Overview

 

The grommet in your ear drum has done its job. There is no more fluid behind the ear drum in the middle ear. Your ear is now healthy again. Most grommets come out on their own. Some grommets, like yours, are slow to come out. It needs to be taken out with a little operation.

The Operation

You have a short general anaesthetic and are completely asleep. The surgeon will shine a very fine microscope into your ear tube. He will pull the grommet out of the ear drum with a special instrument. Because you are asleep you will not feel any pain during the operation. Your operation can be done as a day case. This means that you come into hospital on the day of your operation and go home the same day. When the grommet is out, there is a small hole left in the ear drum. This will usually close up on its own. The surgeon will check your ear drum in the outpatient clinic, to make sure that it has done this.

Before The Operation

Stop smoking and get your weight down if you are overweight. (See Healthy Living). If you know that you have problems with your blood pressure, your heart, or your lungs, ask your family doctor to check that these are under control. Check the hospital's advice about taking the Pill or hormone replacement therapy (HRT). Check you have a relative or friend who can come with you to the hospital, take you home, and look after you for the first week after the operation.

Sort out any tablets, medicines, inhalers that you are using. Keep them in their original boxes and packets. Bring them to the hospital with you. On the ward, you may be checked for past illnesses and may have special tests to make sure that you are well prepared and that you can have the operation as safely as possible. Please tell the doctors and nurses of any allergies to tablets, medicines or dressings. You will have the operation explained to you and will be asked to fill in an operation consent form.

Many hospitals now run special preadmission clinics, where you visit for an hour or two, a few weeks or so before the operation for these checks. If you have a cold in the week before your admission to the hospital, please telephone the ward and let the ward sister know. The operation will usually be put off, and you are given time to get better before being sent for again. You need to get over the cold before the operation can be done because by having an anaesthetic the cold could turn into a serious infection in the chest.

After - In Hospital

There is very often no pain in the ear after removing a grommet. If you do have some earache after the operation, the nurses will give you some medicine to take the discomfort away. A general anaesthetic may make you slow, clumsy and forgetful for about 24 hours. The nurses will help you with everything you need until you are able to do things for yourself. Do not make important decisions, drive a car, use machinery, or even boil a kettle during that time.

After three to four hours on the ward you will be well enough to go home. Usually, the nurses like you to have something to eat or drink before you leave. They will check that your ear is comfortable and is not bleeding. Before you leave the ward, you will be given arrangements for coming back to the ENT (ear, nose, and throat) outpatient clinic in about six weeks' time. There, the doctors will check your ear drum has healed up. The nurses will advise about sick notes, certificates etc.

After - At Home

Make sure you go home by car or taxi, with your relative or friend. You must not drive yourself home. At home, take two painkilling tablets every six hours to control any pain in your ear. It is important to keep your ear dry. Any water in your ear may go through the hole in the ear drum and cause an infection. When taking a bath or a shower, plug your ear with a piece of cotton wool rubbed in Vaseline.

It is safer not to go swimming until the surgeon has checked that the hole in the ear drum has completely closed. If you go swimming, make sure that your ears are very well protected by ear plugs and a tight bathing cap. You will be fit to return to work one or two days after your operation. You will be fit to drive 1-2 days after your operation. It is perfectly safe to travel by air. Air can pass freely through the hole in your ear drum. There will be no problems with changes in pressure.

Possible Complications

As with any operation under general anaesthetic, there is a very small risk of complications related to your heart and lungs. The tests that you will have before the operation will make sure that you can have the operation in the safest possible way and will bring the risk for such complications very close to zero.

If you follow the advice given above, you are unlikely to have any problems. There is a very small risk that the ear may bleed when you get home. If this happens, come back to the ward. There is also a very small possibility of an ear infection. If this happens, you will notice some fluid coming out of the ear (with a bad infections this can be thick, green and/or yellow and smelly) and you might have a headache or temperature. The infection usually settles by taking antibiotics for a week or so.

In a small number of people (2 to 3% of cases), the small hole in the ear drum may not close up after six weeks. Given more time, most of these close on their own without any treatment. A few need to be closed with another operation.

The grommet insertion operation is successful for about 70% of patients who have it. The remaining 30% may need a grommet re-inserted on one or more occasions because the fluid builds up again at a later date.

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