ENT SURGERY
Grommet Insertion
If your child has been struggling with hearing loss, recurring ear infections, delayed speech development, or a constant feeling of blocked ears — glue ear may be the cause. Grommet insertion is one of the most effective and commonly performed procedures in paediatric ENT, offering immediate relief by restoring normal hearing and preventing the damaging cycle of recurring middle ear infections.
At Royal Eye & Ear Hospital, our ENT specialist performs grommet insertion with the skill, care and child-centred approach that gives parents confidence from the very first consultation. The procedure takes as little as 10–15 minutes, your child goes home the same day, and the results can be life-changing for both children and families.
What Is Glue Ear?
Glue ear — medically known as otitis media with effusion (OME) — is a condition where the middle ear fills with a thick, sticky fluid rather than remaining air-filled. This fluid muffles sound, causing hearing loss that can significantly affect a child’s speech development, learning and quality of life.
The middle ear is connected to the back of the nose by a small channel called the Eustachian tube. In young children, this tube is shorter and more horizontal than in adults — making it less efficient at draining fluid and equalising pressure. When the Eustachian tube fails to drain properly, fluid accumulates and becomes thick and glue-like over time.
Grommets — also called ventilation tubes or tympanostomy tubes — are tiny tubes about the size of a match head that are inserted into the eardrum. They create a small ventilation opening that allows air into the middle ear, enabling the accumulated fluid to drain away and preventing further build-up.
Children treated with grommets spend significantly less time with middle ear effusion during the first year of follow-up — and most experience immediate improvement in their hearing.
How It Works
Grommet Insertion involves Four precise steps:
- General anaesthesia — your child is put fully to sleep. The entire procedure is performed while they sleep — they feel nothing and are completely unaware.
- Microscopic examination — using a microscope, the surgeon examines the eardrum through the ear canal. No cuts are made on the outside of the ear.
- Myringotomy — a tiny incision is made in the eardrum to drain any accumulated fluid from the middle ear.
- Grommet placement — the grommet — a tiny plastic or metal ventilation tube — is placed precisely into the incision. It sits flush with the eardrum surface and immediately allows air to enter the middle ear.
The procedure takes just 10–20 minutes and is performed entirely through the ear canal — no external cuts, no visible scars, no stitches.
Why Choose Royal Eye & Ear Hospital for Grommet Insertion?
When your child’s hearing and development are at stake, you want the best possible care. Here is why families across Nairobi trust Royal Eye & Ear Hospital for grommet insertion.
- 🏥 Dedicated ENT Specialists We are a specialist eye and ear hospital — our ENT team is focused exclusively on ear, nose and throat care. Grommet insertion is a core part of our paediatric ENT surgical programme, performed regularly with consistent, high-quality outcomes.
- 👨⚕️ Experienced Paediatric ENT Surgeon Our ENT surgeon Dr. Mohamed Arab has extensive surgical experience performing grommet insertion in children of all ages — with a gentle, child-friendly approach that puts anxious children and worried parents at ease.
- ⚡ One of the Quickest Procedures in Paediatric ENT The procedure takes just 10–20 minutes — one of the shortest surgical procedures performed under general anaesthesia in children. Your child is awake and back with you very quickly after surgery.
- 🏥 Child-Friendly Environment We understand that hospitals can feel scary for small children. Our team goes out of its way to create a warm, welcoming and reassuring environment from the moment you arrive.
- 👂 Combined Procedures Available Grommet insertion is frequently combined with adenoidectomy when enlarged adenoids are contributing to Eustachian tube dysfunction. Performing both at the same time avoids multiple anaesthetic episodes — and our team has extensive experience managing both procedures together.
Benefits of Grommet Insertion for Your Child
Immediate Hearing Improvement
Many parents notice significant improvements in their child’s hearing almost immediately after surgery — often the same day. Grommets allow air into the middle ear and drain the accumulated fluid, restoring normal sound transmission through the eardrum almost at once.
Supports Speech & Language Development
Hearing loss from glue ear during the critical years of speech and language development can have lasting consequences. Restoring hearing with grommets during this window gives children the auditory input they need to develop language normally — closing the gap that months of hearing loss may have created.
Dramatically Reduces Ear Infections
Children with recurring otitis media typically see a dramatic reduction in ear infections after grommet insertion. By maintaining ventilation and preventing fluid accumulation, grommets remove the stagnant environment in which ear infections thrive.
Reduces Time with Middle Ear Fluid
Children treated with grommets spend significantly less time with middle ear effusion during the first year of follow-up — directly reducing the duration of hearing impairment and its impact on development.
Improves Quality of Life
Recurring ear infections mean recurring pain, recurring antibiotics, recurring missed school days and recurring sleepless nights for the whole family. Grommets interrupt this cycle — giving children and families their lives back.
