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London (United Kingdom): RCOG Press, Royal College of Obstetricians and Gynaecologists, (Clinical Guideline 60), 1-92.
This guideline provides recommendations for the management of otitis media with effusion in children under the age of 12 and includes children with cleft palate and Down syndrome. The guideline is applicable to a wide audience, including: health care professionals, service planners, and parents and carers.
National Institute for Health and Clinical Excellence (United Kingdom)
<p>With regard to hearing assessment:</p>
<ul>
<li>Formal assessment of a child with otitis media with effusion (OME) should include a clinical history with consideration for hearing fluctuation, listening skills, and speech and language development, clinical examination including otoscopy, developmentally appropriate hearing testing, and tympanometry.</li>
<li>"Children who have undergone insertion of ventilation tubes for OME should be followed up and their hearing should be re-assessed" (p. 37).</li>
<li>"Co-existing causes of hearing loss (for example sensorineural, permanent conductive and non-organic causes) should be considered when assessing a child with OME and managed appropriately" (p. 28).</li>
</ul>
Children with cleft palate who are suspected of having otitis media with effusion should receive otological and audiological services. Professionals should have expertise in assessing and treating these children in liaison with the regional multidisciplinary cleft lip and palate team.
Children with Down syndrome who are suspected of having otitis media with effusion should receive services from a multidisciplinary team with expertise in assessing and treating this population. Children with Down syndrome with otitis media with effusion and hearing loss should be offered hearing aids.
Children with persistent otitis media with effusion and hearing loss should be offered hearing aids as an alternative to surgical intervention where surgery is contraindicated or not acceptable.
