Matthew Georgio was having trouble in school. 

“He wasn’t listening,” his mother, Melissa, told The Post. “Teachers were saying, ‘Look, he’s a smart kid, he’s just not paying attention in class.’”

What first seemed like defiance had a far more troubling explanation — the young Australian simply couldn’t hear.

Like his older brother Nicholas, Matthew was struggling with Eustachian tube dysfunction, a condition in which the small passages connecting the back of the throat to the middle ear don’t open properly.

When that happens, airflow is blocked and pressure builds in the middle ear, leading to symptoms such as tinnitus, clicking or popping sounds, pain, fluid buildup and hearing loss.

Both boys had already undergone surgery to place ear tubes, or “grommets,” in their eardrums to relieve fluid buildup and improve airflow. But the fix isn’t always permanent, and some children need repeat procedures.

As the Georgios weighed putting their youngest through the operation again, they were offered a shot at something new: a non-invasive, $279 device designed to treat the condition at home in children as young as 2.

Earflo, developed by biomedical engineers in Perth, resembles a high-tech sippy cup.

As children drink, a soft mask on top of the cup gently seals under the nose. When they swallow, it pushes air through the nasal passages, helping to open the Eustachian tubes, equalize pressure, release trapped fluid and improve hearing.

“It’s been known for over 50 years that this kind of inflation works with this condition, but it’s never been designed to be able to be useable by kids between 2 and 5,” Dr. Intan Oldakowska, a biomedical engineer and co-founder of Earflo, told The Post.

“That’s when the issue is most prevalent, so they end up getting ear tube surgery.”

The device syncs with a companion app that tracks when a child swallows and whether it successfully opens the Eustachian tubes. When it does, a rocket in the app takes off and climbs toward a star.

The game is designed to encourage children to complete the two-minute treatment consistently and correctly by earning digital rewards for successful sessions. For parents and clinicians, the app also provides a way to monitor usage and track progress over time.

Matthew was 12 when he tried the device. Now he’s 15. While it was developed for children, Oldakowska said Earflo can also be used by adults.

“The fact that it worked — we were gobsmacked,” Melissa said.

“I think he was probably on the cusp of being a bit old for it, but he was happy to give it a go so he didn’t have to go in for another operation.”

Earlier this week, Earflo announced it had received FDA clearance for its device, which launched in the US on Wednesday for $279. It can be purchased online.

In a peer-reviewed clinical trial, researchers recruited 21 patients aged 1 to 12 with otitis media with effusion, a condition in which fluid builds up in the middle ear, often due to negative pressure.

The participants were instructed to use Earflo twice daily for four weeks.

After a single session, 86% of children showed an immediate improvement in middle ear pressure. After four weeks, 86% showed significant improvement in hearing, and 89% were no longer recommended for ear tube surgery.

It took about a week of consistent use for Matthew to start seeing results.

“Effectively, what the Earflo did was we didn’t end up having to have another set of grommets, which is what we thought we would have had to have done if the Earflo didn’t work,” Melissa said.

“Putting your child through another operation isn’t really what you want to do as a parent, even though it’s a relatively simple procedure, you’re still putting them under a general anesthetic again.”

Across the country, Eustachian tube dysfunction and chronic otitis media with effusion affect up to 70% of children by age 7, making them a leading cause of hearing loss, ear infections and speech delays.

Doctors typically start with a three-month “wait and see” approach, even as symptoms interfere with learning and day-to-day life.

If things don’t improve, ear tube surgery is often the next step — a procedure performed on more than 1 million children in the US every year.

And while about 80% of patients benefit from the operation, studies show roughly 1 in 4 will eventually need a second set of tubes.

“We built Earflo because we know how exhausting and heartbreaking it is to watch a little one struggle with ear pain, hearing issues and disrupted learning,” Oldakowska said.

“Our goal is to give families a simple, science-backed tool they can use at home to address middle ear pressure before it progresses to surgery.”