Reconsidering management for otitis media with effusion in children

Abstract

Otitis media is the most commonly diagnosed illness apart from the common cold and treatment by insertion of tympanoplasty tubes is the most frequent operation in children beyond the neonatal period. Approximately nine in every ten children have had at least one episode by the age of two years and figures for South Africa may even be higher. Recent research findings have led to a more conservative approach to treatment of otitis media with effusion as opposed to previous recommendations for prompt insertion of tympanostomy tubes to avoid suspected developmental delays due to the mild conductive hearing loss. A large scale longitudinal clinical trial has demonstrated that prompt versus delayed insertion of tympanostomy tubes does not affect developmental outcomes and therefore a conservative approach of monitoring the condition and hearing status alongside speech and language development is recommended without the use of medication as routine management. These recommendations may ultimately result in significant healthcare savings for South Africa but must be implemented within a collaborative team approach to ensure developmental outcomes are not compromised due to poor surveillance.