and language. If glue ear doesn’t clear up on its own within a few months, your doctor may suggest you have grommets put in. For more information, see our treatment of glue ear section.
Acute middle ear infection in children
If you’re a parent you’ll probably know that middle ear infections are common in children, and unfortunately they’re often painful.
Fever in children
If your child’s temperature is 38°C (100.4°F) or above, then it means they have a fever.
Adenoid and tonsil removal
Adenoid and tonsil removal is a procedure that involves taking away small lumps of tissue at the back of your nose and throat.
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- Otitis media with effusion in under 12s. NICE guideline NG233. National Health and Care Excellence (NICE). nice.org.uk, published August 2023
- Otitis media with effusion. bestpractice.bmj.com, last reviewed December 2023
- Otitis media with effusion. Patient. patient.info, last updated November 2023
- Otitis media (secretory). The MSD Manuals. msdmanuals.com, modified September 2022
- Glue ear (OME). ENT UK. entuk.org, published October 2021
- You and your anaesthetic. 6th ed. Royal College of Anaesthetists. rcoa.ac.uk, published April 2023
- Grommets: a decision-making tool for parents. ENT UK. entuk.org, published October 2021
- Otitis media with effusion. Treatment and management: myringotomy. Medscape. emedicine.medscape.com, updated February 2022
- Myringotomy. Medscape. emedicine.medscape.com, updated November 2021
- Tonsil and adenoid anatomy. Medscape. emedicine.medscape.com, updated July 2015
- Glue ear. National Dead Children’s Society. ndcs.org.uk, accessed February 2024
- Personal communication Mr Nicholas Clifton, Consultant Ear, Nose and Throat Surgeon, June 2024
- Best Practice Guidance: Removal of adenoids for treatment of glue ear. Academy of Medical Royal Colleges. ebi.aomrc.org.uk. Under review, due to be published in September 2024
- Victoria Goldman, Freelance Health Editor
