What is Grommet Insertion?
Grommets are tiny ventilation tubes used commonly in adults and children suffering from an ear condition called glue ear. Symptoms of this condition include recurrent ear pain, hearing loss, or infection leading to discharge from the ear. Grommet insertion refers to the placement of a grommet into the eardrum in a minor operation to let air in and out of the ear and prevent these symptoms. You can expect it to remain in place for 6 to 12 months until it falls out as the ear gets better.
Indications for Grommet Insertion
Your physician may recommend grommet insertion if you have glue ear or recurrent ear infections that have been going on for 3 months or more. Glue ear is a common problem among children, where sticky fluid (or glue) accumulates behind the eardrum in the middle ear. Grommets enable air into the middle ear (the space behind the eardrum) which decreases the possibility of fluid building up there and keeps the ear healthy. Even if an infection occurs, the pus will drain out via the grommet.
Preparation for Grommet Insertion
In general, preparation for grommet insertion may involve the following steps:
- A review of your medical history and a physical examination is performed to check for any medical issues that need to be addressed prior to the surgery.
- You may need to undergo lab tests or imaging to help detect any abnormalities that could compromise the safety of the procedure.
- You will be asked if you have allergies to medications, anaesthesia, or latex.
- You should inform your doctor of any medications or supplements you are taking or any medical conditions you have which could compromise the safety of the procedure.
- You may be asked to stop taking certain medications, such as blood thinners, anti-inflammatories, aspirin, or other supplements for a week or two.
- You should refrain from smoking at least a few days prior to surgery and several weeks after, as it can hinder the healing process.
- You should not consume any solids or liquids at least 8 hours prior to the surgery.
- Arrange for a friend or family member to drive you to and from the hospital on the day of your procedure.
- A signed informed consent form will be obtained from you or your family after the pros and cons of the surgery have been explained.
Procedure for Grommet Insertion
Grommet insertion is a minor procedure that takes about 20 minutes and is usually performed under a general anaesthetic. Your child will be asleep throughout the operation. During the procedure, your physician will make a tiny hole in the eardrum and the fluid in the middle ear will be removed using a suction device. A plastic or metal grommet is then inserted to allow air into the middle ear and prevent fluid build-up as in the case of glue ear.
Postoperative Care and Recovery
Following the minor surgery, you or your child will be transferred to the recovery room for a short period of observation. The procedure is normally performed as a day case, which means you should be able to go home later that day. You may experience mild discomfort from the operation site which can be managed with simple over-the-counter pain medications. Antibiotic eardrops may also be prescribed if needed. It is important to keep water out of the ears to avert the risk of infection. You are advised to use water-proof ear plugs, ear putty, swimming caps, or ear wraps to keep water out of ears. You or your child will require 1 to 2 days off from work or school to facilitate a full recovery. Avoid swimming pool activities until your first follow-up appointment. Visit your healthcare provider immediately if you experience severe pain, ear infection (discharge), or fever that does not respond to prescribed medications.
Risks and Complications
Grommet insertion is a very safe procedure; however, as with any surgery, some risks and complications may occur, such as:
- Infection
- Pain and discomfort
- Discharge from the ear
- Bleeding
- Perforated eardrum
- Adverse reactions to anaesthetics
- Recurrence of glue ear after the grommet falls out