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Journal articles on the topic 'Grommets'

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Published: 4 June 2021

Last updated: 20 February 2023

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1

Shone, G. R., and I. P. Griffith. "Titanium grommets: a trial to assess function and extrusion rates." Journal of Laryngology & Otology 104, no. 3 (March 1990): 197–99. http://dx.doi.org/10.1017/s0022215100112265.

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AbstractTitanium grommets have been promoted as having the advantage of a slower extrusion rate than other types of ventilation tube. A prospective trial was therefore designed to compare the function and extrusion rates of these grommets with those of the widely used Shepard design of Teflon grommet in a single group of patients. Thirty-one children had one type of grommet inserted in one ear and the other type in the opposite ear. After eight months there were significantly more Titanium grommets still functioning (p < 0.05) but after 12 and after 16 months there was no significant difference in the extrusion rates of the two types of grommet. There was a higher incidence of infection with granulation tissue formation around the Titanium grommet. Accordingly it is concluded that the extra expense of the Titanium grommet is not justified, particularly as the long-term effects of these grommets on the tympanic membrane are not known.

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2

Fitzsimons, Kate J., Lynn P. Copley, Jan H. Van Der Meulen, Channa Panagamuwa, and Scott A. Deacon. "Grommet Surgery in Children with Orofacial Clefts in England." Cleft Palate-Craniofacial Journal 54, no. 1 (January 2017): 80–89. http://dx.doi.org/10.1597/15-047.

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Objective To assess grommet insertion practice in the first 5 years of life among children with an orofacial cleft in England. Design Analysis of national administrative data of hospital admissions. Setting National Health Service hospitals, England. Patients Patients born between 1997 and 2005 who underwent surgical cleft repair. Intervention Children receiving grommets before the age of 5 years. Outcome Measures The proportion of children receiving grommets before the age of 5 years, the timing of the first grommet insertion, and the proportion of children having repeat grommet insertions were examined according to cleft type, the absence or presence of additional anomalies, socioeconomic deprivation, and region of residence. Results The study included 8,269 children. Before the age of 5 years, 3,015 (36.5%) children received grommets. Of these, 33.2% received their first grommets at primary cleft repair and 33.3% underwent multiple grommet insertion procedures. The most common age for the first procedure was between 6 and 12 months. Children with a cleft affecting the palate were more likely to receive grommets than children with a cleft lip alone (45.5% versus 4.5%). Grommet insertion practice also varied according to year of birth, absence or presence of additional anomalies, socioeconomic deprivation, and region of residence. Conclusion Grommets practice in children with a cleft appears to vary according to their clinical characteristics. The differences in practice observed according to deprivation and region of residence need to be further explored.

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3

Sood, S., and A. Waddell. "Accurate consent for insertion and later removal of grommets." Journal of Laryngology & Otology 121, no. 4 (April 2007): 338–40. http://dx.doi.org/10.1017/s0022215107001508.

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Each year in the UK over 30 000 patients undergo insertion of grommets. The grommet insertion may cause many problems like persistent otorrhoea, scarred drum, retraction pockets and retention. The grommets may be extruded from the middle ears by the normal epithelial migration mechanism once they have served their purpose. These may become infected and require removal. We have analysed the Department of Health Hospital Episode Statistics relating to the insertion and removal of grommets (ventilation tubes). We have shown that 7.6 per cent of patients who have grommets inserted will have grommets removed.

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4

Pringle, M. B. "Grommets, swimming and otorrhoea — a review." Journal of Laryngology & Otology 107, no. 3 (March 1993): 190–94. http://dx.doi.org/10.1017/s0022215100122601.

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Ever since Armstrong reintroduced the concept co grommeet insertion parents have been asking ‘may my child swim?’, yet there is still no consensus as to the correct answer. This paper reviews the work that has been done on this subject in the last 25 years. A review of teh reates of otorrhoea following grommet insertion, irrespective of swimming, shows a variation from 12 to 64 per cent. Evidence suggests that pressures of 12–23 cm H2O are needed to push water through a grommeet and that it is unlikely that water will enter the middle ear during surface swimming. Only bath water seems to cause significant inflammtory changes to middle ear mucosa. Not a single paper comparing swimming without ear protection can be safely permitted for children with grommets.

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5

Swanson, Alfred B., Genevieve de Groot Swanson, B. Kent Maupin, Sho-min Shi, John G. Peters, Dirk H. Alander, and Valeria A. Cestari. "The Use of a Grommet Bone Liner for Flexible Hinge Implant Arthroplasty of the Great Toe." Foot & Ankle 12, no. 3 (December 1991): 149–55. http://dx.doi.org/10.1177/107110079101200304.

