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A grommet is a commonly performed operation. It is one of the first operations taught to a training ENT surgeon. There are different types of grommets used in clinical practice and the two that I prefer include the Shah grommet (much more commonly used) and a T tube.

Shah grommets are a shorter lasting grommet that I often say to patients should stay in for approximateley 9-18 months.They are relatively atraumatic with few long term sequelae.

T tubes are inserted as a long term ventilation tube and are rarely, first line treatments and are often only placed after multiple short term grommet insertions. Unfortunately as a result of staying in place for significantly longer, when they extrude they can leave a perforation in the eardrum.

A grommet is a ventilation tube that is placed in the eardrum by the ENT surgeon. It can be placed under local anaesthetic but in children and not infrequently it can be placed under a general anaesthetic.

There are many reasons why grommets are inserted but usually they are to ventilate the middle ear space where the small ossicles of the ear are situated.

Indications for grommet placement include

Glue ear with a significant defecit in hearing persisting for greater than 3 months

Reccurent episodes of acute middle ear infections

Significant retraction pockets

Part of another operation to maintain ventilation of the middle ear

Grommets can be short term and long term and can last from a few months to a few years. The longer term grommets have a higher incidence of leaving a hole in the eardrum when they extrude.