Glue Ear in Children: Symptoms, Causes and When Grommets Are Considered

Glue ear can develop after a cold or ear infection when inflammation affects the Eustachian tube. Children are particularly prone to the condition because their Eustachian tubes are smaller and still developing.

Other factors that may contribute include:

• Frequent colds and upper respiratory infections
• Enlarged adenoids
• Eustachian tube dysfunction
• Nasal inflammation or allergies

Recognising the Signs and Symptoms

Changes in hearing are often the most noticeable sign. A child may ask for things to be repeated, turn up the television volume, speak more loudly or seem less responsive when spoken to.

Other signs can include difficulty following conversations in noisy environments, changes in speech clarity, blocked or full ears, and problems with concentration or communication.

Because glue ear can develop without pain, some children may show only subtle changes. Parents can also learn more about related childhood ear problems in our guide to common ear symptoms and diseases in children.

Effects on Hearing, Speech and Learning

Fluid in the middle ear can interfere with the movement of sound, resulting in temporary conductive hearing loss. This may be more noticeable in noisy places, such as classrooms, where it can be harder for a child to follow conversations.

When reduced hearing persists, it may also affect speech development, language and learning in some children. Behaviour at school may also change if a child is finding it difficult to hear instructions or participate in classroom activities.

Glue Ear Diagnosis and Hearing Assessment

Diagnosis usually involves examining the ears and assessing middle ear function and hearing.

An ear examination can identify changes behind the eardrum. Tympanometry may then be used to assess how the eardrum and middle ear are functioning, while a hearing test can determine whether fluid is affecting the child’s ability to hear.

These findings are considered together when deciding whether monitoring, grommets or another approach may be appropriate.

Natural Recovery and Ongoing Monitoring

Fluid from glue ear often clears on its own within a few months, so many children are monitored initially rather than treated straight away.

The length of monitoring depends on factors such as how long the fluid has been present, whether hearing is affected and whether there are concerns about speech development, learning or behaviour at school.

When Grommets Are Considered

Where fluid persists for longer, or where glue ear is affecting a child’s hearing, speech development or behaviour at school, grommet insertion may be considered as one of the available treatment options.

A grommet is a small tube inserted into the eardrum during a short procedure. It allows air into the middle ear and helps prevent fluid from remaining trapped behind the eardrum. Grommets do not treat the underlying cause of the fluid build-up, and fluid can return in some children after the grommets naturally fall out.

Whether grommets, continued monitoring, or another approach is appropriate depends on the individual child’s examination findings, hearing test, and tympanogram. These factors are considered together when planning treatment at a paediatric ENT clinic.

What to Expect if Grommets Are Recommended

Grommet insertion is generally carried out as a short day procedure under general anaesthesia in children, and most children go home the same day. The procedure involves placing the small tube through the eardrum to ventilate the middle ear.

After the procedure, follow-up is used to check the child’s ears, hearing, and grommet position over time. Parents should also receive aftercare guidance, including any advice about water exposure or swimming.

Grommets are temporary and usually come out naturally as the eardrum heals. The length of time they remain in place varies depending on the child and the type of grommet used.

Supporting a Child While Glue Ear Is Monitored

Simple adjustments can make communication easier while hearing is reduced. Parents can face their child when speaking, reduce background noise, and check that important instructions have been understood.

At school, sitting closer to the teacher may also help a child hear more clearly and follow lessons.

When Further Assessment May Be Appropriate