What are grommets?

A grommet is a small tube that sits in your child’s ear. It helps air to flow between parts of their ear to keep it healthy. They may need a grommet in both ears or just one.

The ear is made up of the outer ear , middle ear and inner ear . The eardrum is a thin piece of skin between the outer ear and middle ear. The grommet sits in a small hole in your child’s eardrum. They will need a short operation to have it fitted.

Why does my child need grommets?

The most common reason for needing grommets is a condition called glue ear . This is when fluid builds up in the middle ear instead of draining away. It is a common condition in young children.

Symptoms of glue ear include:

• problems with hearing
• delayed speech development (in very young children)
• earache
• a feeling of pressure in the ear
• hearing ringing or buzzing sounds (tinnitus)
• problems with balance

Many children have glue ear at some point and it does not always cause problems. The doctor will usually only suggest grommets if your child is having lots of ear infections or hearing problems.

You can read more about glue ear on the NHS website. The video at the bottom of the NHS page explains how the ear works, what happens in glue ear, and how grommets can help.

How do grommets work?

Grommets do not cure glue ear or whatever is causing it. They help to improve the symptoms of ear pain and hearing loss over a period of time.

They do this by allowing air to flow between the outer and middle ear. This balances the pressure on each side of the eardrum. It helps to stop the build-up of fluid that happens in glue ear.

Are grommets just for children?

No. Although it is most common in young children, adults can get glue ear too. It might go away by itself, but if it is causing problems, a doctor might recommend grommets.

You will need to sign a form to say you are happy for your child’s operation to go ahead (consent). People aged 16 and over can give their own consent.

What happens during grommet surgery?

Your child will have a general anaesthetic. This means they will be asleep for the operation and will not feel anything. Your hospital team will explain what will happen and tell you how to prepare. This will include instructions on fasting (not eating and drinking) before the general anaesthetic.

Your child might have the anaesthetic by:

• breathing gas through a mask (more common for younger children), or
• an injection into a vein in their hand or arm (more common for older children)

It will often be possible for you to go with them into the anaesthetic room and stay until they are asleep. You will not be able to go with them into the operating theatre.

The surgeon will make a small hole in your child’s eardrum and drain away any fluid that has built up. They will then insert the grommet into the hole to allow air to flow in and out of the middle ear.

The operation itself takes around 15–20 minutes.

After this, the hospital team will take your child to a recovery room to wake up. They will keep checking your child’s pulse and temperature to make sure they are recovering well from the anaesthetic. They will also check the ear(s) that had the grommet(s) fitted. They might give your child some antibiotic ear drops to reduce the risk of infection.

You will usually be able to take your child home on the same day.

What happens after grommet surgery?

Your child should recover quickly after their surgery. You should also see some improvement in their symptoms straight away. They should be ready to go back to school after a day or two.

During the first couple of days, they might:

• feel drowsy or sick from the anaesthetic
• have a slight earache
• have a small amount of fluid (discharge) or bleeding from their ear

Your hospital team will tell you how you should treat mild symptoms after the operation and what to look out for. Get in touch with them if you are worried or not sure.

Your child might have a follow-up appointment a month or two after having the grommet(s) fitted.

How long do grommets stay in for?

It varies from person to person, but grommets usually stay in for between 6 and 18 months. They fall out by themselves.

In many cases, this is enough time for your child’s ear problems to get better by themselves as they grow. Their symptoms will stop and the hole in their eardrum will heal.

If their symptoms come back after the grommet has fallen out, your child might need another operation to insert a new one. This might happen more than once.

Are there any risks with having grommets?

Grommet surgery is a simple and safe operation. Most people recover well and do not have any complications.

However, as with all operations, there are some risks. These include:

• ear infections
• bleeding or fluid (discharge) for longer than the first few days
• pain
• a hole (perforation) in the eardrum that does not close up after the grommet has fallen out

Infections can usually be treated with antibiotics. Your hospital team will advise you on suitable pain relief if needed. If problems are ongoing, it is possible your child will need surgery to remove the grommet(s). They might also need surgery if they have a hole in their eardrum that does not close up.

Your child’s doctor will explain any risks to you before you decide to go ahead with the operation. Risks may be different if your child has other health conditions.

There are also risks involved in having a general anaesthetic. Problems are uncommon, but a doctor (anaesthetist) will explain any risks to you before the operation.

If you are not sure about something, ask the doctor or someone else from the hospital team.

Do I need to do anything differently while my child has grommets?

Always follow the advice from your own hospital team.

They will tell you to stop water getting into your child’s ears as much as possible while they have grommets. This is to reduce the risk of infection.

Advice will usually include:

• not getting dirty or soapy water in their ears at all
• putting cotton wool covered in Vaseline in their ears when they have a shower or wash their hair
• being allowed to swim, but using earplugs if they are playing under the water
• not diving or going far under the water – this is because the water pressure deeper down is higher, and this can push water through the grommet.

What are the alternatives to having grommets?

Your child’s doctor might not recommend grommets straight away. Ear problems often go away on their own with time. If your child’s symptoms are not too bad, the doctor might suggest waiting a while longer to see what happens.

Depending on your child’s symptoms and what is causing them, the doctor might suggest other options, such as:

• antibiotics, painkillers and nasal sprays
• hearing aids
• removing their adenoids (small lumps at the back of their throat, behind their nose)

The doctor will explain the treatment options for your child based on their symptoms and circumstances.

Contact your GP if your child has symptoms of glue ear. If the problems are severe or keep coming back, they might refer your child to an ear, nose and throat (ENT) specialist. The ENT specialist will assess your child’s symptoms and explain their treatment options.

How do I get grommet surgery for my child?

Grommet surgery for children is available through the NHS and private healthcare providers. You can choose to see a private specialist or have the surgery privately, even if you have seen an NHS GP first.

The NHS has limited funding for adult grommets, so the criteria are strict.

You can search for ‘grommet insertion’ as a procedure from our homepage. Add your location to find hospitals and surgeons near you that offer this service.

How much does private grommet surgery cost?

Private grommet surgery with general anaesthetic might cost between £2,000 and £3,500. This varies between healthcare providers and between areas.

In some cases, adults might be able to have a local anaesthetic instead of a general anaesthetic. This might cost less.

Find out exactly what the cost includes for your particular healthcare provider. They will tell you whether there are extra costs for an initial consultation and any aftercare. They might offer you payment plans or packages.

Your healthcare insurance might cover grommet surgery. Check your policy and ask your insurance provider what you need to do.

References

ENT UK Patient Hub: Glue ear
https://www.entuk.org/patients/conditions/4/glue_ear_otitis_media_with_effusion_ome

ENT UK Patient Hub: Grommets – A decision-making aid for parents
https://www.entuk.org/patients/conditions/5/grommets_a_decisionmaking_aid_for_parents

NHS – Glue ear
https://www.nhs.uk/conditions/glue-ear/