Article written by Dr Ameen, ENT Specialist Kuala Lumpur
A myringotomy involves making a tiny incision in the eardrum to drain trapped fluid. A grommet is a small ventilation tube placed into this incision. I perform this procedure to restore normal middle ear pressure and improve hearing. The surgery takes about 10 to 15 minutes. We usually do it under general anesthesia for children and local anesthesia for adults. You will wake up with mild ear fullness. Most patients in my Kuala Lumpur practice go home the same day or stay just one night for observation.
Indications for Surgery
I recommend this surgery when medical treatments fail to clear middle ear fluid or infections. The strongest clinical reasons include:
- Chronic otitis media with effusion: Persistent fluid in the middle ear for more than three months causing documented hearing loss.
- Recurrent acute otitis media: Frequent severe ear infections requiring multiple courses of antibiotics.
- Severe tympanic membrane retraction: Deep pockets forming in the eardrum due to chronic negative pressure.
- Chronic eustachian tube dysfunction: Persistent ear blockage and pressure unresponsive to nasal sprays and decongestants.
- Barotrauma prevention: Protecting the middle ear in patients who must fly or dive despite underlying ear issues.
Complications of the Procedure
Every surgical procedure carries some level of risk. I discuss these thoroughly during our consultation. The overall safety profile is excellent.
- Tympanostomy tube otorrhea: Ear discharge occurs in 10 to 20 percent of cases and is usually treated with antibiotic ear drops.
- Premature tube extrusion: The grommet falls out too early in 5 to 10 percent of patients before the underlying issue resolves.
- Persistent tympanic membrane perforation: The eardrum fails to close after the tube falls out in 1 to 3 percent of cases.
- Tympanosclerosis: Scarring or calcification of the eardrum happens in 1 to 2 percent of patients.
- Local infection: Minor wound infection occurs in 1 to 2 percent of cases.
- Iatrogenic cholesteatoma: A rare skin cyst forming in the middle ear affects less than 0.1 percent of patients.
Estimated Procedure Cost
Medical fees in Malaysia are guided by the Private Healthcare Facilities and Services Act. Based on the PHFSA 2013 regulations for myringotomy and tube insertion (Code D1510), the maximum allowable professional fees are:
- Surgeon Professional Fee (INTER 2): RM865
- Anaesthetist Professional Fee (INTER 2): RM355
- Total Maximum Professional Fees: RM1,220
Total Estimated Cost
- Total Estimated Cost (including hospital facility fees, operating theatre charges, grommet implant costs, medications and consumables): RM10,000 to RM12,000
- Disclaimer: This is an estimated total cost only. Actual bills vary significantly depending on the specific hospital, room type and individual patient needs across Malaysia. Patients should always request a detailed itemised cost estimate from their chosen hospital or medical centre before proceeding.
Frequently Asked Questions
How long do the grommets stay in the ear? Standard grommets remain in the eardrum for six to twelve months. They typically fall out naturally as the eardrum heals and pushes them into the ear canal.
Can my child swim with grommets in place? Children can swim in clean pools without earplugs. However, they must avoid submerging their heads in dirty water like lakes or beaches to prevent bacterial infections.
Will the procedure leave a visible scar? No. The entire surgery is performed entirely through the natural opening of the ear canal. There are no external incisions and therefore no visible facial scars.
Does the surgery cause severe pain? The procedure itself is painless due to anesthesia. Patients usually experience mild ear discomfort or a feeling of fullness for a day or two, which basic oral painkillers easily manage.
What happens when the grommet falls out? The eardrum usually heals and closes the tiny hole on its own. In a small percentage of cases, the perforation persists and requires a minor patching procedure.
When to Seek Consultation
Living with chronic ear fluid or recurrent infections is exhausting for both children and adults. It affects hearing, sleep and daily comfort. Modern ventilation tubes offer a highly effective and safe way to restore normal ear function and prevent long term damage.
If your child struggles with persistent glue ear or you suffer from chronic ear blockages, do not wait for the problem to worsen. Book a consultation at my Kuala Lumpur clinic for a thorough microscopic examination and hearing test. We will map out a clear treatment plan to restore your ear health.
About the Author
Dr. Ameen is a Resident Ear, Nose & Throat Consultant at KPJ Ampang Puteri Specialist Hospital, situated in Selangor near the Kuala Lumpur border and serving patients from both Ampang and Kuala Lumpur.
He earned his medical degree (MB BCh BAO Hons) in Ireland and completed his Master of Otorhinolaryngology at Universiti Kebangsaan Malaysia. With comprehensive tertiary training from Hospital Kuala Lumpur and Hospital Tunku Azizah, he expertly manages complex adult and pediatric ENT conditions, including sinus, ear, throat, and vertigo disorders.
Before taking on his current role as a Resident ENT Consultant at KPJ Ampang Puteri Specialist Hospital, Dr. Ameen spent three years building extensive private center experience in Kuala Lumpur as a sessional ENT Consultant at Sunway Medical Centre Velocity and Columbia Asia Hospital Setapak.
