Glue Ear Treatment in Sydney

Glue ear (otitis media with effusion) is the most common cause of hearing loss in Australian children. It occurs when thick, sticky fluid accumulates in the middle ear without active infection, dampening the eardrum's ability to transmit sound. While glue ear often resolves on its own, persistent cases can impair speech development and learning, making early specialist assessment important.

What Is Glue Ear?

Glue ear, medically known as otitis media with effusion (OME), describes the accumulation of fluid in the middle ear space behind an intact eardrum. Unlike acute ear infections, glue ear does not typically cause pain, fever or visible infection. The fluid ranges from thin and watery to thick and glue-like, and it prevents the eardrum and ossicular chain (the three tiny hearing bones) from vibrating efficiently.

The condition can affect one or both ears. Bilateral glue ear (affecting both ears) causes greater hearing impairment and is more likely to require treatment. Approximately 80 percent of Australian children experience at least one episode of glue ear before starting school, with peak incidence between ages two and five.

Symptoms of Glue Ear

Glue ear is often called the "silent" ear condition because children rarely complain of pain. Parents and carers should watch for:

Difficulty hearing or responding when spoken to, especially in noisy environments
Turning up the television volume or sitting very close to the screen
Delayed speech and language development compared to peers
Inattentiveness or poor concentration at school or childcare
Behavioural changes, frustration or social withdrawal
Frequently asking "what?" or needing instructions repeated
Ear fullness, popping or pressure sensation
Mild balance difficulties or clumsiness

In adults, glue ear presents with muffled hearing, ear fullness, autophony (hearing your own voice loudly) and occasionally tinnitus. Adult-onset unilateral glue ear should always be investigated to exclude a nasopharyngeal cause.

Causes and Risk Factors

Glue ear develops when the Eustachian tube fails to ventilate and drain the middle ear properly. Contributing factors include:

Eustachian tube immaturity: in young children, the Eustachian tube is shorter, narrower and more horizontal, reducing its ability to drain the middle ear
Adenoid hypertrophy: enlarged adenoids can physically obstruct the Eustachian tube opening in the nasopharynx
Upper respiratory infections: frequent colds cause Eustachian tube inflammation and mucus accumulation
Allergic rhinitis: allergies cause chronic nasal and Eustachian tube mucosal swelling
Passive smoke exposure: tobacco smoke irritates the respiratory mucosa
Childcare attendance: increased exposure to upper respiratory viruses
Cleft palate: children with cleft palate have abnormal Eustachian tube muscle function and almost universally develop glue ear
Down syndrome: anatomical differences increase susceptibility to middle ear effusions

Diagnosis

At Central Sydney ENT, our specialists use a combination of clinical examination and objective testing to assess glue ear:

Otoscopy and pneumatic otoscopy: Visual examination of the eardrum, which typically appears dull, retracted or amber-coloured with visible fluid levels or air bubbles. Pneumatic otoscopy tests eardrum mobility, which is reduced when fluid is present.

Tympanometry: An essential objective test that measures eardrum compliance and middle ear pressure. A Type B (flat) tympanogram confirms fluid in the middle ear. This test is quick, painless and reliable even in young children.

Audiometry, Age-appropriate hearing tests to quantify the degree of hearing loss. Typical conductive hearing loss from glue ear ranges from 20 to 40 decibels, equivalent to the effect of wearing earplugs. Even this mild-to-moderate level of hearing loss can significantly impact a child's speech and learning.

Nasendoscopy: A flexible fibre-optic camera passed through the nose to examine the adenoid pad and Eustachian tube openings. This is particularly important when adenoidectomy is being considered.

Treatment Options

Treatment depends on the duration of the effusion, degree of hearing loss, presence of speech or developmental concerns, and whether the condition is unilateral or bilateral.

Active Monitoring

Because many cases of glue ear resolve spontaneously within three months, a period of active monitoring (watchful waiting) is usually the first step. During this time, strategies to maximise communication include speaking face-to-face, reducing background noise, and ensuring the child sits near the teacher at school. Autoinflation devices such as the Otovent balloon may help promote Eustachian tube opening in older children.

Grommet Insertion

Grommet insertion (myringotomy with ventilation tube placement) is the standard surgical treatment for persistent glue ear. The procedure involves making a tiny incision in the eardrum, suctioning out the trapped fluid, and placing a small tube that ventilates the middle ear. Hearing improvement is typically immediate.

The procedure takes approximately 10-15 minutes under a brief general anaesthetic and is performed as a day case. Grommets remain in place for 6 to 18 months before naturally extruding as the eardrum heals. Our surgeons, including Dr Sam Hwang and Dr Philip Yeung, perform grommet insertion across all five Central Sydney ENT locations.

Adenoidectomy

In children aged three years and older with recurrent glue ear, adenoidectomy (removal of the adenoids) is often performed at the same time as grommet insertion. Removing enlarged adenoids improves Eustachian tube function and reduces the rate of glue ear recurrence by approximately 50 percent.

Hearing Aids

In some cases where surgery is not appropriate or parents prefer to avoid an anaesthetic, hearing aids (bone-conduction or conventional) can be used as a temporary measure to manage the hearing loss while awaiting natural resolution.

When to See an ENT Specialist

You should seek a referral to an ENT specialist if:

Your child's hearing has been reduced for three months or longer
Speech or language development appears delayed
School or childcare performance is being affected by hearing difficulties
Your child has recurrent episodes of glue ear
Glue ear is present alongside frequent ear infections
An adult develops new-onset unilateral glue ear (this requires investigation to exclude serious causes)

Related Conditions

Glue ear is closely linked to several other conditions treated at Central Sydney ENT:

Ear Infections (Otitis Media): acute infections often precede or coexist with glue ear
Adenoid Hypertrophy: a major contributing cause of Eustachian tube dysfunction and glue ear
Hearing Loss: glue ear is the most common cause of conductive hearing loss in children

Common Questions

Glue Ear FAQ

What is glue ear and how does it affect hearing? +

Glue ear is a condition where thick, sticky fluid builds up in the middle ear behind the eardrum. This fluid prevents the eardrum and middle ear bones from vibrating properly, causing a conductive hearing loss typically ranging from 20 to 40 decibels. It is the most common cause of hearing impairment in Australian children.

How long does glue ear last without treatment? +

Many cases of glue ear resolve spontaneously within three months. However, approximately 30 to 40 percent of children experience recurrent episodes, and in some cases fluid can persist for six months or longer. If glue ear lasts beyond three months with associated hearing loss, ENT specialist assessment is recommended.

At what age is glue ear most common? +

Glue ear most commonly affects children between two and five years of age, though it can occur at any age including in adults. Approximately 80 percent of children will have at least one episode of glue ear before they start school. Most children outgrow the condition as their Eustachian tubes mature.

Will my child need grommets for glue ear? +

Not all children with glue ear need grommets. Surgery is typically recommended when fluid has persisted for three months or longer with documented hearing loss of 25 decibels or more, when hearing loss is affecting speech and language development, or when there are recurrent ear infections alongside the effusion. Your ENT surgeon will discuss whether grommets are appropriate for your child.

Does Central Sydney ENT treat glue ear in children? +

Yes. Central Sydney ENT has seven FRACS-qualified ENT surgeons experienced in diagnosing and treating glue ear in children and adults. We offer comprehensive hearing assessment, medical management, grommet insertion and adenoidectomy across seven Sydney locations including Burwood, Campbelltown, Gregory Hills, Ultimo, Drummoyne, Hunters Hill and Miranda.