Display Patient Information Leaflets

Date issued: November 2024 

For review: November 2026  

Ref: A-669/TA/ENT/Adult Grommets

PDF: Grommet Adult Tavistock.pdf [pdf] 299KB

About this leaflet

Your surgeon has recommended inserting a grommet to treat your problem, but the decision whether to go ahead is yours entirely. This leaflet gives you some information about the risks and benefits, to help you make an informed decision

Introduction

Grommets are usually recommended for the treatment of “glue ear”, but they are also used occasionally to treat balance problems. 

What are grommets?

A grommet is a tube that sits in a small hole in the eardrum. It can be made of plastic or metal, and they can be short, like a bobbin, or long and T-shaped. The most commonly used type is a plastic bobbin.

What is glue ear?

Glue ear is a common condition where mucus builds up behind the eardrum. When there is a lot of fluid it can interfere with hearing. 

In a lot of cases glue ear will clear up by itself and will not require any treatment. However, if it has persisted for more than 3 months, then most doctors would feel that it requires treatment of some sort.  

What causes glue ear?

The reason people get glue ear is because the tube that normally drains the mucus away (the Eustachian tube) doesn’t work very well. In some patients this is due to the tube being blocked, but most of the time we do not know why the tube does not work. 

Why may an operation help?

There is no treatment available that will make the Eustachian tube work properly, but in patients with glue ear, having a grommet inserted allows the mucus to be removed, and the hearing will then usually improve. 

What will happen if I decide that I don’t want to have an operation?

If glue ear is not treated by surgery, then there is a good chance it will get better by itself in time, but how long this will take cannot be predicted; it may take years. Some people will cope very well with a mild hearing loss, but most people with a persistent hearing loss would want to have it corrected.

Are there any alternatives to surgery?

There are no medicines or other non-surgical treatments that have been shown to be of any benefit in getting the ear mucus to disappear any quicker than it would if left alone. 

A hearing aid can be used to boost sound levels enough to allow a patient with glue ear to hear better, and if you wished to go down this route rather than have grommets inserted then your surgeon will arrange this for you.

The operation 

What does the operation involve?

Anaesthetic

Grommets in adults can be inserted under general anaesthetic, or local anaesthetic. Under general anaesthetic you would be asleep throughout the procedure and will not feel anything.

Local anaesthetic can be given by injection around the ear, or by using a cream inside the ear canal. You would be awake during the procedure, and your stay in hospital would be shorter than if you had a general anaesthetic.

Approach

Grommets are inserted through the ear canal. There are, therefore, no external scars. 

Procedure

A small hole is made in the eardrum, and the excess mucus is removed. The grommet is then placed in the hole.

Dressings

No dressings or bandages are required. Your surgeon may sometimes place a small piece of cotton wool in the ear canal if there has been any bleeding.

Aftercare

You will normally be able to go home on the day of their operation, once you have recovered from the effects of the anaesthetic. If you had the procedure under local anaesthetic, then you could normally leave immediately afterwards.

Follow up

Most grommets will fall out by themselves. Most plastic bobbin grommets last 12 to 18 months, although some can fall out very early, and some may stay in permanently and so will need to be removed with a second operation. T-grommets tend to last for longer.

When the grommets have fallen out, the Eustachian tube may have started to work better in which case the glue ear will not return, but in many cases, the glue will come back and further grommets may need to be inserted. 

Afterwards

Do I need to take any time off work?

If you had the operation under general anaesthetic, then you can return to work the following day. If you had it under local anaesthetic, then you could return to work straight away if you wanted to.

Are there any things I must not do afterwards?

We would normally recommend that you try to keep water out of your ears for 2 weeks following their operation. After this you can safely ignore the presence of the grommets altogether.

Complications 

Are there any complications?

Most operations are successful, and there are generally very few problems. 

However, every operation has risks and these need to be understood before you agree to go ahead with treatment. These risks fall into 3 categories:

Complications of the anaesthetic

If you are having a general anaesthetic your anaesthetist will discuss the anaesthetic with you before your operation.

Complications that can affect any operation

• Pain: which occurs with every operation. Having grommets inserted is usually not very uncomfortable, and most people will be pain free with paracetamol, if they need anything at all.

• Bleeding: this can occur during or after an operation. Bleeding from the ears can occur after grommets insertion but is usually of no significance and settles by itself. 

Complications that are specific to grommets insertion

• Ear discharge: this is not uncommon after grommets are inserted, affecting up to 1 in 3 people. If it lasts more than a day or two you may need to visit your GP to see if antibiotics are required.

• Small hole left in the eardrum: when a grommet falls out, the eardrum usually heals up after it, but sometimes a small hole is left behind. This can affect up to 2 in 100 people with plastic bobbins, and up to 45 in 100 with T-tubes. In some occasions the hole needs to be repaired with a second operation. 

• Grommet blockage: sometimes blood or mucus can dry in the hole in the middle of a grommet and block it up. They can often be unblocked with eardrops but will sometimes need to be removed or replaced.

What now? 

What will happen before my operation?

Most adults having grommets inserted will either have them inserted at the ENT clinic or in the day surgery unit. If you are having a general anaesthetic your fitness for surgery will be assessed, and any necessary tests will be ordered (e.g. X ray, ECG “heart tracing”, blood tests). You will also be asked to sign a consent form that gives your surgeon permission to carry out your operation.

What happens on the day of my operation?

On the day of your surgery, you will be required to attend either the clinic or day surgery unit again. A member of your surgeon’s team will also see you to answer any questions and to confirm you still wish to go ahead.