Grommet Insertion (Adult)

Grommet Insertion (Adults)

Grommet insertion, medically known as myringotomy with ventilation tube placement, is a simple surgical procedure to address middle ear problems such as fluid build-up or recurring infections. While grommets (tiny ventilation tubes) are commonly associated with children, adults may also benefit from this procedure if ear issues affect hearing or quality of life.

Why might you need grommet insertion?

The middle ear is an air-filled space behind the eardrum. It connects to the back of your nose via the eustachian tube, which helps balance pressure and drain fluid. If the eustachian tube doesn’t function properly, it can lead to:

• Glue ear (otitis media with effusion): A build-up of thick, sticky fluid causing hearing loss or a blocked sensation.
• Recurrent ear infections: Frequent infections that disrupt daily life.
• Barotrauma: Pain or discomfort caused by pressure changes, often during flying or diving.

When non-surgical treatments such as antibiotics or nasal sprays fail, grommet insertion can relieve symptoms and prevent further complications.

What preparation is required?

Before undergoing grommet insertion, your doctor will ensure you are well-prepared:

• Medical assessment:
  A thorough examination of your ear and medical history will be conducted to confirm the need for the procedure.
• Medication review:
  Inform your doctor of any medications you are taking, especially blood-thinning medications, as these may need to be adjusted.
• Fasting:
  If the procedure is performed under general anaesthetic, you will need to avoid eating and drinking for at least 6–8 hours before surgery.
• Post-surgery support:
  Arrange for someone to accompany you home after the procedure, as you may feel drowsy if anaesthesia is used.

What does the procedure involve?

Grommet insertion is typically a quick procedure, lasting 10 to 20 minutes. It can be performed under general or local anaesthetic.

Steps involved:

• Making a small incision:
  A tiny cut (myringotomy) is made in the eardrum to access the middle ear.
• Draining fluid:
  Any fluid trapped in the middle ear is gently suctioned out.
• Placing the grommet:
  A small ventilation tube (grommet) is inserted into the eardrum to allow air to flow into the middle ear and prevent fluid build-up.

The grommets usually remain in place for several months before falling out naturally as the eardrum heals.

Benefits of grommet insertion

This procedure offers quick and effective relief from persistent ear problems. Benefits include:

• Improved hearing and reduction of hearing loss.
• Relief from ear pressure and discomfort.
• Fewer ear infections and associated symptoms.
• Easier flying or diving, with reduced pressure-related issues.

These improvements can enhance your quality of life, especially if ear problems have impacted daily activities or work.

Risks and complications

Grommet insertion is a safe and routine procedure, but like all surgeries, it carries some risks:

• Infection: Rarely, an ear infection may develop but can be treated with antibiotic drops.
• Persistent perforation: In a small number of cases, the eardrum may not fully heal after the grommet falls out, requiring further treatment.
• Scarring of the eardrum: Minor scarring can occur but usually doesn’t affect hearing.

Your surgeon will explain these risks fully and answer any questions you may have.

What to expect after surgery

Hospital stay:
Grommet insertion is usually a day-case procedure, allowing you to return home the same day.

Pain and discomfort:
Mild discomfort or a sensation of fullness in the ear is common but typically resolves within a few days. Over-the-counter pain relief, such as paracetamol or ibuprofen, can help.

Hearing changes:
Many people notice an immediate improvement in hearing, but the ear may feel different as it adjusts to the grommet.

Water precautions:
You may need to take precautions to keep water out of your ear, such as using earplugs while swimming or showering. Follow your doctor’s specific advice.

Returning to activities:
Most people can return to work or normal activities the next day. Avoid vigorous activities until cleared by your doctor.

Recovery from grommet insertion is generally quick and uncomplicated. Most people can return to their normal activities the day after the procedure, although it’s essential to follow your doctor’s advice regarding water precautions and physical activity. Mild discomfort or a feeling of fullness in the ear is common but should improve within a few days. To ensure proper healing, keep your follow-up appointments with your surgeon, and report any persistent symptoms, such as pain or discharge, to your doctor. With the right aftercare, you’ll soon experience the benefits of improved hearing and reduced ear problems.