Diving and Water Sports with Grommets
Grommets, also called ear tubes or ventilation tubes, are very common in both children and…
If your child has one ear infection after another, or has been told they have glue ear, it is very natural to feel worried. You might notice the television creeping up in volume, teachers in Melbourne kindergartens or schools mentioning hearing concerns, or your child saying “what” more often than usual. At the same time, the idea of an operation can feel confronting. Many parents end up asking the same question: are grommets safe for my child, and are they really necessary.
Melbourne ENT is a specialist ear, nose and throat clinic located in St Kilda East, Victoria. The clinic cares for adults and children from across Melbourne and regional Victoria. One of the surgeons, Dr Simon Braham, MBBS (Hons), FRACS, has many years of experience in paediatric and adult ENT surgery, including grommet insertion for children with glue ear and recurrent ear infections. He operates at accredited hospitals in Melbourne, including Masada Private Hospital, and also works in the public health system.
This article is designed to give you clear, balanced information about grommets. It explains what glue ear is, how grommets work, the potential benefits and risks, and what to expect if your child has grommet surgery at Melbourne ENT. It is general information only and is not a substitute for advice from your GP or an ENT specialist who has assessed your child.
Glue ear, also known as otitis media with effusion, happens when sticky fluid collects behind the eardrum in the middle ear. Instead of a space filled with air, the middle ear becomes filled with fluid that does not drain well. This makes it harder for the eardrum and tiny hearing bones to move properly and can cause a temporary conductive hearing loss. Glue ear is very common in young children in Melbourne and throughout Victoria, especially in the preschool and early primary school years.
For some children, glue ear causes only mild symptoms and improves on its own. For others, the hearing loss is more significant and continues for months. Parents might notice that their child stands very close to speakers, turns one ear towards them, or seems to ignore instructions in noisy environments. Teachers may comment that a child appears distracted or struggles to follow group directions, when in fact they cannot hear clearly. Over time, this can affect speech, language and confidence.
Grommets are tiny hollow tubes that sit in a small opening made in the eardrum. During surgery, the ENT surgeon makes a tiny incision in the eardrum, gently removes trapped fluid from the middle ear and then places the grommet in the opening. The grommet allows air to move in and out of the middle ear and gives any further fluid a way to drain. This usually improves hearing while the tube remains open. Over time, the eardrum heals and slowly pushes the tube out into the ear canal, where it can fall out unnoticed.
Specialists consider grommets when glue ear or recurrent infections are persistent, and when there is clear evidence that the problem is affecting a child’s quality of life. Children are often referred to Melbourne ENT by their GP after hearing tests show ongoing conductive hearing loss or when repeated infections are making life difficult at home and school. Dr Simon Braham considers not only test results but also speech, learning, sleep and behaviour when advising on treatment.
Insertion of grommets is one of the most common paediatric ENT procedures performed in Australia. For most otherwise healthy children, it is a short, low risk operation that can be done as day surgery. This means your child comes into hospital, has the procedure under a short general anaesthetic, spends some time in recovery and then goes home the same day once they are comfortable and drinking.
In Melbourne, children seen at Melbourne ENT usually have their grommets inserted in accredited private hospitals such as Masada Private Hospital, or in public hospitals depending on the arrangement. A specialist anaesthetist looks after your child during the operation, monitoring their breathing, heart rate and comfort. Modern paediatric anaesthesia is very safe for most children, although no anaesthetic is completely risk free. Any specific risks related to your child’s health are discussed with you before surgery.
Having an experienced ENT surgeon also contributes to safety. Dr Simon Braham is a Melbourne based Ear, Nose and Throat Surgeon and Fellow of the Royal Australasian College of Surgeons. At Melbourne ENT he performs grommet surgery regularly and follows evidence based guidelines for when tubes are likely to be helpful. The decision to operate is based on whether the expected benefits, such as improved hearing and fewer infections, outweigh the potential risks for your child at this point in time.
In practical terms, grommets are generally considered safe for children who meet appropriate criteria. The main question is not whether the procedure is possible, but whether it is the right choice for your child now, compared with continued observation or other treatments.
