Clinical Practice Guideline: Otitis Media with Effusion (Update)
Otolaryngology—Head and Neck Surgery
Rosenfeld, R. M., Shin, J. J., et al. (2016).
Otolaryngology—Head and Neck Surgery, 154(1 Suppl), S1-S41.
This updated guideline provides recommendations for the management of otitis media with effusion (OME) in children 2 months through 12 years of age, with or without developmental comorbidities or conditions that predispose children to OME. Of particular interest to audiologists are the recommendations for screening for OME, monitoring hearing loss, and counseling families.
American Academy of Otolaryngology—Head and Neck Surgery Foundation
<p>Recommendations regarding hearing evaluation:</p>
<ul>
<li>"Clinicians should obtain an age-appropriate hearing test if OME persists for 3 mo or for OME of any duration in an at-risk child" (Recommendation, Grace C Evidence; p. S21). </li>
<li>"Clinicians should reevaluate, at 3- to 6-mo intervals, children with chronic OME until the effusion is no longer present, significant hearing loss is identified, or structural abnormalities of the eardrum or middle ear are suspected"(Recommendation, Grace C Evidence; p. S25).</li>
</ul>
Recommendations regarding counseling:
<ul>
<li>"Clinicians should document in the medical record counseling of parents of infants with OME who fail a newborn hearing screen regarding the importance of follow-up to ensure that hearing is normal when OME resolves and to exclude an underlying sensorineural hearing loss" (Recommendation, Grade C Evidence; p. S13).</li>
<li>"Clinicians should counsel families of children with bilateral OME and documented hearing loss about the potential impact on speech and language development" (Recommendation, Grade C Evidence; p. S23). </li>
</ul>
"Clinicians should determine if a child with OME is at increased risk for speech, language, or learning problems from middle ear effusion because of baseline sensory, physical, cognitive, or behavioral factors (Table 3)" (Recommendation, Grace C Evidence; p. S14).
"Clinicians should obtain tympanometry in children with suspected OME for whom the diagnosis is uncertain after performing (or attempting) pneumatic otoscopy" (Strong Recommendation, Grade B Evidence; p. S10).
