General ENT

Middle ear ventilating tubes - grommets

Ventilation tubes (Grommets) are small plastic tubes shaped like cotton bobbins which are inserted into the eardrum to provide ventilation to the middle ear.

In children, ventilation tube insertion is undertaken under general anaesthetic and may be accompanied by other procedures such as an adenoidectomy or an adenotonsillectomy.

In adults, ventilation tubes can be inserted under local anaesthetic in the clinic.

How do Grommets work?

Normally, fresh air is introduced into the middle ear through the eustachian tube. Eustachian tube dysfunction is relatively common in young children leading to poor ventilation of the middle ear cavity which can result in recurrent infections, "glue ear" and retracted eardrums. Grommets are a temporary eustachian tube and are designed to fall out the eardrum naturally, mostly after a period of months (6-18), and this is determined by the size and shape of the grommet. Mostly grommets are inserted while maturing of the eustachian tube is awaited.

In later life, adults can also be affected by "glue ear" which is treated in the same manner except that grommets can be inserted under local anaesthetic.

If an infection does occur, discharge can leak through the grommet and it is much less painful than if the eardrum were intact. This condition can be treated with ear drops.

Conditions treated by ventilation tube insertion
  • "Glue ear" in children causing hearing loss for 3 months or more
  • Recurrent ear infections especially those occurring over the summer months
  • Retracted eardrums where complications may arise
  • Non-resolving "glue ear" in adults
  • Avoiding potential problems with airflights

Post procedure

Following surgery which is generally not painful, the benefits are immediate in "glue ear" with hearing improving immediately. Children can generally return to school (or equivalent) the next day.

Leaking from the grommets can occur following the surgery and this is best treated with ear drops as is any infection that occurs subsequent to grommet insertion.

Precautions involving water need to be observed following grommet insertion.

  • Immersing the ears under bathwater is to be strictly avoided
  • Showering is advised and no protection of the ears is required
  • Swimming on the surface of treated swimming pool water and sea wetting the ears is allowed
  • Swimming lessons should continue

Occasionally, grommets can block and this is treated with ear drops. In a small percentage of children, a permanent hole can result in the eardrum. Generally, this is repaired at the age of 8 years old or older.

Grommet removal is considered when a persistent discharge arises from the grommet which cannot be treated with ear drops and if the grommets persistently stay in the eardrum for 2-3 years.

If you have any questions about this procedure please contact us.