Glue ear

Also known as otitis media with effusion (OME) or secretory otitis media (SOM)

Key points about glue ear

  • Children with glue ear have sticky fluid in their middle ear (the space behind the ear drum).
  • Glue ear can affect one or both ears.
  • The main symptom of glue ear is having trouble hearing.
  • Hearing loss for long periods during the early years may affect speech and language development.
  • Always see your healthcare provider if you're worried about your child's hearing.

 

Māori wahine holding tamariki
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Glue ear happens when your child's middle ear is filled with fluid. The fluid is thick and sticky, like glue. Glue ear can affect one or both ears. It often follows an ear infection or can happen on its own.

The image below has the parts of the ear labelled and show the location of the middle ear.

 

Ear anatomy with parts labelled



Image credit: Chittka L, Brockmann(external link) Wikimedia Commons with added labels

Read our page on ear infections to find out how fluid can build up in the middle ear. The risk factors for glue ear are the same as for ear infections.

After an ear infection, the fluid in the middle ear may stay around for weeks. This can happen even if your child has had antibiotics. The fluid clears up in 8 out of 10 children within 12 weeks. When there's still fluid for more than a couple of weeks, this is called glue ear.

The medical name for glue ear is OME (otitis media with effusion) or secretory otitis media. The video below shows how it develops and affects hearing.

Video: How glue ear develops

This video may take a few moments to load.

(BUPA, UK, 2013)

For children to hear normally, their middle ear needs to be full of air. When there is fluid instead of air, it's harder for the ear drum to vibrate and carry the noise vibrations to the inner ear. This makes it harder for your child to hear. If both ears contain fluid, your child's hearing can be significantly reduced. Young children who have hearing loss for long periods can have problems with their speech and language development.

Read more about hearing loss in babies and children.

Children with glue ear are not usually unwell. Their only symptom may be hearing loss. Your child may fail a hearing test. Or, your healthcare provider may discover glue ear when they're checking your child for another reason. It's always a good idea for you to make sure your GP or nurse checks your children's ears at every opportunity.

Hearing loss

The amount of hearing loss in children with glue ear varies. For your child, it can be like trying to hear with ear plugs in place – sounds are muffled.

Young children can't tell you about their hearing loss. If your child isn't hearing well, they may:

  • ask you to repeat things
  • seem to ignore you or not answer when you speak to them
  • not hear things properly
  • want the volume turned up louder
  • have delay in their language development.

Behaviour problems

Reduced hearing may cause behaviour problems such as a lack of concentration or attention. Children may feel irritable if they keep missing out on what others are saying. Problems with speech and language development could be a sign of glue ear.

Sleep problems

Although the fluid does not usually cause pain, parents often say their child doesn't sleep well. 

Your healthcare provider will talk with you about what's happening with your child.

Looking in your child's ears

They'll look into your child's ears with an otoscope. An otoscope is a small powerful light with a magnifying lens.

Tympanometry

A tympanometer looks similar to an otoscope. It measures how well your child's ear drum moves back and forth. If there's fluid in the middle ear, the ear drum doesn't move.

Tympanometry is not a hearing test and a 'pass' on this test doesn't necessarily mean that your child can hear well. It just means that it's unlikely they have glue ear at the time of the test.

Hearing test

Sometimes, your healthcare provider may recommend a hearing test for your child.

The best treatment for glue ear is time. For most children, episodes of glue ear get better without treatment. For this reason, your healthcare provider may simply recommend regular check-ups for up to 3 months so they can examine your child's ears.

If your child has fluid in the middle ear for more than 3 months, there are some treatment options.

Regular check-ups

If your child's hearing and development are normal, your healthcare provider may recommend this option. As your child gets older, they are less likely to have glue ear. This is because their eustachian tubes mature to work naturally. The eustachian tubes connect the middle ear of each ear to the back of the nose.

It's important to take your child for regular check-ups during this time.

Grommets

Some children with glue ear may need grommets. If your child does need grommets, your healthcare provider may recommend an appointment with an ENT (ear, nose and throat) specialist. Read more about grommets.

Other treatments for glue ear

Longer courses of antibiotics have been used in the past as treatment for glue ear. But, antibiotics only have a small temporary effect on clearing fluid from the middle ear. Because of this and concerns about the complications of long courses of antibiotics (including the development of antibiotic resistance, allergic reactions, diarrhoea and thrush), they are no longer a common treatment for glue ear.

The following treatments don't work – don't use these for your child:

  • decongestants (such as Pseudoephedrine)
  • antihistamines (such as Phenergan)
  • steroids (such as Prednisone).

If your child has glue ear they may not be able to hear you. It can be helpful to get their attention before you speak to them. Remember to speak slowly and clearly to your child. Try to make sure your child can see your face when you are speaking to them and try to reduce background noise.

Let your child's teachers know that they may also need to get your child's attention before speaking, and that your child may need to sit at the front of the class to hear well. Glue ear is common and teachers are usually aware of the importance of making sure tamariki hear well.

Don't smoke or allow your friends and whānau to smoke around your tamariki.

Apps reviewed by Healthify

You may find it useful to look at some Hearing test apps and Parenting apps.

If you're concerned about your child's hearing or language development, see your healthcare provider.

Some areas have mobile children's ear clinics which visit schools and early childhood education centres. If your area has a mobile clinic, you could also talk to one of the ear nurse specialists. They are specially trained to diagnose, treat, monitor and refer children with middle ear problems.

If your child has glue ear for more than 3 months, or has repeated episodes of glue ear, they should see an ENT (ear, nose and throat) specialist. The specialist may arrange a hearing test for your child.

If your child has had grommets and continues to have hearing or developmental issues, they may need a hearing test. They may also need to see a specialist again.

Otitis media – a common childhood illness(external link) Best Practice Journal, NZ, 2022
Antibiotics guide(external link) BPAC, NZ, 2017
Griffin G, Flynn CA. Antihistamines and/or decongestants for otitis media with effusion (OME) in children(external link) Cochrane Database of Systematic Reviews. 2011;9:CD003423
The tympanic membrane – diagnostic picture tests(external link) BMJ Learning, UK, 2014

Children with Down syndrome or cleft palate disorders are at much higher risk of ear infections and glue ear. They get it at a younger age and are less likely to clear it themselves. Refer early. They also often need ongoing specialist review. Assessment and surgical management of otitis media with effusion in children(external link) National Institute of Healthcare Excellence, UK

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Credits: Content shared between HealthInfo Canterbury, KidsHealth and Healthify He Puna Waiora as part of a National Health Content Hub Collaborative.

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