Grommet insertion — Patient information · Ruqelo Health
Surgery·Surgery
Grommet insertion
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Educational summary — not medical advice. Discuss with your healthcare provider.
Informed by recognized medical guidance
Overview
Grommets are tiny plastic or metal tubes that a surgeon places into the eardrum. They help drain fluid from the middle ear and keep the air pressure normal. This can reduce ear infections and improve hearing.
Key facts
Grommets are most often used in children with glue ear (fluid behind the eardrum) or repeat ear infections.
The procedure is called myringotomy (say: my-ring-GOT-uh-mee) with grommet insertion and is done under general anaesthetic (you are asleep).
Grommets usually fall out on their own after 6 to 12 months as the eardrum heals.
Yes, grommet insertion is one of the most common childhood surgeries. Thousands of children have them each year in the UK and worldwide.
Grommets are most often needed in young children (especially ages 1 to 3) because their ear tubes (Eustachian tubes) are narrower and more likely to get blocked. But adults with chronic ear problems can also benefit.
Symptoms
Questions about this article
Call emergency services immediately if you notice:
Sudden severe ear pain that does not stop.
Fever over 39°C (102°F) with headache and stiff neck (possible meningitis).
Sudden hearing loss in one ear (you or your child cannot hear at all on that side).
Fluid or blood draining from the ear that contains pus (especially after symptom improvement).
Seizures or confusion related to ear infection.
See a doctor urgently (same day) if you notice:
⚠Ear pain lasting more than 2 days despite pain relief.
⚠Deafness or sudden decrease in hearing that lasts more than a few hours.
⚠Child acting very unwell, not eating or drinking, or vomiting.
⚠Pus or discharge from the ear that is not just water.
Common symptoms
Fluid behind the eardrum that does not clear on its own (glue ear).
Recurrent ear infections (acute otitis media) – more than 3 or 4 in 6 months.
Hearing loss that is not improving with other treatments.
Feeling of fullness or pressure in the ear.
Ear pain (otalgia) during infections.
Symptoms in children
Speech or language delay (not saying as many words as expected).
Tugging or pulling at the ears.
Trouble following directions or seeming distracted.
Balance problems or frequent clumsiness.
Not responding when called (especially when the child is well).
Symptoms in older adults
Muffled hearing that comes and goes.
Balance issues or dizziness.
Ear pain or pressure that does not go away with simple treatments.
Recurring ear infections that interfere with daily life.
Causes
Main causes
Blocked Eustachian tubes – the small passage between the middle ear and the back of the throat. In children, these tubes are shorter and more horizontal, making them easier to block.
Fluid buildup (glue ear) – usually after a cold or ear infection, fluid stays in the middle ear and becomes thick like glue.
Repeat ear infections – each infection can damage the eardrum or cause scarring, leading to further fluid problems.
Risk factors
Age: children under 3 are most at risk.
Daycare attendance – more exposure to colds and viruses.
Bottle feeding while lying down (can allow milk to flow into the Eustachian tube).
Family history of ear infections or allergies.
Exposure to second‑hand smoke (tobacco smoke).
Cleft palate or Down syndrome – these conditions affect Eustachian tube function.
When to see a doctor
See a doctor urgently if:
You or your child has ear pain with a fever over 38.5°C (101.3°F).
Pus or blood is draining from the ear.
Sudden hearing loss in one ear.
Book a routine appointment if:
Ear pain or hearing loss that lasts more than a few days.
Child is not meeting speech milestones or seems to be hearing poorly.
Recurrent ear infections (3 or more in 6 months).
You suspect glue ear (feeling of fullness, muffled sounds).
Many ear infections get better on their own or with simple pain relief. If your child has one or two ear infections in a year with no hearing problems, monitoring and home care are often enough. But if infections keep coming back or hearing does not improve, it’s wise to see your doctor.
Diagnosis
A doctor or an ear, nose and throat (ENT) specialist will examine the ears using a special tool called an otoscope (a light with a magnifying lens). They may also use a tympanometer – a device that measures how well the eardrum moves. If needed, they will arrange a hearing test (audiometry).
Tests that may be done
Otoscopy: looking into the ear with a light to see if the eardrum looks dull, bulging, or has fluid behind it.
Tympanometry: a small soft plug in the ear sends a tone and measures how the eardrum responds. A flat graph means fluid is present.
Hearing test (audiometry): you or your child wears headphones and listens to sounds at different volumes. This checks if hearing loss is present and how severe it is.
What to expect at your appointment
Diagnosis is usually quick and painless. The doctor will talk with you about your symptoms and examine both ears. If fluid is found, they may suggest a ‘watch and wait’ approach for a few months, especially in young children, because some cases clear up on their own. If symptoms persist, an ENT referral for grommet insertion may be recommended.
Treatment
Treatment for glue ear or repeat ear infections depends on how long the problem has lasted and whether it is affecting hearing. Options include watching and waiting, managing symptoms at home, and if needed, a small surgical procedure to place grommets.
