Ear tube insertion is a surgical procedure used to drain fluid from the middle ear. In this procedure, a small cut is made in the eardrum. Next, special tubes, called grommets, are placed in the ear to allow fluid to drain from the middle ear. These tubes also allow air to circulate through the area behind the middle ear. Usually the Eustachian tubes, which connect the back of the throat behind the nose to the middle ear, allow air to get into the space behind the eardrum.  Inserting grommets gives the Eustachian tubes time to grow and begin to function better.

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Who is a candidate for the procedure?

• Eustachian tubes that are immature or have not formed correctly while a child is young.

• Recurrent ear infections, called chronic otitis media, despite the use of antibiotics.

• Persistent, severe ear pain unrelieved with pain medications.

• Hearing loss due to fluid in the eardrum, which can cause problems with speech development.

• Complications from ear infections, including inflammation or infection of other parts of the ear.

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How is the procedure performed?

Usually a person is given a general anaesthesia to temporarily put him or her to sleep. Next, a small cut is made in the eardrum, and any fluid is suctioned out. The surgeon will then insert a small tube through the cut. This tube allows fluid to continue to drain from the middle ear to the outer ear and allows air to enter the middle ear.

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What happens right after the procedure?

This procedure is usually done on an outpatient basis in a same day surgery setting. A person is admitted to the surgery centre, has the procedure, and is then monitored in a surgery recovery room. In the recovery room, the person will be monitored for:

• reactions to the anaesthesia

• bleeding from the surgery site

• difficulty breathing

In most cases, once the person is awake and able to drink fluids, he or she can go home from the surgery centre.

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What happens later at home?

Usually a person recovers within 1 or 2 days after the procedure. Eardrops (Cilodex) are prescribed for the first few days after surgery. A person will be given special instructions about how to care for his or her ears and tubes. It is important that he or she follow these directions carefully.

What are the potential complications after the procedure?

• The person may continue to have ear infections that require antibiotics.

• The tubes may come out too quickly. This means that new tubes may need to be inserted if.

• The tubes may have to be removed by a surgeon if they dislodge into the space by the middle ear. • Rarely, a small hole may be left in the eardrum. This may require surgery to patch it.

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What about water protection for the ear?

The lumen of the grommet is so small that it forms an airlock, effectively keeping water out of the middle ear. There needs to be about half a meter of water pressure before water can be forced into the grommet.  Older children that can swim at those depths need to wear earplugs.

The exception is bath time were soapy water can penetrate the grommet without the aid of pressure.

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Additional information PowerPoint:

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Grommets Powerpoint Presentation.pptx