Ear Grommets Surgery
Ear grommets are small ventilation tubes used to treat certain middle ear conditions, including glue ear and recurrent middle ear infections. Complete ENT provides specialist assessment and ear grommet surgery for children and adults in Brisbane and Cairns.
What Are Grommets?
Grommets are tiny tubes that are inserted into the eardrum to help treat common childhood middle ear conditions, such as recurrent acute otitis media, glue ear, and Eustachian tube dysfunction.
Ear infections can cause thick, sticky fluid to collect in the middle ear space, leading to pain, hearing loss, and recurring ear infections (otitis media). Grommets allow air to flow into the middle ear which equalises pressure and helps relieve fluid from the middle ear and helps the Eustachian tube return to normal function.
Also known as tympanostomy tubes or middle ear ventilation tubes, these small plastic tubes are inserted into the affected ear through a small incision in the eardrum. This is a minimally invasive procedure that can be performed under local anaesthetic in adults, but is usually performed in hospital under general anaesthetic in children.
Most children recover quickly from the surgery and ear grommets cause no discomfort while in place. They typically stay in the child’s ear for about six to 12 months, after which time the grommets will naturally fall out as the eardrums heal.
Which Conditions Can Be Treated With Ear Grommets?
Acute otitis media is an infection caused by viral or bacterial agents that can result in pain, fever and pus in the middle of the ear with an inflamed eardrum. Occasionally, the eardrum may also burst, resulting in ear discharge.
Acute otitis media is one of the most common illnesses for children, with nearly every child having experienced a middle ear infection by the age of five. Most children grow out of their ear infections, but this can occur at different ages.
Otitis media is recurrent when the infection occurs three or more times in six months. Repeated middle ear infections are more likely to develop:
- in children prone to upper respiratory infections
- when fluid is still present in the middle ear space from a previous infection
- in children who attend day care
- where the eustachian tube does not function properly
Otitis media which has been present for three months or more with the accumulation of fluid in the middle ear (effusion) is called glue ear. The fluid is often thick and sticky with a similar consistency to glue.
Contributing factors that are most commonly associated with glue ear include:
- poor Eustachian tube function
- attending day care
- children under the age of three
- a previous middle ear infection
- frequent viral infections which occur during winter months
- structural problems such as a cleft palate
Persistent glue ear can also cause the eardrum to be thinned and pulled toward the middle ear (retraction pocket). This can lead to damage of the small bones of the middle ear, further impairing the ability to hear.
The accumulation of fluid in the middle ear may also lead to hearing loss and speech issues in children.
If the eardrum becomes severely retracted, a cholesteatoma may form. This is an abnormal growth of skin in the middle ear that almost always requires surgical removal.
The Eustachian tube is a small passageway that connects the middle ear to the back of the nose and throat. Its primary role is to regulate middle ear pressure and drain fluid away from the ear.
When the Eustachian tube does not function properly or becomes blocked, it causes the accumulation of middle ear fluid. This can result in difficulty hearing as well as pain and infection.
Eustachian tube dysfunction often improves without treatment. Persistent or severe symptoms should be assessed by a doctor and may require further assessment by an ear, nose and throat specialist.
When Is Ear Grommets Surgery Recommended?
Acute otitis media and glue ear can clear up without medical treatment, especially during summer months. Some middle ear infections are associated with generalised viral infections and only require supportive therapy, such as pain relieving medication, oral antibiotics and antibiotic ear drops.
Ear grommets surgery is recommended when a middle ear infection has been persistent for more than three months, along with symptoms of hearing loss, damage to the eardrum, and damage to the small bones of the middle ear.
When considering ear grommets surgery to treat glue ear or acute otitis media, your ENT specialist will want to know:
- Does your child have recurrent ear infections, and how often?
- Are you worried about hearing loss?
- Has your child had a burst eardrum?
- Is it just one ear playing up or both?
A hearing test may sometimes be arranged before surgery. Further tests may be recommended depending on your child’s symptoms and medical history.
Although grommet surgery is most commonly performed in children, adults can also require grommets. Children are more prone to ear infections because their Eustachian tubes are still developing. Recurring ear pain in an adult should be investigated by an ENT to rule out any other contributing problems.
Grommets are a successful tool in improving hearing problems and preventing recurrent ear infections.
Speak with your child’s doctor about a referral to Complete ENT for assessment or further treatment.
What Are The Benefits Of Ear Grommets?