Self-care at home
Use over‑the‑counter pain relief (like paracetamol or ibuprofen) according to the package instructions – always check with a pharmacist if unsure about the right dose for a child.
Apply a warm (not hot) cloth or a warm water bottle wrapped in a towel to the outer ear for 10–15 minutes to ease discomfort.
Keep the head elevated – propping up pillows can help drain fluid from the middle ear while sleeping.
Encourage swallowing or yawning more often – this helps open the Eustachian tubes. Chewing gum (for children old enough) can also help.
Avoid putting anything in the ear, like cotton buds or drops (unless prescribed by a doctor).
Medical treatments
Your doctor may prescribe antibiotic ear drops or oral antibiotics if there is a current infection. For glue ear that does not clear, an ENT specialist might recommend a short course of a steroid nasal spray to reduce inflammation around the Eustachian tube opening. If hearing loss or infections continue, grommet insertion is the most common surgical option. The operation is done under general anaesthetic (you are asleep) and takes about 15 minutes. A tiny incision is made in the eardrum, the fluid is suctioned out, and a grommet (a small tube) is placed to keep the opening from closing. This allows air to flow in and fluid to drain. The grommet will usually fall out on its own after 6 to 12 months, and the eardrum heals naturally.
When is surgery considered?
Grommet insertion is considered when: fluid has been present for more than 3 months and is causing hearing loss (especially if it affects speech or learning) OR when a child has 4 or more ear infections in 6 months despite medical treatment. The decision is made together with your ENT specialist.
Living with this condition
After grommet insertion, most children and adults feel better quickly. Hearing often improves immediately. You will need to keep water out of the ears – use earplugs or a shower cap while bathing or swimming. Your doctor will tell you how long to take this precaution (usually until the grommet falls out). Avoid diving or jumping into water. Follow‑up hearing tests are usually done 3 and 6 months after surgery.
Lifestyle tips
Use earplugs or a waterproof headband when showering, bathing, or swimming.
Avoid putting anything small into the ear canal (like cotton buds).
Keep follow‑up appointments with your ENT team.
If your child has grommets, let the school nurse and teachers know, and keep earplugs in the school bag.
Avoid flying with an ear infection or with grommets that have fallen out and left a hole (if the eardrum hasn’t healed).
Diet and exercise
No special diet is needed after grommet insertion. Normal activities can resume once your doctor says it is safe (usually after a day or two). Avoid contact sports or swimming for the first week, then check with your surgeon. Gentle exercise is fine – walking, playing.
Mental health and emotional wellbeing
Hearing loss and ear infections can be frustrating for both children and adults. Children may feel left out at school or become withdrawn. Adults may feel isolated. It is normal to feel worried before surgery, but most people find grommets greatly improve quality of life. If you or your child feel anxious, talk to the doctor or a counsellor. For mental health crisis support, contact your local crisis team or call a helpline like the Samaritans (if in the UK) – your healthcare provider can give local numbers.
Prevention
You cannot always prevent glue ear or ear infections, but you can lower the risk. Avoid exposing children to second‑hand smoke. Breastfeeding (if possible) can help strengthen the immune system. Try to keep children away from crowded places during cold and flu season. For older children and adults, managing allergies can help reduce Eustachian tube blockage.
Vaccines
The pneumococcal vaccine (PCV) and the flu vaccine can reduce the risk of ear infections caused by certain bacteria and viruses. Check with your doctor about recommended vaccines for you and your child.
Screening programmes
There is no routine screening for glue ear. However, if a child has risk factors (like Down syndrome or cleft palate), hearing checks are often done regularly from birth. For other children, watch for signs of hearing difficulty and mention them to the doctor.
Complications
If left untreated
Persistent hearing loss that can affect speech, language, and learning in children.
Chronic ear infections (otitis media) that can damage the eardrum or middle ear bones.
Formation of a cholesteatoma (a skin cyst that can grow and damage the ear).
Rarely, infection can spread to the bone behind the ear (mastoiditis) or to the brain (meningitis).
Long-term outlook
Grommet insertion is a very safe and effective procedure. Most people have significant improvement in hearing and fewer ear infections. The grommets fall out on their own, and the eardrum heals in nearly all cases. In a small number of children, grommets may need to be replaced if the problem returns. With proper care and follow‑up, the outlook is excellent – children can catch up on speech and learning, and adults can enjoy better hearing and less pain. If you have concerns, your healthcare team is there to help.
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Always verify with your doctor
Health guidelines vary by country and region. The information in this article is based on international clinical guidelines but may not reflect the specific guidelines, medications, or practices in your country. Always discuss your health concerns with your own doctor or healthcare provider, and refer to your local national health guidelines where available.
Important notice This information is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are experiencing a medical emergency, call your local emergency services immediately.
Sources and guidance
This article is educational and is prepared with reference to recognized health information and clinical guidance sources where available. Specific source links may vary by topic.
Last updated: July 9, 2026
Educational note: This information is for education only and is not a diagnosis.
Use it to support, not replace, advice from a licensed clinician.
If symptoms are severe, worsening, or urgent, call your local emergency number or seek emergency care.