One of the best ways to answer the question are grommets safe for my child is to look at some of the myths that cause understandable anxiety.
A very common myth is that grommets are a big, dangerous operation. In reality, the procedure is very precise and limited to the eardrum. There are no cuts on the outside of the ear, and the operative time is usually only a few minutes per ear. The hospital, anaesthetic and recovery are planned with child friendly care, and most children are sitting up, drinking and chatting soon after the procedure. It is still surgery, so care and preparation are important, but it is not major open surgery.
Another myth is that grommets will damage a child’s hearing. For children whose ears are full of fluid and who have measurable conductive hearing loss, grommets usually improve hearing while they are in place. Parents often notice clearer responses to voices, and children may seem more alert to environmental sounds. Long term, the majority of children do not experience significant hearing damage from grommets. There can be small changes such as scarring on the eardrum or a small hole that does not heal in a minority of cases. These possibilities are discussed carefully with parents before surgery.
Some parents are told that all children grow out of glue ear and therefore surgery is never needed. Many children do improve with time, which is why watchful waiting with repeat hearing tests is often the first approach. However, if a child has had significant hearing loss for many months, or if there are clear concerns about speech, language or school progress, the cost of doing nothing can start to outweigh the risks of surgery. At Melbourne ENT, Dr Braham considers the length and severity of symptoms as well as how your child is managing in everyday life before recommending grommets.
It is also a myth that if a child has even one ear infection after grommets, the tubes have failed. Grommets do not create a germ free ear. Children can still catch colds and develop infections. What changes is the way infections behave. Instead of intense pressure behind a blocked eardrum, infections can drain out through the tube, often leading to less pain. They are frequently treatable with ear drops rather than repeated oral antibiotics. If infections are frequent or severe even with grommets, follow up with Melbourne ENT is important to check tube position and look for other causes.
Another worry is that grommets mean an end to swimming and water play. Current advice is much more relaxed than strict long term bans. Normal bathing and careful hair washing are usually allowed, and many children return to swimming in clean pools once their surgeon says it is safe. Ear plugs or headbands may be suggested for diving, deep water, or for children who tend to get ear discharge. At Melbourne ENT, water advice is tailored to your child’s history and activities.
Many families hope grommets will fix all speech and learning issues. Improved hearing can make it much easier for a child to hear speech sounds accurately, which may help progress, but it does not automatically resolve all developmental differences. Some children still need speech therapy, assistance in the classroom or support with learning. Melbourne ENT often works with audiologists, speech pathologists and teachers to provide a coordinated plan.
Finally, it is not true that every child with glue ear needs grommets. Some children have mild, short term fluid that resolves without any intervention. Others have more significant or persistent problems where surgery becomes the more helpful option. The key message from Melbourne ENT is that grommets are recommended when they are likely to make a real difference, not simply because fluid has been seen once.
For many Melbourne families, the most noticeable benefit of grommets is clearer hearing. Children who previously misheard words or needed the television at high volume often respond more promptly and participate more in conversation. In the classroom, they may find it easier to listen to the teacher and follow group instructions, which can improve confidence and engagement.
Reducing the frequency and severity of ear infections is another important benefit. When the middle ear is ventilated by grommets, fluid is less likely to stagnate and cause painful pressure. This can mean fewer nights of broken sleep due to ear pain and fewer last minute trips to doctors or emergency departments. Infections that do occur are often easier to treat.
Better sleep and less pain can also improve behaviour and family life. Children who are no longer dealing with constant discomfort or muffled hearing may be calmer, more settled and less frustrated. Parents often report a general improvement in mood and energy at home once long running ear problems are under control.
From a developmental perspective, improved hearing allows children to access speech sounds more clearly during important stages of language and learning. This can support progress with pronunciation, vocabulary and early literacy. While grommets are not a guarantee of perfect speech or school performance, they can remove a significant barrier that some children face.
At Melbourne ENT, Dr Simon Braham discusses these potential benefits in the context of your child’s specific situation, so that expectations are realistic and families understand both what grommets can achieve and what other supports might still be needed.
