Ventilation Tubes and Grommets
Ventilations tubes are small hollow tubes that are inserted through the ear drum. The most commonly used ventilation tubes are called grommets. Other types include T-tubes and Tri-une tubes.
Why have Operation
Ventilation tubes are used to treat glue ear (middle ear effusion), where there is fluid accumulating behind the ear drum. Glue ear is especially common in young children, due to their Eustachian tubes not grown into position yet. Eustachian tube is important in providing ventilation to the middle ear and equalises pressure between the 2 sides of the ear drum. Thus malfunctioning Eustachian tubes results in negative pressure in the middle ear, and accumulation of fluid called glue ear. Glue ear can cause hearing difficulty and recurrent ear infections. Occasionally the condition can also happen in adults after an episode of cold and viral illness.
The insertion of ventilation tubes help to equalise pressure in the middle ear, and thus stops fluid from accumulating.
Ventilation tubes is also used to treat recurrent ear infections and retraction pocket in the ear drum.
How is the Operation done
The operation is normally performed under general anaesthetic. The surgeon visualises the ear drum under the microscope, makes a hole within the ear drum and inserts the ventilation tube where it sits. The procedure normally takes 10-20 minutes. Patients should be able to go home the same day.
Does it hurt
Ventilation tube insertion should not be painful. However there could be some ear discomfort for a day or two. Simple analgesia should be adequate for the symptoms.
After the operation
Blood-stained discharge might be seen within the next few days. If this persists or foul-smell is noticed, you should contact the hospital or your GP. Water precaution should be observed for as long as the ventilation tubes are in place. Smearing a cotton wool with Vaseline and plugging into the earhole is sufficient for bath or shower. Some patients may prefer to use ear plugs. You should refrain from swimming for the first 3 weeks after the operation. After that period, it is best to avoid diving under the surface while swimming.
How long do I have to be off work
A day or two off work or school should be sufficient for post-operative recovery.
There is a small risk of infection associated with ventilation tubes, especially during a cold. When the ventilation tubes falls out around 8-12 months time, the ear drum heals spontaneously. In < 1% of cases this does not happen, leaving a hole within the ear drum, called a perforation. On the other hand, if the ventilation tube is retained for a few years and failed to extrude on its own, a further procedure might be necessary for removal of the ventilation tube.
Is there any alternative treatment
Hearing aids can be considered for hearing loss. Long term low dose antibiotics can also be used to reduce the frequency of ear infections.