10
Diagnosis
Figure 6. Algorithm
Diagnosis or
suspicion of OME
KAS1a
Child with
Otalgia and/or
Hearing Loss
KAS1b
Perform
Pneumatic
Otoscopy
Newly
Diagnosed At
Risk Child
KAS4b
Obtain
Typanometry
KAS2
OME
present?
Uncertain
NO
YES
KAS4a
TT-KAS8
YES
Obtain Age
Appropriate
Hearing Test
NO
Patient
& Family
Education
KAS6
Do Not Provide:
Steroids
Antibiotics
Decongestants
or
Antihistamines
KAS 8a-c
Watchful
Waiting:
Re-evaluate
3 mos after
onset or
diagnosis
KAS7
END
NO
Re-evaluate at
12-18 mos old
(if not already)
YES
KAS4b
Offer
Surgery
YES
NO
Surgery
Age >4
years
YES
Tympanostomy
tubes alone
KAS12a
Tympanostomy
tubes,
Adenoidectomy
or Both
KAS12b
NO
TT-KAS9
KAS9
KAS4a
At-Risk?
Type B
Tympanogram in
either ear?
At-Risk?
