Station 16

Look at the image below and answer the following questions. 

What is the object seen within the tube on this image? (2 marks)

Shah grommet

Can you give 3 other types of this? (3 marks)

  1. Tiny titanium
  2. Shepherd
  3. T-tube

Give 4 indications for its insertion? (4 marks)

Acute otitis media, mastoiditis, administrations of medication to middle ear, recurrent acute otitis media, glue ear / otitis media with effusion, eustachian tube dysfunction

Can you describe the steps involved in its insertion? (8 marks)

The steps are below:

    1. Microsuction to visualise the tympanic membrane (1 mark)
    2. Myringotomy in the anterior inferior quadrant (2 marks)
    3. Suction of middle ear with a fine end (2 marks)
    4. Place grommet with crocodile forceps and curved needle (3 marks)

What are the complications that require consent for this procedure? (5 marks)

Infection, bleeding, scarring of the drum, hearing loss, tinnitus, early/later extrusion, persistent perforation, need further procedure. 

If performed under local can you give 3 ways of anaesthetising the patient? (3 marks)

EMLA cream, phenol, co-phenylcaine spray. 

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