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Surgical management of otitis media with effusion in children overview

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Surgical management of otitis media with effusion in children

About

What is covered

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.

Updates

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.

Professional responsibilities

The recommendations in this pathway represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take these recommendations fully into account, alongside the individual needs, preferences and values of their patients or service users. Applying the recommendations in this pathway is at the discretion of health and care professionals and their individual patients or service users and does not override the responsibility of health and care professionals to make decisions appropriate to the circumstances of the individual, in consultation with them and/or their carer or guardian.
Commissioners and/or providers have a responsibility to enable the recommendations to be applied (and to provide funding required for technology appraisal guidance) when individual health and care professionals and their patients or service users wish to use them. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this pathway should be interpreted in a way that would be inconsistent with compliance with those duties.

Patient-centred care

People have the right to be involved in discussions and make informed decisions about their care, as described in your care.
Making decisions using NICE guidelines explains how we use words to show the strength (or certainty) of our recommendations, and has information about prescribing medicines (including off label use), professional guidelines, standards and laws (including on consent and mental capacity), and safeguarding.

Updates to this pathway

28 November 2013 Minor maintenance updates
6 November 2013 Minor maintenance updates
3 May 2013 Minor maintenance updates

Short Text

Surgical management of otitis media with effusion in children

What is covered

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.

Sources

The NICE guidance that was used to create the pathway.

Quality standards

Quality statements

Effective interventions library

Effective interventions library

Successful effective interventions library details

Implementation

These resources include support for commissioners to plan for costs and savings of guidance implementation and meeting quality standards where they apply.
These resources will help to inform discussions with providers about the development of services and may include measurement and action planning tools.
These resources provide help with planning ahead for NICE guidance, understanding where you are now, and conducting improvement initiatives.
NICE produces resources for individual practitioners, teams and those with a role in education to help improve and assess users' knowledge of relevant NICE guidance and its application in practice.

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.

Professional responsibilities

The recommendations in this pathway represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take these recommendations fully into account, alongside the individual needs, preferences and values of their patients or service users. Applying the recommendations in this pathway is at the discretion of health and care professionals and their individual patients or service users and does not override the responsibility of health and care professionals to make decisions appropriate to the circumstances of the individual, in consultation with them and/or their carer or guardian.
Commissioners and/or providers have a responsibility to enable the recommendations to be applied (and to provide funding required for technology appraisal guidance) when individual health and care professionals and their patients or service users wish to use them. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this pathway should be interpreted in a way that would be inconsistent with compliance with those duties.

Patient-centred care

People have the right to be involved in discussions and make informed decisions about their care, as described in your care.
Making decisions using NICE guidelines explains how we use words to show the strength (or certainty) of our recommendations, and has information about prescribing medicines (including off label use), professional guidelines, standards and laws (including on consent and mental capacity), and safeguarding.

Updates to this pathway

28 November 2013 Minor maintenance updates
6 November 2013 Minor maintenance updates
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.

Paths in this pathway

Pathway created: September 2012 Last updated: November 2013

© NICE 2016

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