Glue ear in children: risk factors, symptoms and treatment

Around seven in 10 children will develop glue ear at some point, in most cases, after having a cold. Glue ear, medically known as otitis media with effusion, occurs when the middle part of the ear, which sits behind the eardrum (tympanic membrane) fills up with a sticky, glue-like fluid. This causes the sensation of having blocked ears. 

Glue ear usually gets better on its own within three months. However, if it persists, it can have long-term consequences and will therefore need treatment.

View an animation explaining glue ear and its symptoms.

Who is at risk of glue ear?

Although most children will develop glue ear at some point in their childhood, the children most at risk are those with a family history of the condition and those who have craniofacial problems ie misshapen faces due to conditions such as Down’s syndrome or a cleft palate.

What are the symptoms of glue ear?

Glue ear is painless, with the main symptom being partial hearing loss, similar in effect to listening to the world around you with your fingers in your ears ie you can still hear but certain sounds are muffled. 

However, children most often aren’t aware of their hearing loss. Instead, you may notice that your child asks for the volume to be turned up on the TV or tablet, or their teachers may notice that they aren’t paying attention in class. 

In the long-term, persistent glue ear can affect your child’s speech development. Due to their partial hearing loss, they will struggle to hear certain sounds in speech. Difficulty hearing these sounds translates into difficulty mimicking these sounds, causing pronunciation issues when reading out loud or talking. 

These subtle pronunciation changes are often picked up by teachers in school. If your child is not of school-age, look out for pronunciation problems or any other signs that their hearing is reduced. If you’re concerned about your child’s hearing, take them to see your GP, who can refer them for hearing tests. 

Common myths about glue ear

Despite glue ear being such a common condition in children, there are still several myths that I often hear from parents. Here are the three most common:

Myth one

“If my child has or has had glue ear, they should stop swimming”

Glue ear affects the middle part of the ear behind the eardrum, which is a waterproof structure. Consequently, any water that enters the ear while swimming can’t make it into the middle part of your child’s ear. There is, therefore, no reason why your child can’t continue swimming while they have glue ear. Swimming doesn’t worsen the symptoms of glue ear or increase the likelihood of your child developing it.

Myth two

“Cranial osteopathy can help treat glue ear”

There is no evidence that cranial osteopathy, a type of alternative therapy that involves applying gentle pressure to the head, can cure or relieve the symptoms of glue ear. It is not recommended by the UK’s National Institute for Health and Care Excellence (NICE). If your child has glue ear, undergoes cranial osteopathy and then feels better, it isn’t the treatment that helped but rather that their glue ear got better on its own.  

Myth three

“Medication can help treat glue ear”

There are currently no medications that can help treat glue ear. Steroid drops, antibiotics and antihistamines are all ineffective in treating glue ear. As with cranial osteopathy, if your child has glue ear, takes a course of medication and then feels better, it isn’t the treatment that helped — the glue ear simply resolved on its own. 

A child receiving an ear examination

What is the treatment journey for persistent glue ear?

As I’ve already mentioned, glue ear usually gets better on its own in three months. Glue ear that lasts three months or less shouldn’t affect your child’s speech development. 

However, if your child has glue ear for more than three months, treatment may be recommended. In general, if your child has symptoms of glue ear, they will be referred for hearing tests. This is followed by a three-month “active monitoring” period after which your child will need to have another set of hearing tests. 

If the hearing tests suggest there is hearing loss, your child will be referred to an Ear, Nose and Throat (ENT) surgeon for treatment.

What to do during the “active monitoring” period

During this time, your child’s glue ear may get better on its own. However, there is a non-surgical treatment your child can try while waiting for their next set of hearing tests, which is proven to help treat glue ear — the Otovent® balloon. 

This device consists of a balloon with a special tube attached at one end. The opening of the tube is placed into your child’s nostril. Your child then needs to blow up the balloon through their nose. This helps open up the Eustachian tube — a tube that runs from the middle part of the ear to the back of the nose — which helps drain the sticky fluid trapped in the middle ear. 

The Otovent® balloon can be bought online and is a non-invasive way to treat persistent glue ear, with no known risks. 

If you’re very concerned about your child’s hearing loss while waiting for their next set of hearing tests, you can buy bone-conducting headphones with microphones. When you want to talk to your child, speak into the microphone and the bone-conducting headphones will send these sounds directly through the bones of their head to their inner ear. This bypasses their middle ear and allows them to hear clearly despite their suspected glue ear. 

Treatments for glue ear

If your child is diagnosed with persistent glue ear, they will be referred to an ENT surgeon to discuss their treatment options. 

There are two main options for treatment: grommet surgery and hearing aids.

Grommet surgery

This is a quick surgery, performed under general anaesthesia, as a day case. It involves placing a tiny, hollow, plastic tube inside the ear drum. This allows air to circulate into the middle part of the ear. Once the grommet is in place, it is impossible to develop glue ear. This gives the ear a chance to recover and any inflammation to resolve. The grommet will fall out on its own after about a year, at which point, in most cases, the cycle of developing glue ear is broken. 

Around 70% of children who have grommet surgery are cured of glue ear by the time the grommet falls out. In those children where glue ear recurs, grommet surgery can be performed again. 

Hearing aids

If you don’t want your child to have surgery, hearing aids can be fitted. However, hearing loss due to glue ear often varies through the day, which makes it difficult to apply settings on the hearing aids that will consistently provide the level of hearing needed.

What can happen if glue ear is left untreated?

Even in the minority of glue ear cases that persist for three months or more, it will eventually get better on its own. However, this can take years, during which time your child’s learning and development will be negatively affected. 

Occasionally, persistent glue ear can cause retraction, where the eardrum pulls in on itself. This can permanently damage the ear bones in the middle part of the ear. This needs major surgery to correct or the long-term use of hearing aids. It is, therefore, important to see your GP if you suspect your child has persistent glue ear. 

Author biography

Mr Sameer Khemani is a Consultant ENT Surgeon at Spire Gatwick Park Hospital and Surrey and Sussex NHS Trust, specialising in tonsillectomy and adenotonsillectomy, Eustachian tube balloon dilatation, obstructive sleep apnoea and snoring, and grommets insertion. He graduated from Guy's and St Thomas' Hospital Medical Schools, London and trained at a number of prestigious surgical centres, including University College Hospital, Charing Cross Hospital and the Royal National Throat, Nose and Ear Hospital. He also holds a Masters in Surgical Education with distinction from Imperial College London.