Same Day Discharge
The procedure takes 10–20 minutes and is done as a day case — your child goes home the same day. Recovery is quick and most children return to normal activities within a few days
What to Expect After Grommet Insertion
Timeline:
Day 1 — Immediately after surgery Your child will wake up quickly — the procedure is very short and they typically come around within an hour or two. You may notice some mild ear discharge in the first day or two as residual fluid drains through the grommets. This is completely normal and expected. Many parents notice improved hearing almost immediately.
Days 1–3 — First few days Your child may have mild ear discomfort or feel slightly unsteady for a day or two. Most children experience little or no significant pain after grommet insertion. Continue any prescribed antibiotic ear drops as directed. Keep ears dry — water must not enter the ear canal while grommets are in place.
Days 3–7 — Return to normal Most children return to their normal activities within 3–7 days. They can return to school as soon as they feel well — usually within a few days of surgery. Energy and behaviour improvements linked to better sleep and hearing are often noticed within the first week.
Ongoing — Living with grommets Grommets typically remain in place for 6–18 months before falling out naturally as the eardrum heals and closes. During this time, keeping water out of the ears is important — use custom ear plugs or cotton wool with vaseline for swimming and bathing.
Recovery Do's and Dont's:
✅ Use prescribed antibiotic ear drops as directed
✅ Keep ears completely dry — avoid water in the ear canal at all times
✅ Use ear plugs specifically designed for grommets when swimming or bathing
✅ Attend all follow-up ear check appointments
✅ Report any significant ear discharge, pain or fever to your surgeon
❌ Don’t let your child swim without proper ear protection while grommets are in place
❌ Don’t use cotton buds in the ear canal
❌ Don’t ignore ear discharge that is green, yellow, thick or foul-smelling — this may indicate infection
❌ Don’t miss follow-up appointments — grommet monitoring is essential
RESULTS
What Results Can Your Child Expect?
1
Immediate Hearing Improvement
Many parents notice significantly improved hearing in their child almost immediately after surgery — often commenting that their child’s voice becomes quieter as they no longer need to shout to be heard. The improvement in hearing is often dramatic and immediate.
2
Improved Hearing Scores
Studies show that grommet insertion improves hearing levels by around 9 dB in the first 6 months — a clinically significant improvement that restores hearing to within normal limits for most children with glue ear.
3
Reduction in Ear Infections
Children who previously suffered from recurring acute otitis media typically experience a dramatic reduction in ear infection episodes after grommet insertion — often eliminating them entirely for the duration of the grommet’s life.
4
Speech & Development
Children with hearing loss from glue ear frequently show accelerated speech, language and cognitive development after grommets restore their hearing — particularly when the procedure is performed during the critical early years of language acquisition.
Risks & Considerations of Grommet Insertion⚠️
Grommet insertion is a safe and very commonly performed procedure. At Royal Eye & Ear Hospital, our ENT surgeon takes every precaution to minimise risk. As with all surgical procedures, there are some considerations parents should be aware of.
1
Ear Discharge
The most common complication after grommet insertion. Ear discharge may occur in the weeks or months after surgery — usually caused by water entering through the grommet or a minor infection. It is usually treated simply with antibiotic ear drops. Keeping ears dry with ear plugs significantly reduces this risk.
2
Grommet Blockage
The grommet tube can occasionally become blocked with wax or debris — reducing its ventilation function. This is detected at routine follow-up appointments and can usually be managed with ear drops or a simple outpatient procedure.
3
Early Extrusion
Grommets are designed to stay in place for 6–18 months before falling out naturally. Occasionally they may fall out earlier than expected — requiring reinsertion — or remain in place longer than intended, which may require surgical removal.
Patient outcome note: Your ENT surgeon will discuss all potential risks with you clearly before surgery. For children with persistent glue ear affecting their hearing and development, the benefits of grommet insertion significantly outweigh these small risks — and the procedure is one of the most commonly performed and well-studied in all of paediatric surgery.
Frequently Asked Questions About Grommet Insertion
Glue ear (otitis media with effusion) is a condition where the middle ear fills with sticky fluid, causing hearing loss. Signs include your child turning up the television, not responding when called, mishearing words, having delayed speech, seeming inattentive at school, or appearing to have a blocked feeling in the ear. A hearing test and tympanometry can confirm the diagnosis — book an ENT assessment at Royal Eye & Ear Hospital if you are concerned.
Grommets can be inserted in children from a very young age — including infants — if symptoms are severe enough. They are most commonly performed in children aged 1–7 years. Your ENT surgeon will assess your child’s suitability at consultation.
Grommets typically stay in place for 6–18 months before falling out naturally as the eardrum heals. The exact duration depends on the type of grommet used. Your child’s ears will be monitored at regular follow-up appointments to track the grommets’ status.
When a grommet falls out, the eardrum heals naturally over the hole. In the majority of children, the eardrum closes completely and hearing remains normal. In a small number of cases, the glue ear may recur after the grommets fall out — which may require reinsertion.
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