A Cochrane review «Grommets (ventilation tubes) for hearing loss associated with otitis media with effusion in children»1 «Browning GG, Rovers MM, Williamson I, Lous J, Burton MJ. Grommets (ventilation tubes) for hearing loss associated with otitis media with effusion in children. Cochrane Database Syst Rev 2010;(10):CD00»1 included 10 studies with a total of 1 728 subjects. Grommets were mainly beneficial in the first 6 months by which time natural resolution lead to improved hearing in the non-surgically treated children also. Only one high quality trial that randomised children (n=211) reported results at 3 months; the mean hearing level was 12 dB better (95% CI 10 to 14 dB) in those treated with grommets as compared to the controls. Meta-analyses of 3 high quality trials (n=523) showed a benefit of 4 dB (95% CI 2 to 6 dB) at 6 to 9 months. At 12 and 18 months follow up no differences in mean hearing levels were found. Data from 3 trials that randomised ears (n=230 ears) showed similar effects to the trials that randomised children. At 4 to 6 months mean hearing level was 10 dB better in the grommet ear (95% CI 5 to 16 dB), and at 7 to 12 months and 18 to 24 months was 6 dB (95% CI 2 to 10 dB) and 5 dB (95% CI 3 to 8 dB) better. No effect was found on language or speech development or for behaviour, cognitive or quality of life outcomes.
Tympanosclerosis was seen in about a third of ears that received grommets. Otorrhoea was common in infants, but in older children (3 to 7 years) occurred in < 2% of grommet ears over two years of follow up.