Postoperative Care - Grommets
Grommets are small plastic tubes that are inserted into the ear drum, usually as treatment for glue ear, recurrent ear infections or other Eustachian tube problems. You can read more about grommets (also known as ventilation tubes) here. You (or your child) will usually be able to go home a couple of hours after the grommets have been inserted. Occasionally there will be some blood-stained discharge for a day or two; this is nothing to be concerned about. It is not usually a painful procedure; any discomfort can usually be treated with paracetamol and/or ibuprofen. You will usually have a follow up appointment made for one month after the procedure.
If there is a possibility that the ear was infected when the grommets were inserted, then you may be given a course of antibiotic drops to put in the ear for a few days.
Grommets usually stay in place for 9-12 months before they fall out. Whilst the grommets are in place, you can usually avoid any problems by taking a few simple precautions.
Keeping ears dry
The most common problem after grommet insertion is infection. In most cases, this is caused by water getting in to the ears. It is therefore a good idea to keep the ears dry whilst the grommets are in place. This can either be done using ear plugs, or alternatively by using some cotton wool coated with petroleum jelly (for example Vaseline). If you are using the cotton wool method, take a piece of cotton wool about the size of an adult thumbnail, and coat it generously with Vaseline. This can then be place in the shell part of the ear, blocking the entrance to the ear canal. It is not a good idea to insert small pieces into the ear canal, as they can easily get stuck.
Using the cotton wool method is particularly useful if the ear is infected and needs to be kept dry. This is because the cotton wool can be thrown away after each use. If ear plugs are used, it is very difficult to properly clean all of the discharge and bacteria from the surface, and the infection can be reintroduced into the ear with the ear plug.
Sometimes younger children don’t tolerate ear plugs or cotton wool in the ears. If this is the case, then a hair-wash visor can be used for hair-washing, or a shower cap pulled over the ears for a bath or shower without hair-washing.
Can I swim with grommets in?
Yes, it is fine to swim with grommets in (including put the head underwater), however it is advisable to put earplugs in and secure these in place with a headband. Both of these items can be bought from any reasonable sized chemist, or online. Your child shouldn’t swim for a week after the grommets are inserted. Personalised swim moulds can also be made and provide good protection. These are more expensive, and are fitted by an audiologist. Please let me know if you would like me to arrange this.
Can I play sport with grommets in?
Yes, your child can play sport and resume normal activities two days after grommets are inserted.
When can my child return to school after grommet insertion?
Your child will need one day off school after grommets are inserted. If adenoids were removed at the same time, then one week off school will be needed. If the tonsils were also removed, then one to two weeks off school will be required.
When will hearing improve after grommets?
Often an improvement will be noted straight after the procedure. Sometimes it can take a day or two for an improvement to be noted. When the hearing improves, some children become more sensitive to sounds. This is quite normal and usually settles down after a few days, although sometimes it can take several weeks to adjust.
When can I fly after grommets?
You can fly a day or two after having grommets fitted. In most cases flying is more comfortable, as the ear pressures equalise automatically through the grommet.
What happens if I my grommet gets infected?
About 5% of patients will have an infection whilst the grommet is in place. This is often caused by getting water in the ear, and is usually noticed when the ear feels blocked and starts to discharge. Occasionally discharge occurs if you have a cold (upper respiratory tract infection). If you have an ear infection, or think you might have one, please let me know. They are usually straightforward to treat with a course of antibiotic drops in the ear, occasionally with antibiotics by mouth. Sometimes the ear needs to cleaned of discharge to help the antibiotic drops work, this is done by myself using a microscope in the outpatient clinic.