So, your child, or on the off chance you, has glue ear. The doctor has recommended putting a grommet in there through surgery. By now, you probably know what a grommet looks like. The idea of inserting a pipe in your ear sounds scary enough as it is. Thankfully, risks specific to grommet surgeries are relatively minor.
Let’s learn about these minor risks before heading to the operation theatre-
Every surgery carries risks such as infections, bleeding, and reaction to anaesthetics. Grommet surgery is no different. Some common complications include-
The grommets may occasionally get blocked. The doctors usually use ear drops to clear them out and get them working again. But sometimes the grommets are too dysfunctional to be cleared. In this case, the damaged grommets are replaced with new, non-blocked grommets.
If pus is present in the middle ear at the time of surgery, there is a risk of infections after the surgery. Because of this possibility, medication may be given to reduce the risk of infection. In the first several days after surgery, the ear should have only a small amount of clear or blood-tinged discharge with the grommet in its place. If discharge happens later, visit a doctor for treatment because it could indicate the presence of an ear infection.
Do not use over-the-counter eardrops you’ve looked up on the internet. Because, if not administered as prescribed by your surgeon, some eardrops can cause damage to the middle ear or inner ear.
The grommet creates a small hole that does not heal after the grommet is removed – this can happen in roughly 2 out of every 100 children. The hole can function as a grommet, ventilating the middle ear and preventing infection and fluid build-up. It’s common for parents to wait for their children to grow out of their ear issues.
A minor hearing loss and intermittent discharge may occur (depending on the size of the hole). When the child is older, usually around the age of 8-10 years, a procedure to close the hole (myringoplasty) may be required – this operation is successful in 9 out of 10 children.
An ear discharge due to infection may develop at any time. This may occur after a cold, exposure to soapy water, or swimming. This is usually not serious and typically clears quickly with treatment. If the discharge does not respond to treatment by your specialist, the grommet may need to be removed.
Tissue around the grommet may become persistently infected, causing polyp formation and bleeding. Antibiotic ear drops may be prescribed. The grommet may have to be removed.
In about 95 patients in 100, the grommet slowly drifts outwards along the ear canal after rejection by the healing eardrum. This usually occurs between 6 and 18 months after the surgery.
However, occasionally the grommet is retained in the eardrum, and a second operation is needed to remove it. Removal of a retained grommet is usually not done until a few years after insertion.
This occasionally occurs and may require reinsertion of the grommet. Thinning of the eardrum at the site of grommet insertion can occur but usually does not cause a problem.
However, a thin eardrum may be more easily perforated when under stress, for example, during underwater swimming and diving.
Calcium deposits and scarring (tympanosclerosis) of the eardrum can occur due to glue ear, recurrent otitis media, or grommets. Tympanosclerosis usually does not affect hearing. But you should consult a doctor if the condition gets out of hand.
Rarely the grommet may fall into the middle ear. If the hole in the eardrum heals and the patient has no symptoms, there may be no need to remove the grommet. In rare cases, another operation might be needed to remove the grommet.
The condition may recur after the grommet comes out because the cause (such as a poorly functioning Eustachian tube) has not been resolved. About 20 to 30 of every 100 patients may need a grommet inserted again. A few children require numerous placements of grommets until the condition clears completely. By about 10, most children grow out of ear problems.
Repeated grommet placement may cause thinning of a part of the eardrum, leading to an increased risk of a hole in the drum when the grommet falls out. This may require surgery.
Although general anaesthetic has significant risks, major problems are uncommon.
Serious complications are infrequent under modern anaesthetic. Although no risk can be totally eliminated – advances in technology, training, and medications have made general anaesthesia a substantially safer technique in recent years – A person is at least 100 times more likely to suffer significant injury or death in a traffic accident than as a result of anaesthetic during their life.
After their operation and anaesthesia, most youngsters recover quickly and return to their daily routine. Some children may experience unpleasant side effects such as nausea or a sore throat. These normally only last a few days, and medications are available to alleviate them if necessary. The possibility of complications varies depending on your child’s medical condition and other factors.
The risk of problems varies depending on your child’s medical condition and the type of operation and anaesthetic they require. Before the procedure, the anaesthetist can go through everything with you in detail.
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Dr Ronald Chin is an Australian trained Otolaryngologist Head and Neck Surgeon.
After graduating as a Fellow of the Royal Australasian College of Surgeons, Dr Chin undertook further specialized training in Head and Neck Cancer at the Royal College of Surgeons in Ireland.
He has published many research papers and is an active teacher and scholar.
As part of his sub-specialty training, Dr Chin has training in Laser, Da Vinci Robotic, Flex Robotic and complex surgical techniques.
In addition to specialized Head and Neck Cancer, Dr Chin also enjoys general adult and paediatric ENT Surgery and practices sinus, snoring/sleep and general paediatric ENT Surgical procedures.
Dr Ronald Chin
Conjoint Associate Professor
Otolaryngology Head and Neck Surgery
Western Sydney University