Even common procedures have risks and limitations. In the hours after grommet insertion, it is normal for children to feel tired or a bit unsettled as the anaesthetic wears off. Some children have a mild sore throat, nausea or dizziness, which generally responds to rest and simple pain relief. The ears themselves are often only mildly uncomfortable, if at all, and many children are back to quiet play the same day.
Possible complications within the ears include episodes of ear discharge while the tubes are in place. This can appear as fluid or pus from the ear canal. It often occurs after a cold or water exposure and is usually managed with prescribed antibiotic drops and temporary water precautions. In some cases, a grommet may become blocked or fall out earlier than expected, which can reduce its effectiveness. Follow up appointments help pick up and address these issues.
Longer term changes in the eardrum can include areas of scarring or chalky patches. These changes are common to see on examination but usually have little effect on hearing. A small hole that does not close after the tube comes out occurs in a small percentage of children. If this happens and does not resolve with time, an ENT surgeon can discuss repair.
Some children need further procedures. If ears continue to be prone to glue ear as a child grows, a second set of grommets may be recommended. If enlarged adenoids are contributing to ongoing problems, adenoidectomy might also be discussed. At Melbourne ENT, these decisions are made on a case by case basis.
The main limitation to understand is that grommets treat the consequences of Eustachian tube dysfunction and glue ear rather than changing the underlying anatomy. They can provide a window of clearer hearing and more stable ear health, but they do not remove the possibility of future ear problems entirely. This is why ongoing review is part of the plan.
The process usually begins with a visit to your GP. If there are concerns about hearing, speech or recurrent ear infections, your GP may arrange a hearing test and refer your child to Melbourne ENT in St Kilda East for specialist assessment. At the first appointment, Dr Simon Braham will talk with you about your child’s history, examine their ears, nose and throat, and review any hearing test results or school reports.
Hearing tests are an important part of deciding whether grommets might help. These tests measure how well your child hears different tones and speech and can show whether there is conductive loss from fluid in the middle ear. Tympanometry may also be used to assess how the eardrum moves. In some cases, tests are repeated after a period of monitoring if early results are borderline or if glue ear might resolve on its own.
If grommet surgery is recommended, the details of the operation, potential benefits and possible risks will be explained. You will be told which hospital is planned, such as Masada Private Hospital or another Melbourne facility, and what to expect on the day. Pre operative instructions will cover fasting times, what medications to continue or pause, and practical things like what to bring for your child’s comfort.
On the day of surgery, you and your child will be admitted to hospital, meet the anaesthetist and have a chance to ask any last questions. Once your child is asleep, Dr Braham inserts the grommets using a microscope. After the procedure, your child wakes up in recovery under close nursing supervision. When they are awake, comfortable and drinking, you can take them home with written instructions.
Follow up at Melbourne ENT is an important part of care. Your child will usually have a review with Dr Braham to check the position of the grommets and how the ears are settling. Repeat hearing tests may be arranged to confirm improvement. Additional reviews over the following months allow monitoring of when the tubes fall out and ensure that the eardrums have healed.
Many parents also ask about Medicare. In Australia, grommet surgery is usually eligible for a Medicare rebate when clinical criteria are met. If the procedure is done as a public patient in a public hospital, Medicare generally covers the procedure itself, although access and waiting times depend on the hospital. If your child has grommets in a private hospital as a private patient, Medicare pays a rebate towards the surgeon and anaesthetist fees and private health insurance, if held, may contribute towards hospital and theatre costs. Out of pocket costs vary according to your cover and the fees charged. Melbourne ENT provides item numbers and information to help you check rebates and understand likely costs so there are no surprises.
Surgery is not the only approach to managing glue ear and recurrent ear infections. In many children, the first step is watchful waiting. This means allowing time for the ears to clear naturally while monitoring symptoms and repeating hearing tests. It is often appropriate when hearing loss is mild, the child is coping well and the fluid has not been present for long.
Medical and conservative measures can also help. Treating nasal allergies, reducing exposure to cigarette smoke and managing recurrent colds may improve overall ear health. Antibiotics are used to treat acute ear infections when needed, but they do not usually change the long term tendency to glue ear.
