Hello,

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Your are suffering from recurrent ear infection, you had multiple ear surgeries including grommet (tympanostomy tube) insertion.
At present you have ear pain, tinnitus, ear discharge, hearing loss(ear block)
To understand your problem you should know about normal ear structure and function.

• Middle part of ear behind the ear drum(tympanic membrane) is an air filled space. And this space is connected with nose though a tube (eustachean tube ).
• So if this tube gets blocked (mostly due to recurrent cold in childhood), it causes a negative pressure in middle ear and causes hyper activity of glands in middle ear causes accumulation of fluid in middle ear, causes blocking sensation or decrease in hearing.
• To maintain the middle ear aeration , this tympanotomy tube is inserted in ear drum
• But when it getS infected then it will cause ear discharge, pain, tinnitus and hearing loss as in your case.

• So the treatment I would recommend, kindly discuss the same with your local physician:
o For your ear infection we can start Ciprofloxacin ear drops 3 drops three times daily for 5 days
o For better eustachean function we can start antihistamine medication including Tab.Levocetrizine 5 mg once daily for 15 days.
o Once ear discharge, pain improves, you can plan for surgery including removal of grommet and repair of ear drum(tympanoplasty)
o Before surgery you should do one hearing test (audiogram), so we will know base line hearing and can predict the hearing improvement following surgery.

Answers for your questions:

1. Eustachean tube itself causes some hearing loss but it minimise the tympanic membrane vibration( but you have fluid behind tympanic memb, by putting this tube we drain fluid and hearing improves as in your case, it is done several times).

2.Removal of tube and patching up ear drum will be best option. Only thing we have to maintain the eustachean tube function, for that you may require long term antihistamine medicine (may be for 3 weeks).

Hope this helps. Feel free to ask if you have any further queries.
Thank you.
Regards
Dr. Sunil Jalan
MBBS, DLO,MS(ENT), DNB,DAA


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