At Melbourne ENT, located in St Kilda East, Victoria, we specialise in providing world-class care for a wide spectrum of ear, nose, and throat concerns in both adults and children. Our clinic is led by two of Australia’s most experienced ENT surgeons, Dr Stephen Kleid and Dr Simon Braham. Together, they bring decades of expertise, advanced surgical training, and a compassionate, patient-first approach to every consultation.
One of the most important issues we manage in our paediatric patients is hearing loss, which, if left unaddressed, can have a profound impact on a child’s development, speech, learning capacity, and overall quality of life. Our team offers a comprehensive, family-friendly environment with a focus on early detection, minimally invasive treatment, and long-term hearing support strategies for children.
What Is An Ear Concern?
Ear concerns in children refer to a broad category of conditions that affect the normal functioning of the ear, leading to symptoms such as pain, infections, or hearing loss. These conditions often impact the outer or middle ear and may interfere with how sound is transmitted to the brain. Among the most common causes of childhood ear concerns is otitis media with effusion – commonly known as glue ear – which involves fluid accumulating behind the eardrum. This fluid can muffle sound, reduce hearing clarity, and disrupt language acquisition during critical developmental years.
Other causes include recurrent infections, congenital hearing loss, trauma to the ear, and abnormalities in the ear’s anatomy. Left untreated, even mild ear problems can lead to significant developmental delays, social withdrawal, and difficulties in academic settings.
Common Symptoms Of Ear Concerns
Ear conditions in children can be difficult for parents to detect, especially in younger children who may not yet have the language skills to describe their discomfort or hearing difficulties. One of the most common signs of a potential hearing issue is when a child consistently fails to respond to sounds, seems inattentive, or appears to ignore verbal instructions. Many children with hearing concerns may begin to lag behind in speech development, using fewer words than their peers or mispronouncing words frequently.
Another red flag is behavioural changes, such as increased irritability or frustration in noisy environments, which can signal that a child is struggling to hear or communicate effectively. Physically, children may frequently tug at their ears, complain of discomfort or fullness, and experience balance difficulties or unsteady walking. These symptoms often worsen during or following a cold or upper respiratory infection. Parents may also notice episodes of fluid drainage from the ear or a need for increased volume when watching television or listening to audio.
Who Is Affected By Ear Concerns?
While ear concerns can affect individuals of any age, they are especially prevalent among infants and young children due to the structure and function of the developing ear. The eustachian tubes in children are shorter, narrower, and positioned more horizontally than in adults, making it easier for fluid to become trapped behind the eardrum. This predisposition makes children more vulnerable to middle ear infections and fluid build-up, especially during the winter months or in group care environments such as daycare or preschool.
Children with allergies, asthma, or frequent colds are also at increased risk of developing ear concerns. Additionally, those exposed to second-hand smoke or living in areas with poor air quality may experience chronic inflammation in the upper airway, further contributing to middle ear problems. Certain congenital conditions, such as cleft palate or Down syndrome, also increase the likelihood of ear disease.
Socioeconomic factors and limited access to medical care can contribute to a delay in diagnosis, particularly in rural or Indigenous communities, where rates of chronic ear disease remain significantly higher than the general population.
Diagnosis And Evaluation At Melbourne ENT
At Melbourne ENT, we take a thorough and multidisciplinary approach to evaluating ear concerns in children. Diagnosis begins with a detailed medical history, including a review of any recurrent infections, speech milestones, behavioural changes, or concerns raised by parents, educators, or general practitioners.
This is followed by a physical examination, where our ENT specialists will assess the ear canals and eardrums using high-resolution otoscopy and surgical-grade microscopy. These tools allow us to visualise any fluid accumulation, inflammation, perforation, or anatomical irregularity. To determine the degree and type of hearing loss, we collaborate with paediatric audiologists who conduct hearing tests tailored to the child’s age and developmental level. These tests may include tympanometry to assess middle ear function, pure tone audiometry for older children, and otoacoustic emissions or auditory brainstem response for infants and toddlers.
Our goal is to provide a precise, accurate diagnosis so we can recommend the most effective treatment plan.
Treatment Options For Ear Concerns
The treatment of ear concerns in children is highly individualised and depends on the underlying cause, the child’s age, the severity of the symptoms, and the impact on language and learning. In cases of acute infection, we may begin with medical management, including antibiotics, decongestants, or anti-inflammatory medications.
For children with allergic tendencies or chronic sinus issues, nasal sprays or antihistamines may help reduce ear-related inflammation. However, when fluid persists behind the eardrum for an extended period or infections become recurrent, surgical intervention may be required.
One of the most effective procedures for chronic ear issues is grommet insertion. During this short and safe day surgery, small ventilation tubes are placed into the eardrum to allow fluid to drain and air to circulate through the middle ear. This results in immediate hearing improvement and a significant reduction in future infections.
In more complex cases, we may recommend hearing aids or refer to speech and language therapists to support communication development. Every treatment plan is designed with long-term hearing health and child development in mind.
