Grommet

Grommet insertion is a surgical procedure in which a tiny ventilation pipe (grommet) is inserted into the eardrum to treat glue ear.

Glue ear is a condition in which glue-like fluid fills up in the middle ear and impairs hearing ability. Hearing loss may affect one or both ears. The common symptoms include mild ear pain, irritability, talking quietly, problems with communication and learning, and delayed development of speech and language in children.

The exact cause of fluid build-up in the middle ear is unclear, but it may be due to improper functioning of the Eustachian tube.

The Eustachian tube is a narrow tube that connects the middle ear to the back of nose. The tube helps in maintaining the balance of air pressure between the middle and outer ear. Opening of the tube while swallowing, chewing or yawning allows inflow of air into the middle ear and outflow of fluid thereby balancing air pressure on each side of the eardrum. If the Eustachian tube fails to open properly or gets blocked due to respiratory tract infections or allergies, an air pressure imbalance is created on either side of the eardrum thereby disrupting its function. This imbalance causes the fluid to fill up the space of the middle ear thereby preventing its drainage. Grommets help in maintaining equal air pressure by enabling drainage of this fluid from the middle ear.

Procedure

The aim of the procedure is to effectively restore hearing in individuals who are suffering from hearing loss due to middle ear fluid.

Grommet insertion is a short duration procedure carried out under general anesthesia. Your surgeon will make a small incision of about 2-3 mm in the eardrum and drain out the fluid from the middle ear with the help of suction. A grommet is then inserted into the eardrum which allows immediate entry of air into the middle ear to keep it ventilated.

Post-operative Care

Following the surgery, sound will be heard at a much higher level than before the surgery. This is normal and you will get used to this normal level of hearing in a few days.

It is important to protect the ears from water while the grommets are in place. You may be advised to use cotton wool with Vaseline to plug the ear which prevents water entering the ear.
You can swim if you have your doctor’s permission. Make sure to wear ear plugs while swimming.
Immediately consult your surgeon if you notice foul smelling ear discharge.
Your doctor may prescribe antibiotic drops to prevent ear infection.
Avoid inserting sharp objects into the ear.
Pain medications may be prescribed to relieve pain.

Risks and complications

Generally, grommet insertion is a safe procedure. But as with any surgery, grommet insertion involves certain risks and complications. They include:

Ear infection and discharge
Perforated (hole) eardrum
Minor eardrum damage and scarring

Grommets will allow entry of air into the middle ear for several months until it is naturally pushed out of the eardrum. Grommets will fall out after a period of 6 to 12 months which is usually enough time to resolve glue ear completely. However, if the fluid returns, or the problem of glue ear persists even after the grommet has fallen out, repeat grommet insertions may be required until the problem of glue ear is completely treated.