What is glue ear?

Glue ear happens when fluid builds up inside your middle ear and doesn't drain away. The fluid gets thicker the longer it stays and can become sticky like glue. This fluid build-up can affect your hearing but usually doesn't cause pain.

It's most common in children and often clears up on its own. It can last for weeks or months.

The medical name for glue ear is 'otitis media with effusion'.

Read more about the middle ear.

What are the symptoms of glue ear?

Glue ear often doesn't have clear symptoms, but it's important to know what signs you should look for.

If you have glue ear, you may:

• have trouble hearing
• have issues with balance
• have trouble sleeping
• feel pressure or fullness in the ear
• experience mild pain in their ear

Children may also:

• be irritable
• struggle to pay attention
• have delayed speech and language development
• talk loudly
• rub or pull at their ears

What causes glue ear?

Glue ear is caused when fluid builds up in the middle ear, the space behind the eardrum. This happens when the Eustachian tube, a small tube that connects your middle ear to the back of your nose and throat, gets blocked.

Normally, this tube allows air to enter the middle ear and lets fluid drain out. When it's blocked, fluid builds up and affects your hearing.

Factors that increase your risk of glue ear include:

• ear infections or respiratory infections
• colds
• allergies, such as hay fever
• exposure to cigarette smoke

Who gets glue ear?

Glue ear can happen at any age but is most common in children between 1 and 6 years old. This is because their Eustachian tube is smaller and more likely to get blocked.

Children are more likely to develop glue ear if they:

• have a cleft palate
• have Down syndrome
• go to childcare or are exposed to many other children

Adults can also develop glue ear, especially after respiratory infections or if they have allergies.

When should I see my doctor?

See your doctor if you think you or your child may have glue ear.

If your child gets ear infections often or if you think they aren't hearing well, take them for a hearing test and see your doctor.

You should also get your child's hearing checked after their glue ear gets better. This is to make sure their hearing is back to normal.

How is the cause of glue ear diagnosed?

To diagnose glue year, your doctor will ask questions and may perform some tests.

They may also refer you to an ear, nose and throat (ENT) specialist or an audiologist.

Your doctor or specialist may:

• ask about symptoms like hearing difficulties or recent infections, such as colds
• look in your ear with an instrument called an otoscope
• perform a hearing test (audiometry) to check for hearing loss due to fluid build-up
• do a tympanometry test to measure how well your eardrum moves (fluid in the middle ear will reduce its movement)

How is glue ear treated?

Glue ear often goes away on its own. Your doctor may suggest waiting and monitoring it without treatment.

Medicines

Sometimes, your doctor will prescribe antibiotics to help the fluid clear.

If your child has hay fever, your doctor may prescribe a nasal spray with a steroid medicine.

If you take other medicines for allergies or congestion, tell your doctor before taking the new medicine.

Other treatment options

If glue ear does not resolve on its own, there are a few treatment options your doctor may suggest:

• hearing aids — if glue ear persists and affects hearing
• grommets (ventilation tubes) — if the fluid doesn't go away and is causing hearing loss. These are inserted into the eardrums during a minor surgical procedure to help drain the fluid.
• adenoidectomy — removing the glands in the back of the throat. This may reduce your risk of glue ear, especially if your adenoids are enlarged and are blocking the Eustachian tubes.

What are the complications of glue ear?

Untreated glue ear can cause complications that may affect your or your child's hearing and development, including:

• hearing loss — fluid build-up can cause temporary hearing loss, and in rare cases, it may cause permanent damage to the ear, leading to long-term hearing loss
• speech and language delays — hearing loss in young children can delay their speech and language development
• balance problems — fluid build-up can affect the ear's balance system, leading to coordination issues or dizziness
• frequent ear infections — glue ear can increase your risk of frequent ear infections (otitis media)

How is glue ear prevented?

While glue ear can be caused by ear infections, it's hard to prevent colds that can lead to ear infections. Good hygiene can help lower your chance of catching a cold.

There are some things you can do to lower your or your child's risk of glue ear:

• Keep away from cigarette smoke.
• If your child uses a dummy, try to get them to stop or only let them use it for short periods.
• Breastfeed your baby if you can.
• Hold your baby upright when feeding them a bottle and don't give them a bottle in bed.
• Take your child to the doctor if they often have a blocked or runny nose and ask the doctor to check their ears as well.

Resources and support

• Sydney Children's Hospitals Network has a factsheet on glue ear.
• Royal Children's Hospital Melbourne offers information about ear infections and glue ear in children.
• Hearing Australia explains how to manage glue ear in children, including at home and classroom solutions.
• Aussie Deaf Kids offers a glue ear guide for parents.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.

Looking for information for Aboriginal and/or Torres Strait Islander people?

• The Department of Health and Aged Care has information on ear and hearing health for Aboriginal and/or Torres Strait Islander people.
• Australian Institute of Health and Welfare has information on ear disease in Aboriginal and/or Torres Strait Islander children.