Grommets (also known as ventilation tubes) are tiny plastic tubes that can be fitted into your child’s eardrum to help treat glue ear. The tube lets air pass in and out of his or her ear.
You will meet the surgeon carrying out the procedure to discuss your child’s care. It may differ from what is described here as it will be designed to meet your child’s individual needs.
Fitting grommets in your child’s ears can help treat glue ear.
Glue ear occurs when fluid collects in the middle ear behind the eardrum. The middle ear is the space behind your eardrum. It contains three tiny bones that move when sounds reach them. These transmit sound waves through your middle ear to your inner ear. For the ears to work properly, the middle ear needs to be kept full of air and free from fluid.
The outer, middle and inner ear
Having glue ear can make it difficult for your child to hear properly and, as a result, can cause delays in speech and language development. Glue ear can also increase the risk of your child having a middle ear infection. Your doctor may recommend your child has grommets fitted if glue ear is causing problems with hearing or speech, or if it’s causing lots of ear infections.
Grommets are tiny tubes that let air pass into the ear and stop fluid collecting. The middle ear is able to work normally and your child can hear clearly again. Your surgeon may advise taking out your child’s adenoids at the same time as putting in grommets, as this may help to get rid of his or her glue ear (see adenoid and tonsil removal for more information). Glue ear is most common in children aged two or younger, and less common in children over six. It can also affect adults and grommets can be fitted at any age if glue ear is causing problems.
If your child has hearing problems caused by glue ear, your doctor may suggest ‘watchful waiting’ with hearing tests before recommending treatment. If your child’s hearing doesn’t improve after at least three months, your doctor may recommend treatment with grommets. Your doctor may also advise that your child can use a hearing aid to treat his or her hearing loss instead of having grommets fitted, but this isn’t common.
Grommets are usually fitted as a day-case. This means your child has the procedure and goes home the same day.
If your child has a cold or infection in the week before the operation, let the hospital know. The operation may need to be postponed until your child has fully recovered.
In children, grommets are usually fitted under general anaesthesia. This means your child will be asleep during the operation. If your child is having a general anaesthetic, he or she will be asked to follow fasting instructions. This means not eating or drinking, typically for about six hours beforehand. However, it’s important to follow your anaesthetist’s or surgeon’s advice.
At the hospital, a nurse will ask about your child’s general health and check your child hasn’t had anything to eat or drink.
You must tell the nurse about any allergic or unusual reactions to medicines your child may have had in the past and about any history of bleeding problems in the family.
The surgeon will usually visit your child before the operation. The surgeon will discuss with you what will happen before, during and after your child’s procedure, and any pain he or she might have. This is your opportunity to understand what will happen, and you can help yourself by preparing questions to ask about the risks, benefits and any alternatives to the procedure. This will help you to be informed, so you can give your consent for the procedure to go ahead. You will be asked to sign a consent form if you have parental responsibility for the child.
An operation to fit grommets takes 10 to 20 minutes.
Once the anaesthetic has taken effect, the surgeon will make a small cut into your child’s eardrum and use a fine tube to draw out the fluid. The grommet is then fitted into the ear. Both ears can be treated during the same operation.
The surgeon may put antibiotic and steroid eardrops into your child’s ear to help prevent infection and swelling.
Your child will need to rest until the effects of the anaesthetic have passed. Your child will be groggy, and may feel sick or vomit.
Your child may need pain relief to help with any discomfort as the anaesthetic wears off. The surgeon may prescribe painkillers for a day or two.
The nurse will give you some advice about caring for your child’s ears before you go home. You may be given a date for a follow-up appointment.
If your child needs pain relief, you can give him or her over-the-counter painkillers such as paracetamol or ibuprofen syrup (eg Calpol or Calprofen). Always read the patient information that comes with the medicine and if you have any questions, ask your pharmacist for advice. Do not give aspirin to children under 16.
Your child can usually go to school the next day.
Follow your surgeon’s advice about swimming and bathing. It’s usually fine to swim after two weeks, but your child should not dive under the water.
Soapy water can slide through the tiny hole in the grommet more easily than plain water. When washing your child’s hair, place some cotton wool covered with petroleum jelly (eg Vaseline) into his or her ears to make a waterproof barrier, or use ear plugs.
Call your GP if you have any concerns or if your child develops any of the following symptoms:
As with every procedure, there are some risks associated with having grommets fitted. We have not included the chance of these happening as they are specific to your child and differ for every person. Ask your surgeon to explain how these risks apply to your child.
Side-effects are the unwanted but mostly temporary effects you may get after having the procedure, for example feeling sick as a result of the general anaesthetic. Specific side-effects of having grommets fitted include having a mild earache.
Complications are when problems occur during or after the operation. Most children are not affected. The possible complications of any operation include an unexpected reaction to the anaesthetic.
Complications specific to having grommets fitted are uncommon but can include:
Produced by Pippa Coulter, Bupa Health Information Team, January 2013.
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