Grommet insertion (child) (Insertion of grommets (ventilation tubes) for glue ear)

A short day-case operation in which a tiny tube (grommet) is placed in a child's eardrum to drain fluid and improve hearing in glue ear.

✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review

In short

Grommets are tiny tubes placed in the eardrum to drain fluid and improve hearing in children with glue ear that has not cleared on its own.
Glue ear often gets better by itself, so guidelines recommend watching and waiting for about three months before considering surgery.
It is a short day-case operation under general anaesthetic; most children recover quickly and return to school or nursery within a day or two.
Grommets are temporary and usually fall out within six to twelve months; some children need a second set, and the hearing benefit may fade once they come out.

A plain-English summary. The detail — including risks and recovery — is below.

At a glance

TypeDay-case surgery for a child (under general anaesthetic)

AnaestheticGeneral anaesthetic (your child is asleep)

How long it takesThe operation itself usually takes about 10 to 15 minutes

Hospital stayDay case; most children go home the same day

Time off workOften back at school or nursery within a day or two

When you'll see resultsHearing usually improves quickly once fluid is drained

On the NHS?Commonly done on the NHS when criteria are met, after a period of watchful waiting; also offered privately

A general guide. Your surgeon will give you advice for your situation.

Best fit

Hearing usually improves quickly once the fluid is drained.

Pause if

When glue ear has not been present long enough, as it often clears on its own within about three months.

Main recovery point

Your child wakes in recovery and is brought back to you. They may be sleepy, hungry or a little upset from the anaesthetic. Most are ready to go home once...

Good aftercare

Clear written advice on pain relief, ear care, water precautions and warning signs.

First few hours

Your child wakes in recovery and is brought back to you. They may be sleepy, hungry or a little upset from the...

First day or two

Some bleeding or fluid from the ear is normal. Give child paracetamol or ibuprofen for any discomfort, and any...

First weeks

Hearing often improves quickly. Keep dirty or soapy water out of the ears as advised, and watch for ear discharge...

Six-week check

Your child usually has a follow-up appointment, often with a hearing test, to check the grommets are in place and...

Medical line illustration of ear microsuction eardrum for Grommet insertion (child). — Illustration only - not a diagnosis, medical advice or a promise of result. Your anatomy and treatment plan may differ. Vuemedics does not publish before-and-after photos.

What is grommet insertion for glue ear?

Glue ear (the medical name is otitis media with effusion) is when sticky fluid builds up behind the eardrum. It is very common in young children, often follows colds, and can dull a child's hearing for a while. Most cases get better on their own, which is why doctors usually watch and wait for about three months first.

If glue ear lasts and is affecting a child's hearing, speech or learning, an ENT surgeon may suggest grommets. A grommet is a tiny tube placed through a small cut in the eardrum. It lets air into the middle ear and lets the fluid drain, so hearing usually improves.

Grommets are not permanent. They usually work their own way out as the eardrum heals, after about six to twelve months, and the small hole then closes by itself. Some children need a second set if glue ear comes back.

This guide is written for parents and carers. The operation is done under a general anaesthetic, so your child is asleep, and is usually a day case, meaning you go home the same day.

Types & techniques

There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.

Short-term grommets

The usual type, designed to stay in for about six to twelve months and then work their own way out as the eardrum heals.

Longer-lasting (T-tube) grommets

Stay in longer and are sometimes used for children who need ventilation for an extended time. They can carry a slightly higher chance of leaving a small hole when they come out.

Grommets with adenoid removal

Sometimes the adenoids are removed at the same time, which can reduce the chance of needing repeat grommets in some children. Your surgeon will discuss whether this is suitable.

Hearing aids as an alternative

Not a type of surgery, but a non-surgical option. Hearing aids can be offered instead of grommets, especially if surgery is not suitable or not wanted.

Grommets vs watchful waiting vs hearing aids

	Grommets	Watch and wait	Hearing aids
Surgery needed	Yes	No	No
Helps hearing	Usually, quickly	Often clears alone	While worn
Anaesthetic	General	None	None
Effect lasts	Months, then tubes fall out	Permanent if it clears	While worn

Glue ear often settles by itself, so a period of watching is usual first. Grommets and hearing aids are both reasonable options if it persists; the right choice depends on your child and your family's preferences.

