What’s the operation for?
Your child will have been suffering from “glue ear”, a build up of sticky fluid in the ear. This stops the eardrum letting sound through properly.
A grommet is a tiny plastic tube shaped like a cotton reel. During this operation, the surgeon will drain the fluid that has built up in the ear and insert a grommet through the eardrum. This lets air pass into the ear, and allows the fluid to drain. Having grommets inserted can help children with glue ear to hear better.
When children have a cold or infection, they often get swollen adenoids (tissue at the back of the nose that helps to fight infection). Swollen adenoids can make glue ear worse. Sometimes, surgeons recommend that children have their adenoids taken out and have grommets inserted at the same time. For more information about having adenoids taken out, please see the separate treatment summary sheet, tonsillectomy and adenotonsillectomy for children.
Grommet insertion is routinely performed under general anaesthesia. This means that your child will be asleep throughout the procedure. Occasionally, older children have grommets inserted under local anaesthesia. This completely numbs the area, but your child will still be awake. The operation is usually carried out as a day-case, with no overnight stay in hospital.
Your child’s surgeon will explain the benefits and risks of having grommets inserted, and will also discuss the alternatives to the procedure.
About the operation
Once the anaesthetic has taken effect, the surgeon will look at the eardrum through a microscope. A tiny cut (about 2mm) is made in the eardrum, and a fine sucker is used to draw out some of the fluid. The grommet is then inserted into the hole. Sometimes ear drops containing an antibiotic and a steroid are put into the ear to help prevent infection. Both ears can be treated during the same operation, which usually lasts ten to 20 minutes.
Afterwards, your child may have earache, but often there is no pain. There may also be a little blood-stained discharge from the ear, but this is quite normal. Occasionally children notice a popping or clicking in the ears, but this is not harmful.
With the grommets in place, the fluid in the eardrum will usually clear up. The body will naturally push the grommet out into the ear tube as the eardrum heals, usually over a period of six to 12 months. Sometimes the grommet does not come out by itself and has to be removed with another small operation.
By the time the grommet has fallen out, the glue ear has usually gone away. However, the sticky fluid may return and some children need several operations to have grommets put in.
Having grommets inserted is a routine and generally safe surgical procedure. However, all surgery does carry an element of risk.
Complications specific to grommet insertion are uncommon. However, ear infections can occur. These are usually treated with antibiotics.
When the grommet has fallen out, the hole in the eardrum usually closes up of its own accord. In a few cases the hole does not seal up. This can be treated with another operation. When the grommet comes out, there may be a small scar left on the eardrum, but this usually has no effect on hearing. Ask your surgeon to explain how any risks apply to your child.