12
Treatment
Table 5. Summary of Guideline Key Treatment Action
Statements
Statement Action Strength
6. Patient education Clinicians should educate families of children
with OME regarding the natural history of
OME, need for follow-up, and the possible
sequelae.
R
7. Watchful waiting Clinicians should manage the child with OME
who is not at-risk with watchful waiting for
3 months from the date of effusion onset (if
known) or 3 months from the date of diagnosis
(if onset is unknown).
S
8a. Steroids Clinicians should recommend against using
intranasal steroids or systemic steroids for
treating OME.
S
(against)
8b. Antibiotics Clinicians should recommend against using
systemic antibiotics for treating OME.
S
(against)
8c. Antihistamines or
decongestants
Clinicians should recommend against using
antihistamines, decongestants, or both for
treating OME.
S
(against)
9. Hearing test Clinicians should obtain an age-appropriate
hearing test if OME persists for ≥3 months OR
for OME of any duration in an at-risk child.
R
10. Speech and
language
Clinicians should counsel families of children
with bilateral OME and documented hearing
loss about the potential impact on speech and
language development.
R
11.Surveillance of
chronic OME
Clinicians should reevaluate, at 3- to 6-month
intervals, children with chronic OME until the
effusion is no longer present, significant hearing
loss is identified, or structural abnormalities of
the eardrum or middle ear are suspected.
R
12a. Surgery for
children less than 4
years old
Clinicians should recommend tympanostomy
tubes when surgery is performed for OME
in a child less than 4 years old; adenoidectomy
should not be performed unless a distinct
indication (e.g., nasal obstruction, chronic
adenoiditis) exists other than OME.
R
12b. Surgery for
children 4 years old
or older
Clinicians should recommend tympanostomy
tubes, adenoidectomy, or both when surgery
is performed for OME in a child 4 years old
or older.
R
13. Outcome
assessment
When managing a child with OME clinicians
should document in the medical record
resolution of OME, improved hearing, or
improved quality of life.
R
