What are grommets?

Grommets are minuscule plastic tubes placed in a tiny hole in the eardrum. Their purpose is to let air circulate into and out of the ear, thereby keeping it healthy. The reason to use them is that some people accumulate fluid behind the eardrum, sometimes referred to as ‘glue ear‘. Though it is more common in young children, it can happen in adults, and the exact cause of it is not known.

Most young children will experience glue ear at some point, but it doesn’t always lead to complications. The need to treat it arises when it starts causing difficulties with hearing or speech, or if it is leading to a series of ear infections.

How are grommets put in the ear?

The patient is placed under a short general anaesthetic in order for the grommets to be placed in the eardrum. The procedure is typically undertaken as a day case hospital admission. As the operation is performed inside the ear canal, there will be no visible cuts on the exterior of the ear.

A very small incision is made on the eardrum itself under a microscope. The use of the microscope is to better visualise the area. Through this opening, the fluid behind the eardrum is carefully sucked out. When this is done, the grommet is inserted into the small opening in the eardrum. In total, the procedure usually takes 10-20 minutes.

How long does a person keep the grommets?

The eardrum is constantly growing so, after a while, the grommets will fall out by themselves. This process usually takes between 6 months and 1 year, though it can take longer in older children. It is often not noticeable when they fall out since the grommets are so small.

Are grommets always necessary?

Glue ear usually gets better by itself eventually, but it can take some time to happen. For the first 3 months, children are usually left alone to monitor whether the condition fixes itself. After this point, they will be looked at again and a decision will be made as to whether grommets are necessary.

If there are no complications associated with the glue ear, it may be fine to simply wait for it to remedy itself. However, if it is causing issues like poor hearing, ear infections or hampering a child’s speech, grommets may be the right way to go.

If grommets are put in, it’s possible the glue ear will return once the grommets fall out. This happens to approximately 33% of children who have grommets inserted. In this case, it may be necessary to put new grommets in and keep repeating until the child outgrows the problem.

You are free to change your mind about the procedure at any point – signing a consent form does not obligate your child to have the operation. If you wish to seek a second opinion about the treatment, you can consult your specialist and they will arrange it for you. Alternatively, you may wish to approach your GP to ask them to arrange a second opinion for you.

Are there any alternatives to grommets?

Some children may find that steroid nasal sprays are helpful if they have a nasal allergy. Excessive congestion in the nose as a result of allergies can impact the way the nose and ears function. The problem of glue ear is not helped by antibiotics, decongestants or antihistamines, nor is it helped by alternative treatments like cranial osteopathy.

The use of a nasal balloon to open up the tube to the ear can be helpful for older children if done regularly. Removing the adenoids may also help with glue ear, and some surgeons may recommend doing this at the same time as putting the grommets in.

If glue ear is causing issues with hearing and speech, a hearing aid can sometimes be useful. This might mean that your child does not need the operation and can simply wait for the glue ear to go away – your specialist can advise on this.

Is there anything I can do to help my child?

If poor hearing is an issue, it’s important that you speak clearly to your child and always wait for them to answer. Ensure they can see your face when you speak to make it easier for them to understand you. You should inform their nursery/school teachers that your child has a hearing issue – it may be helpful for them to sit nearer the front of the class.

Do grommets cause discomfort or ear infections?

Grommets do not usually cause any discomfort and their hearing should improve immediately. Ear infections are very uncommon, but any presence of yellow fluid could indicate they have one. It will be less painful than a normal infection, but you should still go to your GP. They may prescribe some antibiotic ear drops which should swiftly remedy the problem.

What about swimming?

Your child should be safe to start swimming again around 2 weeks after the operation. However, spending lots of time underwater is not advised as it may allow water to pass through the grommets into the ear.

Earplugs can be helpful if your child loves to swim. You should also take care in the shower or the bath, as soapy water is more likely to pass through the grommet. Incidentally, there should be no need for additional time off school – your child should be fine to return the day after the operation.

Any other information about grommets?

Grommets should not prevent a child from flying on an aeroplane and they should not experience any pain from the change in pressure. Your child’s hearing will need to be tested after the grommets have been inserted to confirm it has improved. The same will need to happen once the grommets have come out – usually about 9-12 months after the operation.

Sometimes, when a grommet falls out, it leaves a small hole in the eardrum. This should heal up with time, but sometimes an operation is needed to close it. The grommet can leave a small amount of scarring in the eardrum, but this usually has no effect on hearing.