8
Management
Table 5. Saline Washout (Irrigation) to Prevent Postoperative
Tube Otorrhea
1. Fill a 3.0 ml syringe with 1.5 ml of sterile saline solution
2. Attach a #3 French otologic suction to the end of the syringe
3. Prepare to irrigate the middle ear space by either:
a. Inserting the tip of suction through the myringotomy incision into the middle ear
space before the tube is inserted (best when using soft, silicone tube), OR
b. Placing the tip of the suction flush against the opening of the tube after the tube is
inserted (best when using a rigid, fluoroplastic type tube)
4. While occluding the cutoff bypass hole in the suction thumb plate, have an
assistant gently push the syringe plunger to irrigate the middle ear space
5. Suction the ear canal to remove the irrigating solution then repeat, if necessary,
until the fluid is clear (may require 2 or 3 washouts)
Table 6. Risk Factors for Developmental Difficulties*
Permanent hearing loss independent of otitis media with effusion (OME)
Suspected or confirmed speech and language delay or disorder
Autism spectrum disorder
Syndromes (e.g., Down) or craniofacial disorders that include cognitive, speech, or
language delays
Blindness or uncorrectable visual impairment
Cle palate, with or without associated syndrome
Developmental delay
Intellectual disability, learning disorder, or attention deficit hyperactivity disorder**
* Sensory, physical, cognitive, or behavioral factors that place children who have OME at increased
risk for developmental difficulties (delay or disorder).
** e conditions in this row are a new addition to the list.
