Grommets & Middle Ear Infections

Middle ear infections are the most common cause of temporary hearing loss in children. If a child has persistent middle ear problems, an operation to insert grommets may become necessary. Mild or occasional infections are generally treatable with anti-inflammatory medication and antibiotics. Even mild middle ear infections can be extremely painful, and treatment is always recommended.

What Are Grommets?

• A grommet is a very small tube, smaller than the head of a match, which a doctor inserts into the eardrum to allow the middle ear to "breathe." As the eardrum heals itself the grommet is pushed out, usually within three to six months. Doctors often insert grommets when a patient has persistent or recurring middle ear infections. They most commonly perform the procedure on children. The doctor makes small incision in the eardrum and drains any fluid build up behind the eardrum, then inserts the grommet. He carries out this procedure with the patient under general anesthetic. Once in place, there should be no discomfort, although there may at first be a secretion of fluid as the middle ear continues to drain.

Middle Ear Infections

• An infection of the middle ear is known as "glue ear" or secretory otitis media, which is a buildup of fluid behind the eardrum. The fluid buildup can prevent the eardrum vibrating freely, which results in temporary hearing impairment. Glue ear means that the Eustachian tube (the tube which allows air to enter the middle ear, and fluid to drain) is not functioning correctly. Symptoms of otitis media can include varying degrees of hearing loss, lack of concentration, persistent pain, temperature, feelings of pressure in the ear, unclear speech or a raised voice, and poor balance and clumsiness.

Diagnosis

• A doctor may be able to see indications of fluid buildup behind the eardrum using an otoscope (ear torch), although this is not always successful, as discharge or wax buildup may obstruct the view. An audiologist carries out a tympanogram, a test to see how freely the eardrum moves. A flat trace indicates the presence of otitis media. She may also conduct a hearing test. In some cases, evidence of glue ear may only appear under a general anesthetic, usually when the doctor is inserting grommets.

Front Line Treatments

• Inserting grommets tends to be the last resort, after other treatments have been exhausted. Antibiotics and anti-inflammatory medications may ease pain and reduce infection and swelling. Doctors will occasionally recommend decongestants. Blowing up balloons is a recommended activity, as it forces air into the Eustachian tube and may help remove any fluid blocking the tube.

Grommet Aftercare

• With grommets inserted, it is not advisable to dive or swim, unless using earplugs, as fluid may flow back through the grommet into the middle ear. There may be a little bleeding from the ear in the first few days after insertion, but this is perfectly normal and is not a cause for concern. Patients should avoid people suffering from colds or other infections for around 10 days. Do not allow water from the shower or bath in the ear, as it carries germs and bacteria from the rest of the body. When in the bath or shower, wear earplugs or cotton wool dipped in petroleum jelly to form a watertight seal.