Concierge ENT · London
Private myringotomy and grommets in London, by a consultant ENT surgeon.
A proper day-case grommet procedure - following the NICE NG138 pathway for glue ear and recurrent otitis media, with paediatric anaesthesia, in-house audiology, and adenoidectomy considered where appropriate.
Why patients choose us
- 01
A consultant ENT surgeon, in theatre
Not a training list and not a walk-in. A named paediatric or adult ENT surgeon, a proper microscope-equipped theatre, and the anaesthetic that suits the patient.
- 02
The NICE NG138 pathway, followed properly
For a child with glue ear, we make sure the three-month watchful-wait, the two audiograms and the tympanogram are all done - not skipped to get to surgery faster.
- 03
Independent, and free
We are paid by no clinic, so the recommendation - grommets, adenoidectomy, or neither yet - is impartial and costs you nothing.
Indicative pricing
What private grommets cost in London.
Indicative ranges across our partner clinics. Send the details and we quote firm figures across two or three options - including whether adenoidectomy is worth adding.
In short
Bilateral grommets under GA for a child: £2,800–£4,500, home the same day.
| Procedure | Indicative range | Typical duration | Recovery |
|---|---|---|---|
| Bilateral grommets (child, GA) | £2,800–£4,500 | 20–30 min | Same day home |
| Grommets + adenoidectomy (child, GA) | £3,500–£5,500 | 30–45 min | Same day home |
| Unilateral grommet (adult, LA) | £1,800–£3,000 | 10–15 min | Same visit |
| Bilateral grommets (adult, LA) | £2,200–£3,800 | 15–20 min | Same visit |
| Long-term T-tube insertion (per ear) | £2,400–£4,000 | 20 min | Same visit |
| ENT consultation + audiogram | £250–£450 | 45 min | Same visit |
Prices vary by clinic, by which ENT surgeon does the case, by the anaesthetic used, and by whether adenoidectomy is added on the day. We come back with a firm quote within one working day.
The problem
The right pathway, the right anaesthetic, the right ENT surgeon.
Grommets are one of the most common paediatric operations in the UK - and one of the most poorly explained in the private market. We follow the NICE NG138 pathway, make the adenoidectomy call clearly, and keep audiology in-house.
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Not sure it is needed yet?
The NICE NG138 three-month watchful-wait is often the right first step - we say so before we book theatre.
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Worried about the anaesthetic?
A paediatric anaesthetist is on every child’s list. Adult cases can usually be done under LA in the clinic.
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Want it done properly?
A named consultant ENT surgeon, a microscope-equipped theatre, in-house audiology and a clear follow-up plan.
The journey
From enquiry to audiogram - what happens, in order.
One clinician from first message to grommet review - including the hearing test that confirms it worked.
Phase 1 · Before your procedure
Concierge, off-stage for you
Phase 2 · On the day
A few hours at the clinic
Phase 3 · After
Concierge, back on
- 01
Before
You tell us what is going on
A short, confidential form. The child’s age, how long the hearing has been down, any speech or school concerns - or for adults, the recurrent ear problems or barotrauma story.
- 02
Before
We come back with a recommendation
Within one working day: whether grommets are indicated now, whether an audiogram or tympanogram is needed first, and whether adenoidectomy should be considered alongside.
- 03
Before
We arrange the appointment
Usually within one to two weeks. Fasting instructions for the child, and clear guidance on the day-case pathway.
- 04
On the day
Arrival at the clinic
Arrival, consent and a chat with the ENT surgeon and paediatric anaesthetist. GA for children, LA for straightforward adult cases.
- 05
On the day
The procedure itself
Five to ten minutes under the operating microscope. A small incision in the ear drum, the effusion is suctioned, a grommet is placed, and antibiotic drops are instilled.
- 06
On the day
Home the same day
A short recovery, written aftercare, and home within a few hours. Back to school or work the next day for most.
