Referral guideline – Persistent otitis media with effusion (OME)/’glue ear’

Introduction

Persistent OME or glue ear is the presence of a middle ear effusion for longer than 3 months, without symptoms or signs of acute inflammation.

It is associated with noticeable hearing loss which is usually transient and self-limiting.

It can also present as behavioural problems, imbalance or a dull aching otalgia.

A middle ear effusion will be present in ~80% of children at 2 weeks following acute suppurative otitis media, reducing to 40% at 1 month, 20% at 2 months and 10% at 3 months.

GP management

  • Active observation over 8-12 weeks should be undertaken to review symptoms and repeat the otoscopy
  • Audiology should be considered if hearing loss is present > 3 months or sooner if there is evidence of speech delay
  • Antihistamines, decongestants and antibiotics have no beneficial effect

When to refer

  • Persistent effusion lasting more than 3 months AND
    • audiology shows bilateral hearing loss, or
    • significant impact on child’s speech, development, social or educational status
  • Structural damage to the tympanic membrane

Essential referral info

  • Presenting complaint and reason for referral
  • Audiology report or details of audiology report
  • Detailed history including impact on speech, development and social or educational status
  • Patient details (name, age and gender)
  • Medicare number
  • Parent/carer’s name and contact details
  • Referring clinician details (name, contact details, provider number, date and length of referral)

From 1 May 2019 referral criteria will apply at CHQ. This condition has minimum demographic and essential clinical referral information that is required to be included prior to submission of the referral. Visit the CPC website for the required condition. If you are unable to provide the required “essential information” please state the reason when you submit the referral.

Helpful referral info

  • Other past medical and surgical history
  • Antenatal and perinatal history that may be relevant – prematurity, birth weight, birth trauma, or alcohol/drug use in pregnancy
  • Family history
  • Current medications and allergies
  • Immunisations
  • Examination findings – including any dysmorphic features, full ocular examination
  • Is the patient of Aboriginal or Torres Strait Islander descent?

Parent service

Otolaryngology Head and Neck Surgery

Contact details

Hospital Switchboard
(Ask for Otolaryngology (ENT) On-call Registrar)
t: 07 3068 1111