Grommet Insertion: Treatment, Cost and Side Effects

Grommet Insertion is a treatment that is usually done in case of children suffering from different types of the ear ailment otitis media. Otitis Media is an inflammatory disease of the middle ear. Intermittent pain in the ear accompanied in rare cases with fever are symptoms of Otitis Media. There are two types of Otitis Media - acute Otitis Media and Otitis Media with effusion. In otitis media generally the Eustachian tube of the child gets swollen and blocked. This may happen due to a variety of reasons like viral fever, allergies, sinus problems, etc. The Eustachian tube is responsible for draining out fluid and mucous from the ear. Due to the tube being blocked the fluids and mucous from the ear gets accumulated in the Eustachian tube instead. This results in infection and causes pain. This blockage and infection may be temporary and can be treated through medication. However in case it persists for a very long duration or is of a recurrent nature then Grommet insertion treatment is done. The grommets ventilate the ear by artificially allowing air to flow in and this helps in clearing out the Eustachian tube thus alleviating the pain and reducing infection.

In grommet Insertion treatment a small plastic tube called the grommet is placed across the tympanic membrane of the ear to allow ventilation and air flow to the middle ear. The surgery is usually performed under general anesthesia and usually takes around 30 minutes or so. Before the surgery, a doctor using a microscope examines the ear. Then a small incision is made in the tympanic membrane and any fluids present are drained out using micro suction instruments. After this the grommet is inserted into the tympanic membrane. The procedure is quite painless and the child can easily go back to home once the surgery is done. The grommet has flanges on each side to hold its position and stop the hole in the tympanic membrane from closing and usually stays in the ear from 6 to 18 months. In case a grommet for a longer duration is needed, grommets designed in the shape of T called T-Tubes are used. As the child grows up the tympanic membrane extends out wards and the grommet automatically falls out. In rare case you may to visit the doctor for removal of grommets if they do not fall out automatically.

In case the child suffers from Otitis Media for a period of more than 3 months or has recurring infection (at least 4 times in a year) then you should go fro grommet insertion immediately after consulting with a qualified ENT specialist

Since there are no major surgical incisions or procedures , every body is eligible for grommet insertion treatment

In certain cases, the tube may get blocked or may fall out of place into the middle ear leading to infection. Surgery is needed to remove the grommet then. Usually the hole made in the eardrum closes as the child grows up. However sometimes it does not close permanently and causes hearing problems. The perforation can be closed through surgery. Temporary discharge from ears for 2 -3 days post grommet insertion is common but in cases it may persist and in such cases antibiotics can be used to treat the infection. Rarely, benign tumors known as Cholesteatoma may form behind the tympanic membrane. If not removed in time they can lead to loss of hearing. These side effects however are very rare and account for 1-2 % of the grommet insertion surgeries

The first and foremost thing you should do after a grommet insertion treatment is to make sure that the child does not get any water into the ear as this can lead to infection. You should also avoid swimming pools and other common water bodies. The water in these may have bacteria and can cause infection if it passes through the grommet into the middle ear. While bathing you can put some cotton coated in Vaseline to prevent water from going into the child’s ear. Additionally avoid cleaning or putting anything into the ears after surgery apart from the prescribed eardrops or cotton swabs.

Recovering from the grommet insertion takes very less time .The child may just need a few hours to recover from the effects of anesthesia and then can resume daily activities immediately.

The cost of grommet insertion surgery is usually in the range of Rs. 50,000 to 70,000

While the treatment in more of a preventive nature that is done to avoid occurrence of Otitis Media, the results can be either permanent or temporary depending on whether the problems reoccur or not as the child grows up.

Mild case of otitis media can be treated with medications like antibiotics and eardrops. However, in case of severe and recurrent infection you can go for Otologic laser assisted myringotomy where lasers are used to perforate the eardrum.