Grommets and Glue Ear: A Five-Year Follow up of a Controlled Trial

The principal therapy for seromucinous otitis media is directed at reestablishing aeration of the middle ear cleft by the use of ventilating tubes, as first advocated by Armstrong (1954).This communication is an analysis of the results of management of seromucinous otitis media in matched pairs of ears by inserting a grommet in one ear and carrying out no operative intervention in the other ear. Material and methodsSixty children aged between 4 and 10 years with seromucinous otitis media in both ears were originally included, but 5 failed to attend for follow up, thus leaving a total of 55 (92% followup rate).In each instance the diagnosis was made on a careful history, otoscopy and pure tone audiometry.Under a general anaesthetic both ears were inspected with the microscope, and at random selection only one ear was drained and a Shephard grommet was inserted anteroinferiorly through a radial incision.A careful adenoidectomy was performed, along with whatever other surgery was required in the upper respiratory tract.Pure tone audiometry was repeated forty-eight hours postoperatively and prior to discharge from hospital.Thereafter, follow up was carried out at three-monthly intervals for the first year and then reviewed five years later.On each visit otoscopy and pure tone audiometry were performed and at the five-year review impedance measurement was also carried out.