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Press-fit titanium grommets were developed to shield flexible hinged silicone implants used for arthroplasty of the radiocarpal, metacarpophalangeal, and metatarsophalangeal joints. Since 1985, 179 titanium circumferential grommets were used in 90 first metatarsophalangeal joints with excellent, pain-free, functional results and favorable bone response around the implant stems and at the bone-grommet interface. There were no complications due to particulate reactivity, implant fracture, or grommet fracture. The use of circumferential titanium grommets appears to be a safe and effective method to improve the long-term durability of flexible hinge implant arthroplasty of the first metatarsophalangeal joint.

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6

Dingle, Ann F., Liam M. Flood, B. Udhi Kumar, Robert C. Newcombe, and C. Stat. "Tympanosclerosis and mini grommets: the relevance of grommet design." Journal of Laryngology & Otology 109, no. 10 (October 1995): 922–25. http://dx.doi.org/10.1017/s0022215100131688.

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AbstractFifty children with otitis media with effusion undergoing grommet insertion had into one ear a Minititanium grommet inserted and into the other ear a Mini-teflon grommet. Post-operative follow-up until after extrusion of the grommets demonstrated only a small difference between the extrusion times of the two grommets (a significant difference of 41 days) and no difference in the degree of tympanosclerosis seen with each grommet. We propose that the mass of a grommet appears to play less of a role than has previously been suggested in the pathogenesis of tympanosclerosis following grommet insertion and that duration of intubation may be the most significant factor.

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7

Todd, G. B. "Audit of the incidence of persistent perforation of the tympanic membrane following grommet removal or extrusion." Journal of Laryngology & Otology 107, no. 7 (July 1993): 593–96. http://dx.doi.org/10.1017/s0022215100123795.

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The incidence of persistent perforation following grommet removal or extrusion in 210 ears was assessed, and found to be zero per cent. Collar button grommets were retained longer than Shepard grommets, and the percentage of ears requiring two or more tube insertions was 51.9 per cent.

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8

Herdman, R., and J. L. W. Wright. "Grommets and cholesteatoma in children." Journal of Laryngology & Otology 102, no. 11 (November 1988): 1000–1002. http://dx.doi.org/10.1017/s002221510010711x.

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Cholesteatoma in children may be a sequel to chronic exudative otitis media with tympanic membrane retraction but he the role of grommets in the possible facilitation of squamous epithelial invasion into the middle ear is not yet clear. A retrospective study was made of the history and prior treatment in 25 children who underwent mastoidectomy for cholesteatoma at St. Mary's Hospital between 1975 and 1986. Thirteen patients had undergone previous middle ear aeration procedures which included myringotomy, cortical mastoidectomy and grommets. There was no difference in the site or severity of cholesteatoma in the operated and non-operated cases. Of the seven patients with a history of multiple grommets three had primarily attic, and three had primarily mesotympanic disease. The latter had greater ossicular erosion. One patient with an intact tympanic membrane had grommet insertion subsequently developed a cholesteatoma. While cholesteatoma due directly to the presence of grommets is rare, it appears that children who require multiple grommet insertions constitute a high risk group and should be very closely monitored.

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9

Greig, A. V. H., M. E. Papesch, and A. R. Rowsell. "Parental perceptions of grommet insertion in children with cleft palate." Journal of Laryngology & Otology 113, no. 12 (December 1999): 1068–71. http://dx.doi.org/10.1017/s0022215100157913.

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AbstractOtitis media with effusion is almost universal in children with cleft palate and can delay speech, language and educational development by causing hearing loss. Grommet insertion at the time of cleft palate repair is common. There is debate about whether the benefits of grommets outweigh the risk of complications. A postal questionnaire was used to investigate parental perceptions of middle-ear ventilation via grommet insertion in children attending the multidisciplinary cleft palate clinic. These children's case notes were reviewed. Many children had speech and language delay, but parents thought this improved after grommet insertion. Overall parents were pleased with the results. This confirms that grommets have an important part to play in the management of children with cleft palate.

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10

Karkanevatos, A., and T. H. J. Lesser. "Grommet insertion in children: a survey of parental perceptions." Journal of Laryngology & Otology 112, no. 8 (August 1998): 732–41. http://dx.doi.org/10.1017/s002221510014157x.

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AbstractGrommet insertion is a widely accepted method of treatment of glue ear in children. There have been questions raised over the last few years about the indications for grommets and whether assessing the hearing alone is an efficient outcome measure. Parental pressure accounts for one of the factors that is taken into consideration when the decision to insert grommets for glue ear is made. In this paper, a prospective questionnaire is used to investigate the parental perceptions of the effectiveness of grommet insertion in children, focusing on alternative outcome measures such as general health, language, and social skills. The results of this survey suggest that grommet insertion causes improvement in many factors other than hearing and this seems to account for the parental pressure for siblings to have grommet insertion.

