Efficacy of Grommet Insertion for Improvement in Hearing among Patients of Secretory Otitis Media

Abstract

Aim: To determine the improvement of hearing after grommet insertion in patients with secretory otitis media. Study Design:A Quasi-Experimental study. Place and Duration: ENT, Head & Neck Surgery department of Lady Reading Hospital MTI, Peshawar and Azra Nahid Medical College, Lahore for duration of two years from February 2019 to February 2021. Methods: The study was performed on 48 ears with secretory otitis media. Before the operation,evaluation of both ears along with tympanmontometry and Pure Tone Audiometry were performed. Documentation ofhearing loss was done pre-operatively. During the operation accomplished under GA, a grommetwas placed in the anterior inferior quadrant of the tympanic membrane. After the surgery, PTA was repeated in the postoperative period before the patient was discharged from the hospital. Results:Our study included 28 patients with secretory otitis media and a total of 48 ears. Of the ears, 27 (56.25%) were male and 21 (43.75%) were female. Both ears were affected in 21 patients. Two patients had unilateral ear involvement. The right ear was affected in 26 cases (51.1%) and the left ear in 22 cases (48.9%). 7-55 years was the age range of the patients and 14.10 ± 9.11 years was the mean age. The degree of preoperative hearing loss was mild (20-40 dB) in 5 (10.41%) ears, moderate (40-60 dB) in 37 (77.1%) ears and severe (60-80 dB) in 6 (12.5%) ears. The degree of postoperative hearing loss was mild (20-40 dB) in 36 ears (75%), moderate (40-60 dB) in 11 ears (22.9%) and severe (60-80 dB) in one ear (2.1%). Hearing improvement was not seen in 8 (16.6%) ears, an improvement of 5-10 dB in 34 (70.8%) ears, and an improvement of 10-20 dB in 6 (12.5%) ears. There was a statistically significant difference between preoperative and postoperative hearing loss in the ears, the hearing loss was significantly less after grommet insertion; p = 0.017. Conclusion:The insertion of Grommet provides a significant improvement in hearing in patients with secretory otitis media. Keywords:Pure tone audiometry, Tympanometry, Middle ear, Secretory otitis Media and Grommets.