Grommet Insertion

Discharge Information: post insertion of Grommets / Ventilation Tubes

Dear Patient/Carer:

Please read this document carefully as it contains important information that complements the instructions given by your MEG ENT Specialist during your recent surgical admission.

Medications:

• Pain Management:
  • Most patients do not experience pain.
  • Mild discomfort can be controlled with simple pain medication, such as common over-the-counter analgaesics (e.g. Paracetamol or Ibuprofen).
• Antibiotics:
  • We don’t routinely prescribe antibiotics after this type of ear surgery.
  • Your MEG ENT specialist will instruct you on the use of Antibiotic eardrops if required

Ear Care:

• Water Precautions:
  • N.B. Whilst the evidence of strict water precautions leading to fewer infections after grommet insertion is limited, and a number of guidelines around the world recommend against water precautions, we recommend you discuss the risks and benefits with your MEG surgeon
  • If you and your MEG surgeon decide that water precautions are to be followed strictly then:
    • You must keep your ear(s) dry until the grommet(s) extrude.
    • If you do get water in the ear canal, it may enter the middle ear through the Grommet(s), and may result in an infected/discharging ear.
    • You must start the use of water-proof ear plugs (silicon plugs, blu-tac®) at the time of your routine shower or bath.
      • Ensure the Ear-plugs are for water exclusion (not the noise protection variety).
      • After each use, please clean the plugs with water and soap and allow them to dry for the next use.
      • Blu-tac® should be discarded after single use
    • In the case of small children:
      • It is useful to start the use of the plugs as a game, a few days before the surgery takes place, so they become used to the sensation of having the ear plugs during the bath/shower time.
      • It is often helpful to reinforce ear plugs for swimming with a cap or head-band.

Return to normal activity

• You/or your child will require 1 – 2 days/weeks off work/school to allow a full recovery.
• You/or your child should avoid swimming pool activities/lessons until the postoperative appointment with your MEG ENT Specialist.
  • You may restart these activities using adequate swimming ear plugs and a head band
    or cap afterwards
• Please do not dive under water even with plugged ear canals.

Attend your nearest Emergency Department or Local GP Clinic if:

• You or your child experience ear infection (discharge), fever, or severe pain that doesn’t respond to the prescribed analgaesics.
• Your MEG ENT specialist would be keen to provide advice to your doctor if required.

On your Post-operative Appointment

• Your MEG Specialist will perform an otoscopy to inspect the grommet(s)
• You will need to arrange a hearing test prior to this review and ensure you bring a copy of the results on the day of your appointment.
• You may be discharged for ongoing GP follow-up after this.

Grommets After care

• Bleeding:
  • Bleeding occurs occasionally, especially when the grommets have been in position for some time. It is alarming but almost never serious.
  • It is usually associated with infection and the formation of a small polyp of reactive granulation tissue at the site of the grommet.
  • It needs treatment with Antibiotic ear drops (SEE BELOW) and often removal of the grommet.
• Discharge/Infection:
  • Discharge from the ears occurs in probably 15-20% of patients with grommets, due to getting water in the ears or from an upper respiratory infection.
  • It is not disastrous but should be treated.
  • Often patients are treated for some time with oral antibiotics, unsuccessfully because the main organism is resistant to these.
  • Most ear discharges respond to antibiotic ear drops of which Ciloxan® or Ciproxin HC® are the safest and most effective (needs doctor’s prescription).
• Extrusion
  • Your grommet(s) should extrude in 6-9 months after insertion.
  • Please follow the water precautions advised by your MEG Specialist until then.
  • Visit your local GP for ear examination & review every 4 months or earlier if you experience an ear infection or hearing loss.

We will confirm the date and time of your post-operative appointment soon.
Do not hesitate to contact us if you require further information regarding these instructions.

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