The Low-Down on Grommets, Tonsils and Adenoids

The insertion of grommets and the removal of the tonsils and adenoids can help improve the health of children living with continual ear, nose and throat concerns.

Grommets

Grommets are tiny plastic tubes that sit in the ear drum. Wide on either end and narrow in the middle, grommets are inserted into the ear to relieve pressure and the build-up of fluid, commonly referred to as ‘glue ear’, that can happen with ear infections that keep coming back. 

“Generally children are prone to middle ear infections because the eustachian tube - the tube that runs from the back of the nose to the middle ear - doesn’t work effectively,” says Dr Chris Dalton, National Medical Director at Bupa. “Normally this issue rectifies itself by the early school years but some eustachian tube dysfunction can continue into adulthood.” 
 
Grommets are one of the options in managing  reoccurring middle ear infections, and may also be inserted if hearing loss is detected by an audiologist. The operation generally takes 20 minutes under anesthesia and in most cases, recovery is fast. 
 
Facts about ear infections and grommets:
  • There is a higher likelihood of middle ear infection in children who are exposed to secondhand smoke, using a dummy or being bottle-fed, and are often around other children who may have an infection (such as in childcare). 
  • Some evidence suggests dustmite, pollen and mould allergies may contribute to middle ear infections.
  • There is a higher incidence of middle ear infections in indigenous children. 
  • Grommets generally fall out between six to 12 months but some stay in longer. 
  • Earplugs must be worn when showering, bathing or swimming  following the procedure as water can make infection more likely.  
Little girl in hospital

Tonsils and Adenoids

The tonsils and adenoids are lymphoid tissue located in the throat and nose. “They [tonsils and adenoids] act as an early warning system and are involved in defending the body from infection. That said, the immune system [can] work  well without them,” says Dalton. 
 
Because adenoids are constantly meeting organisms that cause infections, they often become infected and swell up, blocking airflow. This can lead to problems such as breathing difficulties, snoring, and a dry and sore throat. However, it’s likely adenoids and tonsils would only be removed if your child has infections that constantly come back, making them unwell, interfering with their breathing, or causing language development problems. 
 
Once the tonsils and adenoids are removed, children can experience improved nasal function, sleep better and are likely to snore less if at all. 
 
Day surgery under anesthesia is required for adenoid removal and there’s generally little discomfort in the days afterward (although swelling can last for up to fourteen days). 
 
Removal of the tonsils, however, requires an overnight stay in hospital and a recovery period of at least two weeks. A soft diet is often recommended for the first few days after tonsils are removed but some children are back to eating their normal foods within 48 hours. Possible complications can arise when the scabs start to form and they break off, sometimes causing bleeding. Older children and adults can experience significant pain for up to 10 days post-operation.  
 
If you are concerned about your child and want to learn more about tonsils, grommets and adenoids, speak to your GP. She or he can refer your child to an Ear, Nose and Throat specialist (ENT) once hearing loss is detected or after a period of repeated illness or infection.

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