All children with chronic glue ear will experience some degree of conductive hearing loss, such as muffled sounds or misunderstood speech. This is because the thick fluid build-up prevents the tiny bones and eardrum from moving freely which impairs the passage of sound through the middle ear.
Grommets help to drain the middle ear fluid and most patients will notice a significant improvement in their hearing ability. Restoration of your child’s hearing may be especially important in assisting children with delayed speech development or learning difficulties.
Persistent glue ear may also be associated with a delay in speech development, learning difficulties at school, behavioural problems, and some balance issues. By treating the underlying cause, grommet surgery can also help to improve these symptoms.
A grommet allows air to enter the middle ear and equalises pressure across the eardrum. This may allow a retracted eardrum to return towards a more normal position and reduce the risk of further damage to the eardrum or middle ear bones.
Grommets generally decrease the frequency of infection in children with recurrent otitis media. Such infections are also less severe with less pain and fever. In some children, infections stop completely while grommets are in place.
Grommets allow air into the middle ear, help trapped fluid drain away and help to equalise pressure, which all reduces the risk of infection. There may be some discharge through the grommets, but these infections can be treated with ear drops rather than oral antibiotics.
The Ear Grommet Insertion Procedure
Looking through an operating microscope, the surgeon inspects the eardrum and makes a small incision in it about two to three millimetres long. This is known as myringotomy. Some of the middle ear fluid can then be gently suctioned out. The grommet is placed into the incision, with a flange sitting either side of the eardrum.
Inserting grommets is a minor surgical procedure, taking about 20 to 30 minutes. The patient does not feel the grommet sitting in the eardrum and it is not possible to touch the grommet when a finger is inserted into the ear canal. Post-operative recovery is typically quick and most patients experience significant improvement in their symptoms within a few weeks. The small hole in the eardrum (from the incision) will heal quickly after the grommets fall out.
What should you expect after ear grommet surgery?
Most patients go home as soon as they have recovered sufficiently from the anaesthetic. They can have a light meal soon after they are awake. Children can usually return to school the day after surgery.
Some pain is normal after an ear grommet procedure. Any ear pain is usually mild, and medication for pain relief can be given if required. A small amount of clear or blood-tinged discharge from the ear may occur for one or two days. The outer ear can be gently cleaned with cotton wool or a soft cloth. You should never use a cotton bud in the ear canal.
Ear Plugs and Keeping Ears Dry
It is important to avoid getting water in the ears while they are healing. Many surgeons believe that an infection can occur if unsterile water gets into the middle ear through the grommet. Simple precautions you can take to protect your child’s ears from water after their grommet ear surgery and while the grommets are in place include:
- soft silicone ear plugs
- cotton wool with petroleum jelly
- made-to-measure moulded earplugs (especially for swimming)
- swimmers ear putty
- ear wraps or a swimming cap in addition to swimming plugs
The surgeon will inspect the ear grommets two to four weeks after surgery. A hearing test can be arranged to measure hearing improvement and to exclude any underlying sensorineural (inner ear or nerve) hearing loss that was hidden due to the glue ear.
Follow-up Visits
Follow-up visits are required until the grommets fall out, as they are designed to do after about 6 to 12 months. However, some children may require specialist follow-up for several years. The eardrum usually heals quickly when the grommet falls out. After the grommets ear surgery, a small scar may be left on the eardrum but this does not affect hearing.
Contact Complete ENT
Complete ENT provides assessment and treatment for glue ear, frequent ear infections, hearing concerns and other ear, nose and throat conditions.
Ear Grommets Cairns
Main Cairns Rooms
Level 1, Wallamurra Towers
189-191 Abbott Street
CAIRNS QLD 4870
07 4019 7830
Ear Grommets Brisbane
Main Brisbane Rooms
7/135 Wickham Tce
BRISBANE QLD 4000
07 3905 5999
Ear Grommets Surgery FAQs
What Are Ear Grommets?
Ear grommets are small plastic or silicone ventilation tubes inserted in a tiny cut made in the eardrum. They are commonly used to treat glue ear, recurrent middle ear infections and related hearing difficulties.
What Do Grommets Do?
Grommets allow air through a tiny hole (held open by the grommet tube), to enter the middle ear and help trapped fluid drain out. This can equalise pressure, reduce the frequency or severity of infections and improve conductive hearing loss caused by middle ear fluid.
How Long Does Grommet Surgery Take?
Grommet insertion is a short procedure that generally takes around 30 minutes. Children usually have the procedure under general anaesthetic, so additional time is required for preparation and recovery.
Want to Schedule an Appointment?
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07 3905 5999