The grommet basics

What are grommets?

These tiny tubes are inserted into the eardrum to keep it open and allow air into the middle ear. They can be made from plastic, metal or Teflon and are either long- or short-term. Short-term ones will generally fall out on their own after about six months: the eardrums will naturally grow closed again, pushing them out. Long-term grommets may also grow out on their own, but removal under general anaesthetic may be necessary.

Who needs grommets?

When your child has repeated bouts of middle ear infection, or experiences hearing problems due to fluid in the middle ear (called glue ear), an ENT might recommend grommets.

‘Sometimes parents will take their child for speech or occupational therapy when they notice a problem,’ says Dr Ola Basson, a Cape Town ear, nose and throat (ENT) specialist. ‘But a hearing test will immediately indicate whether or not the problem is developmental or in fact related to the child’s ears.’

Any hearing loss suffered because of glue ear will clear up immediately when grommets are inserted, because the cylinders drain the fluid.

Should your child get an ear infection in future, grommets allow antibiotic drops to be administered directly into the ear – making the medication more effective and avoiding a course of systemic antibiotics. By keeping the eardrum open, they equalise ear pressure, meaning less or no pain for your child.

Ear infections themselves can be caused by different things – for example, children’s Eustachian tubes are still immature and much shorter than an adult’s, explains Dr Basson.

The Eustachian tube connects the middle ear to the back of the throat. When this tube does not work effectively and becomes blocked, fluids won’t drain properly and can build up behind the middle ear. Also, the tube’s proximity to the adenoids, at the back of the nose, can cause them to become infected and enlarged, leading to further infections.

Left untreated, ear infections can cause hearing and speech problems, and trouble with balancing. They can also affect a child’s appetite and therefore growth, behaviour (frustration over not being able to hear properly or fully participate in activities) and sleep (not to mention the parents’).

How are they inserted?

After consultations with an ENT surgeon, your child will be scheduled for a procedure called a myringotomy, which is when incisions are made in the eardrums to insert the grommets. The operation, under general anaesthetic takes only a few minutes. After a few hours’ observation, your child will be able to leave hospital the same day. Recovery is amazingly fast and complications are rare.

‘Grommet insertions offer really big benefits and the procedure carries a very low risk,’ says Dr Basson. ‘It is such a simple and effective operation that it should be available in primary health care.’ Thousands more South African children could benefit from it, but unfortunately in state hospitals the waiting list can take from one to six months, which means a child has to endure ear infections for that much longer.

The procedure, if done privately, will cost between R700 and R2 000, excluding hospital costs of approximately R5 000 and the anaesthetist’s fee. 

Are grommets the answer? Read three real moms' stories.

Has your child had grommets?

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