Preparing for your surgery

Expect a hearing test before surgery to confirm glue ear is affecting your child's hearing.
Follow the fasting instructions carefully: your child must stop eating and drinking for set times before the anaesthetic.
Tell the team about any allergies, medicines, recent coughs or colds, or past problems with anaesthetics.
Explain to your child, in simple words, that they will have a sleep so the doctor can help their ears.
Bring a favourite toy or comforter, and a change of clothes, to help your child feel settled.
Plan for one parent or carer to be with your child before and after, and to take them home.
Arrange a day or two at home afterwards before returning to school or nursery.
Have child paracetamol or ibuprofen at home for any discomfort, and any ear drops if prescribed.

What happens

Grommet insertion is a short operation done under a general anaesthetic, so your child is asleep and feels nothing. You can usually stay with your child while they go off to sleep, and be there when they wake up.

The surgeon uses a microscope to look into the ear canal. They make a tiny cut in the eardrum, gently suction out the sticky fluid, and place the small grommet in the hole. No cuts are made on the outside of the ear, and there are no stitches.

The operation itself usually takes about 10 to 15 minutes per ear. Your child then wakes up in the recovery area and is taken back to the ward, where you can be with them.

Most children go home the same day, once they are awake, comfortable and able to eat and drink. Many feel surprisingly well quite quickly, although the anaesthetic can make some children a little upset or sleepy at first.

Is this operation right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

May not be suitable if…

When glue ear has not been present long enough, as it often clears on its own within about three months.
When a hearing test does not show that hearing is affected enough to need surgery.
When the child has a current cough, cold or chest infection, until they are well enough for an anaesthetic.
When hearing aids or continued watching would be a safer or preferred option for that child.
When another problem, such as a palate abnormality, needs assessing first.

Delay surgery if…

Your child has a current cold, cough, fever or chest infection.
Fasting instructions for the anaesthetic have not been followed.
Glue ear has not yet been watched for the recommended period.
A pre-operative hearing test has not been done or is unclear.
Your child is otherwise unwell on the day of surgery.

Alternatives to discuss

Watchful waiting, as many cases of glue ear clear by themselves.
Hearing aids, which can improve hearing without an operation.
Treating any underlying problem, such as allergies or nasal symptoms, where relevant.
Adenoid removal in selected children, sometimes with grommets.
Simple measures and time, with regular hearing checks, in mild cases.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

What matters most to me?

Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.

What are all my options?

Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.

What would make me pause?

Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.

What happens if I do nothing today?

For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.

Anaesthetic choices

The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.

General anaesthetic

Children have grommets inserted while fully asleep. A children's anaesthetist looks after your child, and serious problems are very uncommon in healthy children.

Benefits

Hearing usually improves quickly once the fluid is drained.
Can help with speech, learning and behaviour where these were affected by poor hearing.
Allows air into the middle ear, which can reduce repeated fluid build-up while the grommets are in.
A short day-case operation, so most children are home the same day.
Grommets usually come out by themselves, so they do not need a second operation to remove them.

Risks & complications

More common

Slight bleeding or fluid oozing from the ear for a day or two, which is normal
Mild ear discomfort or grumpiness for a short time after the anaesthetic
Temporary upset, sleepiness or feeling sick from the general anaesthetic
Ear infections that cause discharge while the grommets are in place

Less common

A grommet coming out earlier than expected, so the problem may return
Repeated or ongoing ear discharge that needs ear drops
Glue ear coming back after the grommets fall out, sometimes needing a second set
A small area of hardening or scarring on the eardrum (tympanosclerosis), which usually does not affect hearing

Rare but serious

A small hole in the eardrum that does not heal after the grommet comes out, occasionally needing repair
A serious problem from the general anaesthetic, which is very uncommon in healthy children

Grommets are a commonly performed and generally low-risk children's operation, but they are still surgery with a general anaesthetic, so the decision should be shared and not rushed. The main things to weigh are that the hearing benefit may fade once the grommets come out, that some children need a second set, and that a small hole in the eardrum occasionally remains. Ask the surgeon how many grommet operations they do, and what they would expect for your child.

Published figures to discuss

Grommet insertion is a common and generally low-risk children's operation, but it involves a general anaesthetic and the hearing benefit is temporary. The figures below come from UK and international sources and are indicative; ask your surgeon what they would expect for your child.

