What you need to know about your operation
What are Grommets?
Grommets are small plastic tubes that sit in the eardrum and let air in and out of the middle ear.
Why are they used?
They are normally used because there is fluid behind the eardrum (glue ear) which is causing persistent hearing problems (conductive hearing loss) or because of frequent ear infections.
They may also be used to try to correct retraction pockets in the eardrum which are due to chronic negative pressure (vacuum) in the middle ear which causes thinning and collapse of segments of the drum. This process can lead to recurrent infection, cholesteatoma formation (skin cysts within the middle ear) and permanent damage to the hearing.
What does the operation involve?
The day of the operation:
Admission is almost always on the day of surgery. The nurses will complete some routine paperwork and tests. You will be asked to change into a gown ready for theatre. The Anaesthetists will come to see you and discuss the anaesthetic side of things. A member of the ENT team will also see you before your operation.
In children, the operation is performed under general anaesthetic. In adults, it may be possible to perform the operation under local anaesthetic.
The operation itself:
The operation involves making a tiny cut in the eardrum for the grommet to sit in. Any fluid (glue) is suctioned through the hole before the grommet is inserted. The procedure normally takes about 10 minutes but you may be asleep for longer.
After the operation:
The procedure is not normally particularly painful but children sometimes feel that sounds are very loud for a day or two. There may be a small amount of bloody discharge from the ear for a few days post-op and in some cases, you may be sent home with some antibiotic drops to use.
Your discharge from hospital:
If a local anaesthetic was used, full mobility can be resumed 1-2 hours following surgery. Following general anaesthesia, you will need to arrange for a responsible adult to pick you up from the hospital, take you home and stay with you for 24 hours after discharge. Depending on how fit and active you are before your operation, you may need to arrange for someone to stay with you for a few days
POST OPERATIVE CARE
What is the follow up after the operation?
In cases where the only concern is the hearing loss, the first follow up appointment after the operation will be in the audiology department for a hearing test. If the hearing test shows a hearing improvement and your child’s hearing is within normal limits, no further review will be arranged and your child will be discharged back to the care of your GP. In other cases with a history of ear infections or eardrum in drawing, a follow-up appointment will be arranged in the ENT clinic with a hearing test.
What should I do when I leave the hospital?
The ears should be kept dry for two weeks. Following this swimming is allowed but diving underwater should be avoided. Getting the ears wet with soapy water can cause discharge and you may be advised to use cotton wool balls covered in Vaseline in the ears when washing hair.
This is perfectly safe with grommets in as the air pressure on either side of the eardrum is the same and therefore there will be no symptoms of pressure.
You should not drive for at least 24 hours following your operation. You can then drive when you are able to perform an emergency stop safely.
See above with regard to water exposure. Do not use cotton buds in the ears.
You should be fine to return to work/school the day after surgery.
Are there any risks involved in this operation?
Although modern surgery and anaesthetics are considered to be safe, all medical procedures carry some risks. The surgeon will discuss all these risks with you.
Risks associated with the operation are:
Risks associated with a general anaesthetic are rare and include:
Are there any alternatives to this operation?
Glue ear may resolve after a period of “watchful waiting”. We would normally wait for at least 3 months before recommending grommets to see if there is any improvement over this time. If the glue ear is not causing any significant problems with hearing and if there are no concerns about your child’s speech development, ear infections or in drawing of the eardrum we can just watch and wait. If there are concerns it may be better to put grommets in, and we would advise you about this.
In some cases, a hearing aid may be appropriate to treat the hearing loss and speech problems caused by glue ear. This would mean that your child would not need an operation. In older children (>6 years) the Valsalva manoeuvre or nasal balloon technique may get rid of fluid or retraction pockets. If a recurrent infection is the main problem a longer course of low dose antibiotics is sometimes helpful. For glue ear though, antibiotics, antihistamines and decongestants do not help. Steroid nasal sprays may help some children if they have a nasal allergy. Alternative treatments, such as cranial osteopathy, are not helpful. Taking out the adenoids may help to improve glue ear, and your surgeon may want to do this at the same time as the grommet operation.
If you would like a second opinion about the proposed surgery please ask your G.P or Surgeon to arrange this.
Are there any risks of not having this operation?
In the case of glue ear:
In the case of frequent recurrent ear infections:
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