Otitis media with effusion: An audit on the indications and outcome

Abstract

One of the reasons for the variation in the number of grommet insertions amongst different hospitals could be that the indications for surgery differ amongst them. Even ENT surgeons within the same hospital may have different criteria for grommet insertion. Definitive criteria for grommet insertion in children with Otitis media with effusion (OME) were established in 1995 at the Ipswich Hospital NHS Trust. A subsequent audit was performed on children with grommets inserted between 1995 and 1996 to assess whether the indications for surgery fell within the defined criteria. The improvement of symptoms, parental satisfaction as well as the reasons for parental disappointment were analysed. The result of the audit shows that 240 out of 245 children who had grommet insertion met the preset criteria. Seventy-five percent of the children noticed an improvement of hearing at the 6 months review. The overall percentage of children with improvement of their speech, education and behaviour was 41.6%, 33% and 20.4% respectively. Forty-seven percent of the children also noticed a reduction in the frequency of acute otitis media. On the whole 78.5% of the parents were pleased with the operation at the 6 month review. The main reason for disappointment at 6 months was grommet extrusion or the grommet acting as a source of discharge.