Grommets; what are they and why might they be needed
What are Grommets?
Grommets are tiny hollow tubes, usually made of plastic or metal, that are surgically inserted into the eardrum.
The purpose of grommets is to ventilate the middle ear and allow any fluid build up to drain.
They are primarily used to treat conditions like Glue Ear and recurrent middle ear infections.
Grommets also usually fall out on their own as the ear drum naturally heals
With that in mind lets hear what our Audiologist Louise Hart has to say on grommets and how we can help at Tracy James Hearing.
In the medical field there is always more than one name for something they are also called tympanostomy tubes, myringotomy tubes, or pressure equalizing tubes. They are fitted by ENT surgeons either under a general or a local anaesthetic, and are often done at the same time as removal of tonsils or adenoids.
What are the benefits of grommets?
Grommets can improve hearing straight away post-surgery
Grommets can help prevent future re-occurrence of glue ear particularly if adenoids or tonsils are removed at the same time. (these can often block the eustachian tube and if they do so this may increase the likelihood of glue ear)
Children and Grommets
Grommets are more often fitted to children as glue ear is common in childhood due to the anatomical difference between children and adults. Most children will have at least one incident of glue ear during their childhood. Grommets are only recommended after a child has had 2 hearing tests, 3 months or more apart which shows that the glue ear hasn’t resolved and the hearing is being significantly affected. (often in cases where there is only a mild effect on the hearing, ENT may watch and wait and suggest the use of nasal sprays, Otovents etc).
Glue ear in adulthood is less common and if it is there longer than 3 months referral to ENT should always be made as this is not a normal state for the adult middle ear. The only exception are adults with Downs Syndrome, cranial facial abnormalities or those who have had a recent history of radiotherapy around their head or neck.
Grommets are a safe procedure and done routinely throughout the world. Like any surgical procedure there are risks and those should always be discussed with you by your ENT surgeon prior to any operation.
Grommet surgery
A surgeon makes a small incision in the eardrum
Any fluid (such as otitis media) is removed
The grommet is inserted into the hole
The grommet allows air to pass through the eardrum, equalizing air pressure on either side
The grommet is there to teach the eardrum to learn to re-ventilate itself.
So why not just make an incision and suck out the glue ear?
We find if you do that the glue ear just returns as the middle ear hasn’t had enough time to learn how to re-ventilate itself so the glue ear just comes back.
How long do grommets stay in for?
Grommets usually stay in place on average for six to 18 months and then fall out (remember it can be less or more than this time)
As they fall out the hole in the eardrum will close over
There are grommets called T-Tubes these are long term grommets (they are more like a tube without the flange on the end) they stay in and only come out if they are taken out surgically. They are usually fitted when there is a history of recurrent middle ear infections, persistent fluid in the middle ear, (where grommets haven’t worked) or recurrent barotrauma.
Written by: Louise Hart PG Dip RCCP RHAD
How can we help?
At Tracy James Hearing we can diagnose glue ear and monitor hearing pre and post surgery. We can also provide recommendations on alternatives to surgery such as, watch and wait or hearing aids. We can refer to ENT for consideration of grommets and/or appropriate alternative intervention. We can test children from the age of 6 months onwards.
