What is ear grommet insertion in adults and children?

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Ear grommets, also known as ventilation tubes, are small tubes inserted into the eardrums by a medical professional and can be done both on adults and children. These tiny tubes play a crucial role in addressing conditions like glue ear, where thick, sticky fluid accumulates in the middle ear, often resulting from chronic ear infections. Glue ear can impact various aspects of one's health, if you suspect that you may be experiencing glue ear, seeking advice from a healthcare provider is essential.

What are ear grommets for? A solution for glue ear

Ear grommets are tiny tubes, typically made of materials like plastic or Teflon with coatings to minimize infection risks. Their primary function is to facilitate the flow of air into the middle ear and aid in the drainage of thick fluids down the back of the nose and throat. Individuals experiencing prolonged glue ear or frequent ear infections may find grommets in ears beneficial. Prolonged glue ear can lead to hearing loss, making the placement of grommets a valuable intervention to address such issues. There are two main types of grommets: 

  • Short-term tubes: smaller in size, generally remain in place for about six months to a year before naturally falling out
  • Long-term tubes: larger and equipped with flanges for stability, provide a more extended solution for sustained ear health
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Ear grommet surgery: how does it work?

Grommets are inserted in the ears by a surgeon who conducts a myringotomy, an operation performed in a hospital under general anesthesia. This ensures a painless experience for the individual undergoing the procedure. The myringotomy involves a small incision in the eardrum, enabling the suctioning of fluid from the middle ear before the grommet is carefully placed. Typically conducted under a surgical microscope with a small scalpel, this day surgery procedure lasts approximately 30 to 45 minutes, encompassing the administration of anesthesia, the operation itself, and recovery room time. Patients, including children, are often well enough to return home within two hours of the procedure.

Without the insertion of a grommet, the hole created during the myringotomy would naturally close within a few days. The grommet serves a crucial role in maintaining the opening, allowing for ventilation and the free flow of air into the middle ear space. For those seeking effective solutions to ear health concerns, the myringotomy and grommet insertion procedure offer a safe and efficient means to promote auditory well-being.

Possible discharge after grommets myringotomy

If the ear experiences significant inflammation, it's possible to observe discharge after the grommets placement, such as ear bleeding or ongoing fluid discharge for up to a day after the operation. This occurrence is normal, and it's advised to clean the external ear as needed. However, it's crucial never to insert anything into the ear canal. Post-surgery, the patient is under observation in the recovery room and typically can return home within an hour if no complications arise. Ear drops and painkillers may be prescribed in case of discomfort or discharge.

How long to keep ears dry after grommets insertion

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Post-procedure, it's vital to avoid water exposure to prevent infections. While ear plugs can keep water out effectively, recent studies suggest moisture protection may not be essential after grommet placement, except for specific activities like diving or in potentially contaminated water. The advisable ear plugs for grommets' protection are the ones made of silicone that are easily insertable and removable, forming an airtight seal in the ear canal for efficient protection. Some soft silicone options in this category are particularly moldable and hypoallergenic, making them ideal also for swimmers.

Ear grommets in adults and children recovery time

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After the insertion of ear grommets, a recovery period is necessary, typically ranging from 1 to 2 days or weeks, depending on individual circumstances. During this time, it is advisable for you or your child to take time off from work or school to facilitate a complete recovery. Engaging in swimming pool activities or lessons should be avoided until the postoperative appointment with your ENT Specialist. Following the specialist's guidance, you may gradually reintroduce these activities, utilizing appropriate swimming ear plugs to ensure protection and support for the healing process. Prioritizing a cautious and gradual return to normal activities contributes to a smoother recovery after ear grommet placement.

Ear grommets falling out

Typically, regular ear grommets stay in the eardrum for an average of 8 months, though this timeframe can vary between 3 to 24 months. Eventually, the grommet will naturally dislodge from the eardrum, often coming out with earwax. Regular ear examinations serve as indicators of when grommets have naturally fallen out. Following the grommet's expulsion, the eardrum's perforation often heals rapidly. However, in certain cases, children may experience a recurrence of fluid in the ear, potentially leading to a reappearance of glue ear. In such instances, a subsequent operation may be necessary to insert new grommets and address the condition effectively.

