Grommets and Children's Hearing Aids - ask the expert.

My son is 12 and has had grommets for the last three years. One fell out, and his hearing was normal in that ear for a while. But we have been back to the hospital today and his hearing in that ear is below normal again and the other ear still has no improvement. We have been told that if the next lot of grommets do not work he will need  children's hearing aids! Is there anything else that can be done to prevent this?

Grommets are used to aerate the middle ear, and prevent fluid building up. A grommet itself is basically a small tube that's inserted into the ear drum. Lots of children need them - in fact insertion of grommets is one of the most common children's operations.

They are usually needed because a child has suffered from frequent ear infections or has persistent middle ear fluid, which is causing hearing loss.

Inserting grommets

Inserting a grommet usually results in an improvement in hearing. But the grommets only have this beneficial effect when they are in place. They are designed to come out of their own accord within six to 12 months of the operation. In fact they're only a stop-gap measure while the child matures and the natural mechanisms that aerate the middle ear (the Eustachian tube) become efficient. For most children, this natural mechanism usually matures by the time they reach puberty, but a small proportion will have persistent problems with their ears even into adulthood.

Each time a grommet is inserted, there's a certain degree of scarring of the ear drum. For this reason, repeated sets of grommets should be viewed with caution.

Looking forward

If hearing loss is causing significant problems, one of the alternatives is children's hearing aids as you have been advised. But these would only usually be considered if the hearing loss was having a significant effect on your son either in terms of his education, or his development.