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11

Salam, M. A., and C. Wengraf. "Glue under pressure: A bad prognostic sign for recurrence of otitis media with effusion." Journal of Laryngology & Otology 106, no. 11 (November 1992): 974–76. http://dx.doi.org/10.1017/s0022215100121504.

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AbstractOne hundred and thirteen children with bilateral otitis media with effusion (OME) underwent myringotomy and insertion of Shah grommets. They were classified into three groups according to the presence or absence of ‘glue under pressure’ unilaterally or bilaterally. The follow up period ranging between 18 and 32 months determined the comparative rate of recurrence of OME and the number of grommet reinsertions. This study shows a significantly higher incidence of recurrent OME, requiring grommet reinsertion, in ears with glue under pressure (60 per cent) compared to those with glue not under pressure (7.4 per cent). Thus it was possible to identify a subset of children with OME who have a poorer prognosis for recurrence and who should be treated with long-stay grommets in the first instance.

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12

Kumar, Manoj, Anwar M. Khan, and Sinead Davis. "Medial displacement of grommets: an unwanted sequel of grommet insertion." Journal of Laryngology & Otology 114, no. 6 (June 2000): 448–49. http://dx.doi.org/10.1258/0022215001906039.

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Grommet insertion is one of the commonest surgical procedures performed in the UK. We have come across three cases in which grommets have displaced medially in the middle ear after establishing a satisfactory postinsertion position. We suggest that an abnormally long myringotomy incision and improper placement of the grommet are responsible for this unwanted outcome.

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13

Outhoff, Kim. "Grommets." South African Family Practice 57, no. 3 (May 1, 2015): 3. http://dx.doi.org/10.4102/safp.v57i3.4307.

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14

Tahery, J., and S. R. Saeed. "An easier way of inserting the Shah permavent grommet." Journal of Laryngology & Otology 119, no. 1 (January 2005): 36–37. http://dx.doi.org/10.1258/0022215053222798.

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Ventilation tube insertion plays an important role in the management of otitis media with effusion. In selected cases, repeated grommet insertion due to persistent eustachian tube dysfunction necessitates the need for longer-term ventilation. Insertion of such tubes can however occasionally be more difficult than insertion of standard grommets. One such long-term ventilation tube is the Shah permavent grommet. This paper describes a simple modification of the technique that is less time-consuming and less traumatic.

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15

Rimmer, J., C. E. B. Giddings, and N. Weir. "History of myringotomy and grommets." Journal of Laryngology & Otology 121, no. 10 (June 11, 2007): 911–16. http://dx.doi.org/10.1017/s0022215107009176.

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The first recorded myringotomy was in 1649. Astley Cooper presented two papers to the Royal Society in 1801, based on his observation that myringotomy could improve hearing. Widespread inappropriate use of the procedure followed, with no benefit to patients; this led to it falling from favour for many decades. Hermann Schwartze reintroduced myringotomy later in the nineteenth century. It had been realised earlier that the tympanic membrane heals spontaneously, and much experimentation took place in attempting to keep the perforation open. The first described grommet was made of gold foil. Other materials were tried, including Politzer's attempts with rubber. Armstrong's vinyl tube effectively reintroduced grommets into current practice last century. There have been many eponymous variants, but the underlying principle of creating a perforation and maintaining it with a ventilation tube has remained unchanged. Recent studies have cast doubt over the long-term benefits of grommet insertion; is this the end of the third era?

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16

Rimmer, Joanne, Charles E. Giddings, and Neil Weir. "The History of Myringotomy and Grommets." Ear, Nose & Throat Journal 99, no. 1_suppl (March 19, 2020): 2S—7S. http://dx.doi.org/10.1177/0145561320914438.

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The first recorded myringotomy was in 1649. Astley Cooper presented 2 papers to the Royal Society in 1801, based on his observations that myringotomy could improve hearing. Widespread inappropriate use of the procedure followed, with no benefit to patients; this led to it falling from favor for many decades. Hermann Schwartze reintroduced myringotomy later in the 19th century. It had been realized earlier that the tympanic membrane heals spontaneously, and much experimentation took place in attempting to keep the perforation open. The first described grommet was made of gold foil. Other materials were tried, including Politzer’s attempts with rubber. Armstrong’s vinyl tube effectively reintroduced grommets into current practice last century. There have been many eponymous variants, but the underlying principle of creating a perforation and maintaining it with a ventilation tube has remained unchanged. Recent studies have cast doubt over the long-term benefits of grommet insertion; is this the end of the third era?

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17

Clark, M. "Grommets, dude?" BMJ 327, no. 7405 (July 3, 2003): 46. http://dx.doi.org/10.1136/bmj.327.7405.46.

