Ear Nose & Throat Sydney
Dr  Narinder Singh  MBBS (Syd) FRACS (ORL-HNS) - Consultant ENT Specialist Surgeon - Clinical Lecturer University of Sydney
Ear Nose & Throat Sydney, Dr Narinder Singh
Ear Nose & Throat Sydney, Dr Narinder Singh Ear Nose & Throat Sydney, Dr Narinder Singh
 
Ear Nose Throat

Children

Grommets

What are Grommets?

Grommets are small plastic tubes that are inserted into your child's eardrums. They are also called "Tympanostomy tubes".

What are Grommets used for in Children?

Grommets are used to treat 2 conditions in children:

  • Recurrent Acute Otitis Media (RAOM)
  • Glue ear

What is "Acute Otitis Media" (AOM)?

Acute Otitis Media (AOM) is an infection of the "Middle ear". The infection usually begins with a cold or flu which spreads into the middle ear. The middle ear is the space behind the eardrum. Normally this space contains air and the 3 small bones of hearing. When the middle ear becomes infected, this space fills up with fluid and pus.

It is normal for most children to have at least 1 infection of the middle ear when growing up. Typically, this occurs between the age of 6 months and 2 years.

What is "Recurrent Acute Otitis Media" (RAOM)?

RAOM means repeated infections of the "middle ear".

More than 3 infections in a 6 month period is defined as RAOM

Is RAOM bad?

RAOM can cause the following problems:

  • Persistent fluid in the ears can reduce your child's hearing, which may affect speech and learning.
  • Persistent fluid may temporarily affect your child's balance and co-ordination.
  • Repeated infections can cause damage to the ear drums.
  • Repeated infections often require multiple courses of antibiotics.

How is RAOM diagnosed?

See your GP if you think your child has RAOM. Your GP will ask about your child's symptoms and examine your child's ears. Infection of the middle ear can be seen as thick fluid and pus behind the ear drum. If the infection is severe, the eardrum may burst and discharge pus from the ears.

How is RAOM treated?

See your GP if you think your child has RAOM. Treatment options include:

  • Do nothing: If the symptoms are not severe, treatment may not be necessary
  • Long term antibiotics: These may eventually clear the repeated infections
  • Non-surgical measures:You can try the non-surgical measures listed below. There is not much scientific evidence that these measures work well, but it may be worth trying them
  • Referral to Dr Singh: for insertion of grommets

What do grommets do in RAOM?

A Grommet creates a small opening in the eardrum. This allows fluid, pus and infection in the middle ear to drain out so that the ear can return to normal.

How are grommets inserted?

Grommets are inserted while your child is asleep under a general anaesthetic. The grommets are inserted through the ear canal - there are no cuts made on the outside.

Where is the operation performed?

In the interests of your child's safety, Dr Singh performs children's grommet insertion at Westmead Private Hospital and Hospital for Specialist Surgery. Westmead Private Hospital is one of Australia's leading private hospitals. It is part of the Westmead healthcare campus, the largest Hospital complex in the Southern Hemisphere. Westmead Private Hospital is also affiliated with the University of Sydney Faculty of Medicine, Australia's oldest and largest Medical School.

Are there any alternatives to surgery?

Yes. Grommet insertion is an "Elective" procedure, meaning it is your choice to have the operation performed. Alternatives to surgery include:

  • Do nothing: Your child may keep getting problems related to the ears.
  • Long-term antibiotics: Sometimes, a long course of antibiotics for many weeks or months may reduce the risk of ear infections.
  • Non-surgical measures: There is not much scientific evidence that these measures work well, but it may be worth trying them. Techniques include:
    • Steam inhalation
    • Swallowing hard
    • The "Otovent" device

Are there any risks to surgery?

Yes. Everything we do in life has risks. Even something as simple as crossing the street has risks... but we still cross the street. Dr Singh will explain the risks of your child's operation and provide you with an information pamphlet that explains the risks in detail. If you have any questions about risks, ask Dr Singh during your consultation.

What should I do next?

See your GP if you think your child has ear problems (repeated ear infections, discharge from the ears, reduced hearing, poor speech development, poor co-ordination - bumping into things and falling over). Ask your GP for a referral to see Dr Singh and call us for an appointment.

What is "Glue ear"

After an infection of the middle ears, your child will be left with fluid in the ears. In most cases, this drains away by itself within 3 months of the infection. If the fluid is still present after 3 months, it is called "Glue ear". After 3 months the fluid is very thick and sticky - like glue.

Is Glue Ear bad?

Glue ear can cause the following problems:

  1. Glue ear can reduce your child's hearing, which may affect speech and learning.
  2. Glue ear may temporarily affect your child's balance and co-ordination.

How is Glue Ear diagnosed?

See your GP if you think your child has Glue Ear. Your GP will ask about your child's symptoms and examine your child's ears. Glue Ear can be seen as thick fluid behind the ear drum and reduced ear drum movement.

How is Glue Ear treated?

See your GP if you think your child has Glue Ear. Treatment options include:

  • Long term antibiotics: These may eventually clear the fluid
  • Short term steroid medications: These may clear the fluid
  • Non-surgical measures: You can try the non-surgical measures listed below. There is not much scientific evidence that these measures work well, but it may be worth trying them
  • Referral to Dr Singh: for insertion of grommets

What do grommets do in Glue Ear?

Grommets create a small opening in the eardrums. This allows the glue-like fluid in the middle ears to be cleaned out so that the ears can return to normal.

How are grommets inserted?

Grommets are inserted while your child is asleep under a general anaesthetic. The grommets are inserted through the ear canal - there are no cuts made on the outside.

Where is the operation performed?

In the interests of your child's safety, Dr Singh performs children's grommet insertion at Westmead Private Hospital and Hospital for Specialist Surgery. Westmead Private Hospital is one of Australia's leading private hospitals. It is part of the Westmead healthcare campus, the largest Hospital complex in the Southern Hemisphere. Westmead Private Hospital is also affiliated with the University of Sydney Faculty of Medicine, Australia's oldest and largest Medical School.

Are there any alternatives to surgery?

Yes. Grommet insertion is an "Elective" procedure, meaning it is your choice to have the operation performed. Alternatives to surgery include:

  • Do nothing: Your child may keep getting problems related to the ears.
  • Long-term antibiotics: Sometimes, a long course of antibiotics for many weeks or months may clear the fluid
  • Short term steroid medications: These may clear the fluid
  • Non-surgical measures: There is not much scientific evidence that these measures work well, but it may be worth trying them. Techniques include:
    • Swallowing hard
    • The "Otovent" device
    • Hearing aids

Are there any risks to surgery?

Yes. Everything we do in life has risks. Even something as simple as crossing the street has risks... but we still cross the street. Dr Singh will explain the risks of your child's operation and provide you with an information pamphlet that explains the risks in detail. If you have any questions about risks, ask Dr Singh during your consultation.

What should I do next?

See your GP if you think your child has ear problems (repeated ear infections, discharge from the ears, reduced hearing, poor speech development, poor co-ordination - bumping into things and falling over). Ask your GP for a referral to see Dr Singh and call us for an appointment.

DISCLAIMER: The material on this page represents general information only and is NOT medical advice. For specific medical advice about your individual circumstances you must consult a trained medical practitioner. Always see your GP first. If your GP is unable to fix your child's ear problem, ask your GP for a referral to Dr Singh. Dr Singh always works together with you and your GP to achieve your best health outcome. IMPORTANT: Do not try to diagnose your medical problem by yourself! Do not rely solely on information found on the internet. Always see your GP first.



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