- 07
After
Audiogram and grommet review
Hearing test at four to six weeks to confirm improvement. Grommet review at six and twelve months. The tubes extrude on their own, usually within a year.
Typical end-to-end: 2–3 weeks from enquiry to procedure. Post-op audiogram: 4–6 weeks.
When it helps
When grommets are the right step.
The situations we see most, plus the one red flag in adults that changes the workup entirely.
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Persistent glue ear in children (OME)
Bilateral middle-ear fluid with a 25–30dB+ hearing loss lasting three months or more, per NICE NG138 - with an impact on speech, school or behaviour.
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Recurrent acute otitis media (RAOM)
Three or more ear infections in six months, or four or more in a year - grommets reduce the frequency and severity of attacks.
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Adult recurrent OME
Often secondary to Eustachian tube dysfunction. In unilateral adult OME we always exclude nasopharyngeal pathology first.
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Chronic barotrauma
For divers, aviators and hyperbaric-oxygen patients who cannot equalise - a grommet bypasses the Eustachian tube.
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Cleft palate and craniofacial anomalies
Anatomical predisposition to OME. Grommets are often planned around palate repair and reviewed regularly.
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Down syndrome
Narrow Eustachian anatomy and a higher OME rate - a lower threshold to place tubes, and closer follow-up afterwards.
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Infected or atypical effusion
Where the middle-ear fluid needs culture - during the myringotomy the effusion is sent for microbiology.
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Red flag: unilateral adult OME
Persistent one-sided middle-ear fluid in an adult needs a nasopharyngeal examination to exclude nasopharyngeal carcinoma before grommet insertion.
Procedure options
Not all grommets are the same.
What each option actually involves - and which tube fits which problem.
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Short-term grommets (Shepard, Sheehy)
The standard first-line tube for a child with glue ear. Sits in place six to twelve months, then extrudes on its own.
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Medium-term grommets (Shah, Paparella)
Longer-dwelling design, typically in place twelve to eighteen months - used when a longer effect is needed.
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Long-term T-tubes
For recurrent OME that has failed multiple short-term tubes, cleft palate or immunodeficiency. Higher rate of persistent perforation.
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Myringotomy alone (no tube)
A drainage-only incision, occasionally used in acute infection to relieve pressure - heals over within days.
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Grommets with adenoidectomy
Adenoids removed at the same GA. Per NICE NG138, considered where nasal obstruction or recurrent effusions justify it.
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Adult grommet under LA
Straightforward adult cases can be done under local anaesthetic in the clinic, in ten to fifteen minutes.
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Grommet under GA (adult)
Preferred for anxious adults, narrow canals, or where more than a simple insertion is planned.
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Consultation and audiogram only
An honest assessment - hearing test, tympanogram, and a discussion of whether surgery is needed at all.
Our vetted London network
A small panel of ENT surgeons, we picked them.
Consultant ENT surgeons across central, north, west and south London - with a paediatric or otology subspecialty focus. Not listed publicly - introductions are made privately, once we understand your case.
Selection criteria
How we choose every ENT surgeon in our network.
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Consultant ENT surgeons with a paediatric or otology subspecialty interest
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Paediatric anaesthetists for every child on the list
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Adenoidectomy discussed alongside grommets where NICE NG138 supports it
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Full audiology support - pre-op tympanogram and post-op audiogram in-house
Safety and recovery
What to expect afterwards - honestly.
Grommet insertion is a common, safe day-case procedure. The things worth planning are the drops, the water advice, the audiogram - and knowing what is normal after.
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Same-day discharge is standard
Grommets are a day-case procedure. Most children are home within a few hours and back at school the next day.
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Topical antibiotic drops for five days
A short course of ear drops after insertion reduces the chance of early infection through the tube.
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Water precautions vary by surgeon
Some surgeons ask for strict water avoidance, others allow bathing but not diving. Custom-moulded swim plugs are commonly used either way.
