Authors' recommendations: Key points Otitis media with effusion (OME) is common in children. Most cases resolve spontaneously. Persistent (>=3 months), bilateral hearing loss (>=25 dB) is the major concern for OME. There is good evidence that surgical insertion of grommets provides short-term benefit in correcting hearing loss associated with OME. The benefit diminishes with time. Adjunct adenoidectomy provides a small additional benefit in hearing. Evidence is insufficient to ascertain possible long-term benefits of adjunct adenoidectomy combined with grommet insertion. Good quality, long-term trials have demonstrated that watchful waiting (delayed insertion of grommets if OME remains unresolved) compared to immediate insertion of grommets does not result in disadvantage in language, behaviour or social development for children with persistent bilateral OME diagnosed under 3 years old who do not otherwise have disabling conditions. It is uncertain whether the safe use of watchful waiting is generalisable to older children and children who have already shown disruptions in language and behaviour development at diagnosis. Limited, preliminary evidence suggests that surgical insertion of grommets without adenoidectomy may be cost-effective compared to doing nothing after 3 months of watchful waiting.

Project Status: Completed

URL for project: http://www.nhshealthquality.org/nhsqis/files/EN22_Grommets.pdf

Year Published: 2008

URL for published report: http://www.nhshealthquality.org/nhsqis/4252.html

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Scotland

Organisation Name: Quality Improvement Scotland

Contact Address: Delta House, 50 West Nile Street Glasgow G1 2NP Scotland United Kingdom Tel: +44 141 225 6988; Fax: +44 141 221 3262

Contact Name: shtg.hcis@nhs.net

Contact Email: shtg.hcis@nhs.net

Copyright: NHS Quality Improvement Scotland (NHS QIS)