International consensus (ICON) on management of otitis media with effusion in children
Otitis media with effusion (OME) is a common childhood disease defined as the presence of liquid in the middle ear without signs or symptoms of acute ear infection. Children can be impacted mainly with hearing impairment and/or co-occurring recurrent acute otitis media (AOM) thus requiring treatment...
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Published in | European annals of otorhinolaryngology, head and neck diseases Vol. 135; no. 1; pp. S33 - S39 |
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Main Authors | , , , , , , , |
Format | Journal Article Conference Proceeding |
Language | English |
Published |
France
Elsevier Masson SAS
01.02.2018
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Abstract | Otitis media with effusion (OME) is a common childhood disease defined as the presence of liquid in the middle ear without signs or symptoms of acute ear infection. Children can be impacted mainly with hearing impairment and/or co-occurring recurrent acute otitis media (AOM) thus requiring treatment. Although many meta-analyses and national guidelines have been issued, management remains difficult to standardize, and use of surgical and medical treatments continue to vary. We convened an international consensus conference as part of the 2017 International Federation of Oto-rhino-laryngological Societies Congress, to identify best practices in OME management. Overall, regional differences were minor and consensual management was obtained on several important issues. At initial assessment, although a thorough medical examination is necessary to seek reflux, allergy or nasal obstruction symptoms; an age-appropriate auditory test is the only assessment required in children without abnormal history. Non-surgical treatments poorly address the underlying problem of an age-dependent dysfunctional Eustachian tube; auto-inflation seems to be the only beneficial, low-risk and low-cost non-surgical therapy. There was a clear international recommendation against using steroids, antibiotics, decongestants or antihistamines to treat OME, because of side-effects, cost issues and no convincing evidence of long-term effectiveness. Decisions to insert tympanostomy ventilation tubes should be based on an auditory test but also take into account the child's context and overall hearing difficulties. Tubes significantly improve hearing and reduce the number of recurrent AOM with effusion while in place. Adjuvant adenoidectomy should be considered in children over four years of age, and in those with significant nasal obstruction or infection. |
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AbstractList | Otitis media with effusion (OME) is a common childhood disease defined as the presence of liquid in the middle ear without signs or symptoms of acute ear infection. Children can be impacted mainly with hearing impairment and/or co-occurring recurrent acute otitis media (AOM) thus requiring treatment. Although many meta-analyses and national guidelines have been issued, management remains difficult to standardize, and use of surgical and medical treatments continue to vary. We convened an international consensus conference as part of the 2017 International Federation of Oto-rhino-laryngological Societies Congress, to identify best practices in OME management. Overall, regional differences were minor and consensual management was obtained on several important issues. At initial assessment, although a thorough medical examination is necessary to seek reflux, allergy or nasal obstruction symptoms; an age-appropriate auditory test is the only assessment required in children without abnormal history. Non-surgical treatments poorly address the underlying problem of an age-dependent dysfunctional Eustachian tube; auto-inflation seems to be the only beneficial, low-risk and low-cost non-surgical therapy. There was a clear international recommendation against using steroids, antibiotics, decongestants or antihistamines to treat OME, because of side-effects, cost issues and no convincing evidence of long-term effectiveness. Decisions to insert tympanostomy ventilation tubes should be based on an auditory test but also take into account the child's context and overall hearing difficulties. Tubes significantly improve hearing and reduce the number of recurrent AOM with effusion while in place. Adjuvant adenoidectomy should be considered in children over four years of age, and in those with significant nasal obstruction or infection. |
Author | Couloigner, V. Peer, S. Jia, H. Calmels, M.-N. Teissier, N. Simon, F. Haggard, M. Rosenfeld, R.M. |
Author_xml | – sequence: 1 givenname: F. surname: Simon fullname: Simon, F. organization: Department of Pediatric Otolaryngology, hôpital Necker-Enfants–Malades, Paris-Descartes University, AP–HP, 149, rue de Sèvres, 75015 Paris, France – sequence: 2 givenname: M. surname: Haggard fullname: Haggard, M. organization: Department of Psychology, Cambridge University, Downing Street, Cambridge CB2 3EB, United Kingdom – sequence: 3 givenname: R.M. surname: Rosenfeld fullname: Rosenfeld, R.M. organization: Department of Otolaryngology, SUNY Downstate Medical Center, 450, Clarkson avenue, MSC 126, Brooklyn, NY 11203, United States of America – sequence: 4 givenname: H. surname: Jia fullname: Jia, H. organization: Department of Otolaryngology, Shanghai Ninth People's Hospital & Shanghai Jiaotong University School of Medicine, 639, Zhizaoju Road, Shanghai 200011, China – sequence: 5 givenname: S. surname: Peer fullname: Peer, S. organization: Department of Pediatric Otolaryngology, Red Cross War Memorial Children's Hospital, University of Cape Town,, Rondebosch, Cape Town 7700, South Africa – sequence: 6 givenname: M.-N. surname: Calmels fullname: Calmels, M.-N. organization: Department of Otolaryngology, Purpan Hospital, Paul-Sabatier-Toulouse-3 University, CHU de Toulouse, 1, place du Dr-Baylac, 31059 Toulouse, France – sequence: 7 givenname: V. surname: Couloigner fullname: Couloigner, V. organization: Department of Pediatric Otolaryngology, hôpital Necker-Enfants–Malades, Paris-Descartes University, AP–HP, 149, rue de Sèvres, 75015 Paris, France – sequence: 8 givenname: N. surname: Teissier fullname: Teissier, N. email: natacha.teissier@aphp.fr organization: Department of Pediatric Otolaryngology, hôpital Robert-Debré, Paris-Diderot University, AP–HP, 48, boulevard Sérurier, 75019 Paris, France |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/29398506$$D View this record in MEDLINE/PubMed |
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Keywords | Otitis media IFOS International consensus Effusion OME Seromucous otitis |
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Title | International consensus (ICON) on management of otitis media with effusion in children |
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