Prospective study of tympanosclerosis developing after grommet insertion.

Grommets have been used as a treatment for middle-ear effusions since their introduction by Armstrong in 1954. However, it is now accepted that the presence of a grommet in a tympanic membrane is associated with the development of tympanosclerosis in that membrane. Furthermore, it has been shown that this is a progressive phenomenon and that the incidence increases with time to as much as 65 per cent at 3 to 4 years after grommet insertion (Mawson and Fagan, 1972; Tos and Poulsen, 1976). Initially it was suggested that the development of tympanosclerosis might be due to the middle ear disease rather than to the grommet (McKinnon, 1971). However, most recent studies have found that, in bilateral cases of effusion, tympanosclerosis develops more frequently in ears with a grommet than in those without (Brown, Richards and Ambegaokar, 1978; Lildholt, 1979). This prospective study was designed to show the development of tympanosclerosis in the tympanic membrane of children treated for bilateral middle-ear effusions and to elicit any factors from the clinical history and operative technique which might be associated with the pathogenesis of the complication.