Grommets unplugged: how tiny tubes transform kids' hearing and health

Grommets, also known as ventilation tubes or ear tubes, are small devices inserted into a child’s eardrum to help treat persistent ear problems. Many parents may be unaware of how grommets can dramatically improve their child’s hearing and overall well-being.

In this article, Dr Kevin Kulendra explains the most common questions about grommets and how they can benefit your child.

 

What are grommets, and why are they used?

Grommets are tiny tubes made of plastic or metal that are surgically inserted into the eardrum. Their primary function is to allow air to enter the middle ear, which helps to equalise pressure and prevent the build-up of fluid. Grommets are commonly used to treat conditions like:
 

• Glue ear (otitis media with effusion): a condition where thick, sticky fluid accumulates in the middle ear, causing hearing problems.
   
• Recurrent ear infections: grommets can help prevent frequent infections by improving ventilation in the ear.
   
• Eustachian tube dysfunction: in some cases, a child’s Eustachian tube (the passage between the middle ear and the back of the throat) may not function properly, leading to fluid retention and pressure.
  
   

How do grommets improve hearing?

When fluid builds up behind the eardrum due to glue ear, it can cause temporary hearing loss. This can impact a child’s speech development and learning, particularly during their early years. Grommets allow air into the middle ear and drain fluid, often resulting in an immediate improvement in hearing.

Parents might notice that their child becomes more responsive to sounds, improves in speech clarity, and engages more with their surroundings after the procedure. For children experiencing recurrent infections, grommets reduce the frequency and severity of ear problems, leading to fewer missed school days and less discomfort.

 

What is the grommet insertion procedure like?

The insertion of grommets is a straightforward and quick procedure, typically performed under general anaesthesia. It usually takes around 10 to 15 minutes, and your child can often go home the same day. Here’s what you can expect:
 

• Anaesthesia: general anaesthesia is used to ensure your child remains still and pain-free during the procedure.
   
• Surgical process: a small cut is made in the eardrum, and the grommet is inserted. The tube allows air to flow through the middle ear and helps fluid drain away naturally.
   
• Post-operative care: the recovery time is minimal, and children typically resume normal activities within a day or two.
  
   

How long do grommets stay in place?

Grommets usually stay in place for about 6 to 12 months, though this can vary depending on the child and the type of grommet used. Over time, the grommets will naturally fall out as the eardrum heals. In most cases, they come out without causing any discomfort, and your child may not even notice.

Follow-up appointments are essential to monitor the grommets and ensure they are working correctly. If the grommets fall out too early or ear problems persist, a second procedure may be necessary in rare cases.

 

Are there any risks or side effects?

Grommets are a safe and effective treatment, but as with any medical procedure, there are potential risks. The most common issues include:
 

• Infections: although grommets reduce the frequency of ear infections, there is a small chance of an infection developing around the grommet. This can usually be treated with antibiotic ear drops.
   
• Ear discharge: some children may experience mild discharge from the ear, but this is typically temporary.
   
• Scarring: in rare cases, the eardrum may develop a small scar after the grommet falls out, though this usually does not affect hearing.
   
• Persistent perforation: occasionally, the hole in the eardrum may not close after the grommet falls out. In such cases, further treatment may be needed to repair the eardrum.
  
   

What happens after the grommets fall out?

Once the grommets fall out, most children no longer need further treatment. However, in some cases, fluid may begin to build up again, or ear infections may return. It’s important to attend follow-up appointments to monitor your child’s progress and hearing.

For parents, it’s reassuring to know that if grommets are needed again, the procedure can be repeated safely. However, many children outgrow the need for grommets as their Eustachian tubes mature and function more effectively.

 

Should I consider grommets for my child?

If your child has persistent hearing loss due to glue ear or suffers from frequent ear infections, grommets may be a helpful treatment option. Discussing the pros and cons with an ENT specialist can help you make an informed decision.