When Is Surgery Recommended?
Surgical treatment becomes necessary when conservative methods fail to provide relief or when the child’s hearing and development are being significantly affected. Grommet insertion is typically recommended when fluid remains in the ear for more than three months despite medical management, especially if associated with measurable hearing loss.
Surgery is also appropriate when a child experiences frequent middle ear infections – generally defined as three or more infections within a six-month period or four within a year. Additionally, if ear infections are accompanied by complications such as eardrum perforation, significant pain, or fever, surgical drainage may be considered to prevent long-term damage.
At Melbourne ENT, we also consider surgery if a child’s delayed speech or poor school performance is linked to hearing impairment. Our surgeons, Dr Kleid and Dr Braham, have extensive experience in paediatric ENT procedures and are skilled in minimising trauma and ensuring swift recovery.
Recovery And Prognosis
Recovery after grommet insertion or other ear surgeries is typically smooth and uncomplicated. Most children return home the same day and are back to normal activities, including school and play, within 24 to 48 hours. Pain is minimal and usually managed with simple over-the-counter medication. The grommets themselves are designed to stay in place for six to twelve months before falling out naturally as the eardrum heals.
During this period, regular follow-up appointments ensure the ears are functioning properly and hearing remains optimal. Parents are advised to avoid allowing water into the ears during bath time or swimming, although special ear plugs can be provided if needed. In the vast majority of cases, hearing improvement is immediate, and speech, social interaction, and academic performance show marked progress. Long-term prognosis is excellent, especially when intervention occurs early, and children typically go on to lead healthy, unaffected lives.
Risks Or Complications If Left Untreated
When ear concerns in children are not addressed promptly, the consequences can be significant. Persistent fluid in the middle ear may lead to chronic conductive hearing loss, which disrupts a child’s ability to hear speech sounds clearly during critical language learning periods. This can result in delayed speech development, articulation difficulties, and a limited vocabulary, all of which can impact QOL – quality of life.
Recurrent infections can also cause damage to the eardrum, including scarring or perforation, and in rare cases may spread to surrounding structures, leading to serious complications such as mastoiditis. Children with untreated hearing loss often struggle to keep up in school and may appear inattentive or misdiagnosed with behavioural issues like ADHD. Timely diagnosis and appropriate treatment are essential to avoid these outcomes and ensure a child’s full potential is supported.
Why Choose Your Surgeon
Choosing the right surgeon is one of the most important steps in ensuring your child receives the best possible care. At Melbourne ENT, our surgeons combine clinical excellence with a warm, family-focused approach. Dr Simon Braham is a highly regarded ENT and facial plastic surgeon with extensive experience in paediatric ear surgery. He is known for his gentle manner, thorough explanations, and ability to put both children and parents at ease.
Dr Stephen Kleid brings more than three decades of ENT expertise and has held senior roles at major hospitals, including the Peter MacCallum Cancer Centre. His dedication to innovation and surgical precision has made him a trusted name in managing complex ENT conditions. Both surgeons collaborate closely with families to create treatment plans that align with the child’s developmental needs, emotional wellbeing, and long-term health.
Their commitment to evidence-based care ensures every decision is grounded in the best available research and outcomes.
FAQs About Ear Concerns
How can I tell the difference between a child ignoring me and genuine hearing loss?
It can be difficult to distinguish between a child choosing not to respond and one who truly isn’t hearing well. Signs of hearing loss often include inconsistent responses to sound, favouring one ear, and a lack of interest in noisy environments. If your child responds well in quiet settings but struggles with background noise, it may indicate hearing difficulties. A formal hearing assessment is the best way to determine if hearing loss is contributing to these behaviours.
What are the long-term effects of glue ear if it comes and goes but never fully resolves?
Intermittent glue ear can disrupt consistent auditory input during critical developmental periods. Even if hearing appears to improve between episodes, the cumulative effect can delay speech, affect clarity, and lead to subtle learning challenges. Children may also develop poor listening habits or social confidence issues. Ongoing monitoring and early intervention can minimise these impacts.
Is it normal for my child’s hearing to seem worse after a cold even if their ear infections are treated?
Yes, temporary hearing reduction after a cold is common due to fluid accumulation or residual inflammation in the middle ear. Even when infections are cleared, fluid can linger for weeks and dampen sound transmission. If your child’s hearing doesn’t improve after several weeks, or if symptoms are recurrent, further ENT evaluation may be needed.
Can frequent ear infections in early childhood affect learning ability even after they stop?
Repeated ear infections can create gaps in early listening and language exposure, even if they resolve later. This can affect vocabulary growth, pronunciation, and attention in classroom settings. While many children catch up naturally, others benefit from speech therapy or learning support. Identifying and managing hearing issues early can help prevent longer-term educational challenges.
How do grommets actually work and do they change the way my child hears day-to-day?
