Shortly your child will have grommets placed, in 1 or both ears.
Preparation at home. Try to prepare your child as much as possible. Via the website you can watch an information film.
How the ear works; Sound is air vibration. This vibration enters via the ear canal through the ear drum, which also vibrates. This is transferred through a chain of 3 small bones; the hammer, anvil and stirrup found behind the ear drum in the middle ear. The stirrup passes the sound vibrations to the organ responsible for the sense of hearing; the cochlea. The signals created in the cochlea are passed to the brain by a nerve. When the signals reach the cerebral cortex, we hear sound. If mucous remains in the middle ear ( for example after a cold or if the eustachian tube doesn’t work properly) then sound becomes muted and hearing is impaired, sometimes together with ear infections.
The Operation A small incision is made in the ear drum. A small grommet ( 3mm) is placed in the opening. The surplus mucous is suctioned out. The ear can now heal and function normally in time. The grommet prevents the ear drum from closing.
Anesthetic You may accompany your child to the operating theatre until he/she is under anesthetic. Your child will be put to sleep using a mask. For older children a drip is sometimes inserted into the arm or hand. In every case the anesthesist decides for a mask or drip. During your child’s operation, you can wait in the hall, you are not allowed in the operating theatre. You will be picked up and guided to recovery when the operation has finished.
After the operation Your child may be sleepy for the first hour, but will soon feel better. Your child may experience a little pain, and you may see some blood coming out of the ear. This is no cause for alarm, its normal just after the operation.
Discharge The nurse will decide when your child may go home. The specialist will not come to the ward before your child is discharged.
Check – up The check – up with the ENT specialist is planned 8 weeks after the operation. You need to make the appointment yourself by telephoning the assistant.
How long do grommets stay in place? Depending on the type of grommet, the ear will reject it after 3- 18 months, then the ear drum will heal itself. Sometimes it is necessary to replace grommets.
Damage by grommets Grommets are meant to prevent damage, by for example preventing a speech- language- deficit, damage by repeated infections and weakening of the ear drum. A child can still have a middle ear infection when a grommet is in place. The symptoms are however much less severe than those for a child without grommets. Moreover, the treatment is easier; antibiotics are not always necessary. In a few cases, the incision in the ear drum doesn’t close up by itself.
After care
Food and drink There are no dietary restrictions when you get home, but avoid a heavy meal in the evening as the bowel needs some time to get moving after anesthetic.
School and creche If there are no problems, your child can go to school or creche the next day. Don’t allow your child to be unaccompanied in traffic, because anesthetic can cause reduced concentration.
Showering , bathing and swimming Your child can have a shower, but don’t direct the shower head towards the ears. Having a bath is fine too, but avoid putting the head under water. Make sure that no soap or shampoo gets into the ears. To prevent this you can put cotton wool rubbed in acid- free Vaseline in the ears. You can also use these while washing the hair. Avoid swimming for at least a week after having grommets placed. Usually there are no problems after that period. You can talk to your ENT specialist regarding the use of earplugs during showering and swimming.
Flying As your child has grommets, there can be no vacuum in the middle ear, so he/ she will no longer have ear pain during a flight. Therefore there are no precautionary measures necessary before flying.
Complications
Bleeding Having grommets inserted can cause a little bleeding from the ear. This is completely harmless. The bleeding will stop itself within 2 days.
Ear discharge When discharge comes out of your child’s ear, this means he/she has a middle ear infection. Pus can run out of the ear easily via the grommet, with no fever or pain. If this persists for longer than 3- 4 days, you have to contact the ENT specialist.
Fever Children actually never get a fever after insertion of grommets. If your child’s temperature rises above 38 degrees Celsius then you have to contact the ENT specialist.
Pain Pain in the ears and throat are associated with the surgery. You may give children’s paracetamol in suppository form according to your child’s weight.
Questions and problems The children’s day care can be contacted during the day on telephone number 020-755- 6677, or telephone the ENT outpatients clinic.
During evening and night you can contact the hospital on 020-755-7000 and ask for the nurse in charge.