Skip to main content

Featured post

Why Some People Can't Stop Coughing

  Understanding Refractory Chronic Cough: What You Need to Know   Have you ever faced a cough that simply refuses to subside?   While most coughs resolve independently, some persist for an unacceptable length of time—weeks, months, or even years. This condition is known as refractory chronic cough (RCC), and it is a significant issue that demands attention in the medical community, especially among specialists in ear, nose, and throat (ENT) care.   In this blog post, we will clearly outline what RCC is, why it occurs, and the most promising treatments available to those suffering from relentless coughing.     What is Refractory Chronic Cough?   A chronic cough is defined as one that lasts longer than eight weeks in adults. For many individuals, it is associated with conditions such as asthma, allergies, acid reflux, or certain medications. However, there are instances where the cough continues even after these underlying causes have been effectively ad...

"Exploring Post-Grommet Complications: What You Need to Know"


 Navigating Postoperative Complications of Grommet Insertion: A Comprehensive Guide

Grommet insertion, a standard surgical procedure to alleviate symptoms of middle ear disorders, can sometimes be accompanied by postoperative complications. Among these, one of the most frequently encountered issues is otorrhea or ear discharge. Understanding the nature of postoperative complications and their management is crucial for patients and healthcare providers.

Types of Otorrhea

Postoperative otorrhea manifests in various forms, including early, delayed, chronic, and recurrent. Early otorrhea occurs within four weeks of surgery, while delayed otorrhea surfaces four or more weeks post-surgery. Chronic otorrhea persists for three months or longer, while recurrent otorrhea involves three or more discrete episodes. Studies suggest that ear discharge after grommet insertion affects a significant proportion of patients, with rates varying from 16% to as high as 80%.

Prophylactic Measures and Treatment

Despite efforts to prevent postoperative otorrhea using prophylactic antibiotic drops, water precautions, or alterations in surgical technique, evidence suggests that these methods may not reliably avert the complication. Consequently, current guidelines from the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) advise against prophylactic postoperative topical antibiotics.

However, in cases of uncomplicated delayed or chronic otorrhea, several randomized controlled trials advocate for the use of topical antibiotics over oral antibiotics. Oral antibiotics may be warranted if systemic infection is evident. It's important to note that topical antibiotics containing aminoglycosides should be avoided due to their potential for causing deafness. When initial treatment fails, ear debridement coupled with bacterial and fungal cultures is recommended to guide antimicrobial therapy.

Addressing Underlying Factors

Beyond symptomatic treatment, managing risk factors for eustachian tube dysfunction is crucial. Conditions such as allergic rhinitis, adenoiditis, and chronic rhinosinusitis can impact eustachian tube function and should be addressed accordingly. Interventions may include medical therapies such as antihistamines, steroids, antimicrobial agents, or surgical procedures like adenoidectomy.

Tube Management and Follow-Up

Tube removal may be necessary for cases of chronic otorrhea unresponsive to conservative measures. Postoperative follow-up is essential to detect complications such as tube obstruction or premature extrusion. Early tube occlusion, occurring in approximately 5%- 11% of cases, warrants attempted removal of the obstruction using appropriate instrumentation. Replacement may be required if recurrent otitis media persists despite attempts at clearance.

Understanding Tube Lifespan and Sequalae

While there are no definitive guidelines regarding the optimal duration of a patent tympanostomy tube, the typical lifespan is around 12 months. Prolonged retention beyond five years can increase the risk of complications such as persistent perforation or granulation tissue formation. Surgical repair options, including myringoplasty or tympanoplasty, may be considered in cases of persistent perforation.

Preventing and Addressing Hearing Loss

While residual postoperative hearing loss following grommet insertion is rare, it's essential to consider pre-existing congenital hearing loss, which may influence outcomes. Preoperative evaluation and appropriate management are vital to ensure optimal hearing outcomes post-surgery.

In conclusion, understanding the spectrum of postoperative complications of grommet insertion and implementing appropriate management strategies are essential for optimizing patient outcomes. Collaboration between patients, caregivers, and healthcare providers is paramount in navigating these challenges effectively.

📞 When in doubt, seek guidance


Mr Gaurav Kumar
Ear, Nose & Throat Consultant

To book an appointment, visit https://tinyurl.com/GKAppointmentBooking

Phone Number: 07494914140
Disclaimer: For general information only, always seek medical advice from your treating consultant.