Figure	Reported range	How to interpret it	Source / confidence
Persistent hole in the eardrum after grommet comes out	Around 1 in 100 children with standard short-term grommets, and higher with longer-lasting T-tubes	May occasionally need a small operation to repair it.	Cochrane — Ventilation tubes (grommets) for glue ear in childrencochrane.orgPublished figure
Ear discharge while grommets are in place	Common; affects a noticeable proportion of children at some point	Usually settles with ear drops; report heavy or smelly discharge.	Guide sourcesClinical context
Glue ear returning after grommets come out	Happens in a significant minority; some children need a second set	The benefit on hearing tends to fade once the grommets are out.	Guide sourcesClinical context
Serious general-anaesthetic complication	Very rare in otherwise healthy children	Modern paediatric anaesthesia is generally very safe; discuss any specific concerns.	Cochrane — Ventilation tubes (grommets) for glue ear in childrencochrane.orgSource-linked context

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

Recovery — what to expect, and when

Children usually recover quickly from grommet surgery. Many are back to normal within a day, although the general anaesthetic can make some children tired or unsettled at first. Most return to school or nursery within a day or two.

First few hours

Your child wakes in recovery and is brought back to you. They may be sleepy, hungry or a little upset from the anaesthetic. Most are ready to go home once awake and eating.

First day or two

Some bleeding or fluid from the ear is normal. Give child paracetamol or ibuprofen for any discomfort, and any prescribed drops. Most children return to school or nursery.

First weeks

Hearing often improves quickly. Keep dirty or soapy water out of the ears as advised, and watch for ear discharge, which may need ear drops.

Six-week check

Your child usually has a follow-up appointment, often with a hearing test, to check the grommets are in place and working.

Six to twelve months

Grommets usually work their own way out as the eardrum heals, and the small hole closes by itself. Glue ear sometimes returns and needs review.

What's normal — and not a worry

A little blood or fluid oozing from the ear for a day or two
Some grumpiness, tiredness or feeling sick after the anaesthetic
Mild ear discomfort that eases with child paracetamol or ibuprofen
Noticing hearing improve over the first days

Aftercare

Give child paracetamol or ibuprofen as needed for discomfort, following the dosing instructions for your child's age and weight.
Use any prescribed ear drops exactly as directed.
Wipe away any ooze gently from the outer ear; do not poke anything inside the ear.
Follow the surgeon's advice on keeping water out of the ears, for example when bathing or swimming.
Let school or nursery know, and keep your child home for a day or two if they need it.
Watch for signs of an ear infection, such as discharge, and arrange ear drops if needed.
Keep the follow-up appointment and hearing test.
Keep the hospital or clinic contact number to hand in case of problems.

Before-surgery checklist

Child paracetamol or ibuprofen at home
Any prescribed ear drops collected
A day or two booked off school or nursery
Advice on water and bathing understood
Hospital or clinic contact number saved
Follow-up appointment and hearing test date noted

Scars and how they heal

There are no cuts on the outside of the ear, so there is no visible scar. The tiny cut in the eardrum is made from the inside through the ear canal and usually heals over once the grommet falls out. Occasionally a small area of hardening (tympanosclerosis) or, rarely, a small hole remains in the eardrum.

⚠ Get urgent help if…

Difficulty breathing, or your child being very floppy or hard to wake (call for emergency help)
A high temperature that does not come down, or your child seeming very unwell
Severe or worsening ear pain after the first day or two
Heavy bleeding from the ear, rather than a little ooze
Ear discharge that is heavy, smelly or lasts more than a few days
Your child not drinking, or showing signs of dehydration such as very few wet nappies
Increasing drowsiness, a severe headache or a stiff neck

Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your surgeon gives you.

Results & realistic expectations

After grommets, most children hear better quite quickly once the fluid is drained, and this can help with speech, attention and behaviour where poor hearing was the cause. A follow-up hearing test usually confirms the improvement.

It is important to know that grommets are a temporary fix. They usually fall out within six to twelve months, and once they are out the hearing benefit may fade and glue ear can return. Grommets treat the fluid and the hearing while they are in place; they do not change the tendency to get glue ear, which most children grow out of with time.

How long it lasts

Grommets usually stay in for about six to twelve months and then come out by themselves as the eardrum heals. The small hole then closes on its own in most children. Because glue ear can come back after the grommets are gone, some children need a second set, and a few need ongoing follow-up. Most children grow out of glue ear as they get older and their ears develop.

Combining with other procedures

Grommets are sometimes done at the same time as removing the adenoids (adenoidectomy), which can reduce the chance of needing repeat grommets in some children, or alongside tonsil removal if that is also needed. Your surgeon will explain whether combining operations is sensible for your child and what extra risks that adds.

