Grommets in Children: A Parent’s Guide to Ear Grommets, ENT and Surgery in Australia
If someone has mentioned grommets for your child, you may have left the appointment with more questions than answers. You might be google searching “ear grommets - Child” to try and find answers.
Do we need a hearing test first? Who actually decides whether my child needs grommets? Do we need an ENT referral? Should we go public or private? What happens at the ENT appointment? And if the ENT recommends surgery, what happens while we wait?
This guide is not designed to tell you whether your child needs grommets. That decision belongs with the healthcare professionals assessing them. Instead, it walks Australian parents through what the pathway can look like — from recurrent ear problems or hearing concerns through to audiology, ENT assessment, surgery and follow-up.
Already further along the pathway?
Repeated ear infections, glue ear or hearing concerns? Recurrent Ear Infections in Toddlers: Grommets, Glue Ear, Hearing & Speech
Speech delay part of the picture? Speech Delay in Toddlers: My Child Isn’t Talking — What Should I Do?
Confused about how long the ENT referral lasts? How Long Does a Specialist Referral Last in Australia?
What are grommets?
Grommets are tiny ventilation tubes placed through the eardrum. They allow air into the middle ear and can help with problems caused by persistent fluid behind the eardrum. They are also called ear grommets, ventilation tubes, tympanostomy tubes or ear tubes.
Grommets may be considered in children with persistent glue ear or some patterns of recurrent middle-ear problems. But knowing what a grommet is is usually only the beginning for a parent.
The more useful question is: How does my child get from “there’s a problem with their ears” to someone deciding whether grommets are appropriate?
The grommet pathway: what can happen next?
There is no single identical pathway for every Australian child. Depending on why concerns were first raised, the pathway may involve some combination of:
GP → hearing assessment / audiology → ENT referral → ENT assessment → treatment decision → grommet surgery if recommended → follow-up
It is not always perfectly linear. A child may already have seen an audiologist before ENT becomes involved. Another may be referred because of recurrent infections. Another may have speech or developmental concerns that prompt hearing assessment.
Understanding what each stage is trying to establish can make the process much easier to navigate.
Why might grommets be discussed for a child?
Two issues parents commonly encounter are recurrent middle-ear infections and glue ear. Glue ear means fluid remains behind the eardrum. Persistent middle-ear fluid can affect hearing, and hearing difficulties can become relevant when a child also has speech or language concerns.
That does not mean every child with ear infections, glue ear, hearing concerns or speech delay needs grommets. The significance depends on the individual child and the overall clinical picture.
For parents, it can be useful to stop thinking about each appointment as an isolated event and instead keep track of the pattern: infections, hearing results, speech concerns, sleep or behaviour changes, and what has happened over time.
If repeated infections are what brought you here, read Recurrent Ear Infections in Toddlers: Grommets, Glue Ear, Hearing & Speech for the earlier part of the pathway.
Does my child need a hearing test before seeing ENT?
Hearing assessment can be an important part of investigating persistent middle-ear problems. The exact order of audiology and ENT assessment depends on your child’s circumstances and the service they are accessing.
If your child has already had audiology, keep the report. If hearing has been tested more than once, keep the earlier results as well as the latest ones. A sequence of results may tell the treating team more than a single test viewed in isolation.
Also tell the clinician about observations that may not be obvious during a short appointment, such as inconsistent responses to sound, frequently asking for repetition, unusually loud speech or television volume, speech or language concerns, or recurrent ear problems.
These observations do not establish the cause. They help the professionals assessing your child understand the history.
What if my child also has speech delay?
Ear problems, hearing and speech can end up being treated as separate issues even though parents may be experiencing them as one larger pattern.
Persistent middle-ear problems can affect hearing, and hearing is an important part of assessing a child with speech or language concerns. But speech delay has many possible contributors, so ear problems should not automatically be assumed to be the cause.
A useful navigation question is: Has hearing been appropriately considered as part of my child’s speech assessment?
If your child has speech delay alongside recurrent ear infections, glue ear or possible hearing difficulty, make sure the professionals involved know about the whole pattern.
For the broader speech pathway, including speech pathology, hearing assessment and when paediatric or developmental assessment may enter the picture, see Speech Delay in Toddlers: My Child Isn’t Talking — What Should I Do?
Who decides whether my child needs grommets?