Popular Post

Quinsy Abscess

 How to tell the difference between tonsillitis and quinsy? 🤔🩺 Tonsillitis vs. Quinsy: Spotting the Differences 🩺🤔   Feeling under the weather with a sore throat? It's essential to know the difference between tonsillitis and quinsy. Here's how to tell them apart:   1. Tonsillitis:   Symptoms: Sore throat, difficulty swallowing, fever, swollen tonsils with white or yellow patches, swollen lymph nodes in the neck, and possibly a cough and hoarse voice. Cause: Usually viral or bacterial infections, such as the common cold or strep throat. Treatment: Rest, hydration, over-the-counter pain relievers, and sometimes antibiotics for bacterial tonsillitis. 2. Quinsy (Peritonsillar Abscess):   Symptoms: Severe sore throat on one side, difficulty swallowing, fever, drooling, muffled voice, swollen tonsil on one side, swollen uvula, and possibly a visible abscess on the tonsil. Cause: Complication of untreated or inadequately treated tonsillit...
Read more

“Where Are Your Tonsils? Your Health’s First Line of Defence!”

  Where Are Your Tonsils Located?   Learn About Their Position and Importance for Your Health Have you ever wondered where your tonsils are and why their location is significant for your health? Let's explore the fascinating world of tonsils and understand their crucial role in your body's defence system. What Are Tonsils? Tonsils are two oval-shaped masses of lymphoid tissue located at the back of your throat. They are part of your immune system, which is a complex network of cells, tissues, and organs that work together to defend the body against harmful invaders. The tonsils are vital in protecting your body from infections. They are often referred to as the "first line of defence" because they are strategically positioned to catch and filter out germs that enter through your mouth or nose. Where Exactly Are They Located? Your tonsils are situated in the pharynx, just behind the soft palate. There are two tonsils, one on each side of your throat. If you open your ...
Read more

Boil in the Ear canal can be very painful...

How do I know I have boil in the ear canal? The ear canal is lined by skin up to the eardrum. Skin in the outer third of the ear canal has hair follicles. Hair follicles can get infected with bacteria and can form boil or furunculosis. It is challenging to look in our own ear canal. You can only feel a bump in the ear canal entrance which is tender to touch. Why is so painful when we have boil in the ear? Ear canal skin is very tightly attached to underlying cartilage. So any swelling in the skin stretches it and makes it very sore to touch. How do we get boil in the ear canal?  Most common causes of boil in the canal is dryness of the skin and trauma. Dry skin leads to cracks and these cracks can get infected. People who use dry earbuds, fingers, towel edges or pens and traumatise ear canal skin, which can get infected with bacteria. How do I release the temptation of using earbuds? Some people can get very dry skin due to sensitivity to soup, shampoo o...
Read more

Bleeding From Ears

  Why is my Q-tip bleeding from my ear?   It can be alarming if you've ever noticed blood on your Q-tip after cleaning your ears. Here are a few reasons why this might happen:   🚫 Avoid Inserting Q-tips Too Deep: The most common cause of bleeding is inserting Q-tips too far into the ear canal. This can lead to irritation, scratches, or even damage to the delicate ear tissues.   🩹 Ear Injuries or Scratches: Vigorous or improper cleaning can cause small injuries or scratches inside the ear canal. These injuries may result in bleeding when you use a Q-tip.   🩸 Ear Infections: Infections like otitis externa or swimmer's ear can make the ear canal more sensitive. Cleaning during an active infection can cause bleeding.   🔄 Wax Impaction: Excessive earwax can cause blockages, leading to a feeling of fullness and impaired hearing. Attempting to clean it out with a Q-tip may cause bleeding, especially if the wax is impacted.   👂 What to Do...
Read more

Eustachian Tube Dysfunction

Are you unable to pop your ears or feeling pressure in your ears? Eustachian tube dysfunction is a very common problem after flu or cold or even after long haul flight when you feel hearing is muffled, feel pressure around the ears and sometimes you feel as if you are underwater. Good news is most of the time it is temporary.  If you try decongestants, antihistamine ( hay fever tablets ) and Valsalva (ie try and pop your ears) things should improve after a few days to a week. Why do we have symptoms of Eustachian tube dysfunction? The eustachian tube is present at the back of our nose and connects the nose to the middle ear. It is there to maintain equal pressure on both sides of the eardrum. The eustachian tube also helps in clearing normal mucus from the middle ear.  Hence opening and closing of this ventilation tube are very important for hearing. Normally every time we yawn and chew this tube opens and closes without us noticing it. So, if this opening of ventila...
Read more