Follow-up & long-term care

Your child will usually be seen about six weeks after the operation, often with a hearing test, to check the grommets are in place and working. After that, follow-up is arranged as needed to check the grommets, your child's hearing, and whether glue ear returns once the grommets come out.

Follow the advice you are given about keeping water out of the ears.
Watch for ear discharge while the grommets are in, and seek ear drops if it occurs.
Keep hearing-test and follow-up appointments so any return of glue ear is picked up.
Be aware that a second set of grommets is sometimes needed if glue ear comes back.

Revision and secondary surgery reality

Grommets usually fall out on their own, so removal surgery is not normally needed.
Some children need a second set of grommets if glue ear comes back.
A small hole that does not heal may occasionally need a repair operation later.
Adenoid removal is sometimes added at a later operation to reduce repeat glue ear.

Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.

What good aftercare looks like

Clear written advice on pain relief, ear care, water precautions and warning signs.
A named contact and route to the ENT team if problems occur.
A follow-up appointment with a hearing test to check the result.
A plan for what to do if glue ear returns after the grommets come out.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

Whether one or both ears are treated.
The surgeon's fee and the anaesthetist's fee for the general anaesthetic.
The hospital or day-case facility fee.
Whether the adenoids are removed at the same time, which adds to the cost.
Hearing tests before and after the operation.
Follow-up appointments to check the grommets and hearing.

Make sure your written quote includes

Whether the price covers one or both ears.
The surgeon's fee, the anaesthetist's fee and the facility or day-case fee.
The cost of hearing tests before and after surgery.
Whether adenoid removal, if recommended, is included.
Follow-up appointments after the operation.
What happens to the cost if a second set of grommets is needed later, or if a complication needs further care.

On the NHS? Grommets are commonly done on the NHS when a child meets the criteria, usually after a period of watchful waiting; private treatment is mainly used for a quicker appointment or choice of surgeon.

You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

Choosing a surgeon safely

Check your surgeon is on the GMC Specialist Register for this area.
Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

How Vuemedics verifies every consultant →

Questions to ask your medical professional

Take this to your consultation. A good surgeon will welcome every one of these.

Has my child's glue ear been present long enough, and is their hearing affected enough, to need grommets now?
What are the benefits and risks of grommets compared with waiting or hearing aids for my child?
Do you recommend removing the adenoids at the same time, and why?
How many grommet operations do you do, and what results do you see?
What water precautions should we follow, and for how long?
What follow-up and hearing tests will my child have, and what happens if glue ear comes back?
Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
Will you be the surgeon who carries out my operation, and who looks after me afterwards?
What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
What does a realistic result look like — and what can this operation not achieve?
What are my options, including waiting, doing nothing for now, or choosing a different approach?
Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Frequently asked questions

Will my child be asleep for the operation?

Yes. Grommet insertion in children is done under a general anaesthetic, so your child is fully asleep and feels nothing during the short operation. You can usually be with them as they go to sleep and when they wake up.

How long does my child need off school or nursery?

Most children recover quickly and can go back to school or nursery within a day or two, once they feel well. Some may need a little longer if they are tired after the anaesthetic.

Can my child swim with grommets?

Many surgeons allow swimming with care, but advice varies, and some advise keeping soapy or dirty water out of the ears. Follow the specific advice your surgeon gives for your child.

How long do grommets stay in?

Usually about six to twelve months. They then work their own way out as the eardrum heals, and the small hole closes by itself in most children. They do not normally need another operation to remove them.

Will my child need a second set?

Sometimes. Glue ear can come back after the grommets fall out, and some children need a second set. Removing the adenoids at the same time can reduce this chance for some children.

Is it better to just wait?

Often, yes, to begin with. Glue ear frequently clears on its own, so guidelines suggest watching for about three months first. Grommets are considered when it persists and is affecting hearing, speech or learning.

Are there alternatives to surgery?

Yes. Watchful waiting is usual first, and hearing aids can be offered instead of grommets, especially if surgery is not suitable or not wanted. Your ENT team can talk through the options.

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NICE — Otitis media with effusion in under 12s (NG233) Great Ormond Street Hospital — Treatment of glue ear with grommets ENT UK — Glue ear (patient information) NHS — Glue ear Cochrane — Ventilation tubes (grommets) for glue ear in children

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.