This pre-referral guideline covers Otitis media with effusion in children of all ages.

Initial work-up

• Usually associated with noticeable hearing loss. A middle ear effusion will be present in approximately:
  • 80% of cases at 2 weeks following  ASOM<
  • 40% at 1 month
  • 20% at 2 months
  • 10% at 3 months
• Audiology (hearing test) if hearing loss is present > 3 months.

Pre-referral treatment

• Review at 3 months – for persistent middle ear effusion or hearing loss.
• For symptomatic cases that have not resolved in 3 months, a prolonged course of antibiotics will result in resolution of a significant proportion. 

When to refer

• Child is symptomatic due to hearing loss, and this is thought likely to be present for a significant period of time in the future.
• Bring audiology test results.

Referral form (pdf)

Parent handout (pdf)

Resources

Kids Connect (RCH Primary Care Liaison)

Kids Health Info (Parent fact sheets online)

Contact information

References

Paediatric Handbook Ear, Nose and Throat Conditions, Chapter 21 (pp312-324); Robert Berkowitz and Michael Marks; Seventh Edition, Blackwell Publishing. By the staff of the Royal Children's Hospital, Melbourne, Australia