11
OME
present?
YES
Obtain Age
Appropriate Hearing
Test if Change in
Hearing or No Prior
testing
TT-KAS2 KAS9
Surveillance
every 3–6
months
KAS11 TT-KAS5
Document at least one
of the following:
• Resolution of OME
• Improved hearing
• Improved QOL
NO
At-Risk?
Eardrum
damage or
Symptoms
Bilateral
OME?
NO NO
KAS11
NO
Hearing
Loss >20 dB
HL or hearing
difficulties?
KAS11
YES
Counsel
families re:
Potential Impact
on Speech and
Language
KAS10
Offer
Surgery
YES YES
TT-KAS9 TT-KAS4
YES
TT-KAS3
TT-KAS5
NO
NO
Surgery
Performed?
END
At-Risk:
• Other Permanent hearing loss
• Speech and language delay
• Autism-spectrum or other
pervasive developmental
disorders
• Syndromes or craniofacial
disorders with cognitive, speech,
and language delays
• Blindness or uncorrectable visual
impairment
• Cleft palate
• Other developmental delay
OME attributable Symptoms:
• Vestibular problems
• Poor school performance
• Behavioral problems
• Ear discomfort
• Reduced quality of life
• Recurrent Acute Otitis
Media
Key:
• KAS: OME CPG Key Action
Statement
• TT-KAS: Tympanostomy
Tube CPG Key Action
Statement
YES
KAS4 TT-KAS8 TT-KAS4
KAS13
