Paediatric & adult ENT · London
Ear tubes (grommets): a plain-English patient guide.
Grommets are tiny tubes that ventilate the middle ear for children with glue ear and for adults with eustachian tube dysfunction. This is what the operation involves, when it’s the right call, and what happens after.
Why patients choose us
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Paediatric ENT and audiology together
A consultant paediatric ENT surgeon and a qualified audiologist working from the same notes — not a hearing test in one place and surgery in another.
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Watchful waiting when it’s right
NICE says three months of observation before grommets for most children. We won’t shortcut it — but we also won’t leave a child on a waiting list once the case is clear.
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Independent, and free
We are paid by no clinic, so the recommendation — surgery, hearing aids, or more time — is impartial and costs you nothing.
Indicative pricing
What grommets cost privately in London.
Indicative ranges across our partner clinics. Send the details and we quote firm figures across two or three options.
In short
Bilateral grommets for a child under GA: £2,400–£3,800, home the same day.
| Procedure | Indicative range | Typical duration | Recovery |
|---|---|---|---|
| Grommets — child, both ears, GA | £2,400–£3,800 | 30 min in theatre | Home same day |
| Grommets + adenoidectomy — child, GA | £3,200–£5,200 | 45 min in theatre | Home same day |
| Grommets — adult, one ear, LA in clinic | £900–£1,600 | 15 min | Same visit |
| T-tube (long-term grommet) — adult, LA | £1,100–£1,900 | 20 min | Same visit |
| Audiology assessment + tympanometry | £140–£260 | 30–40 min | Same visit |
| ENT consultation only | £200–£350 | 30 min | Same visit |
Prices vary by clinic, by which ENT surgeon does the case, by whether adenoids are removed at the same time, and by anaesthetic. We come back with a firm quote within one working day.
The problem
The right test, at the right time, before surgery.
Glue ear either resolves on its own within three months or it doesn’t. The mistake is either operating too soon — or leaving a child with hearing loss for a year while nothing is done.
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Not sure it is glue ear?
Tympanometry (a five-second pressure test) and pure-tone audiometry tell you within one appointment.
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Worried about a GA?
It is short, delivered by a paediatric anaesthetist, and your child is home within a few hours. We explain what happens minute by minute.
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Want it done properly?
A consultant paediatric ENT surgeon, a proper theatre, and a written aftercare plan — including the 3–6 month hearing recheck.
The journey
From audiology to recheck — what happens, in order.
One ENT surgeon and one audiologist from first appointment to the 3–6 month recheck.
Phase 1 · Before
Testing and watchful waiting
Phase 2 · On the day
A few hours at the clinic
Phase 3 · After
Aftercare and audiology recheck
- 01
Before
A proper audiology assessment
Pure-tone audiometry (or age-appropriate testing) plus tympanometry to confirm middle-ear fluid and quantify the hearing loss.
- 02
Before
Three-month watchful waiting
Per NICE guidance for otitis media with effusion, most children are re-tested after three months — many cases resolve on their own.
- 03
Before
Repeat tympanometry and hearing test
A flat (Type B) trace on both ears with persistent hearing loss of 25–30 dB or worse is the usual threshold for surgery.
- 04
Before
The surgical decision
A named consultant ENT surgeon reviews the tests and your child. Grommets alone, or with adenoidectomy if this is a repeat set (NICE, ≥ 2 years old).
- 05
On the day
Grommet insertion
10–15 minutes per ear under a short general anaesthetic for children — or in-clinic under local for most adults. Home the same day.
- 06
After
Aftercare and drops
Written aftercare: keep soap out of the ears, ear plugs for swimming if preferred (the evidence is weaker than the reputation), and antibiotic drops if there is post-op discharge.
- 07
After
Audiology recheck at 3–6 months
A repeat hearing test confirms the tubes are working. Grommets typically extrude on their own between 6 and 18 months.
Typical end-to-end: 3 months of observation, then 2–3 weeks to surgery. Grommets extrude in 6–18 months.
When it helps
When grommets are the right step.
The situations we see most, plus the one red flag in adults that means investigation, not a grommet.
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Glue ear (OME) with hearing loss
Persistent middle-ear fluid causing 25–30 dB hearing loss for three months or more, most often in children aged 2–7.
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Speech and language delay
Undetected glue ear in a young child can hold back speech, listening and school progress — grommets restore hearing quickly.
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Recurrent acute otitis media
Four or more episodes of ear infection in six months, or six in a year — grommets ventilate the middle ear and cut recurrence.
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Adult eustachian tube dysfunction
Persistent blocked-ear feeling, muffled hearing or pressure that won’t clear — a grommet under local anaesthetic often settles it.
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Barotrauma prevention
Frequent flyers, divers and those needing hyperbaric oxygen sometimes have grommets fitted to prevent pressure injury.
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Chronic adult OME
Adults with long-standing middle-ear fluid — often after a viral illness or with allergic rhinitis — benefit from ventilation.
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Down syndrome and cleft palate
Children with these conditions have much higher rates of glue ear and often need earlier, sometimes repeat, sets of grommets.
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Red flag: adult unilateral OME
Persistent fluid in one adult ear needs a nasopharyngeal examination to exclude a nasopharyngeal tumour — do not delay.
Grommet options
Short-term, long-term, or no surgery at all.
The different tube types, the adenoidectomy question, and the non-surgical alternative — laid out plainly.
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Shepard / Armstrong (short-term)
The standard grommet — small silicone or fluoroplastic tube that ventilates the middle ear and extrudes on its own in 6–18 months.
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Goode T-tube (long-term)
A flanged tube that stays in place for 2–5 years. Used when repeat sets have been needed — higher rate of persistent perforation on removal.
