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This pre-referral guideline covers Otitis media with effusion in children of all ages.

Initial work-up

• Usually associated with noticeable hearing loss. A middle ear effusion will be present in approximately:
  • 80% of cases at 2 weeks followingÌý ASOM<
  • 40% at 1 month
  • 20% at 2 months
  • 10% at 3 months
• Audiology (hearing test) if hearing loss is present > 3 months.

Pre-referral treatment

• Review at 3 months – for persistent middle ear effusion or hearing loss.
• For symptomatic cases that have not resolved in 3 months, a prolonged course of antibiotics will result in resolution of a significant proportion.Ìý

When to refer

• Child is symptomatic due to hearing loss, and this is thought likely to be present for a significant period of time in the future.
• Bring audiology test results.

Referral form (pdf)

Parent handout (pdf)

Resources

Kids Connect (RCH Primary Care Liaison)

Kids Health Info (Parent fact sheets online)

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References

Paediatric Handbook Ear, Nose and Throat Conditions, Chapter 21 (pp312-324); Robert Berkowitz and Michael Marks; Seventh Edition, Blackwell Publishing. By the staff of the Royal Children's Hospital, Melbourne, Australia