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Grommets (tympanic tubes) in case of CF

Hello Dr. Mainz,
3 months ago, grommets have been placed in both ears of our son, as he had an impairment of hearing. As one of those grommets got out of place now, another one should be placed in 2 weeks. We read your answer that tympanic tubes are not favorable in case of CF. What should we do now? In the CF center, this was not communicated.
Dear family,
in general, many things in life are in an area that cannot be judged clearly to be right or wrong.
If it is not absolutely necessary, we recommend to refrain from tympanic tubes in case of illnesses like CF or PCD (primary ciliary dyskinesia, in the airways similar to CF with impaired self-clearing of the airways) because, as described, biofilms can stick to foreign bodies (here the tympanic tube) - also with Pseudomonas aeruginosa.
If the clinical complaints are so strong, that there is a severe impairment of hearing, it has to be weighed - in the single case tympanic tubes can hardly be avoided. In case of CF or PCD it is sensible to do also swabs in the ear for microbiological investigations, in order to detect a colonization with problematic germs early and to treat it sucessfully. We are glad, if the grommets are not necessary anymore in the course of time.
In the single case, a paracentesis can also be sufficient, in order to relieve; that means, the tympanic membrane is only opened with a little cut in order to get relief and to let the effusion flow off. This little cut is closing in general alone within a short time frame. Partly this is also the case after putting in of grommets and an early loss. In case of very severe problems, the effusion does always reoccur, so that one can hardly relieve without tympanic tubes (or via another placing).
Please excuse my delayed answer,
Best regards,
Dr. J. Mainz