Paediatric ENT Specialist Adelaide - Grommets

Grommets

What they are and What they do

Grommets are tiny flanged tubes, usually made out of plastic, which are inserted through a small cut in the ear drum to allow air into the ear until the Eustachian Tube begins to function normally. Grommets are also called Ventilating Tubes, Tympanostomy Tubes, Pressure Equalization Tubes, or simply Tubes. This operation of inserting Grommets is the most common operation performed in children.

Grommets come in different sizes with the smaller tubes usually inserted initially. They tend to extrude out of the ear after 6 to 12 months as the ear drum replaces itself, and you may not notice when this occurs. Sometimes the grommets can fall out sooner, and sometimes they can stay in for longer than expected.

Larger tubes are chosen when it is desirable for the tube to stay in the ears longer. These are reserved for the small percentage of patients who have had repeated grommets inserted because of ongoing ear problems. Often a further procedure is required to remove long-term tubes when it is felt that they are no longer required.

The function of grommets is not so much to drain fluid from the middle ear, but rather to ventilate the middle ear which is usually the job of the Eustachian Tube – the tube that goes from the back of the nose to the ear. This tube does not function so well in young children due to various factors, and occasionally this dysfunction can persist into adulthood. Grommets will ventilate the middle ear which

  1. allows the aeration of the middle ear and this helps restore the lining of the middle ear back to health, and
  2. enables mucous and fluid to drain down the Eustachian tube.

Grommets are therefore useful in children who suffer with

  1. recurrent ear infections (Recurrent Acute Otitis Media)
  2. persistent middle ear fluid (Otitis Media with Effusion)

as well as a number of other situations including ear problems related to pressure change such as those experienced in some children when flying.

Where these conditions are present, the possible benefits of grommets include

  • improvement in hearing where hearing loss is due to middle ear fluid
  • reduction in frequency of ear infections
  • resolution of structural changes of the eardrum

This can also result in

  • improvements in balance and mobility
  • improvements in sleep
  • improvements in speech development
  • improvements in well being and happiness of the child (and parents!)

although these do not apply to all patients who may benefit from grommets.