Paediatric ENT Specialist Adelaide - Grommets and Water
Grommets and Water
The hole in most grommets is a tiny 1.14 mm and this allows air into the middle ear to restore the lining of the ear back to health. It can also permit water into the middle ear which may lead to an infection. In most cases, the surface tension of water prevents it from penetrating into the middle ear. However, there are two situations where water may enter through the grommet – firstly, when the water is soapy (because soap breaks surface tension) and secondly, where there is increased water pressure that may push water through the grommet.
Bath water is perhaps the worst fluid that you can expose ears with grommets to – it is soapy (and so enters the middle ear through open grommets more easily) and is by nature dirty. When having a bath, the bacteria count in bath water can become quite high. Soap and shampoo can be irritating so it is also best to protect the ears from this irritation.
The ears can be protected from bath water by placing cotton wool smeared in Vaseline into the entrance of the ear canal, disposing of this after the bath is complete. This should be continued until the grommets have fallen out and the ear drums have healed. Alternatively, you can use ear plugs as mentioned below.
If your child refuses any protection of their ears when in the bath, then either use fresh tap water rather than bath water when washing their hair or use a shower.
I would recommend avoiding swimming completely for a few weeks while the ear drum heals around the grommet following surgery.
Because of surface tension, it actually takes a great deal of pressure to force non-soapy water through grommets. This is unlikely to occur with surface swimming or shallow diving.
After a few weeks, surface swimming in the sea or in a swimming pool is usually safe. Nevertheless there are a small percentage of children who will develop recurrent infections, and because of this I would encourage all children and adults with grommets to wear ear plugs and a head wrap / swimming cap whenever swimming. These can be purchased from most pharmacies, sports stores, or large swimming centres. Some health funds will reimburse part of the cost of these.
Ear plugs should be placed in the outer ear to block the ear canal, but not directly into the canal itself. Avoid the use of substances such as Blu-Tack.
If your child repeatedly resists using earplugs, then they may continue with swimming lessons without the earplugs. Be on the lookout for pain after swimming or ear discharge. If this occurs, it can usually be treated with antibiotic ear drops.
Diving with grommets is to be avoided – the increased pressure can force water through the grommet into the middle ear resulting in pain and infection.
Swimming in waterholes is also to be avoided. Because the water is relatively still, bacterial counts can be quite high and this can result in a serious infection if this water passes through the grommet.
If you or your child has problems with discharge from the ears while grommets are in position, or any other problems, always feel free to contact the rooms for an earlier appointment.