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This commissioning statement refers to:
This commissioning statement does not refer to:
* During the watchful waiting period, advice on educational and behavioural strategies to minimise the effects of hearing loss should be offered. The child's hearing should be re-tested at the end of this time.
Patients should make shared decisions with clinicians, using Shared Decision-making Aids for Glue Ear
At least 50% of otitis media with effusion (OME) causing bilateral hearing loss of at least 20dB will resolve spontaneously within 3 months therefore a period of watchful waiting for at least 3 months is required1. Parents should be advised on educational and behavioural strategies to minimise effects of hearing loss. The RCS guidance also states that care should be provided via an integrated care pathway, which should include "prevention through public health programmes to decrease exposure to cigarette smoke during infancy and childhood"1.
NHS choices points out that factors which increase the risk of getting glue ear include2:
NICE CKS3 points out that:
NICE clinical guideline 60 4supports the above criteria and covers:
A Cochrane review6 concluded in 2010 that "In children with OME the effect of grommets on hearing, as measured by standard tests, appears small and diminishes after six to nine months by which time natural resolution also leads to improved hearing in the non-surgically treated children. No effect was found on other child outcomes but data on these were sparse. No study has been performed in children with established speech, language, learning or developmental problems so no conclusions can be made regarding treatment of such children."
NB: Leeds health pathways include the following rarer indications for grommets