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18

Goncalves, N., D. Lubbe, S. Peer, and J. Fagan. "‘Smart’ grommets." Journal of Laryngology & Otology 133, no. 2 (January 14, 2019): 155–56. http://dx.doi.org/10.1017/s0022215118002281.

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AbstractObjectiveA novel, smartphone-based technique for endoscopic grommet insertion is presented.Results and conclusionThis method is both cost-effective and time-saving, offering a valuable alternative to the traditional microscope-based method in a resource-constrained setting.

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19

Kavanagh, F. G., W. Hasan, D. A. Smyth, and J. E. Fenton. "Polyps, grommets and eosinophilic granulomatosis with polyangiitis." Journal of Laryngology & Otology 132, no. 3 (January 9, 2018): 236–39. http://dx.doi.org/10.1017/s0022215117002444.

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AbstractObjective:To explore the link between nasal polyposis, refractory otitis media with effusion and eosinophilic granulomatosis with polyangiitis.Methods:A retrospective observational study was carried out of patients diagnosed with refractory otitis media with effusion necessitating grommet insertion and who had nasal polyps. Patients were evaluated to determine if they fulfilled the diagnostic criteria of eosinophilic granulomatosis with polyangiitis.Results:Sixteen patients (10 males and 6 females) were identified. The mean age of grommet insertion was 45.4 years. The mean number of grommets inserted per patient was 1.6. The mean number of nasal polypectomies was 1.7. All 16 patients had paranasal sinus abnormalities and otitis media with effusion, 14 had asthma, 9 had serological eosinophilia and 7 had extravascular eosinophilia. Nine patients met the diagnostic criteria for eosinophilic granulomatosis with polyangiitis.Conclusion:The co-presence of nasal polyps and resistant otitis media with effusion should raise the possibility of eosinophilic granulomatosis with polyangiitis.

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20

Cherry, J. R. "Grommets and cholesteatoma." BMJ 342, feb08 1 (February 8, 2011): d647. http://dx.doi.org/10.1136/bmj.d647.

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21

Marcy, S. Michael, and GEORGES PETER. "GROMMETS AND SWIMMING." Pediatric Infectious Disease Journal 5, no. 3 (May 1986): 387. http://dx.doi.org/10.1097/00006454-198605000-00034.

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22

Pringle, M. B. "Swimming and grommets." BMJ 304, no. 6821 (January 25, 1992): 198. http://dx.doi.org/10.1136/bmj.304.6821.198.

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23

Francois, M., P. Benzekri, J. N. Margo, P. Jaquemin, and P. Bordure. "Swimming and grommets." BMJ 304, no. 6829 (March 21, 1992): 778–79. http://dx.doi.org/10.1136/bmj.304.6829.778-b.

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24

Mohammed, H., M. H. Qureshi, and P. Yates. "Outcomes of examination under anaesthesia of post-nasal space and grommet insertion in adults presenting with otitis media with effusion." Journal of Laryngology & Otology 135, no. 7 (June 3, 2021): 620–24. http://dx.doi.org/10.1017/s0022215121001444.

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AbstractBackgroundIn adults, otitis media with effusion causes considerable morbidity and has poorly established outcomes. A small number of nasopharyngeal carcinoma patients present with isolated ear-related symptoms. The investigation of choice for these patients is a point of debate.MethodsA retrospective cohort study was conducted using a local database of adult patients who underwent examination under anaesthesia of the post-nasal space with grommet insertion for otitis media with effusion between January 2014 and January 2016.ResultsNinety-eight patients met the inclusion criteria. Follow-up duration ranged from 39 to 63 months. Complications of grommets were present in 36 out of 98 patients (36.73 per cent). The findings of examination under anaesthesia of the post-nasal space were documented as abnormal in three patients. No patient was diagnosed with nasopharyngeal carcinoma.ConclusionGrommets in adults with otitis media with effusion as the sole presenting feature carry a high complication rate, especially in those with previously inserted grommets. Examination under anaesthesia of the post-nasal space offers a low yield. A magnetic resonance imaging scan of the post-nasal space may be a more sensitive alternative.

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25

Davies-Husband, C. R., C. Harker, T. Davison, and P. D. Yates. "Post-surgical tympanostomy tube follow up with audiology: experience at the Freeman Hospital." Journal of Laryngology & Otology 126, no. 2 (November 11, 2011): 142–46. http://dx.doi.org/10.1017/s0022215111002982.

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AbstractBackground:Tympanostomy tube (grommet) insertion is a common procedure, with little guidance in the current literature regarding post-operative surveillance. Our institution implemented a protocol to follow up post-surgical grommet patients via audiology at six weeks.Methods:A retrospective audit of all patients less than 16 years old who had undergone grommet insertion during a three-month period.Results:A total of 149 patients had grommets inserted. Exclusion criteria left a cohort of 123 individuals; 82 (67 per cent) were followed up by audiology. Of these, 13 (11 per cent) did not attend follow up, and were discharged; 53 (43 per cent) were discharged from audiology with normal thresholds; and 16 (13 per cent) were referred back to a consultant. Therefore, the overall reduction in patients followed up by an otolaryngologist was 54 per cent.Conclusion:We recommend a six-week follow up with audiology following grommet insertion, allowing for referral back to ENT services in the event of related complications.

