Otitis Media With Effusion
Glue ear(Otitis Media With Effusion) is a common condition in children that affects their hearing. It makes fluid build up inside their ear, dampening and muffling sound waves passing through their eardrum. You can’t see the fluid yourself, so parents noticing behavior changes and symptoms is usually how pediatricians find it.
What Is Glue Ear?
Glue ear is a common condition where inflammation makes thick, sticky fluid fill up your middle ear, the space behind your eardrum. This condition can affect one or both ears at a time. It’s a specific subtype of a condition called otitis media with effusion (middle ear inflammation with fluid buildup).
Glue ear usually happens because of an ear infection, but it can happen for other reasons, too. While glue ear is most common in children under 6 years old, anyone can develop it. It’s temporary and usually not serious, but having it long-term can damage your child’s hearing.
Ear infections are the most likely cause of glue ear. Your body uses inflammation as part of its immune response to an infection. Inflammation inside your middle ear can narrow or block your eustachian tubes, making it hard for fluid inside to drain out. When the fluid is thicker and stickier, it looks like glue, which is where this condition gets its name.
As fluid builds up, it presses on your eardrum (tympanic membrane). It’s like holding your hand on the head of a drum. Pressure from your hand dampens the vibration, keeping the drum from making as much sound as it should. Likewise, dampening the sound waves as they pass through your eardrum is what muffles sounds in your affected ears.
But inflammation that causes glue ear can also happen for other reasons, including:
- Allergies.
- Enlarged adenoids.
- Having gastroesophageal reflux disease (GERD).
- Increases in air pressure, including flying in an airplane, altitude changes while driving on a mountain or scuba diving.
- Irritants, like cigarette smoke.
- Congenital and genetic conditions, like Down syndrome or cleft palate.
- Viral upper respiratory infections, like a cold or the flu.
Earwax buildup doesn’t cause glue ear. Getting water in your ear while showering or swimming doesn’t cause the condition either.
The main symptom of glue ear is hearing loss. That’s because fluid buildup inside your child’s middle ear muffles sound waves.
Other symptoms your child might have include:
- Ringing or buzzing in their ears (tinnitus).
- Feeling pressure or fullness in the affected ear.
- Ear pain.
- Popping sensation in their ears when swallowing.
- Balance difficulties.
Younger children and babies may not be able to tell you when they experience symptoms like these. Instead, they may behave differently. Some behaviors you might see include:
- Sleepiness.
- Fussiness or irritability.
- Lack of concentration.
- Wanting to play alone.
- Not responding when you call their name or talk to them.
- Asking you to repeat what you said.
- Asking you to turn up the volume on the TV or electronics.
- Talking unusually loudly.
Pediatricians often find glue ear after parents notice symptoms or behavior changes and ask for an appointment. It takes a special medical instrument called an otoscope to see the fluid buildup that happens with glue ear.
The main risk factors for glue ear include:
- Attending daycare.
- Being under 6 years old.
- Bottle feeding.
- Exposure to tobacco.
- Having many siblings.
- Having frequent upper respiratory infections.
Glue ear can muffle sounds, causing hearing loss in your affected ear. Hearing loss can also make it harder for children to communicate and learn to speak, and may cause a speech delay. They also might have trouble learning and keeping up in school.
How doctors diagnose glue ear
Your child’s pediatrician can diagnose glue ear with a combination of methods. The first thing they’ll do is perform a physical exam and ask you about your child’s symptoms.
In some cases, your provider might recommend that your child see an audiologist for further testing. This specialist might run tests like a hearing test or tympanometry.
How is glue ear treated?
Most of the time, glue ear goes away on its own without treatment within three months. But depending on what’s causing it and how severe it is, your child’s provider might recommend one or more of the following treatments:
- Antibiotics.
- Steroid nasal sprays.
- Myringotomy (a surgery that might include placing a tube in the eardrum).
- Adenoidectomy.
- Hearing aids.
Surgery usually isn’t a first-line treatment. If your child still has glue ear after three months of trying other treatments, your provider may recommend surgery at that point.
When should I take my child to their pediatrician?
You should take your child to their pediatrician if you notice signs that they might have trouble hearing. You should also take them if they have symptoms of an ear infection, especially when the symptoms last longer than two days.
What can I expect if my child has glue ear?
If your child has glue ear, they might not be able to tell you about the symptoms. That makes spotting behavior changes especially important. And it’s important to remember that while it might look like your child is ignoring you or acting out, they can’t help what’s happening to them.
Is there anything I can do to treat glue ear at home?
You might be able to use home remedies for glue ear. But it’s best to call your child’s provider and ask them for guidance before trying to treat it yourself. Some remedies you might try include:
- The Valsalva maneuver.
- Keeping a warm, damp cloth or compress on the affected ear.
- Nasal balloons (your provider can recommend these and guide you on using them).
You should never use ear candles as a treatment for glue ear. There’s no evidence to support their effectiveness. Worse still, using them can lead to injuries like burns.
Can glue ear be prevented?
You can reduce the odds of your child getting glue ear by making ear infections less likely to develop. Some things you can do include:
- Breastfeeding: Breast milk provides vital nutrients that your baby needs to help fight off infections.
- Holding your baby upright during feeding: Keep your baby in a seated position rather than lying them flat while they eat. This may help prevent fluid from entering their Eustachian tubes during feeding.
- Avoiding cigarette smoke: Try to keep smoke out of your house and car as much as possible.
- Testing for allergies: Ask your child’s healthcare provider about allergy testing if you think allergies might be a factor behind your child’s glue ear.
- Cleaning and disinfecting: Teach your child proper handwashing. And sanitize surfaces and clean toys regularly.
References
- Amdur RL, Linder JA. Upper Respiratory Symptoms, Including Earache, Sinus Symptoms, and Sore Throat. In: Loscalzo J, Fauci A, Kasper D, Hauser S, Longo D, Jameson J. eds. Harrison’s Principles of Internal Medicine, 21st ed. McGraw-Hill Education; 2022.
- American Academy of Family Physicians. Otitis Media (with Effusion) (https://familydoctor.org/condition/otitis-media-with-effusion/). Last updated 8/6/2018.
- Shah UK. Secretory Otitis Media in Children (https://www.merckmanuals.com/home/children-s-health-issues/ear-nose-and-throat-disorders-in-children/secretory-otitis-media-in-children). Merck Manual (Consumer Version). Modified Sept. 2022.
- National Deaf Children’s Society (U.K.). Glue ear (https://www.ndcs.org.uk/information-and-support/childhood-deafness/causes-of-deafness/glue-ear/).
- National Health Service (U.K.). Glue ear (https://www.nhs.uk/conditions/glue-ear/). Last reviewed 6/5/2023.
- Searight FT, Singh R, Peterson DC. Otitis Media With Effusion (https://www.ncbi.nlm.nih.gov/books/NBK538293/). 2023 May 20. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-.
- Rayala BZ. Otitis Media: Acute Otitis and Otitis Media with Effusion. In: Usatine RP, Smith MA, Mayeaux, Jr. EJ, Chumley HS. eds. The Color Atlas and Synopsis of Family Medicine, 3rd ed. McGraw-Hill Education; 2019.
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