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Hearing improvement is immediate
Once the effusion is drained and the tube is in, hearing improves the same day - often dramatically for a child who has had persistent glue ear.
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Grommet blockage or discharge is common
A mucky ear (otorrhoea) through the tube happens in up to a third - usually settles with topical drops.
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Persistent perforation in 2–5%
After the tube extrudes, the ear drum usually heals over. A small percentage need a subsequent myringoplasty to close a residual hole.
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Tympanosclerosis is usually silent
Chalk-like patches on the ear drum after grommets are common and rarely cause any hearing problem in themselves.
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Recurrence in 20–30%
One in four to five children need a second set of grommets after the first tubes extrude - this is a normal part of the pathway, not a failure.
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Red flags
Fever, severe ear pain, spreading redness behind the ear, or a sudden new hearing loss after grommets are reasons to call the clinic or A&E the same day.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever grommet was used, the note the ENT 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
Indication and side
Why the procedure was done - glue ear, RAOM, barotrauma - and which ear or ears were treated.
- 02 Technique
Anaesthetic, incision and tube
Whether it was done under LA or GA, where in the drum the incision was made, and which grommet was placed.
- 03 Findings
The effusion and the middle ear
What was aspirated - thin serous fluid, thick mucoid glue, or infected pus - and whether adenoidectomy was done at the same visit.
- 04 Impression
Follow-up, drops and audiogram
Read this first: the drop course, the water advice, when the audiogram is booked, and when the grommet review is due.
Recognised by major UK insurers
Cover for grommets varies by insurer and by indication - usually funded when medically indicated for glue ear or recurrent otitis media. We confirm cover before booking.
Frequently asked
Everything we get asked about grommets.
Quick answers on the NICE pathway, hearing, swimming, adenoidectomy, and how long the tubes stay in.
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What is a myringotomy with grommets, and when is it needed?
A myringotomy is a tiny incision in the ear drum. The middle-ear fluid is drained, and a small ventilation tube - a grommet - is placed through the incision to keep the middle ear aired. It is the standard treatment for persistent glue ear in children and for recurrent middle-ear infections when medical treatment has not been enough.
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How long do grommets stay in?
Short-term grommets (Shepard, Sheehy) usually extrude on their own in six to twelve months. Medium-term tubes (Shah, Paparella) last twelve to eighteen months. Long-term T-tubes stay for years and are used when a child needs prolonged ventilation.
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Does my child need grommets straight away?
Not usually. NICE NG138 recommends three months of watchful waiting with two hearing tests and a tympanogram, because a lot of glue ear resolves on its own. Grommets are considered when the hearing loss is 25–30dB or more, is bilateral, has persisted three months, and is affecting speech, learning or behaviour.
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Should the adenoids come out at the same time?
Often yes. In children with persistent OME and nasal obstruction, adenoidectomy alongside grommets reduces the chance of the effusion coming back after the tubes extrude. NICE NG138 discusses this, and it is a routine decision on the day.
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How much do grommets cost privately in London?
Bilateral grommets under GA for a child are typically £2,800–£4,500. Adding adenoidectomy takes it to £3,500–£5,500. An adult grommet under LA is usually £1,800–£3,000. We come back with a firm quote within one working day.
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Can my child swim with grommets in?
Practice varies by surgeon. Some ask for strict water avoidance, others allow bathing and pool swimming but not diving or head-under water. Custom-moulded silicone swim plugs are widely used either way. Always follow the surgeon’s own instructions.
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When will the hearing improve?
Straight away. Once the effusion is drained and the tube is in, the middle ear is aired and sound reaches the inner ear normally. A formal audiogram is arranged four to six weeks later to confirm the improvement.
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Do the grommets come out on their own?
Yes. The ear drum grows outwards and pushes the grommet out over months. Around 20–30% of children need a second set placed when the fluid returns after the first tubes extrude - this is a normal part of the pathway, not a failure.
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