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Assessment of a child with otitis media with effusion

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Assessment of a child with OME should include:

  • a detailed history with focus on:
    • development of age appropriate speech and language

    • difficulties faced due to hearing loss such as
      • lack of concentration or behavioural problems
      • hearing fluctuation
      • poor educational progress
    • recurrent ear infection and upper respiratory tract infections (1,2)
      • in more than 50% of cases acute otitis media (AOM) precedes OME (although OME may occur and persist without an infection) (3)

    • balance problems and clumsiness

    • previous relevant medical history e.g. Down syndrome, cleft palate

    • social history - parental smoking

    • pregnancy, delivery and neonatal period - uncommon causes of sensorineural hearing loss, both hereditary and acquired should be considered (1,2)

  • clinical examination

    • examine the ear with an otoscope
      • there are no signs of an acute inflammation (4)
      • evidence of middle ear effusion include:
        • abnormal colour of the tympanic membrane e.g. - yellow, amber, or blue
        • loss of light refelx
        • opacification of the membrane (except due to scarring)
        • reduced or absent mobility of the tympanic membrane (can only be demonstrated with a pneumatic-otoscopy)
        • retracted/concave tympanic membrane or fullness or bulging (not typically)
        • presence of air bubbles or an air/fluid level (4)

    • general upper respiratory health

    • general developmental status(1)

  • hearing tests
  • audiometry, both impedance tympanometry and pure tone testing, is an essential part of the management of glue ear

Notes:

  • co-existing causes of hearing loss should also be considered in children with OME e.g. - sensorineural, permanent conductive and non-organic causes (1)

Reference:


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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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