• 13 FEB 15

    Insertion of Grommets

    What are Grommets?

    Grommets are small plastic tubes the size of a grain of rice, shaped like a tiny bobbin reel. They are placed in the ear drum to act as ventilation tubes, to allow air into the middle ear and to restore the normal function of the middle ear.
    Grommets come in a variety of designs, shapes and sizes and the most appropriate one will be chosen by your specialist. The grommets usually stay in place for 6-18 months and are gradually extruded from the ear drum, which heals up behind it.
    There are some long-term grommets (known as T- tubes or Triune tubes) that are larger and are designed to stay in for up to several years.

    When are grommets advised?

    – For recurrent acute ear infections in young children
    – For persistant glue ear (OME) causing hearing loss and / or recurrent infections. Hearing loss is better immediately.
    – For speech and language development delay in the presence of glue ear
    – For chronic eustachian tube dysfunction causing pressure symptoms eg in cabin crew
    – Patients with certain conditions such as Down’s Syndrome or Cleft Palate may benefit from grommet insertion

    General information

    In children grommets are inserted under a short general anaesthetic. The anaesthetic is very light and the effects wear off very quickly. Sometimes there may be some vomiting from the anaesthetic or the effects of clearing the ear.
    In adults they may be placed under local anaesthetic in the consulting rooms. Long-term tubes may still require a general anaesthetic.
    Grommet insertion may be undertaken at the same time as tonsil and adenoid surgery.

    Post-operative considerations

    – You or your child will need to go straight home and  rest for 24 hours.
    – There is mild discomfort that is usually relieved by paracetamol.
    – Patients with grommets are allowed to swim after a short period of recovery.
    – There are no dietary restrictions and patients can fly within 24-48 hours.

    Complications

    There is a small risk of persistant bleeding or infection postoperatively that may need to be treated with antibiotic drops. The grommet may become blocked and deafness or symptoms recur.
    Some patients may experience dizziness (vertigo). This is rare in children.
    There is a small risk of recurrent or persistant infection with the grommets in place.
    When the grommets extrude out, there is a small (<1%) risk of a persistant hole (perforation) left behind in the eardrum. This normally heals over the next few weeks. Rarely the hole will persist and may require a second operation at a later date to repair it.

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