The clinical and cost effectiveness of surgical insertion of grommets for otitis media with effusion (glue ear) in children

NHS Quality Improvement Scotland
Record ID 32008000045
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
Year Published: 2008
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Scotland
MeSH Terms
  • Middle Ear Ventilation
  • Otitis Media with Effusion
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
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Copyright: NHS Quality Improvement Scotland (NHS QIS)
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