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New Guidelines Say 'Watchful Waiting' is Best Approach to Fluid in the Middle Ear
FOR IMMEDIATE RELEASE
(800) 274-2237, Ext. 5221
LEAWOOD, Kan. - Most toddlers and preschoolers will be diagnosed with fluid in their middle ears - or otitis media with effusion (OME) - at some time before school age. A new practice guideline from the American Academy of Family Physicians (AAFP), American Academy of Pediatrics and the American Academy of Otolaryngology-Head and Neck Surgery outlines the best way for physicians to diagnose and treat OME. The guideline is published in the May issue of Pediatrics and is available on the AAFP Web site.
More than 2 million cases of OME are diagnosed in the United States every year - at an estimated cost of $4 billion to the health care system. OME is different from acute otitis media (AOM). OME is fluid-only, while AOM includes intense signs and symptoms of infection and inflammation. OME can happen spontaneously, or as a result of AOM. Usually OME will clear up on its own without treatment. But OME can affect hearing, and lead to speech, language and/or learning delays if it persists.
The guidelines emphasize appropriate diagnosis, and provide management options including observation, medical intervention and referral for surgery:
- Physicians should use pneumatic otoscopy as a primary diagnostic method for OME. This tool uses light, magnification and a gentle puff of air to determine the presence of middle ear fluid.
- Physicians should distinguish children with OME who are at risk for speech, language and/or learning problems from other children with OME.
- Physicians should manage children with OME who are not at risk with "watchful waiting" for at least three months before recommending other treatment.
- Antihistamines and decongestants are not effective treatments for OME.
- Antibiotics and corticosteroids are not recommended for routine management of OME.
- When a child needs surgery for OME, tympanostomy tube insertion (drainage tubes in ear drums) is the preferred initial surgical treatment.
- Adenoidectomy (removal of adenoids) should not be performed unless a specific reason exists to do so.
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