Patients having deafness due to secretion collected in the ears need treatment by medications first and if that fail need surgical removal and insertion of a ventilating tube called grommet or T tube. Grommets and T-tubes are tiny tubes, which are inserted into the eardrum. The grommets are like button made of silastic or Teflon material and is non irritant to the body. They allow air to pass through the eardrum, which keeps the air pressure on either side equal. The surgeon makes a tiny incision in the ear drum (called a myringotomy), fluid is suctioned out, and a tube is placed.
T tube is a long-shafted tube has a large T-shaped inner flange that keeps it in place for a relatively longer time than ordinary grommet.
Grommets usually stay in place for six to twelve months and then fall out, but T tube remains much longer period and should be removed unlike grommet which falls out by itself. Since fluid is usually removed at tube placement, hearing is immediately restored.
Antibiotic ear drops are prescribed post op. In young children, this is usually done under a light general anesthesia, although there are some other options that are occasionally used. Older patients may tolerate the procedure under local anesthesia.The hole can be created with a laser, as well.
Types of Grommets
There are many designs ,varying in shape, color, and composition. In general, smaller tubes stay in for a shorter duration, while large inner flanges hold the tube in place for a longer time.
How long do the tubes stay in?
The duration of tube retention is related several factors especially tube design. For the average child, we usually recommend a tube that stays in, on average, about 8-12 months. In certain situations, such as children having multiple sets of tubes, cleft palate patients who may need tubes for a longer time, or other patients with chronic eustachian tube dysfunction, we may place longer acting tubes…such as a T-tube.
Do the tubes have to be removed?
Over 90% of the time, the tubes extrude spontaneously. If the tube is staying in for several years, or if the tube is causing infections, the tube may be removed. Depending on the patient, this require general anesthesia.
Grommets and Swimming
This is controversial and many ear doctors still recommend all sorts of water precautions or ear plug use. I recommend it is better use while swimming.