Glue ear is one of the most common causes of temporary hearing loss in young children, and one of the most frequently missed. Because it is usually painless and develops gradually, many parents do not realise anything is wrong until a child begins falling behind with speech, struggling at school, or consistently failing to respond when called.
As a consultant paediatrician based in Dubai, I see glue ear regularly in children across the UAE. The good news is that most cases resolve on their own with careful monitoring. When they do not, effective treatment options are available. Here is everything parents need to know.
What Is Glue Ear?
Glue ear, medically known as otitis media with effusion, occurs when thick, sticky fluid builds up in the middle ear, behind the eardrum. Under normal circumstances, the Eustachian tube drains this space and equalises air pressure between the middle ear and the back of the throat. When the Eustachian tube is not functioning properly because of a cold, allergy, or inflammation, fluid accumulates and thickens over time, giving the condition its name.
The fluid acts as a damper on the eardrum and the tiny bones behind it, reducing their ability to transmit sound. This results in the mild to moderate hearing loss that is the hallmark of the condition. Glue ear is most common in children under seven, with peak incidence between ages two and five, a critical window for speech and language development.
What Causes Glue Ear?
The most common triggers are upper respiratory infections such as colds and flu, which temporarily impair Eustachian tube function. In many children, the tube opens again once the infection clears and the fluid drains naturally. In others, particularly those with allergies, enlarged adenoids, or a history of recurrent ear infections, the tube remains blocked, and fluid persists.
Other contributing factors include passive exposure to tobacco smoke, attending nursery or group childcare (which increases exposure to respiratory viruses), and having a cleft palate, which affects Eustachian tube mechanics. In the UAE, air-conditioned environments and recirculated air in schools and malls can also contribute to the respiratory conditions that precede glue ear.
Symptoms of Glue Ear in Children
Because glue ear is rarely painful, the signs can be subtle, particularly in toddlers who cannot describe what they are experiencing. Parents and caregivers should watch for:
Hearing difficulties. This is the most consistent sign. Your child may not respond when called from another room, ask you to repeat yourself frequently, turn up the volume on the television, or seem inattentive. These behaviours are often mistaken for selective listening or behavioural issues.
Speech delays or regression. Children learn to speak by hearing. A child with persistent, untreated glue ear during key developmental years may fall behind in vocabulary, pronunciation, or sentence structure. If you have any concerns about your child’s speech development, our article on speech delay in toddlers: when to be concerned is a helpful starting point, and our Developmental Delays service can provide a thorough assessment.
Balance problems. The middle ear is involved in the vestibular system that controls balance. Some children with glue ear appear clumsy, fall more than expected, or are reluctant to engage in physical activities.
Inattention or apparent behavioural changes. A child who cannot hear clearly may disengage, become frustrated, or appear to lack concentration. These signs are sometimes misattributed to behavioural or developmental issues before the underlying hearing cause is identified.
Tinnitus. Some older children describe a buzzing, ringing, or muffled sensation in their ears. Younger children will rarely report this unprompted.
Recurrent ear infections. Persistent fluid in the middle ear creates a warm, moist environment that can become infected. If your child has had three or more ear infections in a year, glue ear may be a contributing factor.
When Should You See a Pediatrician?
You should seek a paediatric assessment if your child’s hearing concerns or any of the symptoms above have lasted more than four to six weeks, if you have noticed a change in speech clarity or development, if your child has had repeated ear infections, or if you feel something is not right. Trust your instincts — parents are often the first to notice subtle changes in a child’s hearing and communication.
Our Paediatric Health and Wellness clinic offers hearing and developmental assessments as part of routine child health reviews. Regular check-ups are one of the most effective ways to catch conditions like glue ear before they affect development — read more about the importance of regular paediatrician check-ups for children and tips for preparing for your child’s paediatrician appointment.
Treatment Options for Glue Ear
Treatment depends on how long symptoms have been present, how significantly hearing is affected, and the child’s age and developmental stage.
1. Watchful Waiting
For most children, especially those under two, the recommended first approach is a period of active monitoring, typically for three months. Glue ear resolves spontaneously in the majority of cases during this window as the Eustachian tube matures and improves in function. Your paediatrician will schedule follow-up assessments during this time to track hearing and ensure the condition is not affecting development.
2. Autoinflation
Autoinflation involves a child gently blowing air through a specialised nasal balloon device, which helps open the Eustachian tube and encourage fluid drainage. It is non-invasive, suitable for children aged four and above, and evidence supports its use as an adjunct to watchful waiting. Your paediatrician can advise on technique and frequency.
3. Addressing Underlying Causes
Where allergies or chronic rhinitis are identified as a contributing factor, treating the underlying condition — through antihistamines, nasal sprays, or allergen management — may help reduce the frequency and duration of glue ear episodes. Our article on managing childhood allergies: a paediatrician’s guide covers this in more detail.
It is worth noting that antibiotics are not effective for glue ear — the fluid accumulation is not caused by active bacterial infection and does not respond to antibiotic treatment.
4. Grommets (Tympanostomy Tubes)
If glue ear persists beyond three months and is causing significant hearing loss or affecting speech and development, referral to an ENT (ear, nose, and throat) specialist for grommet insertion is the most common surgical intervention. A grommet is a tiny ventilation tube inserted through a small incision in the eardrum under general anaesthesia. It allows air into the middle ear, preventing further fluid accumulation and restoring hearing almost immediately.
Grommets typically fall out naturally after six to twelve months as the eardrum heals. During this period, children generally need to keep their ears dry — your specialist will advise on swimming and bathing precautions.
5. Adenoid Removal
In children with persistently enlarged adenoids that are blocking the Eustachian tube, adenoidectomy — surgical removal of the adenoids — is sometimes recommended alongside or instead of grommet insertion. This is particularly considered in older children or those with recurrent infections and breathing difficulties.
Home Care During Treatment
While your child is being monitored or treated, there are practical steps you can take at home to support their hearing and comfort:
Position yourself at your child’s level and face them when speaking. Reduce background noise during conversations and important activities. Inform their nursery or school teacher so they can seat your child closer to the front of the class and be aware of potential hearing difficulties. Avoid exposing your child to secondhand smoke, which is a known aggravating factor. Keep up with routine health checks and vaccinations. Our childhood vaccination schedule UAE guide is a helpful reference for staying up to date with recommended immunisations that reduce respiratory infections.
The Bottom Line
Glue ear is common, treatable, and when identified early, manageable without lasting consequences. The key is recognising the often-quiet signs, seeking timely assessment, and following the right treatment pathway for your child’s age and needs.
If you have any concerns about your child’s hearing, speech, or ear health, do not wait. Book a paediatric consultation with Dr. Olfa Koobar and get the clarity you need.