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26

Abdullah, V. A., M. B. Pringle, and N. S. Shah. "Use of the trimmed Shah permavent tube in the management of glue ear." Journal of Laryngology & Otology 108, no. 4 (April 1994): 303–6. http://dx.doi.org/10.1017/s002221510012660x.

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AbstractTwenty-five children (mean age six years) with de novo bilateral ear effusions received a ‘trimmed’ high grade silicone (HGS) Shah permavent ventilation tube in one ear and a conventional polyethylene Shah grommet in the other.The extrusion rate and the degree of tympanosclerosis formation was examined. At 29 months the conventional grommet had extruded in 90 per cent of children and a recurrent middle ear effusion was found in over 50 per cent of these ears.The average length of stay for the conventional grommet was 12.5 months. Five permavent tubes had extruded, one was extruding but the remainder were all in place and patent. Comparing ears on each side the amount of tympanosclerosis was worse in the ear with the conventional grommet in 47 per cent of children and worse on the permanent side in 11 per cent of the children.The ‘trimmed permavent’ appears to act as a medium to long-term grommet which self extrudes without serious complications. Its use at the primary operation in young children may save repeated insertions of conventional grommets.

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27

Saleem, Y., S. Ramachandran, L. Ramamurthy, and N. J. Kay. "Role of otoacoustic emission in children with middle-ear effusion and grommets." Journal of Laryngology & Otology 121, no. 10 (April 10, 2007): 943–46. http://dx.doi.org/10.1017/s0022215107007347.

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Objective: To evaluate the role of otoacoustic emission in children with middle-ear effusion and grommets.Materials and methods: A prospective study was carried out on a total of 90 ears. All children listed for grommet insertion had a pre-operative and post-operative (three to six months after grommet insertion) pure tone audiometry, tympanometry and otoacoustic emission recorded. A comparison was made between pure tone audiometry and otoacoustic emission both pre-operatively and post-operatively.Results: Pre-operatively, 63 ears had an abnormal pure tone audiometry of which 59 had absent otoacoustic emission. Therefore the sensitivity of otoacoustic emission in detecting a conductive loss was 59/63 = 94 per cent (95 per cent confidence interval 85 to 98 per cent). All 27 ears with normal hearing pre-operatively had normal otoacoustic emission. The specificity of otoacoustic emission was 27/27 = 100 per cent, (95 per cent confidence interval, 88 to 100 per cent). The positive predictive value was 59/59 = 100 per cent (95 per cent confidence interval, 94 to 100 per cent). After three to six months all post-operative patients with grommets had a normal pure tone audiometry and otoacoustic emission. So both pure tone audiometry and otoacoustic emission were strongly related both in patients with middle-ear effusion and in patients with grommets.Conclusion: As the demonstration of hearing in young and difficult-to-test children can be problematic and time-consuming, we suggest that otoacoustic emission can be used as an alternative to pure tone audiometry in patients with middle-ear effusion and grommets.

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Maung, K. H., T. Tun, and N. D. Stafford. "Do-it-yourself grommets." Journal of Laryngology & Otology 125, no. 12 (August 11, 2011): 1268–69. http://dx.doi.org/10.1017/s0022215111001964.

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AbstractIn the absence of a healthcare budget enabling the import of ready-made aural grommets, Myanmar ENT surgeons have devised an ingenious ‘home-grown’ solution. We describe how grommets are made from raw materials bought from the local market.

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29

Tshifularo, Mashudu. "Grommets and swimmers ear." South African Family Practice 60, no. 5 (October 23, 2018): 21–25. http://dx.doi.org/10.4102/safp.v60i5.4916.

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30

MILLS, R. P., C. ALBIZZATI, and A. S. TODD. "Ear drops and grommets." Clinical Otolaryngology 15, no. 4 (August 1990): 315–19. http://dx.doi.org/10.1111/j.1365-2273.1990.tb00475.x.

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31

Isaacs, David. "Glue ear and grommets." Medical Journal of Australia 156, no. 7 (April 1992): 444–45. http://dx.doi.org/10.5694/j.1326-5377.1992.tb126465.x.

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32

Isaacs, David. "Glue ear and grommets." Medical Journal of Australia 156, no. 12 (June 1992): 884. http://dx.doi.org/10.5694/j.1326-5377.1992.tb137016.x.

