Do‐It‐Yourself Grommet

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.