grommets
What are grommets?
A grommet is a very small plastic tube that is inserted into the eardrum
Grommets are also called tympanostomy or ventilation tubes
They are more common in young children but can also be used in adults
During insertion a small cut is made in the ear drum to insert the grommet
A short anesthetic is required for the procedure
How do they work?
The eustachian tube is responsible for maintaining normal middle ear pressure. It connects the middle ear (the space behind the ear drum) to the back of the nose. When the eustachian tube fails, pressure changes and fluid builds up behind the eardrum. This can be problematic and result in grommets. Grommets maintain normal middle ear pressure by allowing air into the middle ear space and reduces the risk of fluid building up in that space. They are a temporary measure to help until the eustachian tubes mature or work better. Most grommets stay in place for about 6 to 18 months and fall out by themselves. In some cases a “long term grommet” is needed. This is called a T-Tube and can stay in for 18+ months.
When are grommets needed?
Grommets are usually recommended when there is a history of glue ear that won't clear up, or frequent ear infections. Grommets are likely to be recommended if:
A fluid build up remains behind the eardrum. Not draining away naturally after 3 months if both ears are affected, or 6 months if only one ear is affected.
You have had 6 acute ear infections in one year, especially if the infections have occurred in both ears.
Your eardrum is not in a normal position due to ongoing middle ear pressure issues.
You have had previous complications because of ear infections.
Do they work?
Parents often report a better quality of life for their children after grommet insertion with improved hearing, better sleeping and overall behaviour.
How are they inserted?
A brief general anaesthetic is required during which the surgeon makes a small cut in the ear drum, suction out any fluid and inserts the grommet. The surgery usually takes about 10 to 15 minutes and is performed by a specialist ENT (ear, nose and throat) surgeon. You usually go home the same day.
Possible complications
A grommet may occasionally block. If this happens, you may need ear drops to help clear it. If that fails the grommet may need to be replaced.
There is a small chance of persistent ear discharge.
A small but significant risk is that the hole in the eardrum fails to heal after a grommet comes out. If this happens, an operation to repair the hole may be needed. (only done once a child is 8 years +)
In a small number of cases, grommets may not come out by themselves within 3 years. In this case a small operation will be needed to remove the grommet. The decision to remove working grommets must be weighed up against the possible risk of recurring ear infections and glue ear.
All possible risks and complications will be discussed with you by your surgeon before undergoing the procedure.
Ear discharge:
Initially, after insertion, the ear may leak. This should clear up within a few days. If not make sure to talk to your surgeon.
With persistent ear discharge, especially if it is smelly, an infection is likely and treatment is needed. This may include ear suctioning, eardrops or in some cases antibiotics.
Ear discharge can also happen if water gets into the ear or when you get a cold or chest infections.
Important to Note:
Swimming:
Unless your surgeon told you otherwise it is recommended to keep your ears dry
If you go swimming make sure the water is clean for example sea water or very clean swimming pools
If you get infections from water exposure it is advised to use earplugs and a swimming cap
Remember while you have grommets it is important not to:
Dive
Swim deep underwater
Go into spa’s or hot pools
Hair washing:
Soapy water in the ear can lead to infection
It is best to use earplugs, Blutack or cotton wool with Vaseline to keep water out of your ears
Take care not to push these to deep into the canal where they can get stuck
See a doctor or ear nurse if you have any ear pain, discharge or reduced hearing.