Otorrhoea in a child with tympanostomy tubes

What it is

A tympanostomy tube, the grommet, is placed at myringotomy: an incision created in the tympanic membrane to relieve the pressure caused by an excessive buildup of fluid, or to drain the middle ear. The tube may remain for 12 months. Otorrhea through the tube, written as TT otorrhea, is one of the listed complications of having it.

Causes and risk

The tube is inserted for:

• Chronic otitis media with effusion together with a hearing deficit.
• Recurrent otitis media despite antimicrobial prophylaxis, meaning 3 in 6 months or 4 in 1 year.
• An intracranial complication such as meningitis or mastoiditis.
• Persistent Eustachian tube dysfunction.
• Barotrauma.

A discharging ear in a child has other causes besides the tube. Acute otitis media gives otorrhea once the tympanic membrane is perforated. Chronic suppurative otitis media is chronic inflammation of the middle ear with tympanic membrane perforation and otorrhea lasting at least 2 weeks. Cholesteatoma gives a foul smelling unilateral otorrhea. Mastoiditis gives otorrhea with tenderness to pressure over the mastoid and a retroauricular swelling with a protruding ear, and fever and hearing loss with it.