Grommets (ear tubes)
What are grommets?
Grommets are very small plastic tubes that sit in a hole in the ear drum. They allow air in and out of the middle ear. They are also called tympanoplasty tubes or ear tubes or pressure equalization tubes.
Why does my child need grommets?
Your child might require grommets if they:
- Get a lot of ear infections-grommets help in preventing getting more ear infections
- Have fluid in the middle ear that will not go away-fluid in the middle ear is called glue ear and is very common in young children.
How are grommets inserted?
The grommets are placed in the eardrum under a short general anaesthetic and the procedure is usually performed as a day case admission to hospital. The operation is carried out down the ear canal so there are no cuts to see on the outside of the ear. A small opening is made in the eardrum using a microscope to magnify the area and the fluid is sucked out of the ear with a fine sucker. The grommet is then placed in the opening in the eardrum. The procedure takes between ten and twenty minutes.
How long do grommets stay in the ear?
Grommets fall out by themselves as the eardrum is constantly growing. They may stay in between 6 and 18 months. You may not notice when they drop out.
Does my child have to have grommets?
Children younger than 7 years are at increased risk of otitis media because of their immature immune systems and poor function of the eustachian tube, a slender connection between the middle ear and back of the nose that normally ventilates the middle ear space and equalizes pressure with the external environment.
Glue ear tends to get better by itself, but this can take a while. We like to leave children alone for the first three months, because about half of them will get better in this time. After three months, we will see your child again and decide whether we need to put in grommets. If the glue ear is not causing any problems, we can just wait for it to settle by itself. If it is causing problems with poor hearing, poor speech or lots of infections, it may be better to put grommets in. If we do put in grommets, the glue ear may come back when the grommet falls out.
What are my options?
Steroid nasal sprays may help some children if they have nasal allergy; Congestion in the nose caused by allergy may affect the normal function of the nose and ears. Antibiotics, antihistamines and decongestants do not help this type of ear problem. Alternative treatments, such as cranial osteopathy are not helpful. Using a nasal balloon to open the tube to the ear may help older children if used regularly. Taking out the adenoids may help the glue ear get better, and your surgeon may want to do this at the same time as putting grommets in. A hearing aid can sometimes be used to treat the poor hearing and speech problems that are caused by glue ear. This would mean that your child would not need an operation.
Can my child swim or fly in an airplane with grommets?
Your child can start swimming a couple of weeks after the operation; diving under the water is not a good idea as water may pass through the grommet into the ear. Some parents have earplugs made if their child is a very keen swimmer, to use until the grommets have come out, or use special headbands to stop water getting in. The hole in the grommet is too small to let water through, unless the water is dirty or has shampoo or soap in it.
It is OK to fly in an aeroplane with grommets. The pain from the change in pressure in the aeroplane cannot happen when the grommets are working.
The content on the Nairobi ENT website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions.
- Rosenfeld, Richard M., et al. “Clinical practice guideline: tympanostomy tubes in children.” Otolaryngology—Head and Neck Surgery1_suppl (2013): S1-S35.
- Rosenfeld, Richard M., et al. “Clinical practice guideline: otitis media with effusion.” Otolaryngology-Head and Neck Surgery5 (2004): S95-S118.
- Rosenfeld, Richard M., et al. “Clinical practice guideline: otitis media with effusion (update).” Otolaryngology–Head and Neck Surgery1_suppl (2016): S1-S41.