Grommet Insertion

*Please see the bottom of this page for a video on Grommet Insertion*

What is a grommet?

A grommet is a plastic tube that is placed across the tympanic membrane to allow ventilation of the middle ear 

Reasons why grommets are inserted

How are grommets inserted?

The operation is performed as a day surgery under general anaesthesia, and the whole procedure including the anaesthesia usually takes 20 to 30 minutes. The procedure is often combined with an adenoidectomy.

The operation involves 3 Stages:

Stage 1
Making an incision in the tympanic membrane - myringotomy (G3)

G3 - Myringotomy

G3 - Myringotomy

Stage 2
Removal of the glue by micro-suction (G4)

G4 - Micro-suction of glue

G4 - Micro-suction of glue

Stage 3
Insertion of the grommet into the tympanic membrane (G5)

G5 - Grommet within the tympanic membrane

G5 - Grommet within the tympanic membrane

FAQs

What should I expect after the operation?

The surgery is relatively painless and most children are back to their normal selves within a couple of hours after waking from anaesthesia. They are not aware of the presence of the grommet. If there is some discomfort this will respond well to simple pain control such as Calpol.

There may be some discharge from the ears which usually settles within a few days. Antibiotic drops are often prescribed to use for a few days to stop any discharge drying and blocking the grommet. 

A clinic check is needed 2 weeks after surgery to ensure that the grommet is functioning and that the hearing has recovered.

Are there any complications? 

Ear infections / discharge
This is the most common complication from grommet insertion. About 25% of children will have one ear infection while the grommet is in place. These present as a discharge and are not usually painful.

  • Infections are often due to water contamination - swimming may have to be restricted if this is a recurrent problem.
  • They may also occur with a cold that results in a middle ear infection which discharges through the grommet.

Treatment consists of topical antibiotics and avoiding water contamination. Sometimes oral antibiotics are needed. 

It is important to have the ear checked after the infection has resolved to ensure that the grommet has not been pushed out or become blocked. 

Scarring
Tympanosclerosis, scarring of the eardrum, may occur but is usually of no consequence. Such scarring may also occur with glue ear and ear infections.

Residual perforation
In most cases, as the grommet comes out, the hole behind closes. Although, in 1-2% of children this may not happen. If the perforation  fails to close, then further surgery is needed to close the perforation - and this is carried out after the age of 8..

How long before my child can return to school?

Children may return to school a couple of days after the operation.

How do I take care of grommets? 

Care is needed to avoid water getting through the grommet behind the eardrum as this will cause an infection. This is mainly an issue with washing with soapy water and it is best that the ear is blocked to prevent this from happening.

A simple option in the bath can be  placing cotton wool smeared with Vaseline into the ear. 

Can my child swim? 

Gentle swimming is usually not a problem. However if your child likes to jump into the water and swim to the bottom of the pool  or in big waves in  the sea, then it is best to protect the ears by wearing  swim plugs. These may be purchased from a sports shop or chemist, or can be custom made for your child's ear.

Do the grommets have to be removed?

No, the grommets normally come out by themselves, after 9 to 18 months and  are carried out of the ear canal naturally. 

When the grommets fall out, will my child need another set? 

About 20 – 25% of children who have had a set of grommets will develop glue ear again and need a further set of grommets.