Grommets don’t appear to improve long-term hearing, but they do improve it in the short term and may prevent recurrent ear infections.
While the grommet is in place, it ventilates the middle ear, preventing build-up of fluid. This can provide immediate improvement in hearing and reduce the risk of recurring middle ear infections.
Longer term, the evidence for the effectiveness of grommets isn’t clear-cut. If the glue ear is causing temporary hearing loss, children may not learn to speak properly and their learning ability could be delayed. Short-term improvements in hearing, development and learning have been found in children with glue ear who’ve had grommets inserted, but after 1 year there’s no difference compared to children who didn’t have grommets.
Grommets normally stay in place for 6 to 12 months. Longer lasting ventilation tubes, called T-tubes, are designed to stay in place for 18 months or longer. Eventually they should drop out by themselves.
Parents report good results from grommets – when their child’s hearing improves, the pain of recurrent infections is relieved, and the subsequent anxiety and disruption to family life is gone.
In children, the procedure is done under a general anaesthetic which can be frightening for them and their parents, but it’s extremely safe. As the procedure is very quick, children aren't under anaesthetic for very long.
In adults the procedure can be done using local anaesthetic, but a general anaesthetic may be given.
Grommet procedures can have complications. Most resolve by themselves but sometimes the grommets need to be removed. Here is a list of signs to look out for:
- Persistent discharge from the ear which may need treatment with antibiotic drops.
- Grommets can get blocked, requiring ear drops to unblock them.
- A hole in the eardrum can remain after grommets have fallen out.
- The grommets can fall out too soon. They can also be pushed into the middle-ear cavity (this is rare).
- In some children, grommets don’t fall out by themselves. If so, your child may need a minor procedure to remove them.
- Cold air or water may cause discomfort because the hole in the grommet allows exposure of the very sensitive lining of the middle ear.
- Occasionally the body reacts to the presence of a grommet and the area becomes inflamed and may discharge. If this happens the grommet will have to be taken out. Sometimes the eardrum may become hardened and calcified.
- Other rare adverse events include hearing loss, tinnitus and dizziness.
Ask your surgeon about the results and risks associated with the procedure. Also ask about their rates of patient satisfaction and the rate of complications after procedures they’ve performed.