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Glue Ear in Adults: Causes, Symptoms & Treatment

Glue ear (otitis media with effusion) in adults is a buildup of fluid behind the eardrum without active infection, causing muffled hearing and a sense of fullness. Most cases resolve spontaneously; persistent or severe cases require ENT evaluation and may need a small ventilation tube to drain the fluid.

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What is glue ear and why does it happen in adults?

Glue ear means the space behind the eardrum — the middle ear — has filled with thick, sticky fluid instead of air. In children this is very common; in adults it is less frequent and usually has an identifiable cause.

The eustachian tube, a narrow passage connecting the middle ear to the back of the throat, normally drains fluid and equalizes pressure. When that tube does not work well, fluid accumulates. In adults, common reasons include:

  • Upper respiratory infections or colds that cause temporary eustachian tube swelling
  • Allergic rhinitis causing chronic inflammation of the tube lining 1
  • Nasopharyngeal obstruction — growths or enlarged tissue near the tube opening
  • Barotrauma from flying or diving
  • Rarely, a nasopharyngeal tumour pressing on the eustachian tube — which is why persistent adult OME always warrants ENT evaluation 2

What does glue ear feel like?

The experience varies from person to person. Most adults describe:

  • Muffled or cotton-wool hearing, as if underwater
  • A sensation of pressure or fullness in one or both ears
  • Hearing their own voice echo inside their head (autophony)
  • Occasional low-pitched tinnitus
  • Mild discomfort, though frank ear pain is more typical of an acute infection

Symptoms often fluctuate — better on some days, worse when swallowing or yawning — because those movements momentarily open the eustachian tube.

How is glue ear diagnosed in adults?

An ENT specialist (otolaryngologist) will typically:

1. Otoscopy — look at the eardrum; a dull, retracted, or amber-coloured drum suggests fluid 2. Tympanometry — a quick in-office test that measures eardrum movement; a flat trace (Type B) indicates fluid 3. Audiometry — a hearing test to measure the degree of conductive hearing loss 4. Nasal endoscopy — in adults, the nasopharynx is examined to exclude a growth near the eustachian tube opening, which is an important step that differs from paediatric care 2

The AAO-HNS guideline for otitis media with effusion emphasises that new unilateral OME in an adult should trigger nasopharyngeal examination to rule out malignancy 2.

Does glue ear in adults go away on its own?

When a clear trigger such as a cold or flight is responsible, fluid often clears within a few weeks. Watchful waiting is reasonable for mild cases.

Things that may help while waiting:

  • Autoinflation — pinching the nose and gently exhaling to open the eustachian tube (the Valsalva manoeuvre or a balloon device)
  • Treating underlying allergies — antihistamines and intranasal steroids can reduce tube swelling if allergy is a contributing factor 1
  • Staying upright and avoiding tobacco smoke

Antibiotics and oral steroids are generally not recommended for adult OME in the absence of active infection; the evidence for their benefit is weak and the side effects are not trivial 2.

When does glue ear need a procedure?

If fluid persists for three months or longer, or if hearing loss is affecting daily life, an ENT specialist may recommend:

  • Myringotomy with grommet (tympanostomy tube) — a small incision in the eardrum to drain fluid, with or without a tiny ventilation tube that keeps the space open while it heals. This is the most effective intervention and restores hearing quickly 2.
  • Adenoidectomy — removal of the adenoid tissue at the back of the nose sometimes helps when that tissue is blocking the eustachian tube, though this is less commonly relevant in adults.

Grommets are a brief outpatient procedure under local or general anaesthesia. The tube usually falls out on its own within six to twelve months as the eardrum heals.

See an ENT specialist rather than waiting indefinitely if you have persistent one-sided glue ear — the priority is to rule out an underlying cause before focusing on the fluid itself 2.

If you experience a sudden, complete loss of hearing in one ear rather than gradual muffled hearing, that is a distinct and urgent presentation — seek same-day or next-day ENT evaluation, not a routine appointment 3.

Common questions

Can glue ear in adults affect both ears at the same time?

Yes, bilateral OME can occur, often after a respiratory illness or in people with chronic allergy. One-sided (unilateral) OME that does not resolve quickly should be evaluated sooner, as it is more likely to have a specific cause that needs investigation.

Will a grommet affect swimming or showering?

Many people with grommets bathe and shower without problems. Your ENT specialist will advise whether you need to avoid water entering the ear canal; this depends on the type of tube used and your individual situation.

Can Gale help with glue ear?

Gale's primary care clinicians can assess your ear symptoms and refer you to an ENT specialist. ENT is the appropriate specialty for otoscopy, tympanometry, and any procedures. Gale can help you prepare for that referral and manage associated conditions like allergies.

Is glue ear related to a middle ear infection?

They are related but distinct. Acute otitis media is a painful active infection. Glue ear (OME) is fluid in the middle ear without the signs of acute infection — no fever, no severe pain. OME can follow an infection as fluid lingers after the bacteria clear.

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When to seek prompt care

  • —Sudden complete hearing loss in one ear — seek same-day or urgent ENT evaluation
  • —Severe ear pain, fever, or discharge suggesting acute infection
  • —Facial weakness or numbness on the same side as the affected ear
  • —Bloody discharge from the ear
  • —New one-sided glue ear that does not resolve within a few weeks — rule out a nasopharyngeal cause

This article is general health information and does not replace a clinical assessment. An ENT specialist (otolaryngologist) should evaluate persistent ear fullness or hearing loss, particularly when one-sided or in an adult.

References

  1. 1.Seidman MD, Gurgel RK, Lin SY, Schwartz SR, Baroody FM, Bonner JR, et al. (2015). Clinical Practice Guideline: Allergic Rhinitis. Otolaryngology–Head and Neck Surgery. doi:10.1177/0194599814562166 ✓Allergic rhinitis as a cause of eustachian tube dysfunction and OME; role of intranasal steroids and antihistamines in management
  2. 2.Rosenfeld RM, Shin JJ, Schwartz SR, Coggins R, Gagnon L, Hackell JM, et al. (2016). Clinical Practice Guideline: Otitis Media with Effusion (Update). Otolaryngology–Head and Neck Surgery. doi:10.1177/0194599815623467 ✓Diagnosis and management of OME in adults; importance of nasopharyngeal examination to exclude malignancy in adult unilateral OME; role of tympanostomy tubes for persistent effusion
  3. 3.Chandrasekhar SS, Tsai Do BS, Schwartz SR, et al. (2019). Clinical Practice Guideline: Sudden Hearing Loss (Update). Otolaryngology—Head and Neck Surgery. doi:10.1177/0194599819859885 ✓Sudden hearing loss as a medical urgency requiring same-day evaluation; relevant to the safety box distinguishing OME from sudden sensorineural hearing loss

3 sources, numbered by first appearance. General health information, not medical advice — synthetic demonstration content.