What are grommets? They are very small plastic tubes, which sit in a hole in the eardrum. They let air get in and out of the ear, which keeps it healthy.
Why do we use grommets? Some people get fluid behind the eardrum. This is sometimes called ‘glue ear’ and is very common in young children, but it can occur in adults too. We don’t know exactly what causes glue ear. Most young children will have glue ear at some time, but it doesn’t always cause problems.
We only need to treat it if it affects hearing or speech, or it causes lots of ear infections.
How are grommets inserted? They are inserted in the eardrum under a light general anaesthetic usually as a day case admission to hospital. The procedure takes between ten and twenty minutes.
It is carried out in the ear canal so there are no cuts on the outside of the ear. A small opening is made in the eardrum using a microscope to magnify the area and the fluid is sucked out of the ear using a fine sucker. The grommet is then placed in the opening in the eardrum.
How long do grommets stay in for? They fall out by themselves as the eardrum is constantly growing. They may stay in for six months, or a year, or sometimes even longer in older children. You may not even notice when they drop out.
Does my child have to have grommets? Glue ear usually gets better by itself, but it can take a while.
It is good practice not to treat the child for the first three months, because about 50% will get better in this time. After three months, we will see your child again and decide whether grommets are needed.
If the glue ear is not causing any problems, we can just wait for it to settle by itself. If it is causing problems with poor hearing, poor speech or lots of infections, we will probably advise grommets.
If we do insert grommets, glue ear may come back in 1 in 3 children after the grommet falls out. We may need to insert more grommets until your child grows out of the problem.
Are there any alternatives to grommets? Steroid nasal sprays may help some children if they have nasal allergy; Congestion in the nose caused by allergy may affect the normal function of the nose and ears.
Antibiotics, antihistamines and decongestants do not help this type of ear problem and alternative treatments, such as cranial osteopathy, are not helpful. A nasal balloon to open the tube to the ear may help older children but must be used regularly.
Taking out the adenoids may help the glue ear get better, and your surgeon may want to do this at the same time inserting grommets. A hearing aid can sometimes be used to treat the poor hearing and speech problems caused by glue ear and would mean that your child would not need an operation.
Are grommets sore? No. Grommets are not usually sore. But you can give your child painkillers such as paracetamol or ibuprofen if you think it will help. Grommets should improve your child’s hearing immediately. Everyday sounds can appear too loud until your child gets used to having normal hearing again, which usually takes only a few days.
What about ear infections? Most people with grommets don’t get ear infections.
An infection may produce yellow fluid but it will not be as sore as a normal infection and your child won’t be as ill.
You should take your child to your GP who may prescribe antibiotic ear drops which should deal with the problem. Ask your GP or ENT doctor for help if infections become troublesome
Can my child swim with grommets? Yes within a couple of weeks of the operation. But diving under water is not a good idea as water can pass through the grommet into the ear.
Keen swimmers can use tailor-made earplugs or special headbands and ear putty to stop water getting in. It is a good idea to plug your child’s ears with a cotton-wool ball covered in Vaseline in the bath or shower.
How long will my child be off school? Only the day of the procedure. He/she should be able to get back to normal the following day
Can I do anything to help my child? You can speak clearly and be patient for your child to answer. Being able to see your face when you speak and calling your child’s name to get him/her to look at you before you speak can help a lot. And remember to tell teachers that your child has a hearing problem. It is also a good idea to sit at the front of the class.
What else should I know about grommets? It is ok to fly with grommets? The pain from the change in pressure in the aeroplane cannot happen when the grommets are working.
We need to check your child’s hearing after grommets have been inserted, to make sure their hearing is better, and see your child usually 9 to 12 months after the procedure once the grommets have come out. This is to check their ears and hearing. Sometimes a small hole in the eardrum is left behind. This usually heals with time, but sometimes we need to operate to close the hole. The grommet can leave some scarring in the eardrum but this does not usually affect hearing.
This page been adapted from information authored by Peter Robb and Haytham Kubba on behalf of ENT UK.