Grommets (also called ventilation or tympanostomy tubes) are tiny bioplastic tubes placed surgically in one or both eardrums. They let air into the middle ear. Over time the grommets fall out and the eardrum heals. They are surgically placed at any age, though frequently used in children.
When grommets are considered
Grommets are typically used to prevent recurrent middle-ear infections (acute otitis media), to clear the hearing loss caused by glue ear (otitis media with effusion), or to address ear-pressure problems with flying. Your child may be considered for grommets after three or more middle-ear infections in six months, or if glue ear has persisted for more than three months, particularly when it’s affecting hearing, speech or behaviour. For more on these conditions, see Ear Infection & Hearing Disorders.
Grommets may also be used for Eustachian tube dysfunction, as part of hyperbaric oxygen treatment, or along with other ear procedures.
Before surgery
Your anaesthetist may contact you before surgery to discuss any medical issues. You’ll receive clear instructions about when to start fasting before the procedure.
The surgery
Grommets are inserted under general anaesthesia for children and most adults. Occasionally, surgery on adults can be performed under local anaesthesia with or without sedation. Grommet insertion is typically a day-surgery procedure, unless it’s being performed in combination with other surgery.
During surgery, an operating microscope is used to inspect the eardrum. A small incision is made in the eardrum and any fluid in the middle ear is suctioned out. The grommet is then inserted into the incision, creating a channel that allows air to ventilate the middle ear. This helps prevent middle-ear infections and drains any residual fluid.
After surgery
Patients can usually return home on the same day, once they’ve recovered from the anaesthetic. If grommet placement has been combined with other procedures, you may need to stay in hospital overnight.
Recovery
Children should minimise activity for the first 24 hours and have an adult with them at all times until they’ve fully recovered. Recovery is generally quick — children can return to school or childcare the following day, and adults can usually return to work the next day.
Paracetamol may be needed for the first day or two, but significant pain is uncommon after this procedure. You may be given antibiotic eardrops to use for the first week following surgery — please use them as prescribed.
Nausea or vomiting in children is normal after surgery. If your child does feel nauseous or vomit, avoid food for around an hour. If the nausea and vomiting do not pass, please call the clinic or seek medical attention immediately.
Avoiding water
Keep the ear canals dry for the first two weeks after surgery. While bathing, keep your child’s head above the waterline. For showering, place a small piece of cotton wool with a smear of Vaseline over the outer surface of the ear before showering (and discard the cotton wool afterwards), or use earplugs in the opening of the ear canal.
Costs
Before proceeding, our practice will provide written documentation of all costs associated with your procedure — your surgeon’s fee, anaesthetist’s fee and hospital fees. Claiming from your health insurance fund will be explained to you at that time.
Risks and complications
All surgery carries risks, and it’s important to be aware of them before proceeding. That said, grommet placement is considered a relatively safe procedure with a low risk of serious complications. Potential risks include:
- Infection
- Ear discharge
- Early extrusion of the grommet
- Perforation of the eardrum
- Polyp formation and bleeding
- Recurrence of glue ear or middle-ear infection
- Scarring or thinning of the eardrum at the grommet site
- Retained grommet
- The grommet falling into the middle ear (extremely rare)
Dr Padhye will discuss the potential risks and complications associated with your child’s procedure during your initial consultation.
Your initial consultation
Every patient begins with an initial consultation with Dr Padhye. He’ll perform a thorough assessment, review your medical history and answer any questions you may have. If grommets are indicated, he’ll present a surgical plan and discuss the procedure — so you can make an informed decision about whether to proceed.
Your follow-up appointment
Dr Padhye sees his patients approximately six weeks after grommet insertion. Our practice will coordinate the date with you before surgery. If you have any further questions before or after surgery, please feel free to call our clinic — we’re always here to help.
