What is a Grommet Insertion with Adeno-Tonsillectomy?

Grommet insertion is used to treat Glue Ear - a common condition where fluid collects in the middle ear behind the eardrum. A grommet (small plastic or metal tube) is inserted into the eardrum during surgery help clear this fluid and restore hearing.

During adeno-tonsillectomy surgery, both the adenoids and the tonsils are removed through the mouth.

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Grommet Insertion with Tonsillectomy & Adenoidectomy ​- image EXPLAINER


Grommet Insertion with Tonsillectomy & Adenoidectomy ​- who is it for?

Who Is Grommet Insertion with Adeno-
Tonsillectomy For?

Grommet insertion surgery is recommended for patients with fluid build up in the middle ear. Associated symptoms, including hearing loss, earache and infections can affect the patient’s speech, schooling or work.

An adenoidectomy is usually recommended for those children who have a very blocked nose or disturbed sleep, and to help prevent glue ear from building up.

Tonsillitis happens if the tonsils become infected. This causes pain, fever and difficulty swallowing and can make you feel unwell.

Surgery is recommended as it is the only dependable way to stop tonsillitis that keeps on coming back.

What are the benefits?

The grommet ventilates the middle ear by allowing air to enter it, preventing fluid build-up and resulting deafness.

The adenoids and tonsils help to fight off infection. However, frequent enlargement or inflammation can cause constant pain and fever, as well as difficulty in swallowing and breathing. An adeno-tonsillectomy is the only dependable way to stop tonsillitis and enlargement of adenoids from recurring.

With the removal of adenoids, the patient should get relief from a blocked or runny nose, and may experience a better quality of sleep. 

In addition, surgery is the only dependable way to stop tonsillitis that keeps on coming back.

What happens During Surgery?

For the grommet insertion, any fluid build-up in the middle ear is removed by suction. A small hole is made in the eardrum and a grommet inserted.

An adenoidectomy operation is performed under a general anaesthetic and usually takes about 20 minutes.

Your surgeon will remove the adenoids through the mouth. A pack will be placed at the back of the nose to stop any bleeding.

The tonsillectomy is performed under a general anaesthetic and usually takes about 30 minutes.

Your surgeon will perform the tonsillectomy through the mouth using one of the following techniques:

  • Cold dissection technique – A steel instrument is used to peel or cut the tonsil away from the layer of muscle underneath it.
  • Diathermy technique – A special instrument that uses an electrical current to remove tonsil tissue and stem bleeding.
  • Coblation technique – Your surgeon will use an instrument that uses radio-frequency energy to dissolve the tonsil.


For adults undergoing a tonsillectomy, only the first 2 techniques are used.

How long will I stay in hospital?

You  should be able to go home the same day.

What is my recovery time?

You should not swim for 6 weeks following surgery, nor dive deeper than 2 metres once able to do so. Other normal activities can usually be resumed 1 to 2 days after surgery.

Depending on the material and design, the grommet will fall out of the ear by itself 6 to 18 months after surgery.

With an adeno-tonsillectomy, pain can last for up to 2 weeks. It usually gets gradually worse over the first 4 to 5 days before beginning to improve. Associated pain tends to be worse first thing in the morning.

You will need to stay off work or school and away from groups of people for 2 weeks. This is to help prevent throat infections while your throat is still healing.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

Most people make a full recovery.

SURGERY - criteria

Do you qualify for This ENT Self Pay Procedure?

You are suitable for this Ear, Nose and Throat surgery if:

  • You are 1 years old or older
  • You are not pregnant
  • You do not require complex rehabilitation or have a chronic disease that would require immediate post-operative care in an intensive care unit
  • You do not have sickle cell anaemia, renal failure or have had a cardiac arrest or cardiac intervention (e.g. insertions of stents) in the last six months

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