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Monday Panel to Preview Proposed Updated Guideline for Otitis Media With Effusion

0927-Ear InfectionA proposed clinical practice guideline for treating patients with otitis media with effusion is expected to be published in the first quarter of 2016, but it will be previewed during a Miniseminar from 7:30 to 9:00 am Monday in Ballroom C4 of the convention center.

“Clinical practice guidelines are usually considered out of date after five years, so we are well overdue on this one,” said Richard M. Rosenfeld, MD, MPH, chair of the committee that developed the guideline. “There is a lot of new evidence and new research, and this condition continues to be one of the main reasons children see physicians and have surgery. So, the Foundation thought it was important to update the guidance and share the update with the membership.”

During “Otitis Media with Effusion Update,” Dr. Rosenfeld and three panelists will explain the proposed changes from the current guideline, which was published in 2004. Attendees also will have the opportunity to provide last-minute feedback during the session, and that feedback could be incorporated into the new guideline. The condition is the number one reason infants fail hearing screens.

The proposed guideline includes new recommendations:

  • Treating newborns with otitis media with effusion, including what to expect regarding the fluid in the ears, and when it is appropriate to intervene. “We also address how to counsel the families,” Dr. Rosenfeld said. “That is not in the current guideline.”
  • Avoiding the use of topical intranasal steroid sprays. “Since the last guideline, the sprays have been studied and shown not to be effective for this condition even though they are widely used for that purpose,” he said.
  • Indications for adenoidectomy as a second surgical option in addition to inserting tympanostomy tubes. “We state for the first time that adenoidectomy is only effective for otitis media with effusion in children 4 years and older unless they have a separate indication for the surgery, such as sinus problems or they can’t breathe because their adenoids are too big,” Dr. Rosenfeld said.
  • Educating patients, counseling families, and promoting shared decision-making. Included in the proposed guideline are educational tools, frequently asked questions lists, and a decision grid to better understand the condition and its management options.
  • Documenting outcomes of managing otitis media with effusion, including if fluid disappears, hearing improves, or the quality of life improves.

During the session, the guideline content and current evidence will be presented, Dr. Rosenfeld said.

“The format is designed to create a dialogue around the guideline update and the background in developing it,” he said. “If we get some interesting feedback at the session or later in the meeting, we could potentially incorporate that into the guideline before it is published.”