Grommets typically stay in the ear for six to twelve months before they fall out naturally as the eardrum heals behind them. These tiny ventilation tubes are designed to be a temporary solution for persistent glue ear, allowing air to reach the middle ear and preventing the vacuum that causes fluid buildup. While most grommets are expelled by the body within a year, some specialised long stay versions may remain in place for two years or more depending on the clinical needs of the patient.
The process of a grommet falling out is usually painless and often goes unnoticed by the child or parent. Once the grommet has been pushed out into the ear canal, it usually hitches a ride on the natural flow of earwax and eventually leaves the ear entirely. In the vast majority of cases, the small hole in the eardrum where the grommet was located closes up quickly and completely on its own.
What We will cover in This Article
- The average lifespan of a standard grommet in the ear
- Factors that influence how long a grommet stays in place
- Different types of grommets including short term and long term tubes
- What happens when a grommet falls out and how to check
- Recovery and follow up care after grommet insertion
- The causes of persistent glue ear requiring surgical intervention
- Triggers for grommet complications and how to avoid them
What is the typical duration for grommets?
In some cases, a surgeon may choose a T tube, which is a larger, long stay grommet. These are typically used for children who have had several sets of standard grommets or who have more complex middle ear issues. T tubes are designed to stay in for several years and may sometimes need to be removed by a specialist rather than waiting for them to fall out naturally.
What happens when a grommet falls out?
When a grommet falls out, the eardrum usually heals over the small gap almost immediately. Most parents only realise the grommet has been expelled during a routine checkup with an audiologist or ENT specialist. Occasionally, you might see a tiny piece of plastic in the earwax on a pillow or near the entrance of the ear canal, but this is not a cause for alarm.
Once the grommet is out, the ear is once again dependent on the Eustachian tube to regulate pressure. If the Eustachian tube is still not functioning correctly, there is a possibility that glue ear could return. Statistics show that about one in three children may need a second set of grommets if the fluid buildup recurs after the first set has been expelled.
What are the causes of glue ear needing grommets?
Grommets are recommended when glue ear has persisted for more than three months and is causing significant hearing loss or developmental delays. The primary cause is a poorly functioning Eustachian tube which fails to equalise pressure between the middle ear and the outside world. This failure creates a vacuum that pulls fluid out of the lining of the ear, filling the space where air should be.
Underlying triggers for surgery
Enlarged adenoids are a common physical cause, as they can block the opening of the Eustachian tube. Recurring upper respiratory infections and chronic allergies also play a role by keeping the tissues in the back of the nose and throat swollen. In children, the horizontal angle of the Eustachian tube makes it much easier for these issues to lead to persistent fluid compared to adults.
What triggers grommet complications?
While grommets are generally very safe, certain triggers can cause complications while they are in place. The most common issue is an ear infection, which can cause the ear to leak fluid through the grommet. This is usually easily treated with antibiotic ear drops and does not mean the grommet has failed.
Environmental risks
Water entering the ear is a common trigger for irritation if the water is soapy or contaminated. While surface swimming is usually safe, diving deep into a pool or using bubble bath can push water through the grommet into the middle ear. Using earplugs during hair washing or swimming can help reduce the risk of infection. Persistent exposure to second hand smoke is another significant trigger that can cause inflammation and lead to the grommet being expelled earlier than desired.
Comparison: Standard Grommets vs. Long Stay T-Tubes
| Feature | Standard Grommet | Long Stay T-Tube |
| Typical Duration | 6 to 12 months | 2 to 4 years |
| Shape | Small collar button | T-shaped with longer wings |
| Falling Out | Happens naturally | Often requires surgical removal |
| Best For | First time glue ear | Recurrent or complex cases |
| Eardrum Healing | Very high success rate | Higher risk of a permanent hole |
My final conclusion
To summarise, grommets are a temporary but highly effective way to manage persistent glue ear, typically staying in place for six to twelve months. They allow the ear to stay clear of fluid while the child grows, and the process of them falling out is a natural part of the healing cycle. While there is a small chance that glue ear may return once the grommet is gone, the majority of children find that their hearing remains clear as their Eustachian tubes mature.
If you experience severe, sudden, or worsening symptoms, such as intense ear pain, a high fever, or foul smelling discharge from the ear, call 999 immediately or visit your nearest A&E.
Can I tell if the grommet has fallen out?
It is difficult to tell just by looking, but you might notice your childs hearing seems muffled again, or a doctor may confirm it during a routine examination with an otoscope.
Does it hurt when the grommet comes out?
No, the process is entirely painless. The eardrum naturally sheds its outer layer, which slowly migrates the grommet out of the tissue and into the ear canal.
What if the grommet stays in too long?
If a grommet stays in for more than two or three years without falling out, a specialist may recommend a very quick procedure to remove it and ensure the eardrum heals correctly.
Can my child fly with grommets?
Yes, flying is actually much more comfortable for children with grommets because the tube automatically equalises the pressure, preventing the ear pain often felt during takeoff and landing.
Will my child need another operation when they fall out?
In most cases, no. The eardrum heals itself. A follow up hearing test is usually performed a few months after the grommet has fallen out to ensure the glue ear has not returned.
What should I do if the ear starts leaking with a grommet?
If you see fluid or pus coming from the ear, it usually indicates a minor infection. You should contact your doctor for advice, as antibiotic ear drops are often required.
Authority Snapshot
This article was written by Dr. Stefan Petrov, a UK-trained physician with experience in general medicine, surgery, and emergency care. Dr. Petrov has contributed to medical education and patient focused health content, ensuring that clinical advice remains accurate and accessible. This guide follows NHS and NICE standards to provide safe, evidence based recommendations for families managing recovery after grommet surgery for glue ear.
