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Post-surgical tympanostomy tube follow up with audiology: experience at the Freeman Hospital
C R Davies-Husband1, C Harker, T Davison
1Department of Otolaryngology, Royal Cornwall Hospital, Truro, UK. camerondh@doctors.org.uk
Insights
A six-week audiology follow-up after tympanostomy tube (grommet) insertion effectively reduces otolaryngology referrals by 54%, identifying complications early.
Area of Science:
- Otolaryngology
- Audiology
- Pediatric Medicine
Background:
- Tympanostomy tube insertion, or grommet insertion, is a frequent surgical procedure.
- Current literature lacks comprehensive guidance on post-operative surveillance for grommet patients.
- A six-week audiology follow-up protocol was implemented at our institution for post-surgical grommet patients.
Purpose of the Study:
- To evaluate the effectiveness of a six-week audiology follow-up protocol for pediatric patients after tympanostomy tube insertion.
- To determine the rate of complications and the need for further otolaryngology (ENT) referral.
- To assess the impact of the protocol on reducing otolaryngologist caseloads.
Main Methods:
- Retrospective audit of pediatric patients (<16 years) undergoing grommet insertion over a three-month period.
- Analysis of audiology follow-up attendance and outcomes.
- Calculation of the reduction in otolaryngologist referrals.
Main Results:
- 123 patients were included in the final cohort after exclusions.
- 67% of patients attended their six-week audiology follow-up.
- 54% reduction in otolaryngologist follow-up was observed, with 13% referred back to ENT services for complications.
Conclusions:
- A six-week audiology follow-up is recommended post-grommet insertion.
- This protocol facilitates timely identification and management of potential complications.
- The audiology follow-up significantly decreases the need for otolaryngologist consultations.
Background:
Tympanostomy tube (grommet) insertion is a common procedure, with little guidance in the current literature regarding post-operative surveillance. Our institution implemented a protocol to follow up post-surgical grommet patients via audiology at six weeks.
Methods:
A retrospective audit of all patients less than 16 years old who had undergone grommet insertion during a three-month period.
Results:
A total of 149 patients had grommets inserted. Exclusion criteria left a cohort of 123 individuals; 82 (67 per cent) were followed up by audiology. Of these, 13 (11 per cent) did not attend follow up, and were discharged; 53 (43 per cent) were discharged from audiology with normal thresholds; and 16 (13 per cent) were referred back to a consultant. Therefore, the overall reduction in patients followed up by an otolaryngologist was 54 per cent.
Conclusion:
We recommend a six-week follow up with audiology following grommet insertion, allowing for referral back to ENT services in the event of related complications.
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