Preparing for grommets

Overview

Grommets are tiny tubes that a surgeon puts into your child's eardrum. They help drain fluid from the middle ear and stop ear infections. This improves hearing and reduces pain.

Getting grommets is a very common operation in children. It is the most common childhood surgery in many countries.

Grommets are most often placed in young children — usually between 1 and 3 years old — who have frequent ear infections or fluid buildup (glue ear). They can also help some older children and adults.

Symptoms

Common symptoms

• Ear pain or pulling at ears
• Trouble hearing (asking 'what?' more often)
• Fluid draining from the ear

Symptoms in children

• Irritability or fussiness
• Trouble sleeping
• Poor balance or clumsiness
• Not responding to quiet sounds

Symptoms in older adults

• Ear fullness or pressure
• Muffled hearing
• Earache that lasts

Causes

Main causes

• Frequent ear infections that don't clear up with medicine
• Fluid that stays in the middle ear for months (glue ear)
• A blocked Eustachian tube (the tube that connects the ear to the back of the throat)

Risk factors

• Being around cigarette smoke (secondhand smoke)
• Bottle-feeding instead of breastfeeding (breastfeeding may lower risk)
• Genetics — if parents had ear problems, children may too
• Attending daycare (more exposure to germs)

When to see a doctor

See a doctor urgently if:

• If your child has new ear pain after grommets and it gets worse
• If you see pus or blood coming from the ear after the operation

Book a routine appointment if:

• If your child has had three or more ear infections in 6 months
• If hearing loss or speech delay is noticed
• For a follow-up appointment after grommet surgery

Diagnosis

A doctor will look inside the ear with a special lighted tool called an otoscope. They may also use a test called tympanometry to check how the eardrum moves.

Tests that may be done

• Otoscopy — a quick look in the ear
• Tympanometry — a gentle air puff test
• Hearing test (audiometry) — to measure hearing loss

What to expect at your appointment

The doctor will explain why grommets might help, what the surgery involves, and how to prepare your child. You'll be given instructions about fasting (not eating or drinking) before the general anaesthetic.

Treatment

Grommets are a common treatment for glue ear and frequent ear infections. The surgeon makes a tiny hole in the eardrum, drains fluid, and places a small tube. This lets air into the middle ear and stops fluid from building up.

Self-care at home

• Keep your child's ears dry while bathing or swimming — use a cotton ball with petroleum jelly in the outer ear
• Give simple pain relief (like paracetamol or ibuprofen) if the doctor says it's safe
• Watch for signs of infection after surgery, like fever or drainage

Medical treatments

Antibiotics may be prescribed before or after surgery to treat active infections. Ear drops might be used after grommet placement. Your doctor will tell you which treatments are right for your child — never use any medicine without advice.

When is surgery considered?

Surgery is usually recommended when ear infections keep coming back (three or more in six months) or when glue ear causes hearing loss that affects speech or learning.

Living with this condition

After the grommets are in place, many children hear better and have fewer earaches. You'll need to keep water out of the ears while the tubes are in — use earplugs or a shower cap. Most children can return to school or daycare in a day or two.

Lifestyle tips

• Avoid swimming in dirty or untreated water
• Use earplugs during baths or showers
• Call your doctor if water seems to get in (it can cause infection)

Diet and exercise

No special diet is needed. Normal activity is fine, but contact sports should wait until the doctor says it's safe — usually about 2 weeks.

Mental health and emotional wellbeing

It can be worrying to see your child have surgery, but most children recover quickly and feel much better. The improvement in hearing often helps with speech, learning, and social skills.

Prevention

You cannot always prevent the need for grommets, but you can reduce the risk of ear infections. Breastfeeding for at least the first few months (if possible) and avoiding cigarette smoke around your child can help.

Vaccines

Make sure your child gets all routine childhood vaccines, including the pneumococcal vaccine, which helps prevent some ear infections.

Screening programmes

Hearing screening is offered for newborns in many places. For children at risk, regular hearing tests can catch problems early.

Complications

If left untreated

• Persistent hearing loss that can delay speech and language
• More severe ear infections that spread to the mastoid bone behind the ear
• Scarring of the eardrum over time

Long-term outlook

For most children, grommets work well. Hearing improves, pain decreases, and ear infections become less frequent. The tubes fall out on their own, and the eardrum heals. Even if more tubes are needed later, the long-term outlook is excellent.

Find support

International organisations

• National Deaf Children's Society (NDCS)
• Hearing Link

Local organisations

• Your local NHS audiology department · United Kingdom

Helplines

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