Comparative assessment of grommets with topical intranasal steroid in cases of otitis media with effusion

Sushil Suresh Chavan, Prakash S Nagpure

Indian Journal of Otology 2017 23(3):146-150

Aim: This study of 56 patients is to assess the effectiveness of grommet insertion compared with non-surgical treatment steroids (topical intranasal) in otitis media effusion (OME) cases and study complications related to the grommet and topical intranasal steroid. Material: A total subjects of various age groups attending out patient department of ENT, Kasturba Hospital, MGIMS Sevagram, Hospital, Wardha from june 2013 to august 2015 who meet the inclusion criteria and give their written consent in local language will be included in the study. Method: Comparison of medical and surgical management were done. Medical management include topical intranasal steroids by Mometasone fuorate. The recommended dose for treatment of the nasal symptoms is 1 spray (50 microgram of mometasone furoate in each spray). Recommended duration of spray is 2 to 4 weeks and the stated achievement of effect of spray is approximately 1 to 2 weeks. Surgical management include myringotomy with grommet insertion. Generally, myringotomy is performed in conjunction with the insertion of a polyethylene tube called as grommet. Infants and small children are best managed by performing this procedure under a general anesthetic. In older children and adults, local anesthetic can be used as a single block in posterior canal wall so as it block Arnold"s nerve. Results: From this present study cases of children 10 (47.62%) patients shows improvement and 17 (48.57%) adult patient shows improvement having minimal difference. Similarly failure of treatment in children is 1 (4.76%) complications in 2 (9.52%) and in adult patients 0 (0%) complication in 2 (5.71%) it was not showing significant differences. p value was not significant and showing that the differences in value was not having any level of significance in same group. It is concluded that topical nasal steroids are not so effective as surgical drainage of exudative material (myringotomy). Conclusion: Use of steroid causes nasal irritation and temporary relief only and in some patient causes only retention of fluid. Sometimes grommet retained in tympanic membrane and not extruded out needed manual removel. Beside that Overall results are in the favour of myringotomy with grommet insertion as a better modality.

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