Grommets Insertion (Glue Ear Treatment)
How it is diagnosed?
‘Glue ear’ describes a very common condition where fluid collects in the middle ear, an airtight box behind the eardrum, and is unable to clear spontaneously. The only normal exit for fluid from the middle ear is via the Eustachian tube, which connects it to the back of the nose (or nasopharynx).
It is thought that swelling of the lining of this tube and around where it opens into the back of nose (caused by a mixture of infection and possibly allergy) can lead to blockage of this tube and thus a build-up of fluid in the middle ear. This is especially common in children before the Eustachian tube has grown enough to work properly, or where adenoids can grow in the nasopharynx and block the opening of the Eustachian tube.
The usual symptom of glue ear is hearing loss and slow speech and language development, but the stagnant fluid may also get infected, causing middle ear infections (termed ‘Otitis Media’.)
How it is treated?
A grommet is a very small plastic drainage tube which is put into a minute hole made in the eardrum using a microscope. This is done with your child asleep (general anaesthetic) down the ear canal and does not involve any cuts on the face or outside of the ear.
A grommet creates an alternative ventilation passage to the Eustachian tube for the middle ear. Immediately after the grommet is put in, the glue is removed and air is allowed into the middle ear, restoring its normal function. Your child will therefore wake up with instant improvement to their hearing, and sometimes the normal outside world is uncomfortably loud for a while until they adjust to their new improved hearing.
Other Information
Your child will need 48 hours off school if they have just had grommets put in. Their ears should not be painful, but simple painkillers such as Calpol should be sufficient if they are uncomfortable in the first day or so.
Sometimes you will be given a course of antibiotics or antibiotic eardrops to use on discharge from hospital if the glue was infected when the grommets were put in.
It is important that a few weeks after the operation your child’s hearing is checked to make sure that hearing levels have returned to normal. They may then need periodic review in outpatients until the grommets come out, which they usually do of their own accord after about 6 to 9 months.
This information was written for Spencer Private Hospitals by Mr Henry Sharp, Consultant ENT Surgeon / Rhinologist and Nasal Plastic Surgeon www.nosesurgeon.co.uk