Different professionals may contribute different pieces of information. A GP may identify recurrent problems and coordinate referrals. An audiologist may assess hearing and middle-ear function. A paediatrician or other clinician may identify a broader pattern that warrants further assessment.
When surgery is being considered, an ENT (ear, nose and throat) specialist assesses the child and discusses whether an operation is appropriate.
An ENT referral therefore does not mean your child is definitely getting grommets. It means specialist assessment can help determine what should happen next.
How do I get an ENT referral for my child?
Your GP can discuss whether an ENT referral is appropriate and which pathways are available. Depending on your location and circumstances, this may involve a public hospital outpatient ENT service, a private ENT specialist, or consideration of both pathways.
If you are being referred privately, it is also worth understanding how specialist referral validity works. Under standard Medicare referral rules, a GP-to-specialist referral generally remains valid for 12 months from the specialist’s first service under that referral unless another period is specified.
For the referral rules in detail, read How Long Does a Specialist Referral Last in Australia? GP Referral Rules Explained. This can be particularly useful when a child is facing a long specialist wait.
Public or private ENT: think beyond the first set of grommets
This is one decision where it can help to think further ahead than the first ENT appointment.
If your child ultimately needs grommets, the first set may not necessarily be the last. Grommets commonly stay in place for months and usually fall out naturally as the eardrum heals, but they can fall out sooner. In some children, the original middle-ear problem returns after the grommets come out and another set may eventually be considered.
For many children, middle-ear problems become less troublesome as they get older. But at the point when you are choosing a pathway, you usually cannot know with certainty whether your child will need one procedure or repeated treatment.
Don’t only calculate the cost of the first private surgery
If you are considering private treatment, ask what the financial picture could look like if your child needed another set later.
Potential costs may include specialist appointments, surgeon fees, anaesthetist fees, hospital or day-surgery charges and other out-of-pocket expenses depending on the service and your private health insurance.
For some families, paying privately for one procedure may be manageable. Paying privately for repeated procedures over several years could be a very different financial decision.
That does not mean repeated grommet surgery will be necessary. It means the possibility is worth considering before choosing a pathway based only on the cost and speed of the first procedure.
Public and private do not always have to be an either/or decision
If the public ENT wait is lengthy and your family can manage the private costs, one option worth discussing with your GP and the relevant services is whether you can pursue an earlier private assessment — and, if clinically recommended, the first grommet procedure privately — while also maintaining an appropriate public ENT pathway.
The practical reason is that the first set of grommets may remain in place during part of the time your child is waiting for a public appointment. If ear or hearing problems later recur after the grommets come out, the family may already be further along the public pathway rather than only beginning to investigate public ENT at that point.
However, do not assume that private treatment guarantees your child will keep a particular public appointment or that a public service will later provide another set of grommets. Public referral acceptance, triage, follow-up and treatment decisions are determined by the relevant health service and your child’s clinical circumstances.
Before spending money privately, ask your GP and the public service what happens to the existing public referral if your child receives private treatment in the meantime.
This approach may be particularly worth considering when the choice is not simply “public or private”, but how to create a sustainable pathway if your child needs ENT care over more than one year.
Questions to ask before choosing public or private
What is the likely public wait in our area?
What would the total out-of-pocket cost of private ENT assessment and grommet surgery be?
What would we potentially pay if another set were needed later?
If we go privately now, what happens to our child’s public ENT referral or waiting-list position?
Who will provide follow-up after the private surgery?
If the grommets fall out before the public appointment and the original problem returns, what should we do?
Thinking about those questions gives you a more realistic comparison than simply asking, “How much does it cost to get grommets privately?”
If you are exploring both systems, also read your existing guide on whether a GP can refer a child to both public and private specialists at the same time.
What information should I take to my child’s ENT appointment?
If your child’s ear problems have unfolded over six or twelve months, it can be surprisingly difficult to reconstruct the sequence during a short specialist appointment. You do not need to create your own medical record, but a concise summary can help.
Audiology results, including earlier tests if hearing has been assessed more than once.
A simple ear-infection history — approximate dates, which ear if known, and what happened afterwards. Confirmation of these details in writing from your GP can be useful as the ENT will likely consider based on the number of ear infections within a specific time frame whether or not Grommets may be appropriate.
Relevant treatment history.
Speech or developmental information if hearing concerns coexist with communication concerns.
Previous ENT history, including previous grommets or adenoid surgery.
Relevant reports from speech pathology or other clinicians.
A written list of the questions you want answered.
