Myringotomy and grommet insertion

Paediatric pre-anaesthetic assessment

Pre-assessment is to ensure your child is fit for their anaesthetic and surgery. It also gives you and your child an opportunity to ask questions about the operation and to discuss what to expect on the day of surgery.

Not all patients require a pre-assessment—you will be notified of the pre-assessment date via letter or phone if it is applicable to your child.

Myringotomy and grommet insertion advice

Your child is having a myringotomy (a small incision in the eardrum) and insertion of grommets. This is usually recommended because your child has one or a combination of the following symptoms:

• Recurrent ear infections
• Hearing loss
• Persistent glue ear

Day of admission

If your child is coming at 07:15am:

• No food or milk after 2:30am and water only until 5:30am

If your child is coming at 12 noon:

• No food or milk after 7:30am and water only until 10:30am.

Your child’s surgery may be delayed or cancelled on the day if the fasting instructions are not followed precisely.

On the day of the operation, a maximum of two adults are permitted to accompany your child—one of whom needs to be a legal guardian to sign consent. Please arrange care for siblings as we cannot accommodate them on the ward.

On arrival, the children’s nurses will prepare your child for surgery by asking if there have been any changes to their health since pre-assessment and to recheck their blood pressure etc. Local anaesthetic cream will be applied to both hands.

All care and procedures will be explained to you and your child. You will see the surgeon who will discuss the operation with you and if you have not already done so sign a consent form. The anaesthetist will also meet you and your child.

One parent/carer may accompany your child to the anaesthetic room.

After the operation

Initially after the operation your child will go to paediatric recovery. As soon as your child wakes you will be called to recovery. They are then transferred back to the children’s ward where their condition will be monitored and closely observed.

Children can be very miserable after waking and as the anaesthetic wears off, this is normal until your child is fully awake. Your child will be encouraged to eat and drink a normal diet once they are fully awake.

If your child needs to stay overnight, one parent/guardian may accompany him/her.

Car parking

The rates are reduced on the operation day for your child, please ask the nurse looking after your child to arrange this.

Discharge home

Pain following myringotomy and insertion of grommets is fairly minimal, however if your child does experience any pain or discomfort give paracetamol as instructed on the bottle.

It can be normal to wake up the morning after the operation with a small blood stained discharge coming from the ear. This is due to the incision made when the grommet was inserted. We advise you wait 24–48 hours before your child returns to school/nursery. This is to ensure they have completely recovered from the anaesthetic and they are back to their usual self.

The grommets do not drain fluid from the ear—they equalise the pressure in the middle ear and keep it dry. If fluid does come out of the ear this could mean that your child has an ear infection and you should take your child to your GP for treatment.

The surgeon advises you to protect your child’s ears and keep them dry with ear plugs or cotton wool and Vaseline. They can swim straight after surgery with adequate water precautions.

Follow-up in the audiology clinic, 4–6 weeks after surgery.