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Surgical management of otitis media with effusion in children
Short Text
Introduction
This pathway covers the surgical management of OME in children.
OME is a common condition of early childhood in which accumulation of fluid within the middle ear space causes hearing impairment. The hearing loss is usually transient and self-limiting, although in some cases it can persist, necessitating surgical intervention in the form of ventilation tube insertion.
This pathway provides recommendations on the surgical management of OME in children under the age of 12 years based on the best available published evidence. It places a 3-month period of active observation at the centre of the care pathway for children with suspected OME and provides guidance as to when surgery is most appropriate in selected patients. These recommendations will require more timely access to audiology services than is currently available. The pathway also considers the management of OME in children with Down's syndrome and children with cleft palate. OME is particularly prevalent and persistent in these children, and they require management by multidisciplinary teams with appropriate expertise in managing these conditions.
Source guidance
The NICE guidance that was used to create the pathway.
Surgical management of otitis media with effusion in children. NICE clinical guideline 60 (2008)
Quality standards
Quality statements
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Successful effective interventions library details
Implementation
Commissioning
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These resources will help to inform discussions with providers about the development of services and may include measurement and action planning tools.
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Pathway information
Information for the public
NICE produces information for the public that summarises, in plain English, the recommendations that NICE makes to healthcare and other professionals.
NICE has written information for the public explaining its guidance on the surgical management of glue ear in children.
Patient-centred care
Patients and healthcare professionals have rights and responsibilities as set out in the NHS Constitution for England – all NICE guidance is written to reflect these. Treatment and care should take into account individual needs and preferences. People should have the opportunity to make informed decisions about their care and treatment, in partnership with their healthcare professionals. If someone does not have the capacity to make decisions, healthcare professionals should follow the Department of Health's advice on consent, the code of practice that accompanies the Mental Capacity Act and the supplementary code of practice on deprivation of liberty safeguards. In Wales, healthcare professionals should follow advice on consent from the Welsh Government.
If the person is under 16, healthcare professionals should follow the guidelines in Seeking consent: working with children. If a young person is moving between paediatric and adult services their care should be planned and managed according to the best practice guidance described in the Department of Health's Transition: getting it right for young people.
Updates to this pathway
3 May 2013 Minor maintenance updates
Supporting information
- clinical history – focus on:
- poor listening skills
- indistinct speech or delayed language development
- inattention and behaviour problems
- hearing fluctuation
- recurrent ear infections or upper respiratory tract infections
- balance problems and clumsiness
- educational progress
- clinical examination – focus on:
- otoscopy
- general upper respiratory health
- general development
- hearing testing – use tests appropriate for child's developmental stage
- tympanometry.
Glossary
Otitis media with effusion.
Child with suspected otitis media with effusion
Child with suspected otitis media with effusion
Information for children, parents and carers
Information for children, parents and carers
Information for children, parents and carers
Give verbal and written information to parents/carers and children on the nature and effects of OME.
Give parent/carers and children the opportunity to discuss options for treatment of OME.
NICE has written information for the public explaining the guidance on the surgical management of glue ear in children.
Source guidance
Failed to load fragment (default behaviour with no loader supplied): staticcontentfragments/source-guidance-nodeAssessment and treatment for children with otitis media with effusion
View the 'Assessment and treatment for children with otitis media with effusion (without Down’s syndrome or cleft palate)' pathAssessment and treatment for children with Down's syndrome
View the 'Assessment and treatment for children with Down’s syndrome' pathAssessment and treatment for children with cleft palate
View the 'Assessment and treatment for children with cleft palate' pathPaths in this pathway
- Assessment and treatment for children with otitis media with effusion (without Down’s syndrome or cleft palate)
- Assessment and treatment for children with Down’s syndrome
- Assessment and treatment for children with cleft palate
Pathway created: September 2012 Last updated: May 2013
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