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Grommet Insertion

Some people get fluid behind the eardrum which is called ‘glue ear’. It is very common in young children, but it can happen in adults too. We do not know exactly what causes glue ear.

If your child is experiencing hearing problems as a result of glue ear, there are ways you can help.  Speak clearly, and wait for your child to answer and make sure he or she can see your face when you speak. Let nursery and school teachers know that your child has a hearing problem as it may help for your child to sit at the front of the class.

What are the associated problems?

Most young children will have glue ear at some time, but it doesn’t always cause problems; treatment is only required if it is causing problems with hearing or speech, or if it is causing a lot of ear infections.

What are the treatment options?

It is recommended that children are untreated for the first three months, because about half will get better in this time. After three months, the child will be reviewed again and only then will a decision be made whether or not we need to operate. Mr Fayad may prescribe nose drops or nasal sprays to alleviate the problem. Antibiotics and antihistamines do not seem to help this type of ear problem.

If the problem has not resolved itself, it may be necessary to insert grommets.

Grommets are very small plastic tubes (they can also be made of titanium), which sit in a hole in the eardrum. They let air get in and out of the ear and this keeps the ear healthy.
The glue ear may come back when the grommet falls out, which happens as the eardrum grows – they may stay in for six months, or a year, or sometimes even longer.

Recurrent glue ear happens to one child out of every three who has had grommets inserted, and more grommets may be required to last until your child grows out of the problem.

Taking out the adenoids may help the glue ear get better, and Mr Fayad may want to do this at the same time as inserting the grommets.

Another option is a hearing aid, as this can sometimes be used to treat the poor hearing and speech problems which are caused by glue ear.  A hearing aid would mean that your child would not need an operation.

What is the recovery like?

Your child should be able to go back to school or nursery the day after the operation as they should not be sore at all. Grommets should improve your child’s hearing straight away and they might think everything sounds too loud until they get used to having normal hearing again. This usually takes only a few days.

Your child can start swimming a couple of weeks after the operation, as long as they do not dive under the water. You do not need to use earplugs – the hole in the grommet is too small to let water through. You do need to avoid getting dirty or soapy water into the ear, so in the bath or shower plug your child’s ears with a cotton-wool ball covered in Vaseline or a paediatric ear-plug.

Mr Fayad will need to check your child’s hearing after grommets have been put in, to make sure their hearing has improved.

What are the possible side effects and complications?

Grommet insertion is a relatively safe operation, but as with all surgical procedures, it is not totally free of any risk. Most people with grommets do not get any ear infections, but if you see yellow fluid coming out of the ear, it may be an infection. It will not be as sore as a normal infection, and your child would not be as poorly. If you get some ear drops from your doctor, the problem will quickly settle. Some doctors may give antibiotics by mouth instead of antibiotic ear drops.

In about two per cent of patients, when a grommet comes out, a small hole is left behind and some of these patients may require a further operation in future to repair the remaining hole if it causes any problems.

The grommet can leave some scarring in the eardrum but this does not affect the hearing.

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