Quick answer. Glue ear is a build-up of sticky fluid behind the eardrum, common in young children, that causes muffled hearing. It often clears on its own after a few weeks, but persistent cases affecting hearing or speech may need grommets.
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Glue ear, known medically as otitis media with effusion, is one of the most common ear problems in young children. Sticky fluid collects behind the eardrum, usually after a cold or ear infection, and dampens hearing. A child may turn the television up, mishear instructions or seem inattentive at school.
Most cases of glue ear settle by themselves within a few weeks to a few months. This guide explains what glue ear is, the symptoms parents should watch for, how it is diagnosed and treated, and when persistent hearing concerns mean a child should be assessed by an ENT specialist.
At a glance
| Approach | What it involves | Typically used for |
|---|---|---|
| Watchful waiting | Monitoring for around three months | Most new cases, as many clear by themselves |
| Hearing tests | Audiometry and tympanometry | Checking the degree of hearing loss |
| Autoinflation | Exercises to open the ear's drainage tube | Some older children, to encourage clearance |
| Grommets | Tiny tubes inserted into the eardrum | Persistent glue ear affecting hearing or speech |
| Treating the cause | Managing allergies or enlarged adenoids | Recurrent or contributing factors |
What is glue ear?
Glue ear (otitis media with effusion) is when the middle ear, the space behind the eardrum, fills with a thick, sticky fluid. Unlike an acute ear infection, glue ear is often not painful, but the fluid stops the eardrum and tiny ear bones from moving freely, which muffles hearing.
It is very common in young children, partly because the tube that drains the middle ear (the Eustachian tube) is shorter and more easily blocked at that age. It often follows colds and tends to be more frequent in the cooler, infection-prone months. Most children grow out of it as they get older and the drainage tube matures.
Symptoms and signs
Because glue ear is usually painless, it can be easy to miss. Signs to look out for in a child include:
- Muffled or reduced hearing – turning up the volume, sitting close to the TV
- Mishearing, or seeming not to listen or pay attention
- Speech or learning concerns, or falling behind at school or nursery
- Becoming irritable, tired or withdrawn
- A feeling of fullness or popping in the ear in older children who can describe it
- Balance problems or clumsiness in some children
In adults, glue ear is less common but can cause a blocked, muffled sensation in the ear.
Causes and risk factors
Glue ear happens when fluid cannot drain properly from the middle ear, often because the Eustachian tube is blocked or not working well. Contributing factors include:
- Recent colds and upper respiratory infections
- Young age, when the drainage tube is naturally narrower
- Enlarged adenoids blocking the tube
- Allergies and nasal congestion
- Exposure to cigarette smoke
- Attending childcare, where infections spread more easily
Cleft palate and some other conditions can also raise the risk, and glue ear may run in families.
How it is diagnosed
A doctor or ENT specialist diagnoses glue ear by examining the ear and testing hearing. Assessment may include:
- Otoscopy – looking at the eardrum, which may appear dull or show fluid behind it
- Tympanometry – a quick test measuring how the eardrum moves, which is reduced when fluid is present
- Hearing tests (audiometry) appropriate to the child’s age
- Examination of the nose and throat to check for enlarged adenoids or allergy
Because glue ear often clears on its own, doctors usually confirm it on more than one visit before recommending treatment.
Treatment options
Most cases of glue ear improve without treatment, so the usual first step is to wait and watch:
- Watchful waiting – monitoring for around three months, as many cases resolve naturally
- Autoinflation – in some older children, exercises that gently open the Eustachian tube to help fluid drain
- Grommets (ventilation tubes) – tiny tubes placed in the eardrum during a short procedure to drain fluid and restore hearing, used when glue ear persists and affects hearing, speech or learning
- Adenoid removal – sometimes done alongside grommets if enlarged adenoids are contributing
- Managing underlying allergies and avoiding smoke exposure
Antibiotics and decongestants are generally not recommended for glue ear itself, as they do not help the fluid clear.
When to see a doctor and which specialist
See a doctor if you notice persistent hearing concerns in a child – for example mishearing, turning up the volume, speech delay or struggling at school – or if a blocked, muffled ear lasts more than a few weeks. Hearing matters for speech and learning, so it is worth getting a proper assessment rather than waiting indefinitely. Seek prompt medical care, and call 995 if a child is severely unwell, if there is a high fever with severe ear pain, or signs of a spreading infection such as redness and swelling behind the ear.
An Ear, Nose & Throat (ENT) specialist can confirm glue ear, test hearing and advise on whether grommets are needed. You can find one through our directory of ENT specialists in Singapore.
What to expect at the appointment
A first visit for suspected glue ear is usually straightforward and gentle. The doctor will ask how your child’s hearing seems at home, whether they sit close to the television, mishear instructions or have had recent colds. They will look in both ears with an otoscope and may carry out a quick, painless tympanometry test, where a soft probe sits briefly in the ear to measure how the eardrum moves. A hearing test suited to your child’s age may follow. Because glue ear often clears on its own, your doctor may ask you to return in a few weeks to see whether the fluid has settled before discussing treatment.
Helping your child at home
While you wait for glue ear to clear, there are simple things that may help. Keep your child away from cigarette smoke, as second-hand smoke is linked to more ear and chest problems. Treat blocked noses and allergies as advised, since a clearer nose helps the ear’s drainage tube work. Speak clearly and face your child when talking, reduce background noise during conversations and let their school or childcare know about the temporary hearing difficulty so they can seat your child near the front and check understanding.
Common questions
Does glue ear cause permanent hearing loss?
For most children the hearing loss is temporary and returns to normal once the fluid clears. Persistent, untreated glue ear during the years when speech is developing is the main concern, which is why ongoing hearing or speech difficulties should be assessed.
Can my child still swim or fly with glue ear?
Swimming is generally fine with simple glue ear, as the eardrum is intact. Flying may cause some discomfort during take-off and landing; swallowing, drinking or sucking a sweet can help. Ask your doctor if you are unsure.
Related guides
- Best ENT Clinics in Singapore — our editorial shortlist
- ENT clinics directory
- Chronic sinusitis
- Labyrinthitis
- Perforated eardrum
- Vocal cord nodules
- Uterine prolapse
Sources
- NHS – Glue ear
- HealthHub Singapore – Ear infections in children
- Mayo Clinic – Ear infection (middle ear)
- KK Women's and Children's Hospital – Ear conditions
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