Grommets are tiny plastic ventilation tubes that are flanged at the end. They are inserted into the eardrum, to equalise pressure in the ear.
Some children may need their grommets replaced as they are naturally expelled with the growth of the eardrum.
Why Is It Done ?
Either acute middle ear infection called otitis media or a blockage of the Eustachian tube known as glue ear are the most common reasons that insertion of grommets is required. In the majority of cases, these conditions affect children but adults can also be affected.
Otitis Media - This is an ear infection with the following symptoms : -
Earache
Deafness
Fever
Feeling of fullness in the ear
Drainage of blood or pus
Feeling unwell
Loss of appetite
Irritability
Loss of balance
Because grommets allow air in from the outside, enabling fluid and mucus to drain normally, future episodes of acute otitis media are reduced as well as an immediate improvement in hearing. Parents of children afflicted with this condition notice an improvement in balance, ability to walk, disposition and sleeping.
Glue ear - Is a chronic ear infection.
A sticky fluid gathers inside the middle ear. Because the middle ear is normally filled with air instead of fluid, hearing can be affected when you have glue ear.
What should I ask my specialist ?
Make sure you fully understand the procedure that is planned; do not be afraid to ask.
It is your right to know all the relevant information, as this is part of informed clinical consent. Your doctor will ask you to sign a consent form.
Apart from what the procedure is about you should also ask about : -
Preparation
Follow up appointments - jot down any questions or concerns you may have so that you can ask your doctor at your next appointment
Most medication should be continued as usual, but some may interfere with the examination. Your doctor will inform you of the medication you should stop. As a guide, the following medication may require special instruction : -
Aspirin (or any related products)
Blood thinners (Warfarin, heparin.)
Arthritis medication
Pain medication
Insulin, and iron preparations
Don't forget to mention any homeopathic or herbal remedies you are taking, as these can have interactions and side effects too.
Where is it done ?
The insertion of grommets is done as a day patient in either a day surgery or hospital.
How long is the procedure ?
The insertion of a grommet takes approximately 10 -15 minutes.
Who is involved ?
The procedure is usually carried out as a day surgery patient in a specialised day surgery or hospital.
The people involved in the procedure are : -
The ENT (Ear, Nose & Throat) surgeon, your doctor (Specialist)
Anaesthetist: they give medication that make you relaxed and sleepy and look after you whilst the procedure is being carried out
Nurses for the procedure and recovery
How do I prepare for the surgery ?
You are normally required to fast for at least 6 hours prior to general anaesthetic.
Young children and babies are required to fast from clear fluids for 2 hours, other fluids for 3 or 4 hours and approximately 5 hours for solids. Surgery for young children and babies is scheduled first to lesson the discomfort of fasting.
Your surgeon will have his/her own specific preparation requirements and those, along with any instructions given to you by the day surgery or hospital, should be strictly followed.
What do I take with me to the day surgery/hospital ?
Do not bring any valuables with you
Leave all jewellery at home, except if you wear a wedding ring
Bring any medication that you would usually take during the day as under most circumstances you may still be able to take these
Remove all nail polish and do not wear any make-up
Any specific requirements your child may need, for example, formula and nappies
What happens to me at the day surgery/hospital ?
When you arrive at the day surgery or hospital, the admissions clerk will attend to the associated paperwork for your stay.
On admission the nurse will request your medical history, confirm your medication and ask you about any known allergies. The surgeon has usually already attended to you signing the operation consent form in his rooms at the time of booking the surgery. An anaesthetist may see you at that time or when you are in the procedure room, to explain what to expect with general anaesthetic.
Having completed the admission processes, you/your child will then be taken to theatre.
What can I expect during surgery ?
Once in the anaesthetic bay of the operating theatre, a small plastic tube called a cannula will be placed into a vein in the arm or hand. If it is general anaesthetic being given, the cannula is used to administer intravenous sedation, which is the first stage of your anaesthetic.
With children, some anaesthetists may choose to administer a gas anaesthetic via a mask which means your child may not have a cannula inserted. Instead, a face mask is placed over the mouth and your child will fall asleep as they inhale the anaesthetic gas.
To reduce the anxiety for a child having the procedure, a parent may be allowed to stay with and possibly hold the child, until the anaesthetic has taken affect.
Once the anaesthetic has taken effect, you/your child will be moved into the operating theatre and the grommet insertion will begin.
A small incision, approximately 2mm long, will be made in the eardrum and the fluid is drained before inserting the grommet. This lets air into the middle ear. Once the grommet is put into place, ear drops may be put in the ear to minimise any discharge.
You/your child will then be moved to the recovery area.
What happens after surgery ?
In the recovery room, nursing staff will monitor you/your child's vital signs such as blood pressure, pulse and temperature until full recovery from the anaesthetic has occurred.
If it is your child that has had the insertion of grommets, you are generally permitted to be in the recovery room beside the bed when your child awakes. Hearing should be back to normal immediately following the grommet insertion. You/your child should be able to go home the same day if there are no complications.
You will be given instructions and advice upon discharge to assist you with care once at home.
The instructions may include the following : -
Keep your/your child's ear/s dry
Ear plugs should be worn when swimming
Avoid getting shampoo in the ear/s while bathing or showering
Do not put anything inside your/your child's ear to clean it
Avoid putting your/your child's head in the water while in the bath
Generally, there is little or no pain experienced following the surgery but if there is pain, paracetamol or ibuprofen can be used as directed.
You/your child may resume normal activities 24 hours after the grommet insertion.
If any of the following symptoms are experienced, please contact your doctor or the hospital immediately : -
Ear discharge that is bloody
Earache
Throbbing in the ear
Infection
Fever
You/your child will normally be required to attend a review with your specialist 14 days after the procedure. The review includes a hearing test. If there are no complications, a follow-up appointment will occur every six months until the grommet is removed. Once the eardrum heals, the grommet will come out on its own. A small grommet will work its way out in about six months and a larger one takes anywhere from 9-15 months.
The list of of ENT Hospitals in India is as follows : -
For more information, medical assessment and medical quote
send your detailed medical history and medical reports
as email attachment to
Email : - info@wecareindia.com
Call: +91 9029304141 (10 am. To 8 pm. IST)
(Only for international patients seeking treatment in India)
For a detailed evaluation send patient’s medical reports / X rays / doctors notes to info@wecareindia.com
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