What are grommets?
Grommets (ventilation tubes) are small tubes that sit in the ear drum to create an artificial hole in the ear drum and let air in to ventilate the air space behind the ear drum. Grommets are used to treat glue ear and recurrent ear infections.
How is the operation performed?
In children the operation is performed under general anaesthetic. The operation takes 5-10 minutes. Using a powerful microscope a small cut 3-4mm is made in the ear drum and the glue is sucked out from the space behind the ear drum. The grommet is then place in the small cut that was made to hold the hole open and prevent it from healing up and closing over. Drops are then placed in the ear and when both ears are done the child is woken up and will usually be ready to go home around two hours later.
Swiming and Grommets?
In the past it was adviced against swimming or any water getting in the ears. This is no longer the case as it it recognised that the vast majority of children have no issues with swimming. It is estimated that strict water precautions would prevent one ear infection over a three year period compared to taking no precautions- review. Occasionally grommets can cause infection or pain when swimming and in these cases it is recommended that ear plugs and/or swimming cap be used (specific custom-made ear plugs can be used). Whilst children can jump in and splash around, they should not dive to the bottom of the swimming pool.
You should not allow water in the ear for the first three days after the operation to allow healing
Will it be painful after the operation?
The opertion is not painful and if required simple painkillers such as calpol and calprofen can be used.
When will the hearing improve after the operation?
Most children will notice the change in hearing straight away after the operation although this is not always the case. Initially sounds may seem too loud for the child but this quickly settles as the child adjusts to the improved hearing.
Flying and grommets
The small ventilation tube prevents pressure changes in the ear when flying and so with grommets there is no pain in ascent or descent during flight making the experience very comfortable.
Time off school/nursery
Children can return to school or nursery 24 hours after the operation.
Complications?
Grommets are temporary and fall out by themselves as the ear drum continues to grow and the grommet gets pushed out. On average grommets last around nine months but there is a wide range. Most children do not then have any further problems but in some the problem can recur and consideration be given to reinserting them or trying a hearing aid.
Some children will experience a painless discharging ear as a result of having a grommet. This usually settles with drops for the ear. In rare cases grommets need to be removed because of persisting infection that fails to settle despite the use of different drops.
Occasionally when grommets come out a small hole can remain in the ear drum where the grommet was. This will often heal by itself. If it does not and is causing problems it can be fixed but this would require a further operation.