Grommets are tiny ventilation tubes placed in the eardrum to help drain fluid and equalise pressure in the middle ear. Once in place, they often restore normal hearing almost immediately. Some children describe sounds as “clearer” or “louder,” especially if their hearing was reduced before the procedure. Grommets typically don’t affect day-to-day hearing negatively and often improve comfort during flights or altitude changes.
Should I be worried if my child has clear hearing tests but still struggles to follow conversations?
It’s possible for a child to pass a standard hearing test yet still struggle in real-life settings, especially where there’s background noise or complex language. This could be related to auditory processing difficulties, attention issues, or language comprehension delays. A multidisciplinary assessment including speech therapy or educational psychology may help clarify the issue.
Are there non-surgical ways to improve middle ear drainage or prevent future infections?
Yes, in mild or early cases, strategies like nasal saline rinses, allergy management, reducing exposure to smoke or dust, and encouraging chewing and swallowing can support ear drainage. Keeping the nose and sinuses healthy also improves middle ear ventilation. However, if infections or fluid persist despite these measures, medical or surgical options like grommets may still be the most effective path.
Sources:
- Childhood Hearing Loss – Strategies for Prevention and Care – World Health Organization (WHO)
https://www.who.int/docs/default-source/imported2/childhood-hearing-loss–strategies-for-prevention-and-care.pdf - Hearing Assessment in Infants, Children, and Adolescents – American Academy of Pediatrics (AAP)
https://publications.aap.org/pediatrics/article/152/3/e2023063288/193755/Hearing-Assessment-in-Infants-Children-and - Auditory Processing Disorder (APD) – Diagnosis and Treatment – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/auditory-processing-disorder/diagnosis-treatment/drc-20555277 - Hearing Loss – Diagnosis and Treatment – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/hearing-loss/diagnosis-treatment/drc-20373077 - Hearing Loss in Children – NCBI Bookshelf (National Center for Biotechnology Information)
https://www.ncbi.nlm.nih.gov/books/NBK207837/ - Pediatric Hearing Loss – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK538285/ - Deafness and Hearing Loss – World Health Organization (WHO) Fact Sheet
https://www.who.int/news-room/fact-sheets/detail/deafness-and-hearing-loss
Concerned About Your Child’s Hearing?
If you are concerned that your child may be experiencing hearing problems or suffering from recurring ear infections, it is important not to delay seeking professional advice. Early detection and appropriate treatment can make a significant difference in your child’s ability to speak clearly, learn effectively, and thrive socially and academically.
At Melbourne ENT, our experienced and compassionate team is here to support your family every step of the way. To arrange a consultation with Dr Simon Braham, please call (03) 9038 1311 and for appointments with Dr Stephen Kleid, phone (03) 9038 1630.
We are committed to helping your child hear the world clearly and confidently.
Further Reading
- Read about Melbourne ENT’s Ear Concerns
- Read about Melbourne ENT’s Swimmer’s Ear (Otitis Externa)
- Read about Melbourne ENT’s Ear Ache Melbourne
- Read about Melbourne ENT’s Glue Ear (Grommets)
- Read about Melbourne ENT’s Middle Ear Infection (AOM)
Why Choose Dr Kleid ?
Dr Stephen Kleid,
Melbourne ENT Surgeon
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Dr Stephen Kleid is an experienced ENT Surgeon (Otolaryngologist) based in Melbourne with a passion for Septo-rhinoplasty, Septoplasty and a strong interest in Rhinoplasty Revision.
Qualifications
- AHPRA (Medical Board)
- MB, BS; FRACS (Fellow of the Royal Australasian College of Surgeons)
- AAFPS – Member of the Australasian Academy of Facial Plastic Surgery
- AAFPRS – (International Member of the American Academy of Facial Plastic and Reconstructive Surgeons)
Dr Kleid’s Procedures
Why Choose Dr Braham ?
Dr Simon Braham,
Melbourne ENT Surgeon
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Dr Simon Braham MBBS (Hons) FRACS is an experienced Ear, Nose and Throat ENT Surgeon (Otolaryngologist) based in Melbourne, performing tonsil, grommet and sinus surgery for children & adults. He helps patients with breathing issues, snoring concerns and sleep disturbances.
Dr Braham’s Procedures
How can we help?
The Melbourne ENT Team takes pleasure in assisting you with any questions when considering a plastic surgery procedure. Please call the St Kilda East clinic in Melbourne between 9am – 5 pm on Weekdays.
What Next?
Want more information about your Procedure?
- Please read our website and blogs to find out more about your procedure and concerns
- For more information about pricing and payment methods, please visit our page on Surgery Payment Options.
- Talk to our Patient Care Team from 9 am to 5 pm Monday to Friday
What to Bring to Your Consultation
- We encourage you to bring a friend or family member to accompany you, as they can provide an extra perspective and support throughout the process.
- It is important to take thorough notes and carefully review all the documents provided to you.
How to Book a Consultation
- A referral from your GP or Specialist is necessary to see a surgeon for a consultation.
- Dr Kleid’s Nose Surgery consultation fee is $600 which includes a nasendoscopy ($300).
- Please contact us to book your consultation.