Grommets

About the procedure

Grommets are small ventilation tubes placed into the tympanic membrane (ear drum) to allow air to flow into the middle ear and help middle ear fluid or glue ear dissipate. 

They are commonly recommended in the following situations:

• Recurrent acute otitis media (middle ear infections), such as more than 4 episodes in a year or 3 within 6 months
• Otitis media with effusion with poor hearing (fluid behind the ear drum) affecting both ears for three months, or one ear for six months
• Delayed speech development because of persistent middle ear effusions
• There are also some rare indications such as severe tympanic membrane retractions from severe eustachian tube dysfunction or needing to provide pressure relief for hyperbaric chamber treatments.

After grommet insertion, it is common for children to show a noticeable improvement in how they respond to sounds. Speech clarity may also improve as hearing becomes clearer.

Grommet insertion is considered a safe and routine procedure. In children, it is performed under general anaesthetic, and discharge home is usually possible about one hour after surgery. In adults, grommets are much more rarely required and are also  often inserted in the operating theatre, although sometimes under local anaesthesia.

Grommets are designed to remain in place for around 9–24 months. They usually fall out naturally on their own, often without being noticed. The small opening in the ear drum typically heals by itself once the grommet has come out.

Surveillance checks will usually be recommended on a 6 monthly basis until the grommets naturally extrude on their own. At least 2 in 3 children who need grommets never need another set inserted.

An appointment can be made with Dr Phillips for further discussion about grommet insertion.

Grommets post-operative instructions

What to expect

Immediately post op:

Your child may experience some brief discomfort after the procedure. This is generally short-lived and often related to the effects of the anaesthetic. Discharge home usually occurs about one hour after surgery.

Day 1 – 7:

You will not usually notice any discharge. Occasionally a small amount of discharge from your child’s ear, which may include blood or pus can occur during the first few days and part of the normal healing process. Ear drops are sometimes recommended and should be used if they have been prescribed in your post op orders. If your child is in pain, paracetamol (Panadol) or ibuprofen (Nurofen) is usually sufficient. Showering is permitted, but swimming should be avoided during this time until after the first post operative visit which is usually at 2-3 weeks after the procedure.

After day 7:  

Return to Swimming is usually restricted until after the first post operative visit and then can resume often without the need for any er plugs in most cases.

It is recommended to avoid submerging the head under soapy water in the bath, and also in dirty water like dams or low flowing rivers.

If you noticed discharge from your child’s ears, this is often associated with a cold or other upper respiratory infection. If discharge continues for more than 24 hours, antibiotic ear drops (such as Ciloxan 3 drops twice per day)) may be required and can be prescribed by a GP or by your Ent surgeon.

If discharge persists for longer than one week following treatment, it is important to contact the clinic, as review by your child’s surgeon may be needed. In some cases, gentle suctioning of the ears may be required or arranging to send a swab of the discharge to a lab for microscopy and culture.

Frequently asked questions