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33

Harrison, Henley C. "Glue ear and grommets." Medical Journal of Australia 157, no. 4 (August 1992): 285. http://dx.doi.org/10.5694/j.1326-5377.1992.tb137160.x.

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34

Coates, Harvey L. "Glue ear and grommets." Medical Journal of Australia 157, no. 4 (August 1992): 285. http://dx.doi.org/10.5694/j.1326-5377.1992.tb137161.x.

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35

Roydhouse, Noel. "Glue ear and grommets." Medical Journal of Australia 157, no. 4 (August 1992): 285. http://dx.doi.org/10.5694/j.1326-5377.1992.tb137162.x.

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36

Mitchell, R. B. "Do-it-yourself grommets." Yearbook of Otolaryngology-Head and Neck Surgery 2012 (January 2012): 165–67. http://dx.doi.org/10.1016/j.yoto.2011.12.005.

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37

KHOO, C. T. K., J. A. DAVISON, and M. ALI. "Tissue Reaction to Titanium Debris Following Swanson Arthroplasty in the Hand: A Report of Two Cases." Journal of Hand Surgery 29, no. 2 (April 2004): 152–54. http://dx.doi.org/10.1016/j.jhsb.2003.09.013.

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Silicone abrasion particles are known to cause inflammatory changes following Swanson arthroplasty. Titanium grommets were introduced to protect the implants from wear and abrasion. Two cases with histological evidence of symptomatic titanium particulate tissue inflammation following Swanson joint replacement with grommets are presented.

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38

Praveen, C. V., and R. M. Terry. "Does passive smoking affect the outcome of grommet insertion in children?" Journal of Laryngology & Otology 119, no. 6 (June 2005): 448–54. http://dx.doi.org/10.1258/0022215054273197.

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Bilateral myringotomy with insertion of ventilation tube (grommet) is the most common surgical procedure done on children under general anaesthetic. A prospective study was conducted on children undergoing grommet insertion to ascertain any relationship between exposures of passive smoking to the outcome of grommet insertion. Six hundred and six children (with 1174 ears) who underwent grommet insertion for recurrent secretory otitis media were followed up till the grommets were extruded. Thirty-three children (65 per cent), whose mothers smoked when they were pregnant, had bilateral narrow external ear canals. The median survival rate of grommet was 59 weeks in children who were exposed to passive smoking as compared to 86 weeks for non-exposed children and the extrusion rate of grommet was 36 per cent higher at the end of one year if both parents smoked compared to the non-smoking group. Post-extrusion myringosclerosis was 64 per cent if both parents smoked and less than 20 per cent if neither parents smoked. It is concluded that post-operative infection rate, attic retraction, post-extrusion myringosclerosis and permanent perforations of tympanic membrane were more common in children exposed to passive smoking. The study provides further support to professional and governmental advice that passive smoking is harmful.

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Stangerup, S. E., S. Schwer, K. Pedersen, S. Brofeldt, and M. Niebuhr. "Prevalence of eardrum pathology in a cohort born in 1955." Journal of Laryngology & Otology 109, no. 4 (April 1995): 281–85. http://dx.doi.org/10.1017/s0022215100129937.

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AbstractThe aim of this study was to compare the prevalence of the different types of eardrum pathology in a cohort of adults not previously treated by grommet insertion with corresponding findings obtained in a cohort previously treated with grommet insertion.A cohort born in 1955 were invited to a screening examination including otomicroscopy. In the untreated cohort, retraction of Shrapnell's membrane was found in four per cent of the ears compared to 20 per cent in the cohort treated with grommets. Tensa pathology, including atrophy and myringosclerosis, was found in six per cent of the ears in the untreated cohort and in 17 per cent in the treated cohort. Normal eardrums were found in 91 per cent of the ears. Despite the increased awareness of secretory otitis, as well as the increased rate of surgical treatment, the prevalence of eardrum pathology seems to be increasing. The reasons for this are discussed.

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Li, Caoyang, David Herrin, John Baker, and Asad M. Sardar. "Simulation of rubber grommets and correlation with test at low frequencies." INTER-NOISE and NOISE-CON Congress and Conference Proceedings 263, no. 1 (August 1, 2021): 5740–47. http://dx.doi.org/10.3397/in-2021-3246.

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Residential air conditioning units include several sources which can lead to vibrational and noise issues. The most important structure-borne source is the compressor which controls the noise and vibration in certain frequency ranges. Compressors are mounted on four relatively stiff rubber grommets which partially isolate the basepan from the compressor motion while also ensuring that the compressor does not move too much. In this work, the grommets are simulated using the finite element method and results are correlated with measurement results with good agreement. It is demonstrated that the hyperelastic properties of the grommets should be increased due to the Payne effect to improve correlation.

