Introduction
A grommet is a small silicone or plastic tube. It can be used to help address infections, hearing problems and eustachian tube dysfunction.
Indications
Common indications to have grommets placed include:
- Recurrent middle ear infections.
- Persistent middle ear fluid.
- Eustachian tube dysfunction.
- Barotrauma.
Risks
The specific risks associated with Grommet surgery include but are not limited to:
Common
- Trauma to Ear canal.
- Ear infections.
- Early extrusion.
- Perforated Ear drum (1:50).
- Recurrence of Problem.
Uncommon and Rare
- Loss or reduction of hearing.
- Altered or lost taste.
- Vertigo / poor balance.
- Facial nerve injury.
Treatment Alternatives
Treatment alternatives can be discussed with Dr Morrissey and will differ from person to person depending upon circumstances. In general, infections can be managed with pain relief and antibiotics when they occur. Middle ear fluid will sometimes respond to “autoinflation” devices but results are variable and it is not for everyone. Eustachian tube dysfunction and Barotrauma can be aided by special ear plugs in some cases.
Preoperative Instructions
Where grommets are being placed under a local anaesthetic, you will need only attend your appointment and allow around an hour in total to complete the procedure. This allows time for the anaesthetic to work before the grommets are placed.
If a general anaesthetic is being used, you will need to follow the instructions provided by the Anaesthetist and admitting hospital. Should you have any queries please contact Dr Morrissey and his staff on (07) 4646 4275.
Procedure
Grommets can be placed under either a general or a local anaesthetic depending upon circumstances. Children will usually require a general anaesthetic.
Once the patient is ready, Dr Morrissey will clean the ear under the microscope and remove any wax or other material. He then checks the eardrum and will make a small incision in the eardrum. If there is fluid present it is then removed with suction. The grommet is placed into the small incision. The grommet is designed to sit in the incision with flanges either side, allowing air in and fluid out of the middle ear.
After the grommet has been accurately placed, Dr Morrissey uses an antibiotic eardrop to minimize the risk of an infection immediately after the procedure.
Postoperative Instructions
Return to normal activities
Most children recover quickly from insertion of grommets. You may choose to keep your child away from day-care, kindergarten and school for 1-3 days following surgery but often they will be well enough to attend.
General activities can be resumed when your child feels up to it.
Pain relief
Children may experience some minor ear discomfort following surgery. Paracetamol (Panadol) or Ibuprofen (Nurofen) is usually all that is required. Please follow dosage instructions as advised by the manufacturer.
Should pain relief requirements exceed this, please contact our Practice.
Antibiotics
Eardrops are prescribed for 3 days following surgery. This will aid in keeping the grommets open and reduce, but not eliminate, the risk of a post-operative infection. Apply as instructed.
Diet
There are no restrictions on diet.
Fever
It is common to have a mild fever for the first 24hrs after the operation. Please call our Practice if there is a persistent fever greater than 38.5°C.
Bleeding / Discharge
On occasion there may be a discharge of fluid or old blood from the ear. This will usually be a small volume and should clear up over a few days.
Grommets and Water Precautions
Following insertion of grommets, excessive water entering the ear canal may travel through the grommet into to the middle ear, potentially leading to ear infections.
Showering is usually not a problem; however, if bathing then please protect the ears by placing cotton wool coated in Vaseline into the entrance of the ear canal or use earplugs.
Avoid swimming completely for 2 weeks following grommet surgery. Beyond 2 weeks it is preferable to use earplugs or a swimming cap / headband to protect the ears from water entry.
A small percentage of children will develop ear infections. This will usually feature discharge from the ear and occasionally pain. If your child develops an infection, then please contact our Practice for advice.
For further information, please consult our “Grommets and Water” handout via our website.
Follow Up Appointment
At the time you book the surgery a post-operative appointment will usually be organised. Please contact our Practice if you are unsure as to the appointment details.
How to contact your Surgeon
For non-emergency issues please call (07) 4646 4275. for further instructions.
ENT Surgeons in Toowoomba share ‘On-Call’ and one is usually available to answer questions. After hours the "On Call" ENT Surgeon can be contacted via the Toowoomba Hospital on (07) 4616 6000.
Should your concerns not be addressed via a phone call, please present to your nearest Emergency Department.
In the event of an Emergency call 000 or attend the nearest Emergency Department.
