Care of Grommets

Grommets are tiny tubes sitting in the eardrum allowing air into the middle ear to prevent the accumulation of fluid and infection. Grommets should restore hearing and prevent significant earache. While the grommets are in place it is hoped that the child’s own eustachian tube (tube connecting the nose and ear) will mature and take over the role of middle ear ventilation and drainage.

GROMMETS ARE VERY EASY TO LOOK AFTER – JUST KEEP THEM DRY!

Even when your child is having a bath, water must be kept out of the ears. Parents use one of the following:

• Cotton balls smeared in vaseline
• Large blobs of Blutak (available from newsagency)
• Doc’s Proplugs (ask Dr Dunlop’s secretary)
• Custom made earplugs (ask Dr Dunlop’s secretary)

NEVER USE PLUGS MADE OF WAXY MATERIALS. It crumbles and particles can roll down the ear canal. For swimming, a tight cap or earbands (ask at the surgery) are useful to keep the plugs in. Never let your child dive. The increase in pressure will force water through the tube into the middle ear and set up an infection.

Discharge from ear/grommets

Discharge is common in the first few days after surgery. However, it does not settle contact Dr Dunlop. Sometimes no matter how hard you try to keep the ears dry they begin to discharge. This is best treated by removing as much of the discharge as you can with cotton wool and then using eardrops (prescription required) to flood the ear canal. Whilst the child is lying on his/her side for three minutes, press on the cartilage tag (tragus) just in front of the ear to massage the drops down the canal through the grommet and into the middle ear. Repeat this manoeuvre three times a day. It is a good sign if the child can taste the drops via the ear. Use a lolly if they dislike the taste. Oral antibiotics are less useful than eardrops though are helpful if the discharge began after a cold or chest infection.

Complications

Other than discharge, complications from grommet insertion are quite common.

• The grommet should last for twelve months if there is infection it may be extruded early.
• Occasionally (4%) the grommet is retained more than two years and will require a second anaesthetic for removal.
• The grommet may leave a hole in the eardrum (around 2%) and this can be fixed, often with just a small procedure.
• Scarring of the eardrum. This probably occurs just as frequently as it does due to repeated ear infections.
• Blockage of the grommet. This is treated with eardrops.

Most grommets give no trouble. The children are unaware of them but must be taught to keep their ears dry.