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De Souza, Christopher E. "Experience with 1450 Endoscopic DCR and Four Methods." Otolaryngology–Head and Neck Surgery 139, no. 2_suppl (August 2008): P77. http://dx.doi.org/10.1016/j.otohns.2008.05.248.

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Objective 1) Comparing 4 methods when doing a DCR. 2) Determining superiority of stenting versus fistulization. Methods Randomized uncontrolled study. 12 years (1994 to 2007), chronic dacryocytitis, 1195 patients studied, primary health care. 1. Resolution of Epiphora 2. Patency 3. Complete resolution of abcess Endoscopic DCR. 4 methods: simple incision, grommet insertion, stenting, and fistulization. 255 patients had their lacrimal sacs incised and drained, 300 had grommets inserted in their lacrimal in an attempt to achieve patency, 225 had lacrimal stents, and 415 had undergone fistulization. Results Of the 255 incisions and drainages, 65% were blocked after 2 months. Of the 300 who had grommets inserted, 68% were blocked after 2 months. Of the 225 who had lacrimal stents, all were patent but 10 (4%) had to be removed because of corneal opacities, and 1 (0.4%) had to be removed because of a foreign body granuloma at the punctum. Of the 415, 5 (1.2%) were blocked after 6 months and 1 (0.2%) patient had epiphora even though the sac was patent. Conclusions 1) Fistulization and stenting are statistically more reliable in achieving resolution of epiphora, restoration of patency, and complete resolution of chronic dacryocystitis. 2) In our experience, we encountered corneal opacities following stenting and since the results with fistulization were comparable to stenting, we prefer to fistulize patients for chronic dacryocystitis as a safe and reliable method.

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Tay, H. L., and R. P. Mills. "Tympanic membrane atelectasis in childhood otitis media with effusion." Journal of Laryngology & Otology 109, no. 6 (June 1995): 495–98. http://dx.doi.org/10.1017/s0022215100130555.

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AbstractA prospective study on the dynamics of tympanic membrane atelectasis during the treatment for glue ear was performed in a sample of 115 ears of 83 children aged between one and 11 years. The progression in the degree of pars tensa atelectasis was analysed in relation to six potentially relevant factors. Multivariate analysis showed that the factor with the most predictive value on the progression of the pars tensa retraction was the grade of atelectasis at initial detection (p<0.0001). The use of grommets did not have any significant influence on the outcome grade of atelectasis. There was an association between previous grommet insertion and localized retractions in the inferior segment of the pars tensa (P<0.0001). However, localized retractions in the postero-superior quadrant were not associated with previous grommet insertion (P<0.02). Although the hearing thresholds of atelectatic ears were significantly worse than normal ears especially at 4 kHz (p<0.006), the difference was less than 5 dB.

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Ponduri, Sirisha, Rebecca Bradley, Pamela E. Ellis, Sara T. Brookes, Jonathan R. Sandy, and Andy R. Ness. "The Management of Otitis Media with Early Routine Insertion of Grommets in Children with Cleft Palate—A Systematic Review." Cleft Palate-Craniofacial Journal 46, no. 1 (January 2009): 30–38. http://dx.doi.org/10.1597/07-219.1.

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Objective: To determine whether early routine grommet insertion in children with cleft palate has a beneficial effect on hearing and speech and language development compared with conservative management. Design: Systematic review of randomized controlled trials, controlled clinical trials, case series, and prospective and historical cohort studies. Main Outcome Measures: The main outcome measure was the effect of early routine grommet placement on the degree of conductive hearing loss. Secondary outcome measures included differences in hearing level, possible side effects, speech and language development, and quality of life. Results: We identified 368 citations for review. From a review of the titles, 34 potentially relevant papers were selected. Of these, 18 studies met our inclusion criteria, including eight case series, six historical cohort studies, three prospective cohort studies, and one randomized trial. Most studies were either small or of poor quality or both. The results of the studies were contradictory, with some studies suggesting early placement of grommets was beneficial and others reporting there was no benefit. Conclusions: There is currently insufficient evidence on which to base the clinical practice of early routine grommet placement in children with cleft palate.

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Gibb, Alan G., and Ian J. Mackenzie. "The Extrusion Rate of Grommets." Otolaryngology–Head and Neck Surgery 93, no. 6 (December 1985): 695–99. http://dx.doi.org/10.1177/019459988509300601.

