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  • Q&A with Australian Health Practitioners

    Should I get grommets for my child or grommets and adenoidectomy?

    Related Topics
    Ear, Nose & Throat Disorders Hearing Loss & Deafness Parenting
    My 14 month old has had 6-7 ear infections in last 6 months.

    After 4 different antibiotics, he has been on bacterium for 10 weeks (every time it's stopped ear infection within a week). Failed hearing tests and has intermittent balance issues.

    He has a constant runny nose (often clear) and excessive saliva since birth.

    History of reflux and allergies

    Rarely has fever or systemic response with ear infection, but screaming +++ and many all nighters.

    Should I go with conservative management and start with grommets or is he a candidate for grommets and adenoidectomy first up?

    Have seen a great ENT who asked me what I want to do.
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  • 3

    Thanks

    Dr David McIntosh

    Ear Nose and Throat (ENT) Surgeon

    David McIntosh is an Australian trained ENT surgeon with international experience. His areas of interest are paediatrics, nose and sinus disease, and providing access to … View Profile

    Just like I know nothing about cars and rely on someone who knows about them to make sure my car works safely, so too should you feel confident in the guidance provided by a specialist in paediatric ENT. take on board the advice you have been given, and feel free to look over the information at our website www.entspecialists.com.au

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    Thanks

    A/Prof Faruque Riffat

    Ear Nose and Throat (ENT) Surgeon

    The history of recurrent otitis media with poor response to antibiotics in the frequency you describe would certainly meet the criteria for recommendation of insertion of ventilation tubes (grommets). The others would be persistent fluid (effusion) in the middle ear, any significant complication of otitis media (mastoiditis, recurrent discharge) or structural abnormalities of the ear drum.

    Adenoidectomy does improve eustachian tube function, but also reduces the bacterial biofilm (slime) that resides in the nasopharynx (chamber at the back of nose where the eusthachian tube opens) to reduce the rates of glue ear, recurrent otitis media and recurrence after grommets extrude.

    There is no evidence for tonsillectomy in reducing otitis media.

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