Grommet insertion is a surgical procedure in which a very small ventilation tube is inserted into the eardrum.

This procedure is usually performed to manage “glue ear” a condition where fluid fills the middle ear space and impairs transmission of sound. There are a range of other conditions that are also managed with grommets. Eg; barotrauma, severe tympanic membrane retraction, mastoiditis.

There are many causes of glue ear but the most common in children is Eustachian tube dysfunction.

The Eustachian tube is a narrow tube that connects the middle ear to the back of nose. The tube helps to equilibrate middle ear pressure with atmospheric pressure. The tube is closed at rest but opens with swallowing and yawning.

The Eustachian tube may fail to open properly if there is locoregional inflammation, allergy, second hand smoke exposure or anatomic abnormalities. Children can also be genetically predisposed to poor eustachian tube function.

The role of a grommet is to ventilate the middle ear and re-establish normal pressure in the middle ear. There are many different types of grommets that are designed to be retained in the eardrum for different periods of time.

The most commonly used grommets are usually extruded from the eardrum spontaneously between 6 – 9 months.

Eighty percent of children requiring grommets do not require further surgery on the ear. Twenty percent will require a second set of grommets and the adenoids are usually removed at the same time.