Questions I would want answered before leaving the ENT appointment
Rather than trying to remember every detail, aim to leave knowing what the next decision point is.
What do you think is happening with my child’s ears?
What did the hearing results show?
Are you recommending monitoring, another assessment or treatment?
Are grommets being considered?
If not now, what would make you reconsider them?
If surgery is recommended, what happens next?
What should we do if infections or hearing concerns continue while we are waiting?
When should my child be reviewed again?
Who should we contact if things change before that review?
The ENT has recommended grommet surgery. What happens now?
If the ENT recommends grommet insertion, the treating service should explain the procedure, anaesthetic, preparation, fasting instructions, recovery and follow-up that apply to your child.
For many families, however, the ENT decision introduces another stage they were not expecting: waiting.
You may have already waited months to reach ENT and then discover that the specialist appointment is not the end of the wait. If your child has now been placed on a surgical waiting list, see our guide Waiting for Grommet Surgery in Australia: What Parents Can Do While on the Waitlist.
What if my child’s problems continue while we’re waiting?
Being on an ENT or surgical waiting list does not mean every new problem should simply be attributed to the condition you are waiting to have treated.
If your child develops new symptoms, recurrent infections, worsening hearing concerns or another meaningful change while waiting, seek appropriate healthcare assessment rather than assuming you must wait until the ENT or surgery date.
If the circumstances that led to the original referral have changed substantially, tell the professionals involved. Updated audiology, speech or developmental information may be relevant to the service assessing your child.
Providing updated information does not guarantee that an appointment or procedure will be brought forward. It means the service has current information on which to base its decisions.
My child’s ear infections keep coming back — should I just wait for ENT?
It can help to separate two questions:
What is the longer-term ENT plan?
What does my child need for the problem happening today?
A future ENT appointment does not replace assessment of a child who becomes unwell in the meantime.
If recurrent infections are the main problem you are trying to navigate, return to Recurrent Ear Infections in Toddlers: Grommets, Glue Ear, Hearing & Speech.
What happens after grommets are inserted?
Your child’s treating service should provide specific post-operative instructions, and those instructions should take priority over generic online information.
Follow-up may be used to check how your child is progressing and, depending on the circumstances, hearing may be reassessed. Grommets usually eventually come out on their own as the eardrum heals.
If your child has ongoing or new problems after surgery, do not assume the presence of grommets explains every subsequent ear symptom. Contact the appropriate healthcare professional or treating service for advice.
Keep the whole story together
One of the hardest things about recurrent childhood health problems is that the story can become fragmented.
The GP knows about the infections. The audiologist has the hearing results. The speech pathologist knows about communication. Childcare may notice that your child does not always respond. ENT may see your child for a relatively short appointment.
Parents are often the people who have watched the entire sequence unfold.
You do not need to diagnose what connects those pieces. But you can help make sure the people assessing your child know those pieces exist.
A simple timeline may communicate the pattern more clearly than trying to reconstruct months of events from memory:
January — ear infection
February — ear infection
March — childcare raises hearing or speech concern
April — audiology
May — another ear problem
June — ENT referral
Where are you in the grommet pathway?
Repeated ear infections or glue ear, but no clear ENT plan yet? → Recurrent Ear Infections in Toddlers: Grommets, Glue Ear, Hearing & Speech
Speech or language concerns as well? → Speech Delay in Toddlers: My Child Isn’t Talking — What Should I Do?
Have an ENT referral but confused about how long it lasts? → How Long Does a Specialist Referral Last in Australia?
Trying to investigate public and private specialist pathways? → Read our guide: Can Your GP Refer to Both Public and Private Specialists at the Same Time?
ENT has recommended surgery and you are now waiting? → See our dedicated Waiting for Grommet Surgery in Australia guide.
The bottom line
If your child may need grommets, the most useful question is often not simply “What are grommets?” It is “Where are we in the pathway, and what needs to happen next?”
For one family, the next step may be hearing assessment. For another, it may be an ENT referral. Another may be deciding whether private treatment is financially sustainable. Another may already be waiting for surgery.
Work out which stage you are at, keep the relevant history together, make sure the professionals involved have current information, and focus on the next decision or service your child needs rather than trying to solve the entire pathway at once.
Important: This article provides general information about navigating children’s health services in Australia. It does not determine whether a child needs grommets and does not replace individual medical advice from your child’s healthcare professionals.
