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Grommets (tympanic tubes) yes or no?

Question
Hello,
Our 4-year-old daughter suffers from CF!
She has an impairment of hearing caused by mucus behind the ear (probably due to a precedent otitis media)!
At first, we were told to wait and have a control after 3 months, if the finding will not improve: grommets….
Now we have 2 opinions, one physician says, no grommets in case of CF because of bacteria and the other physician says, this would totally be nonsense – if necessary grommets have to be put in.
What is your opinion about this?
Many thanks.
Answer
Dear parents of a 4-year-old CF patient,
Foreign bodies made of synthetic material and of other materials are used from bacteria as a surface to adhere. They produce biofilms there and can only hardly be removed, as long as the foreign body is in place. Therefore also the chronic colonization of patients with tracheal cannulas with Pseudomonas aeruginosa is typical (tracheal cannulas are cannulas made of synthetic material, that are placed in case of long-term ventilated patients below the larynx into the trachea and the patients are ventilated via those cannulas).
In case of CF, there is correspondingly the special risk, that biofilms with germs like Pseudomonas adhere to grommets and the germ can from here also colonize the airways chronically.
Therefore, we are glad, if no grommets are placed in case of CF. If it cannot be avoided at all, the additional performance of swabs of the ear is sensible for microbiological investigation.
A paracentesis can be more sensible. Here, the ENT specialist punctures the ear drum with a fine lancet, so that secretion behind the ear drum can drain itself. The ear drum closes itself within a short period of time and there is no foreign body in the ear, with the risk of colonization with Pseudomonas.
Best regards,
PD Dr. Jochen Mainz
06.10.2014