Top 10 Cognitive Behavioural Therapy Strategies for Tinnitus

 Tinnitus, the perception of ringing or buzzing in the ears without an external sound source, can be distressing and debilitating. Cognitive Behavioural Therapy (CBT) has proven effective in helping individuals manage tinnitus by changing their responses to noise. Here are the top 10 CBT strategies for tinnitus relief.   1. **Education and Understanding**  What It Is: The first step in CBT for tinnitus is understanding what tinnitus is and how it affects the brain. This involves learning about the auditory system and the psychological factors that can exacerbate the condition. How It Helps: By gaining knowledge about tinnitus, patients can reduce fear and anxiety associated with the condition, which can help decrease the perceived intensity of the ringing.   2. **Cognitive Restructuring**   What It Is: Cognitive restructuring involves identifying and challenging negative thought patterns related to tinnitus, such as "This noise will drive m...
Read more

Why Some People Can't Stop Coughing

  Understanding Refractory Chronic Cough: What You Need to Know   Have you ever faced a cough that simply refuses to subside?   While most coughs resolve independently, some persist for an unacceptable length of time—weeks, months, or even years. This condition is known as refractory chronic cough (RCC), and it is a significant issue that demands attention in the medical community, especially among specialists in ear, nose, and throat (ENT) care.   In this blog post, we will clearly outline what RCC is, why it occurs, and the most promising treatments available to those suffering from relentless coughing.     What is Refractory Chronic Cough?   A chronic cough is defined as one that lasts longer than eight weeks in adults. For many individuals, it is associated with conditions such as asthma, allergies, acid reflux, or certain medications. However, there are instances where the cough continues even after these underlying causes have been effectively ad...
Read more

Superior Canal Dehiscence Syndrome (SCDS)

🔍 Unlocking the Mystery of Superior Canal Dehiscence Syndrome (SCDS) 🌀✨ It's a rare condition that affects the inner ear, and here's the lowdown:   Cause: SCDS occurs when one of the bony canals in the inner ear, particularly the uppermost semicircular canal, doesn't close or thicken properly during fetal development.   Symptoms:   Hearing Loss: It's a common symptom of SCDS. Sound Distortion: Ever feel like sounds aren't quite right? That could be SCDS at play. Balance Problems: SCDS can throw your balance off, making you feel unsteady. Autophony: Imagine hearing your own heartbeat or breathing louder than usual. That's autophony. World Tumbling Sensation: Loud noises or pressure changes might make you feel like the world is spinning. Diagnosis and Treatment:   CT Scans: A specialist might use these to spot SCDS, but other tests are crucial too. Hearing Tests: Essential for accurate diagnosis. Treatment: Surgery may be necessary for severe symptoms. ...
Read more

Tonsil Stones or Tonsilloliths

Where do Tonsil Stones come from? Tonsil stones or tonsillolith are formed in the tiny crevices on the tonsil surface. Tonsils are present at the back of the throat. Two large tonsils on each side can catch food particles when we eat. This food debris can accumulate bacteria and give a bad smell. This mixture of bacteria and food debris can become solid to form tonsil stones. Can Tonsil Stones go away on their own? Tonsil stones form due to food particle and bacteria. You can prevent stone formation by regularly rinsing mouth after every meal, good oral hygiene and dental care. Gargling with salt water and gentle use of bud to deliver the stones can help in some cases. Soft water floss can help keep tonsil surface clean. If you have, post nasal drip due to sinusitis, seeking treatment advice from ENT surgeon can help. You should not use sharp objects to clean tonsil stones or make tonsil surface bleed. What symptoms do tonsil stones cause? Tonsil ston...
Read more

"Naseptin: Powerful Defence Against Nasal Bacteria!"

  Everything You Need to Know About Using Naseptin Nasal Cream   If you've been dealing with nasal issues, you may have come across Naseptin nasal cream as a potential solution. Whether you suffer from recurrent nasal infections (vestibulitis), nose bleeds or simply need some relief from nasal dryness, Naseptin can be a valuable aid. In this blog, we'll cover everything you need to know about using Naseptin nasal cream to ensure you get the best results from this trusted product.   Unlocking the Power of Naseptin Nasal Cream: A Guide to Its Versatile Uses   Naseptin nasal cream, a powerful ally in nasal health, holds the key to treating infections caused by staphylococcal bacteria. This versatile cream offers much more than meets the eye, and we're here to shed light on its incredible benefits! 🌟 👃 Kicking Nose Infections to the Curb: Say goodbye to those troublesome nose infections! Naseptin comes to the rescue, targeting staphylococcal bacteria and...
Read more