What is a Grommet Insertion with Adeno-tonsillectomy & Turbinectomy?

Surgery including insertion of grommets into the ear, removal of both adenoids and tonsils and a turbinectomy. To treat glue ear, surgery is recommended by placing a grommet (small plastic or metal tube) enabling air to enter the middle ear and prevent fluid build-up. During an Adeno-Tonsillectomy, both adenoids and tonsils are removed via the mouth. A turbinectomy surgery reduces the size of the turbinates (or nasal concha) inside the nose.

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Grommet Insertion with Adenotonsillectomy & Turbinectomy ​- image EXPLAINER


Grommet Insertion with Adenotonsillectomy & Turbinectomy ​- who is it for?

Who Is Grommet Insertion with Adenotonsillectomy & Turbinectomy For?

Grommet insertion is for patients with fluid build-up (glue ear). This is often the result of eustachian tube dysfunction (the tube connecting the middle ear to the back of the nose).

Adeno-Tonsillectomy surgery is for patients experiencing recurring ear, nose and throat infections.

A turbinectomy is for patients with enlarged turbinates in the nose which cause blockages.

What are the benefits?

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

The removal of adenoids can help reduce nose blockages and disturbed sleep. It can also help reduce the risk of glue ear.

The removal of tissue or bone through a turbinectomy can also provide relief from a blocked nose.

A tonsillectomy is the only dependable way to prevent the recurrence of tonsillitis.

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 is 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.


A turbinectomy usually takes 15 to 30 minutes. A local anaesthetic may be used instead of a general anaesthetic.

The size of the turbinates are usually reduced by one of the following techniques:

  • Diathermy – Passing an electric current through a needle placed either on the surface of the turbinate or inside the tissue.
  • Trimming – Cutting away the lower or outer part of the turbinate. This may also involve removing some of the turbinate bone and rolling some of the remaining tissue over the raw area.

Your surgeon may place some packing in your nose to prevent bleeding.

The operation is performed through your nostrils and does not result in any facial scars or black eyes.

How long will I stay in hospital?

Many patients are able to go home the same day. If non-dissolvable packing was inserted into your nose, you will need to stay overnight so that it can be removed the next morning.

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 Self Pay Procedure?

You are suitable for this ENT surgery if:

  • You are 1 year of age or over
  • 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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