Treatment
OME of Short Duration
Î Clinicians should NOT perform tympanostomy tube insertion
in children with a single episode of OME of less than 3 months' duration.
(R-C)
Chronic Bilateral OME with Hearing Difficulty
Î Clinicians should offer bilateral tympanostomy tube insertion to children
with bilateral OME for 3 months or longer (chronic OME)
AND documented hearing difficulties. (R-B)
Chronic OME with Symptoms
Î Clinicians may perform tympanostomy tube insertion in children
with unilateral or bilateral OME for 3 months or longer (chronic
OME) AND symptoms that are likely attributable to OME that include,
but are not limited to, vestibular problems, poor school performance,
behavioral problems, ear discomfort, or reduced quality of life. (O-C)
Recurrent AOM without MEE
Î Clinicians should NOT perform tympanostomy tube insertion in children
with recurrent AOM who do not have MEE in either ear
at the time of assessment for tube candidacy. (R-A)
Recurrent AOM with MEE
Î Clinicians should offer bilateral tympanostomy tube insertion to children
with recurrent AOM who have unilateral or bilateral MEE
at the time of assessment for tube candidacy. (R-B)
Surveillance of Chronic OME
Î Clinicians should reevaluate, at 3- to 6-month intervals, children with
chronic OME who did not receive tympanostomy tubes, until the effusion
is no longer present, significant hearing loss is detected, or structural
abnormalities of the tympanic membrane or middle ear are suspected.
(R-C)
At-Risk Children
Î Clinicians should determine if a child with recurrent AOM or with OME
of any duration is at increased risk for speech, language, or learning
problems from otitis media because of baseline sensory, physical,
cognitive, or behavioral factors (see Table 2). (R-C)
Î Clinicians may perform tympanostomy tube insertion in at-risk children
with unilateral or bilateral OME that is unlikely to resolve quickly as
reflected by a type B (flat) tympanogram or persistence of effusion for 3
months or longer (chronic OME). (O-C)
