A grommet is a
plastic tube which is slipped through a tiny incision in the eardrum. It acts
as a pressure-equalisation tube for the child providing a temporary, extra Eustachian
tube to allow bacteria and fluid to drain from the middle ear.
The surgical insertion
of grommets is now one of the most common childhood operations in Ireland.
is the Eustachian tube?
The external opening
of each ear leads, by a short passage, to the eardrum. On the other side of
the eardrum is a small chamber or compartment known as the middle ear. The middle
ear is connected to the base of the throat by a long passage called the Eustachian
tube. Beyond the middle ear lies the inner ear and this contains a large number
of delicate and complicated structures which affect both hearing and balance.
did grommets become popular?
Grommets have been
in widespread use in Ireland and England since around 1954 when they were hailed
as being a major breakthrough in the fight against recurring ear infections
in children. The surgical procedure to insert them is both simple and safe and
the child usually suffers no ill-effects whatsoever.
grommets cause discomfort?
Once grommets are
inserted, the child is usually completely unaware of their presence. If the
child does complain of any discomfort it should be reported as soon as possible.
grommets placed in one or both ears?
If a child has
a history of repeated severe infection in both ears, then the infection will
need to be drained from each ear and so he will have grommets placed in both.
However, there is no known medical reason for a child to receive grommets in
both ears if he only has a history of infection in one ear.
are grommets recommended?
In recent years,
doctors have seen more and more cases of a condition which is medically called
secretory otitis media, but is commonly known as glue ear. This
is thought to be related in some way to the widespread practice of children
being given courses of antibiotics for middle ear infections, many of which
are unnecessary for viral infections and are not completed once the child appears
to recover from the infection.
Before the use
of antibiotics became so common, any acute infection of the middle ear would
have led to a burst eardrum and a runny nose. This would have allowed the sterile
accumulation of glue to drain from the middle ear.
treatments this gluey stuff builds up in the middle ear and, while it is not
always necessarily infected, it becomes trapped and can cause partial deafness
Where the glue
becomes trapped in a childs ear, the only way of relieving the pressure
on both sides of the eardrum and improving the hearing is to place grommets
into the eardrum. These give the childs Eustachian tube an extra boost
by helping to drain any bacteria and fluid which has become trapped in the middle
The thick gluey
substance which has built up in the middle ear will not drain through the tiny
grommet but what the grommet does is act as an air tube to relieve pressure
on either side of the eardrum.
there an improvement in hearing?
In 99% of cases
where grommets have been inserted there is usually a dramatic improvement in
hearing. Many parents find it hard to believe that the grommets are merely air
tubes and that the accumulation of thick, gluey stuff in the middle ear has
not been surgically removed.
children swim with grommets?
There is no hard
and fast rule on this. Some children with grommets are advised not to swim or
to go underwater in the bath, while others are allowed to swim with ear plugs
and are advised to exercise caution. If in doubt, ask your doctor.
are grommets removed?
Grommets will usually
fall out of their own accord after a number of months and the child will not
even be aware that this has happened. If they do not fall out spontaneously
within 18 months, they will be removed by the ENT surgeon in a simple and painless
The tiny hole left
in the eardrum after the removal of grommets will then heal itself.
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