Do-It-Yourself Grommet

Abstract

Objective: In the absence of a health care budget enabling the import of ready-made aural grommets, Myanmar (Burma) ENT surgeons have come up with an ingenious home-grown solution. We describe how they make their grommets from raw materials, bought from the local market.

Method: A polythene tube is cut into 7.5 mm sections. Each piece is mounted on the tip of a 21-gauge needle, gently touched against the side of a flame, partially melted, and rolled leading edge while maintaining lumen. The tube is turned around, and the process is repeated.

Results: It takes less than 3 minutes to make a grommet. As many as are required can be made instantly. Any defective grommet is discarded. Newly made grommets are threaded onto the needle and placed in a sterilizing solution for future use. Myanmar Audit data showed the average in-situ life for the grommets ranged between 6 to 10 months. Incidence of otorrhea and persistent perforation after grommet extrusion are 5% and 3% respectively.

Conclusion: Local audit data confirms that these grommets are safe to use. In Myanmar (Burma), annual per capita spending on health care is $394 (2.8% of GDP). As survival and functionality are the main priorities, obviously there have not been any randomized controlled trials so far for clinical effectiveness.