Ear grommets, also known as tympanostomy tubes or ventilation tubes, are small, hollow devices temporarily placed in the eardrum to assist the middle ear. These tubes are one of the most common surgical treatments performed on children globally, though they are also used for adults. Their primary purpose is to address issues within the middle ear space, which lies just behind the eardrum. The insertion of a grommet is a minor procedure designed to restore normal air pressure and function. This intervention aims to improve hearing and reduce the frequency of ear-related complications.
What Ear Grommets Are and Their Primary Function
Grommets are tiny, spool-shaped cylinders constructed from materials such as plastic, Teflon, or metal. They fit securely into a small opening in the tympanic membrane (eardrum), creating an artificial channel between the ear canal and the middle ear space. Most grommets are intended for short-term use, lasting between six months and a year, though some larger types are designed to remain in place longer.
The main function of these ventilation tubes is to keep the middle ear aerated and equalize pressure, mimicking a healthy Eustachian tube. When the Eustachian tube is blocked, air in the middle ear is absorbed, creating negative pressure that causes fluid to accumulate. This condition, often called “glue ear” or otitis media with effusion, causes muffled hearing because the fluid prevents the eardrum from vibrating properly.
By inserting a grommet, the tube bypasses the non-functional Eustachian tube, allowing air to flow directly into the middle ear. This ventilation permits trapped fluid to drain away and prevents further accumulation, resolving the hearing loss caused by fluid buildup. Grommets are also used to reduce the recurrence of acute middle ear infections by preventing pressure changes that encourage bacterial growth.
The Procedure for Grommet Insertion
Placing a grommet is a quick surgical procedure known as myringotomy and tube insertion. For most children, the operation is performed under general anesthesia to ensure they remain still, though adults may sometimes use local anesthesia. The entire process is completed in under 15 minutes, making it a common day surgery with no need for an overnight hospital stay.
The surgeon uses an operating microscope to visualize the eardrum clearly. A small incision, called a myringotomy, is then made in the eardrum. If fluid is present in the middle ear space, it is suctioned out through this opening to restore a clear, air-filled cavity.
The grommet is then placed into the incision to keep the opening patent and maintain the ventilation channel. Without the tube, this cut in the eardrum would heal and close within a couple of days. Patients are monitored briefly in a recovery area and are able to go home within a few hours after recovering from the anesthesia. Post-operative pain is minimal, though some mild discomfort or temporary nausea may occur.
Managing Daily Life and Tube Lifespan
Following the procedure, patients experience a rapid recovery, often returning to normal activities the next day. A common concern involves water exposure; while some surgeons recommend strict ear protection, current guidelines suggest that routine water precautions are not universal. The limited benefit of consistently wearing earplugs may be outweighed by the inconvenience and cost for the average child.
Many practitioners advise protecting the ears from dirty water, such as in lakes or rivers, and recommend avoiding deep diving, as pressure can force water through the tube. For bathing and surface swimming, some doctors recommend custom or store-bought earplugs, or cotton wool coated in petroleum jelly, especially immediately post-operatively. If water enters the ear, there is a risk of infection, which often presents as discharge and is treated with antibiotic ear drops.
Grommets are designed to be a temporary solution, staying in place as the eardrum heals and naturally pushes the tube outward. The tubes remain functional for six to eighteen months, depending on their design and the patient’s healing rate. Once the grommet is extruded, it may fall out unnoticed during sleep or bathing. The hole left in the eardrum heals spontaneously and quickly. Regular follow-up appointments are necessary to confirm the tubes are working correctly and that the eardrum has completely healed once the tube is gone.