Treating Ear Discharge after Grommet Insertion

It is not uncommon for children who have had grommets inserted to experience some discharge from the ears at some stage. The main reason to put grommets in is to ventilate the ear (to get air into the middle ear) and prevent infections and/or build-up of fluid in the middle ear – but a secondary benefit is that the grommets can allow any build-up of fluid to drain out of the middle ear into the ear canal.

Often a child is not bothered by their discharging ears. In fact if a child is unwell with a fever, this is often not directly related to the ear discharge but rather is more likely to be related to the underlying viral or bacterial infection of the nose and/or throat (which is then subsequently leading to the ear discharge). If your child is generally unwell, seek a review with your GP.

The discharge can have different consistencies (watery, mucousy, thick pus) and different colours (clear, milky, green, even blood-stained). Don’t be alarmed if the discharge has blood present – this is often due to a small area of irritation next to the grommet that has developed in response to the discharge. This area of irritation is incredibly rich with numerous blood vessels and so can bleed easily. It usually settles with the treatment described below.

At times, the discharge can irritate the skin leading to crustiness at the entrance of the ear canal. This settles as the discharge resolves.

The treatment of choice is to use topical Antibiotic-Steroid ear drops called Ciproxin HC. A prescription is required for these drops. The antibiotic in these ear drops target most of the bacteria present in ear discharge, and they are perfectly safe to use. The recommended dose is 3 drops to the discharging ear, twice a day, for 7 days.

The effectiveness of the drops can be improved by mopping up any secretions in the ear canal using rolled up tissues, and repeating this until the ear canal is relatively clear. Then, if possible, have the child lie on their side with the affected ear upward, and place the drops into the ear canal. A parent can rub or massage the little pointed flap of cartilage in front of the ear canal (the Tragus) back over the opening of the ear canal to “pump” the drops into the deeper part of the ear canal. These strategies improve the penetration of the drops through the grommet and into the middle ear.

Any water getting into the ear will prolong the ear discharge. So it is best to avoid swimming until the ear has dried up. A cotton wool ball coated with Vaseline can be used as a temporary ear plug while your child is having a bath or shower, disposing of this once the wash has been completed.

In summary, if there is discharge from an ear which has a grommet in place then

• Clear the discharge with rolled up tissues
• Treat the discharge with Ciproxin HC ear drops (3 drops twice a day for 7 days)
• Pump the drops deep into the ear canal by massaging the Tragus over the ear canal
• Avoid water entering the ear canal until the discharge has resolved

If the discharge persists despite the above treatment, then contact us for a review appointment so we can consider further treatment.

Note that this advice applies only to ear discharge from grommets. You should not hesitate to seek medical attention from your closest Emergency Department if there is any discharge from the ear following trauma to the ear or head.