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A prospective study was performed to determine the factors Influencing the extrusion rate of tympanostomy tubes. Nine hundred thirty-nine tubes were inserted In 589 patients and the extrusion of these tubes was reviewed up to a period of 27 months. The eight tubes used in the survey were the Shepard, Exmoor, Bobbin, Armstrong, Paparella, Shah, Arrow, and collar button. These tubes were inserted In strict rotation, the operator using the designated tube. The position, type of incision, presence of fluid, quality of tympanic membrane, and degree of difficulty of insertion were all recorded at operation. The sex, age, side of operation, and any simultaneous operative procedures were also recorded. The patients were reviewed the day after operation and then every 3 months thereafter until the tube was extruded. A definite pattern was Identified for the extrusion of each type of tube. At one end of the spectrum, Exmoor and Shepard tubes were, for the most part, extruded between 6 and 9 months after Insertion, while at the other end, most of the collar button tubes were still functioning at 18 months. The design of the tube was the only factor found to be a significant determinant of the extrusion of the tube, although the experience of the surgeon affected the extrusion rate of the Arrow tube. The different dimensions of the Exmoor and collar button tubes are examined and compared.

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ARCHIVIST. "Glue ear, grommets, and adenoids." Archives of Disease in Childhood 85, no. 2 (August 1, 2001): 103. http://dx.doi.org/10.1136/adc.85.2.103.

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Sudhakar-Krishnan, V. "Do grommets prevent language delay?" Archives of Disease in Childhood 87, no. 3 (September 1, 2002): 260—a—262. http://dx.doi.org/10.1136/adc.87.3.260-a.

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LESSER, T. H. J., K. R. WILLIAMS, and D. W. SKINNER. "Tympanosclerosis, grommets and shear stresses." Clinical Otolaryngology 13, no. 5 (October 1988): 375–80. http://dx.doi.org/10.1111/j.1365-2273.1988.tb00769.x.

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Swanson, Alfred B. "Silicone implants and titanium grommets." Journal of Hand Surgery 20, no. 3 (May 1995): 515. http://dx.doi.org/10.1016/s0363-5023(05)80123-6.

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Eppley, Barry L., A. Michael Sadove, David Hennon, and John A. van Aalst. "Treatment of Nasopharyngeal Stenosis by Prosthetic Hollow Stents: Clinical Experience in Eight Patients." Cleft Palate-Craniofacial Journal 43, no. 3 (May 2006): 374–78. http://dx.doi.org/10.1597/04-055.1.

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Objective A series of nasopharyngeal appliance designs is presented that represents our evolving experience over a 20-year period in the adjunctive use of prosthetic stents in the surgical correction of nasopharyngeal stenosis. Design Retrospective assessment of effectiveness of two nasopharyngeal stenosis hollow stent designs in a consecutive series of patients for relief of nasal obstructive symptoms. Setting Tertiary academic medical center, Craniofacial Program at Children's Hospital. Patients Four patients with nasopharyngeal stenosis were treated with a preoperatively fabricated stent made from a clasped palatal appliance onto which hollow acrylic conduits were extended through surgically re-created pharyngeal ports. A subsequent set of four patients with nasopharyngeal stenosis were treated with intraoperatively-fashioned silastic grommets, as opposed to palatal appliances. Interventions Postoperative intraoral stenting of nasopharyngeal ports. Main Outcome Measures Maintenance of pharyngeal port opening after 1 year, improvement in nasal airway obstructive symptoms. Results The palatal appliance stents were less well tolerated and had a lower maintenance of port patency after device removal (4 of 8, 50%). The silastic grommets provided better retention into the ports and increased patient tolerance, as well as better 1-year port maintenance (6 of 8, 75%). Conclusions The grommet stent appliance offers numerous advantages over a conventional dental-clasped appliance for prosthetic nasopharyngeal stenting, including obviation of extensive preoperative preparation, ease of insertion and removal, and exchange of air during the stenting period. Improved nasopharyngeal patency with this device may be due to greater patient tolerance and subsequent longer use.

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Chowdhury, C. R., S. Y. Tsao, J. H. C. Ho, G. K. H. Au, A. Wright, and Y. Tung. "Prospective Study of the Effects of Ventilation Tubes on Hearing after Radiotherapy for Carcinoma of Nasopharynx." Annals of Otology, Rhinology & Laryngology 97, no. 2 (March 1988): 142–45. http://dx.doi.org/10.1177/000348948809700210.

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In patients with nasopharyngeal carcinoma, deafness sometimes occurs following radiotherapy. It is usually conductive, but may be sensorineural. Tinnitus is present frequently and usually is distressing. The role of ventilation tubes (grommets) in relieving these problems was assessed in a prospective randomized controlled trial of 115 patients. In the group with grommets, there was an improvement in hearing, with a reduction of the averaged air-bone gap (p< .01). This was not found in the control group without ventilation tubes, who developed a larger conductive loss (p< .01) and, in addition, a slight deterioration of the averaged bone conduction threshold (p< .01). Surprisingly, the group with grommets did not develop this sensorineural loss (p> .01). In addition, tinnitus was improved significantly by the insertion of ventilation tubes (p< .01). Neither necrosis nor stenosis of the external auditory meatus was found in either group.

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