Hearing Improvement Following Ventilation Tube (Grommet) Insertion in Children with Otitis Media with Effusion

Background: Otitis media with effusion (OME) is among the most prevalent childhood conditions, characterized by the accumulation of fluid within the middle ear cleft in the absence of acute infectious signs. The resultant conductive hearing loss, though often transient, may compromise speech, language, and cognitive development during critical developmental periods. Ventilation tube (grommet) insertion remains the most widely performed surgical intervention for persistent OME associated with hearing impairment; however, the magnitude and durability of audiometric improvement following grommet placement across different age groups and OME laterality patterns warrant further prospective evaluation. Methods: This prospective interventional study enrolled 180 children (312 ears) aged 2–12 years with bilateral or unilateral OME persisting for ≥3 months, who underwent grommet insertion at a tertiary otolaryngology center from February 2022 to January 2024. Pure-tone audiometry and tympanometry were performed preoperatively and at 2 weeks, 3 months, 6 months, and 12 months postoperatively. The primary outcome was change in pure-tone average (PTA) hearing threshold. Results: The mean preoperative PTA was 34.82 ± 8.47 dB HL, which improved significantly to 16.43 ± 5.21 dB HL at 2 weeks (p < 0.001), 14.87 ± 4.96 dB HL at 3 months (p < 0.001), 15.52 ± 5.38 dB HL at 6 months (p < 0.001), and 18.74 ± 6.83 dB HL at 12 months (p < 0.001). Hearing returned to normal thresholds (≤20 dB HL) in 82.4% of ears at 3 months. Younger age (<5 years), bilateral OME, and mucoid effusion type were associated with slightly less favorable audiometric recovery at 12 months. Tympanosclerosis was observed in 28.2% of operated ears, and post-tube otorrhea occurred in 11.5%. Conclusion: Grommet insertion produces a significant and rapid hearing improvement in children with chronic OME, with maximum benefit observed within the first 3 months. Audiometric gains diminish gradually by 12 months, paralleling natural tube extrusion. Younger children and those with bilateral mucoid effusion warrant close audiological follow-up.