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Paparella II (long-term)
A larger long-stay tube for adults or children with severe eustachian tube dysfunction where a standard grommet won’t last.
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Grommets under GA (children)
A short, careful general anaesthetic — usually 10–15 minutes per ear — with a paediatric anaesthetist. Home a few hours later.
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Grommets under LA (adults)
Done sitting up in an ENT chair with local anaesthetic on the ear drum. No sedation needed; drive home yourself.
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Adenoidectomy add-on
For a child aged 2 or over who needs a repeat set of grommets, NICE recommends removing the adenoids at the same time to reduce recurrence.
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Myringotomy without a tube
A small drainage cut in the ear drum without inserting a tube. Rarely used alone — closes within days.
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Non-surgical: hearing aids
A hearing aid can bridge the loss without surgery — reasonable if a family prefers to avoid a general anaesthetic.
Our vetted London network
A small panel of paediatric ENT surgeons, we picked them.
Consultant paediatric ENT surgeons across central, north, west and south London — each working with a dedicated paediatric anaesthetist and audiologist.
Selection criteria
How we choose every ENT surgeon in our network.
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Consultant paediatric ENT surgeons for children, not general trainees
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Registered audiologists using calibrated equipment on-site
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Paediatric anaesthetist for every child under general anaesthetic
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Written aftercare plan and a 3–6 month audiology recheck included
Safety and recovery
What to expect afterwards — honestly.
Grommets are one of the commonest paediatric operations in the UK. Serious complications are rare, but there are a few honest trade-offs worth knowing before you say yes.
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A short, low-risk anaesthetic
For a child, the whole GA is usually under 20 minutes with a paediatric anaesthetist. Serious adverse reactions are very rare.
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Otorrhoea is the commonest complication
A few days of ear discharge after grommets happens in around 10–20% of children — treated with topical antibiotic ear drops, not oral antibiotics.
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Persistent perforation
Under 2% after standard short-term grommets. Higher (10–30%) with long-term T-tubes — a small myringoplasty can repair it later if needed.
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Swimming — the honest answer
The evidence for banning swimming is weaker than the reputation. Most surgeons suggest ear plugs for pools, avoiding deep or dirty water, and keeping soapy bath water out.
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Grommets extrude on their own
Short-term grommets fall out into the ear canal within 6–18 months. The ear drum usually heals over on its own.
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Tympanosclerosis is common but usually silent
Small chalky patches on the ear drum after grommets are common and almost always don’t affect hearing.
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Hearing loss that persists
If hearing hasn’t recovered after grommets, we look for a sensorineural (nerve) component — glue ear can mask it.
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Cholesteatoma
Very rare. A retraction pocket or persistent discharge with debris on the drum needs prompt ENT review.
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Red flags
Adult unilateral glue ear, persistent perforation, chronic discharge, or a grommet that has migrated into the external canal — all need an ENT review.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever grommet was used, the note the surgeon sends you keeps to the same shape.
A quiet reminder
Surgical language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Ear examined and tube used
Which ear (or both), which grommet type was inserted, and whether an adenoidectomy was performed at the same time.
- 02 Technique
Anaesthetic and myringotomy findings
GA or LA, the position of the myringotomy, and what fluid was aspirated — thin serous, thick mucoid (“glue”) or infected.
- 03 Findings
Ear drum and middle ear
Notes on the ear drum (retraction, tympanosclerosis), the middle-ear mucosa, and any adenoid grade if removed.
- 04 Impression
Aftercare and audiology recheck
Read this first: swimming and bathing advice, when to use antibiotic drops, and the date of the 3–6 month hearing recheck.
Recognised by major UK insurers
Most UK insurers cover grommet surgery when medically indicated — including under children’s policies. We confirm cover before booking.
Frequently asked
Everything parents and adult patients ask us about grommets.
Quick answers on swimming, anaesthetic, tube types, and when to call the clinic.
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What are ear tubes (grommets) and why are they used?
Grommets — also called tympanostomy or ventilation tubes — are tiny silicone or fluoroplastic tubes placed through the ear drum. They drain fluid, equalise middle-ear pressure and restore hearing. They are used most often for glue ear (OME) with hearing loss, and for recurrent ear infections.
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How long do grommets stay in?
Standard short-term grommets (Shepard, Armstrong) work themselves out of the ear drum in 6–18 months. Long-term T-tubes (Goode, Paparella) stay in place for 2–5 years but carry a higher risk of a persistent perforation when they come out.
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Is a general anaesthetic really necessary for children?
Yes — a child cannot keep still enough for a surgeon to work on the ear drum under local. The GA is short (usually under 20 minutes), delivered by a paediatric anaesthetist, and children are home within a few hours.
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Can adults have grommets under local anaesthetic?
Usually yes. In adults with eustachian tube dysfunction or chronic OME, a grommet can be inserted in an ENT chair in under 15 minutes with local anaesthetic on the ear drum. No sedation, no fasting, drive home yourself.
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Can my child swim after grommets?
The evidence for a strict swimming ban is weaker than its reputation. Most UK surgeons suggest ear plugs for pool swimming, avoiding deep dives, keeping soap and shampoo out of the ears at bath time, and steering clear of dirty water — but many children swim happily without plugs.
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When should we worry after grommets?
A few days of ear discharge is common and treated with topical antibiotic drops. Call the clinic if there is heavy or prolonged discharge, spreading redness behind the ear, high fever, sudden hearing loss, or if you can see the grommet in the ear canal but hearing has got worse.
Related
Looking for something else?
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Ear infection treatment
Acute otitis media, otitis externa and when antibiotics help.
Learn more -
Hearing loss assessment
Pure-tone audiometry and speech-in-noise testing.
Learn more -
Tympanometry
The five-second middle-ear pressure test.
Learn more -
All tests
Every test and procedure we arrange.
Learn more