Preparing your child and explaining what to expect will go a long way to making the day smooth and enjoyable for everyone. Please feel free to call the play specialist on the 5th floor to discuss the books and games which are available to help prepare your child for surgery. Parents are made to feel welcome and as involved as they wish.
Grommet insertion alone or with grommet insertion is usually a day case procedure.
Your child is usually admitted late on the morning of the surgery to acclimatize to the environment. You will also be seen by the anaesthetist (Dr. Adrian Lloyd Thomas), the resident doctor (a paediatrician) and Mr Albert to confirm details of the surgery and for you to sign the consent form.
A proper breakfast at least 6 hours before surgery is a good idea as it reduces any hunger. Clear fluids can be given up to 2 hours before surgery and a final drink just before the deadline is a good idea as it reduces thirst and stress before the operation. Topical anaesthetic cream (The Magic Cream) will be put on and covered with a clear plastic film. This numbs the skin so that the anaesthetist can give the drugs needed to start anaesthesia. See Dr Lloyd-Thomas's own page for details.
The operation (grommet insertion alone) takes 10 minutes though your child may be away for as long as 1/2 hour. You will be called in good time to be with your child as he/she recovers.
Most children are a little disorientated and thirsty after the procedure and may cry despite adequate analgesia. Once they are fully awake and have had a drink they quickly improve and can go home shortly after.
Once at home most children do well with little or no pain. Occasionally small quantities of fluid may drain from the ear for several days after the surgery. This may be clear or slightly reddish. If discharge persists contact me or your GP. The tube does not act as a drain and any persistent discharge needs treatment.
Children can fly the next day and do not need to be kept away from other children if they have only had grommets inserted.
The evidence is rather contradictory in that studies looking at children swimming have not shown any increase in ear infections. However when grommets are placed in models of the human ear canal, water will pass through with a pressure of water equivalent to only a couple of feet. These studies also show that soapy water may get through the grommet. Initially I would suggest allowing your child to swim, bath and hair-wash without protection. If your child does have a number of episodes of discharge then it is probably sensible to take additional precautions. A swim hat does not stop water from getting into the ear canal but may reduce the pressure. Most preformed over-the-counter ear plugs are poor and I recommend silicone malleable ear plugs. Individually moulded plugs are effective but need to be replaced as the ear grows and are expensive to lose. A neoprene head band is added security for either type of plug.
An infection in the ear can develop in spite of the grommet and is normally manifest by a mild earache and discharge. Often the discharge is thick, sticky and has a noticeable odour. If this happens treatment with ear drops such as Sofradex or Otosporin and oral antibiotics is often required. You should consult your own doctor immediately and it may be necessary for you to come back to the clinic.
Grommets stay in for a varying length of time but most are rejected from the eardrum within nine months to a year. They usually become attached to wax and fall out or they may be removed from the outer ear canal by a doctor. For this reason I like to see patients with grommets every four to six months.