Objective: 1. To highlight the rare presentation of a metallic grommet in the Eustachian tube.2. To highlight how the metallic grommet entered the Eustachian tube.3. To suggest how the foreign body can be removed from the Eustachian tube if symptomatic.Case report: A 49 year old lady presented with symptoms of tinnitus and intolerance to loud sounds in right ear after tympanoplasty. HRCT showed a metallic grommet in the left Eustachian tube. We conjectured that the metallic grommet accidentally slipped into middle ear and could not be retrieved by the treating surgeon. The foreign body migrated to the Eustachian tube.
Conclusion:Metallic foreign body in the Eustachian tube is a rare presentation and it posed a diagnostic dilemma how it entered the Eustachian tube. We discussed the possibilities and the method to retrieve when the symptoms appear. A simple or a complicated surgical procedure (Skull Base) may be undertaken if symptomatic.