A grommet is a small, hollow tube surgically placed into the eardrum to ventilate the middle ear and prevent fluid buildup. These tiny devices, also called tympanostomy or ventilation tubes, are typically made of plastic or metal. The primary function of a grommet is to act as an artificial Eustachian tube, equalizing the air pressure between the middle ear space and the outer ear canal. By keeping this pathway open, the tube allows the eardrum to vibrate normally. They are generally a temporary measure used to treat chronic ear issues, especially in children, while waiting for the natural development of the Eustachian tube.
Conditions Grommets Treat
Grommets are primarily recommended to address two persistent conditions. One is Chronic Otitis Media with Effusion (COME), often referred to as “glue ear,” where thick, sticky fluid accumulates behind the eardrum. This fluid creates a barrier that prevents the eardrum and the small bones of the middle ear from moving properly, causing conductive hearing loss. Untreated hearing loss from glue ear can significantly impact a child’s speech, language development, and overall learning.
The other main condition is recurrent Acute Otitis Media (RAOM), which involves frequent, painful middle ear infections. Repeated infections suggest a problem with the Eustachian tube’s ability to clear fluid and equalize pressure. Grommets provide a continuous vent, reducing the frequency and severity of these painful infections by allowing air to enter.
The Insertion Surgery
The surgical procedure to insert grommets is known as a myringotomy with tube placement. This is a common and quick operation, usually performed on an outpatient basis. For young children, the procedure is carried out under general anesthesia to ensure they remain still and comfortable.
The surgeon first makes a small incision in the eardrum, a step called a myringotomy, often using a surgical microscope for precision. Any fluid found in the middle ear is then gently suctioned out through this tiny opening. Finally, the grommet is carefully placed into the incision, acting as a small porthole to keep the hole open.
Caring for Your Child With Tubes
Following the procedure, children may experience mild discomfort, which is typically managed effectively with over-the-counter pain relievers like acetaminophen. It is common to see a small amount of discharge, which can be clear, bloody, or slightly yellow, for one to three days immediately after surgery as the middle ear drains residual fluid. If the drainage is thick, green, or persists beyond a few days, it may signal an infection and requires a call to the doctor.
A common concern involves water exposure, but earplugs are not routinely needed for simple bathing or showering. It is advisable to avoid pouring soapy water directly into the ears, as soap residue can irritate the middle ear. Precautions like wearing earplugs or a swimming cap are recommended for swimming in untreated water, such as lakes or rivers, or for diving deeper than three feet. If an ear infection occurs with tubes in place, it is often treated with medicated ear drops rather than oral antibiotics, as the medication can reach the infected area directly through the grommet.
When Grommets Come Out
Grommets are designed to be a temporary solution. The tubes are naturally pushed out by the eardrum as it heals and grows, a process called extrusion. This usually occurs between six and eighteen months after insertion, depending on the type and size of the tube used.
The tiny hole left in the eardrum after the grommet falls out typically heals completely on its own. Follow-up appointments are scheduled to monitor the grommets’ function, check for persistent fluid, and confirm the eardrum has closed after extrusion. Regular hearing tests are also part of this monitoring process to ensure the initial middle ear issue has fully resolved. In a small percentage of cases, the fluid problem may return, or the hole may not close, requiring further discussion with a specialist.