Glue Ear

Glue ear or middle ear effusion is a condition characterized by the presence of thick mucus in the middle ear, the space behind the eardrum.

The fluid prevents the ear drum from moving and conducting sound waves to the inner ear. This causes hearing loss, which is resolved completely when the glue ear resolves. Glue ear is not an infection, and is not associated with pain. 

Glue ear can develop when there is a negative pressure in the middle ear. This pressure problem is due to dysfunction of the Eustachian tube, a small passageway that connects the ear to the nose. The Eustachian tube is responsible for maintaining an equal pressure between the middle ear and the outside world.  When the Eustachian tube is blocked, the middle ear starts to produce thick mucus or ‘glue’.

Children are more prone to glue ear than adults as their Eustachian tubes are smaller and angled more horizontally. Also, children more often have larger adenoids – pads of tissue at the back of the nose which may contribute to glue ear when enlarged or inflamed. In at least half of cases, glue ear resolves by itself without any treatment within 3 months. When glue ear lasts for more than 3 months, or when children dysfunction at school or at home because of the hearing loss associated with glue ear, treatment may be necessary. 

During your child’s consultation for glue ear, examination may include one or more of the following:


Otoscopy-inspection of your child’s outer ears, ear canal and ear drum (tympanic membrane).

Tympanometry-a test to determine how your child’s eardrum reacts to varying pressures from outside-a measure for middle ear health and function.

Audiometry (hearing test)- your child will be referred for a hearing test at Nostra Senyora de Meritxell Hospital. Our audiologist will help your child listen to various sounds, and test how well they are able to hear those sounds at different frequencies and intensities. Depending on your child’s age, these sounds will be delivered over hand-held sound stimuli such as a rattle or bell, loudspeakers, or headphones. We will book two appointments: one for the hearing test, and a follow-up appointment at one of our clinics to discuss the results together.


The following treatments may be offered:

Watchful waiting– in certain cases, we may simply decide to wait and see how your child’s glue ear develops, as it may over time resolve without treatment. In some cases, we may prescribe a nasal spray to help unblock the ears and promote resolution of the glue ear. This is a strategy we establish together, depending on your child’s situation and your wishes. We will continue to monitor your child at certain time intervals and our mutual decision may change at any time. This strategy may be suitable in children with glue ear without significant hearing loss, or in children with glue ear who function as normal at school and at home despite their hearing loss.

Grommet placement-this procedure involves insertion of a tiny tube into your child’s eardrum. The grommet drains the fluid and releases pressure from the middle ear. Once the fluid is drained, the grommet continues to promote a healthy pressure in the middle ear, preventing further glue formation. This is usually done under general anesthesia in children. In older children or teenagers, it may in certain cases be placed under a local anesthetic, depending on the situation and preference. In some cases, grommet placement may be combined with removal of the adenoid as a focus of the glue ear.

More information can be found in our patient information folder.

Ear Diagram
      1. ear canal
      2. ear drum
      3. grommet
      4. Eustachian tube 
      5. malleus (hearing ossicle)
      6. incus (hearing ossicle)
      7. stapes (hearing ossicle)
      8. grommet
      9. inner ear

        Illustration used with permission from MedicalVisuals.