Day of grommets

Overview

Grommets are tiny tubes that a surgeon places in your child's eardrums. They help drain fluid from the middle ear and let air in, which can improve hearing and reduce ear infections. This surgery is usually done for a condition called 'glue ear' – when sticky fluid builds up behind the eardrum.

Yes, grommets are one of the most common surgeries in children. In the United Kingdom, around 30,000 children have grommets inserted each year.

Grommets are most often placed in children between the ages of 1 and 3, but they can be used in older children and, occasionally, adults. They are used when glue ear has not improved on its own or after watchful waiting.

Symptoms

Common symptoms

• Hearing loss – your child may not hear well, turn up the TV, or speak loudly.
• Tugging or pulling at the ears
• Difficulty understanding speech in noisy settings
• Balance problems or clumsiness (rare)

Symptoms in children

• Not reacting to quiet sounds or your voice
• Being easily distracted or not paying attention
• Delayed speech or language development
• Frequent ear infections

Symptoms in older adults

• In adults, grommets are less common but may be used for long-lasting glue ear or eustachian tube problems. Symptoms include hearing loss, a feeling of fullness in the ear, and pressure changes.

Causes

Main causes

• Glue ear (otitis media with effusion) – when thick fluid builds up behind the eardrum due to poor eustachian tube function
• Recurrent acute ear infections that do not clear with antibiotics or time

Risk factors

• Being a toddler or preschooler – their eustachian tubes are shorter and more horizontal
• Attending daycare – more exposure to infections
• Bottle feeding instead of breastfeeding
• Secondhand smoke exposure
• Family history of ear problems
• Cleft palate or Down syndrome

When to see a doctor

See a doctor urgently if:

• Your child has a high fever and ear pain after the grommet surgery
• There is persistent or large amounts of fluid draining from the ear

Book a routine appointment if:

• If you think your child has hearing problems that last more than 3 months
• If your child has had 4 or more ear infections in 6 months
• If your child's speech is delayed compared to other children their age

Diagnosis

A healthcare professional, such as a GP or an ear, nose and throat (ENT) specialist, will examine your child's ear with a special light (otoscope). They may also use a quick, painless test called tympanometry to see how well the eardrum moves.

Tests that may be done

• Otoscopy – looking in the ear with a light
• Tympanometry – a small probe placed in the ear that measures eardrum movement
• Hearing test (audiometry) – may be done to check how well your child hears different sounds

What to expect at your appointment

During a hearing test, your child will wear headphones and listen to sounds or be asked to point at pictures when they hear a sound. The tests are painless. The ENT specialist will discuss whether grommets are the right choice for your child.

Treatment

On the day of grommet surgery, your child will be seen by the surgical team. They will have a general anaesthetic (be put to sleep safely). The surgeon makes a tiny cut in the eardrum, suctions out the fluid, and places the grommet. The whole procedure takes about 15 minutes. Your child will wake up in the recovery room and can usually go home a few hours later.

Self-care at home

• Keep your child's ears dry – use a cotton ball with petroleum jelly in the outer ear during baths or showers. Ask your surgeon for specific advice.
• Give simple pain relief as recommended by your doctor (such as paracetamol or ibuprofen) – follow the dose for your child's weight.
• Let your child rest at home for the rest of the day. Most children are back to normal the next day.

Medical treatments

After surgery, your child may be given antibiotic ear drops to use for a few days. These help keep the ear clean and reduce the chance of infection. Always use the drops exactly as directed. No other medications are typically needed on the day.

When is surgery considered?

Surgery is usually recommended when glue ear has lasted more than 3 months and is causing significant hearing loss, speech delay, or frequent infections. The decision is made by your ENT specialist after discussion with you.

Living with this condition

After the grommet surgery, your child can return to normal activities the next day. You may notice improved hearing almost immediately. The grommets usually fall out on their own within a year as the eardrum heals. Some children need a second set if glue ear comes back.

Lifestyle tips

• Avoid getting water deep into the ears – shallow baths are fine, but swimming may require earplugs. Ask your surgeon when it is safe to swim.
• Keep your child away from secondhand smoke, as it increases the risk of ear infections.
• Make sure your child has regular follow-up appointments to check the grommets and hearing.

Diet and exercise

There are no specific diet or exercise restrictions after grommet surgery. Your child can eat normally once the anaesthetic has worn off. Gentle play is fine; avoid rough activities that could hit the ear on the day of surgery.

Mental health and emotional wellbeing

Most children tolerate grommet surgery very well. However, some may feel anxious before the procedure. Explain what will happen in simple, reassuring words. If your child seems very worried, talk to your healthcare team – they can offer distraction techniques or relaxation tips.

Prevention

You cannot completely prevent glue ear, but you can reduce your child's risk by avoiding smoke exposure, breastfeeding when possible, and treating allergies. Good hand washing may also help reduce infections.

Vaccines

Make sure your child is up to date with routine vaccinations, including the pneumococcal vaccine and the flu vaccine. These vaccines help prevent some infections that can lead to ear problems.

Screening programmes

Hearing screening for newborn babies is routine in the UK. For older children, routine hearing checks may be done by your health visitor or school nurse if there are concerns.

Complications

If left untreated

• Hearing loss that can affect speech and language development
• Difficulty learning at school
• Behaviour problems from frustration or not hearing
• Repeated ear infections that may cause damage to the eardrum

Long-term outlook

The outlook is excellent. Most children's hearing returns to normal after grommets are inserted. The grommets fall out on their own, and the eardrum heals in almost all cases. A small number of children may need a second procedure. With treatment, almost all children catch up on any delays.

Find support

International organisations

• National Deaf Children's Society (NDCS)
• American Academy of Otolaryngology – Head and Neck Surgery

Local organisations

• NHS UK: Glue ear information ↗ · United Kingdom

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