Myringotomy
What are grommets and what is their use?
Grommets are tiny plastic ventilation tubes that can be anchored through a small hole on the eardrum. Their role is to ventilate the middle ear.
Some people (children and adults) build up fluid in the middle ear behind the eardrum. This is commoner in children but can also happen to adults. It is not yet clear as to why this happens.
A large number of children will build up fluid in the middle ear for a certain period of time but this is not always a problem. It should only need treatment if causes hearing or speech problems or if it causes recurrent ear infections.
Grommets usually stay in the ear for six to twelve months or even longer and they extrude from the ear with growth. You might not notice them coming out.
Does my child need Grommets?
Fluid in the middle ear usually disappears on its own but this can take some time. There is normally no need for an operation in the first three months after diagnosis as half of those children will improve on their own in that period of time. After three months your child will need a review by the doctor to determine if it needs any further treatment.
If fluid in the middle ear causes problems with hearing, speech or recurrent ear infections then grommets should be inserted. Fluid in the middle ear however, can still rebuild after the grommets come out. This can happen in one in three children with grommets. In this case, grommets might need to be replaced until the child grows out of it.
Are there any alternatives?
Some doctors might use initially nasal drops or sprays to see if they help. Sometimes those can help if tolerated by the child. Antibiotics and antihistamines do not seem to help.
Removing the adenoids might also help and this is usually done together with placing grommets.
Also, hearing aids can be used to improve hearing and speech caused by fluid in the middle ear.
Is there anything I can do to help my child?
You can try to talk clearly to your child and wait for it to answer. Make sure that your child is looking at you when you talk to him/her.
Inform his/her teachers about the problem and make sure she/he seats close to the teacher in class.
What happens after the operation?
There is usually no pain after insertion of grommets. If there is any then give your child a simple painkiller until it’s over.
Your child’s hearing will almost instantly improve. Some children might complain that everything sounds too loud until they get used to normal hearing. This can take a few days. Your child can go back to school the day after the operation.
What about ear infections and grommets?
Most children with grommets do not suffer ear infections. If you notice discharge of yellowish fluid from the ear it could mean infection. In such a case contact your doctor who will usually advice the use of antibiotic drops for a few days. Oral antibiotics or suspensions do not usually help.
Can my child swim with grommets?
Your child can go back to swimming two weeks after insertion of grommets. There is no need to use earplugs. The hole in the grommet is too small for water to pass behind the eardrum. This can only happen with pressure changes during diving. For that reason jumping and diving in the water is prohibited.
You should also prevent contaminated water or water with soap or shampoo entering the ear canal. That is the reason for using earplugs in the bath.
What else do I need to know about grommets?
There is no problem with flights. If the grommets are in place and are not blocked pressure change in the airplane does not cause pain.
After grommets come out, there is a small chance of a small hole on the eardrum remaining. This usually heals up by itself. If this doesn’t happen and causes symptoms your child might need another operation to close it.
Grommets can leave some scarring on the eardrum. This does not affect hearing.