Ear Infections and Ear Grommets

How the ear works

The middle ear is connected to the nose by the passage called the Eustachian tube
The Eustachian tube does two things:
- It helps to maintain an equal pressure inside and outside the middle ear, which allows the eardrum to work effectively
- It allows the fluid from the middle ear to drain away to the nose
The passage opens to allow the pressure to equalise in the middle ear space – this causes the click or popping noise which you can hear as the tube opens
Ear infections are common in children because of Eustachian tube blockage
In children the Eustachian tube is narrow and is easily blocked – which can lead to ear infection

Ear infections are very common in children
One out of every three primary school age children will have some form of middle ear condition – often with reduced hearing
Infection of the middle ear is the most common cause of temporary hearing loss in children
Middle ear infection is also known as otitis media or glue ear
Ear infections in children may be short term (acute ear infection) – or a longer term problem (chronic ear infection)

If the Eustachian tube is not working properly or is blocked the pressure in the middle ear drops – this causes fluid to collect in the middle ear and the ear drum to draw in (ear drum retraction)
Over time the fluid becomes thicker – leading to the name ‘glue ear’’

When the middle ear does not work well, the structures in the ear become blocked and less able to carry sound to the inner ear
This is called conductive hearing loss because the sound is prevented from being properly conducted through the middle ear to the inner ear and nerve of hearing
Middle ear infection causes a partial hearing loss and if treated quickly and successfully, the hearing nearly always returns to normal or near normal

In the early stages a conservative approach might be effective, with an antibiotic and nasal decongestant
When the ear infection is long-standing or recurrent, then a surgical procedure may be needed to place an ear tube (grommet) to re-ventilate the middle ear space

A grommet is a tiny Teflon tube placed across the ear drum to allow air to enter the middle ear
The grommet does the work of the Eustachian tube – giving the middle ear a chance to recover and work properly
Grommets are placed as a day surgery procedure and cause no discomfort

Fluid may drain from the ear following insertion of grommets
Water precautions may be needed – if the water is clean there are usually no problems
Jumping and diving into water is best avoided unless earplugs and a swim cap are worn
Usually the presence of grommets causes no pain and ear pain is one of the first signs of infection – another sign of infection is drainage from the ear
- If this occurs concerns you should visit your local doctor who will contact your surgeon
- Begin Ciloxan ear drops – 3 drops / 2 times a day and arrange to see your ENT specialist for an ear check
Do not use cotton buds to clean the ear canal or remove wax