Side effects of myringotomy

While ear grommet placement is generally considered a safe and common procedure, like any medical intervention, it may have some potential side effects:

1. Ear infection with grommets


Ear infections after ear grommet surgery can occur in the middle ear or around the grommet, albeit less frequently than without the procedure. These infections are usually easier to treat, often requiring only ear drops. Additionally, there is the possibility of grommets coming out too early or remaining in place for an extended period. If a grommet expels prematurely, fluid may return, necessitating repeat surgery.

2. Perforated eardrum


Eardrum perforation is a possible complication that can occur if a tube comes out or a long-term tube is removed, and the hole in the tympanic membrane (the eardrum) fails to close.

In such cases, a minor surgical procedure known as tympanoplasty may be required to patch the hole.

3. Tympanosclerosis


Tympanosclerosis refers to the scarring of the eardrum or tympanic membrane. The eardrum, a delicate and transparent membrane that serves as a barrier between the outer and middle ear, can undergo scarring due to factors such as injury or surgical procedures. The scarring manifests as distinct bright, chalky white lesions or spots on the eardrum. This condition alters the normal structure of the eardrum and can have implications for auditory function and overall ear health.

4. A feeling of blocked ears


It is a common experience for individuals to sense a feeling of blocked ears after grommet surgery. The sensation of blockage may persist for weeks or even months as the delicate structures within the ear gradually readjust to a normal state post-ventilation tube placement. This adjustment period is a natural part of the healing process, and individuals may find relief as their ears gradually acclimate to the presence of the tubes. 

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5. Excessive ear wax

Excessive ear wax production is a common concern that can happen after grommet insertion. Here are some potential reasons for excessive ear wax after grommet placement and some tips on managing it:

  • Altered ear canal environment: Grommets can change the environment of the ear canal, leading to increased production of ear wax. The tubes may disrupt the usual flow of wax out of the ear
  • Dry ear canal: Grommets can sometimes lead to a drier ear canal, causing the wax to become more sticky and less likely to flow out naturally
  • Foreign body reaction: The presence of grommets might trigger the ear to produce more wax as a protective response to the foreign body

How to clean ears with grommets?

Cleaning ears with grommets requires special care to prevent damage to the tubes and the ear canal. Here are some general guidelines, but it's essential to follow your healthcare provider's specific instructions:

  • Ear drops: Your doctor may recommend using ear drops to soften any wax. Follow the prescribed instructions for the type and frequency of the drops
  • Cleaning the external ear: Gently clean the external part of the ear with a washcloth. Avoid inserting anything into the ear canal, especially if you feel resistance or encounter pain
  • Do not use cotton buds: Avoid using cotton swabs to clean inside the ear canal, as this can push wax further down and potentially damage the grommet
  • Professional cleaning: If there is a significant wax buildup, consult your ENT specialist for professional ear cleaning. They can use specialized tools to safely remove excess wax without harming the grommets
  • Regular check-ups: Schedule regular follow-up appointments with your ENT specialist to monitor the condition of the grommets and ensure proper ear health

FAQs about ear grommets

How to remove grommets from ears?

Certain extruded grommets may remain in the ear canal, positioned near the eardrum, potentially leading to blockages and hearing challenges due to subsequent wax accumulation. To address this issue, removal techniques like micro suction or micro forceps can be employed. Although the majority of grommets typically naturally extrude from the eardrum, there are instances where it becomes necessary for an ENT doctor to perform their removal. This uncomplicated procedure is conducted under topical local anesthesia, utilizing specialized small instruments. The small opening left after removal typically undergoes complete healing within a few weeks.

Can you still get ear infections with grommets?

After the insertion of ear grommets, there is a risk of ear infections, particularly if dirty water enters the ear. To minimize this risk, it is advisable to keep the ears dry until the grommets naturally fall out, allowing the eardrums to heal. Preventing exposure to contaminated water, such as in swimming pools, lakes, or other environments, is crucial during this period. Maintaining ear hygiene helps safeguard against infections, ensuring a smoother healing process for the ears with grommets. 

Can you fly with grommets in your ears?

For the majority of children and adults, air travel is generally feasible as soon as the day following grommet insertion. The process of flying after grommet placement is typically considered safe. However, it's essential to consult with a healthcare professional to ensure personalized guidance based on individual health conditions and the specific circumstances surrounding the grommet insertion. Following any medical procedure, including grommet placement, obtaining professional advice ensures a smooth and comfortable experience during air travel.

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