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This is a summary of the NHS Devon commissioning policy for Myringotomy/grommets and adjuvant adenoidectomy for the management of otitis media in children under 12 years.
Children over 12 years – Myringotomy with or without ventilation tubes (grommets) in adults and children aged 12 years and older commissioning policy
Myringotomy/grommets for the management of otitis media in children under 12 years will only be funded if the following criteria are met:
Otitis media with effusion (OME)
Persistent OME with documented hearing loss on 2 occasions assessed at intervals of 3 months or more* AND the child suffers from either (a) or (b):
a) Persistent bilateral OME with a hearing level in the better ear greater than 20 dBHL (averaged at 0.5, 1, 2, and 4 kHz), confirmed over three months†.
b) Persistent unilateral OME with a hearing level in the better ear greater than 20 dBHL (averaged at 0.5, 1, 2, and 4 kHz), confirmed over three months AND the impact of the hearing loss on a child’s developmental, social, or educational status is judged to be significant†.
OR
Children who cannot undergo standard assessment of hearing thresholds where there is clinical and tympanographic evidence of persistent OME and the impact of the hearing loss on a child’s developmental, social, or educational status is judged to be significant†.
*During the watchful waiting period, advice on educational and behavioural strategies to minimise the effects of hearing loss should be offered. The child’s hearing should be re-tested at the end of this time.
†Good practice point: Ensure OME has not resolved once a date of surgery has been agreed, with tympanometry as a minimum.
Recurrent acute otitis media
5 or more documented episodes of acute otitis media in the same ear in the previous 12 months.
Adenoidectomy
Adenoidectomy should only be offered adjunctive to myringotomy/grommets when one or more of the following clinical criteria are met:
Guidance notes on exceptionality
Where the circumstances of treatment for an individual patient do not meet the criteria described above exceptional funding can be sought. Individual cases will be reviewed by the appropriate panel of the ICB upon receipt of a completed application from the patient’s GP, consultant, or clinician. Applications cannot be considered from patients personally.
Individual Funding Requests (IFRs) - North & East (devonformularyguidance.nhs.uk)
Individual Funding Requests (IFRs) - South & West (devonformularyguidance.nhs.uk)
Publication date: October 2019
Updated: November 2024