Other ENT procedures may be considered in certain cases. If enlarged adenoids are blocking the back of the nose and contributing to ear problems, adenoidectomy may be discussed in addition to or instead of grommets. Dr Simon Braham explains when such procedures are necessary and when they are not.
Non surgical supports remain important even when surgery has been done. Speech therapy can help children catch up on language and pronunciation. Teachers can make practical adjustments, such as seating the child closer to the front of the class and checking understanding. Parents can support their child by reducing background noise at home when giving instructions and informing carers about the child’s hearing history. Melbourne ENT encourages this team based approach.
Most children do not notice any negative change in balance after grommet surgery. If anything, children who previously had pressure or fluid related dizziness may feel more steady. After the initial recovery period, most children can return to their usual activities, including running, ball sports and playground games. Your surgeon will advise you about timing, but grommets are not usually a barrier to an active lifestyle.
Children with neurodevelopmental conditions or sensory sensitivities often benefit from extra preparation. It can help to explain the steps in simple language, use visual cues and allow your child to bring a comfort item. Let the team at Melbourne ENT and the hospital staff know about your child’s needs so they can adjust how they give instructions and plan the day. The surgery itself happens while your child is asleep, but thoughtful planning can make the overall experience less stressful.
For some children, the change from muffled hearing to clearer hearing can feel strange. Everyday sounds such as traffic, vacuum cleaners or school bells may seem louder than before. This usually settles as the brain adapts over a few days or weeks. If your child finds certain sounds overwhelming, short quiet breaks or, for a limited time, ear defenders in very noisy environments can help them adjust.
Minor sniffles are common in young children and do not always mean surgery must be cancelled. However, if your child has a significant cough, wheeze or fever, the anaesthetist may recommend postponing the procedure for safety. It is important to contact the hospital or Melbourne ENT if your child becomes unwell in the days before surgery. Decisions are made individually, with your child’s wellbeing as the priority.
fter the initial recovery, most children return to school or kinder with very few restrictions. It can be helpful to tell teachers that your child has had grommets and that their hearing should be clearer. Some children who previously needed to sit at the front of the class may cope better in a usual seat, although clear speech and reasonable classroom acoustics are still important. Teachers should let you know if they notice any ongoing concerns about hearing or attention.
Grommets usually fall out on their own as the eardrum heals, often between 6 and 18 months after surgery. Sometimes parents see a tiny tube in the child’s pillowcase or ear wax, but it is very common not to see them at all. The important thing is that your child attends follow up appointments so the ENT surgeon can check whether the tubes are still in place, have fallen out, and whether the eardrum has healed properly. You do not need to retrieve or keep the grommets themselves.
Children often imagine grommets as large or uncomfortable objects. Showing a picture can help them see how small they really are. You can explain that they are like tiny straws that help the ears breathe and that they will not be able to feel them. It can also be reassuring to say that many children in Melbourne have had grommets and still do the things they enjoy, such as playing, swimming with care and going to school. If anxiety is significant, talk with your GP or the team at Melbourne ENT so they can support you with age appropriate explanations.
For many families, the key question is still are grommets safe for my child. Grommet surgery is a common and generally safe procedure that can significantly improve hearing and reduce the impact of persistent ear problems when it is used in the right situation. It does carry some risks and limitations, so it is not automatically the best option for every child with glue ear.
You should consider seeking advice if your child has frequent ear infections, ongoing concerns about hearing, speech or language delays, or difficulties at kinder or school that might be related to hearing. Your GP is often the best first step and can arrange hearing tests and, if needed, a referral to Melbourne ENT for an opinion from Dr Simon Braham.
Melbourne ENT in St Kilda East provides comprehensive assessment and management of ear, nose and throat problems for children and adults across Melbourne and Victoria. Dr Braham focuses on careful diagnosis, evidence based recommendations and clear communication so that families can make informed decisions.
If you are worried about your child’s ears or hearing, you can start by talking with your GP about what you have noticed. If a specialist assessment is recommended, you can ask for a referral to Melbourne ENT so that Dr Simon Braham can discuss whether grommets or other approaches may be suitable. To learn more about grommet surgery and other ENT services, you can visit the website.
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