Paediatric ENT
Grommets
What are Grommets?
Grommets or “Ventilation Tubes” are tiny hollow tubes inserted into the ear
drum. They allow air back into the middle ear, allowing the eardrum to
vibrate. They are a temporary solution whilst we wait for the middle ear’s own drainage system, the Eustachian Tube, to mature. Grommets last
around 6-18 months and are eventually “pushed” out of the ear drum and ear canal by the normal cleaning mechanisms in the ear.
Who benefits from Grommets?
The greatest benefit is for children who have glue ear, affecting both of their ears lasting for more than 3 months and causing a hearing loss of more than 30dB. They are also recommended in children suffering from more than 5 middle ear infections per year. Occasionally they are recommended for adults who have fluid in the middle ear.
How are they inserted?
In children they are generally inserted under a day stay general anaesthetic. A small cut is made in the eardrum under the microscope and any fluid is sucked out. The grommets are then inserted. Children can go home around 2-4 hours after their surgery.
Is there anything to watch out for after surgery?
Grommet insertion is not generally painful – paracetomol or ibuprofen
for the first 24 hrs should suffice. You should contact us if there is a lot
of pain after the operation.
Ear Discharge – small amounts of watery and bloodstained discharge are normal for the first 3 days. (If there is a lot of discharge, it is smelly, or green, or if there is blood that trickles from the ear, contact us and we will advise).
Ear Drops – antibiotic drops are placed in the ear canal at the time of operation. If the ear is very infected Dr McGuinness will prescribe a further course of eardrops.
Keep the Ears Dry – you need to be careful of water getting in the ears. For the first 2 weeks we advise protecting the ears with cotton wool when bathing or showering.
Are there any complications?
For most children grommet insertion is a very minor routine procedure. Complications can occur but these are generally quite minor. Although we expect that grommets last for around 6-18 months, in some children they fall out before this. This may mean that another set of grommets may need to be inserted.
Some children with grommets can get persistent infections due to infection of the grommet material itself. Rarely this can mean another procedure to remove the grommets. Once the grommets fall out, the eardrum usually repairs itself very quickly. Sometimes this doesn’t happen and the child is left with a perforated eardrum. In some people this needs a second operation to repair, usually when the child is older.
What about swimming?
Children with grommets can still swim but it is a good idea to try and prevent water entering the middle ear. Here at My ENT Specialist we generally recommend using earplugs and a neoprene headband when swimming with grommets.
How do we tell if grommets are working?
Most parents notice fairly immediate changes in their children’s hearing after grommet insertion. The best way to tell how well grommets are working is with an audiogram (hearing test) performed 3-6 months after surgery.
After your child’s surgery
Discomfort – grommet insertion is not generally painful – Panadol or Nurofen for the first 24hrs should suffice. You should contact us if there is a lot of pain after the operation.
Ear Discharge – small amounts of watery and bloodstained discharge are normal for the first 3 days. (If there is a lot of discharge, it is smelly, or green, or if there is blood that trickles from the ear, contact us and we will advise.
Ear Drops – antibiotic drops are placed in the ear canal at the time of operation. If the ear is very infected Dr McGuinness will prescribe a further course of eardrops.
Keep the Ears Dry – you need to be careful of water getting in the ears. For the first 2 weeks we advise protecting the ears with cotton wool when bathing or showering.
- Swimming - Your child should not swim for 2 weeks after the surgery. Children with grommets can swim after this, but we would advise protecting the ears with earplugs and a headband or a swimming cap.
- Ear Infections - children with grommets can still get ear infections especially if dirty water gets into the ears or if they have a cold. These infections are not usually painful and your child will not feel unwell. The best way to treat them is often with eardrops such as Ciloxan, rather than with oral antibiotics.
Post operative appointments
You will receive a call from our nurse around 3 days after discharge and an appointment will be made for 3-4 weeks after surgery.