AAO-HNS GUIDELINES Bundle (free trial)

Figure 5. Management of OME Child age 6 months to 12 years with OME Has the child had persistent OME for 3 months or longer? YES NO Obtain hearing test Has the child had bilateral COME and documented hearing difficulty? Reevaluate child until OME resolves, persists ≥3 months, or is associated with a type B (flat) tympanogram Does the child have unilateral or bilateral COME or a type B (flat) tympanogram? YES Clinician may perform tympanostomy tube insertion YES NO YES Offer tympanostomy tube insertion Does the parent or guardian agree with tympanostomy tube insertion? YES Educate caregivers and proceed with tympanostomy tube placement Reevaluate child every 3-6 months until effusion no longer present, significant hearing loss detected, or structural abnormalities suspected Has the child had unilateral or bilateral COME and symptoms that are likely attributable to OME? YES Clinician may perform tympanostomy tube insertion NO NO Is the child considered "at risk"? NO NO

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