Operations for Glue Ear

Who needs an operation for glue ear?

An operation may be advised to restore hearing to normal if glue ear does not clear after a time of 'watchful waiting'. The time advised to 'wait and see' if the glue ear clears can vary from child to child. It depends on such things as the age of the child, the severity of the hearing loss, whether there have been previous episodes of glue ear, whether schooling, learning or speech is affected, etc.

What are the operations?

• Myringotomy and grommet insertion is the common operation. (See diagram below.) Myringotomy is a tiny cut (about 2-3 mm) made in the eardrum. The fluid is drained and a grommet (ventilation tube) is often inserted. A grommet is like a tiny pipe that is put across the eardrum. The grommet lets air to get into the middle ear. Hearing improves immediately.
• Removal of the adenoids is sometimes advised. Adenoids are small clumps of glandular tissue (similar to tonsils). They are attached at the back of the nose cavity near to the opening of the Eustachian tube. If the adenoids are large then taking them out may improve the drainage of the Eustachian tube. Adenoids tend to be removed only if the child with glue ear also has persistent or recurring colds or other respiratory infections.
• A laser method to make a tiny hole in the eardrum and allow drainage has been developed. This has a similar effect to myringotomy and grommet insertion. Studies show that it is, on average, not as successful as grommet insertion. However, the procedure does not require a general anaesthetic. So, it may have a place in selected cases. Also, a laser rather than a fine knife is sometimes used to create the hole in the eardrum in which to place a grommet.

These operations above only take a short time to do. They are often done as a 'day case'. Sometimes an overnight stay in hospital is needed.

Are there any risks with these operations?

As with any operation, there is a risk of complications from the surgery and with the anaesthetic. However, the risk is very small.

Some common concerns after grommets are put in

• Swimming is usually fine. However, it is best to avoid underwater swimming or ducking the head deeply underwater. Some surgeons advise wearing ear plugs when swimming. Always follow any specific advice about swimming from your surgeon.
• Flying in a plane is actually easier if you have a grommet in your ear. The grommet allows the pressure of air to equalise between the middle and outer ear. This prevents ear pain during landing and take-off.
•  Washing. Try not to get soapy water into the ears. Don't duck the head into soapy water. Wash the outside of the ears in the normal way. A cotton wool ball with Vaseline® placed in the ear canal could be used to prevent water from getting into the ear.

 The diagram below shows where a grommet is placed.

What happens to the grommet after it is put in the ear?

Grommets allow air into the middle ear. Grommets normally fall out of the ear as the eardrum grows, usually after 4-12 months. By this time the glue ear has often gone away. The cut in the eardrum made for the grommet normally heals quickly when the grommet falls out.

Grommets are so small that you may not notice when they fall out of the ear.