What are Tympanostomy Tubes (grommets)?

 

Tympanostomy tubes are small plastic or silastic tubes that are inserted into the ear drum (tympanic membrane) to help ventilate the ear and prevent fluid (essentially mucous) from building up (glue ear or otitis media with effusion). Grommets help prevent infections in the ear (recurrent acute otitis media) These tubes allow the pressure in the middle ear to be equal to the pressure outside the ear. 

 

When are grommets a consideration?

 

Tympanostomy tubes may be suggested when your child's ear infection has failed to improve with antibiotics or has fluid which will not clear after an appropriate length of time. Grommets are especially helpful in reversing the hearing loss due to fluid trapped behind the ear drum. 

 

What is involved with Grommet placement?

 

Placement of tubes occurs through the ear canal under a brief (five to ten minutes) general anesthetic, and rarely requires a blood test or IV. A tiny hole (myringotomy) is made in the eardrum, through which fluid is suctioned. Then a tiny tube (the grommet) is placed in the hole allowing air to enter the middle ear. The procedure is painless and allows your child to resume normal activity upon leaving the hospital.

Tubes usually fall out of the ear (as the ear drum grows) within one to two years unless specified by your doctor. 

 

Frequently Asked Questions

1. Do grommets cause scarring of the ear drum? 

   The tubes selected for use in this practice are unlikely to cause changes in the ear drum. However, if ear drum scarring occurs due to tubes or repeated infection, this rarely causes hearing loss.

2. Do the grommets ever fall in the ear instead of out? 

   No, the tubes migrate out as the ear drum skin sheds, bringing the tube out into the ear canal.

3. Can my child reach the grommet? 

   No, the ear drum (and tube) cannot be reached without a long narrow instrument.

4. When the grommet falls out, is there a hole left in the ear drum? 

   The ear drum heals as the tube is pushed out. Very rarely, the ear drum does not heal completely, leaving a hole. This can be repaired by "patching" the ear drum, a common and highly successful procedure.

5. Do grommets cause drainage? 

   No. Once tubes are placed, the ear should not drain except in the first three days after surgery. If drainage occurs, this is usually the result of a cold, sinus infection, adenoid infection, or rarely, a mastoid infection.

6. Will my child need a second set of tubes? 

   Generally, no. About 20 percent of all children who get grommets in the first place need a second set. Risk factors include: infection starting before six months of age, adenoid disease, immune system problems, cleft palate and sinusitis.

7. Are there any restrictions involved after the tubes are placed in my child?

   Diving should be avoided while the tubes remain in the ears. In addition, ear plugs or ear putty will be recommended if the child lies with ears submerged in bath water, swims deeper than 18 inches, or in dirty water (eg. lake water).