• NICE recommend that children with persistent bilateral otitis media with effusion (OME) documented over a 3-month period and associated hearing impairment should be considered for surgical intervention. • Treatment of OME often requires repeated tubulation of the tympanic membrane if the grommets are extruded before the disease of the middle ear has remitted. • Triune tubes appear to remain in situ and functional for longer than the standard ventilation tubes. • Use of triune grommets may reduce need for repeated tubulation of the tympanic membrane. • Complications from infection or recurrent effusion were similar, regardless of type of grommet used.