Myringotomy/grommets/Otitis Media with Effusion
Please click here to view the full Myringotomy/Grommets/Otitis Media with Effusion Commissioning Statement.
Commissioning position
NHS Vale of York CCG will commission myringotomy/grommets for children aged between 3 and 12 years old with bilateral otitis media with effusion (OME) under the following circumstances:
- documented, persistent, bilateral OME for at least 3 months AND
- documented persistent hearing loss on 2 occasions at intervals of 3 months or more AND
- hearing in the better ear of 25-30 dBHL or worse (less)
There must be a period of at least 3 months watchful waiting from the date of the first appointment with an audiologist
AND the child suffers from at least one of the following:
- At least 5 recurrences of acute otitis media in a year (or 3 in 6 months)
- Evidence of significant delay in speech development
- Evidence of significant educational or behavioural problems attributable to persistent hearing loss
- Hearing level in the better ear of 25-30 dBHL (averaged at 0.5, 1, 2 & 4 kHZ) or worse (or equivalent dBH where dBHL not available)
- Hearing loss of less than 25-30 dBHL with significant impact on the child’s development, social or educational status
- A significant second disability such as Down’s syndrome or cleft palate
NB: In children with additional disabilities such as Down’s Syndrome or cleft palate, involvement of a specialist multidisciplinary team with expertise in assessing and treating OME in these children is essential1.
Urgent referral is advised in the following circumstances
- Suspicion of cholesteatoma (atypical features and persistent foul discharge)
- OME is complicating sensorineural deafness (eg with excessive hearing loss) or is delaying diagnosis or the patient has treatment with aids or cochlear implants (this would be an indication for immediate grommets)
NB: Do not perform adenoidectomy at the same time unless evidence of significant upper respiratory tract symptoms
Patient information leaflet operations for glue ear
To submit an application to the CCG's Individual Funding Request Panel, please click here for further information.
