Otitis media with effusion (OME) in primary care: follow-up protocol
Abstract Introduction and objective: With the intention of improving the quality of care of children with otitis media with effusion (OME), the pediatricians of primary care (PAP) have been provided procedures diagnostic and training media, establishing a rule of consensus action. In this paper we present the Protocol developed for the monitoring of OME in children. Method: A team of pediatricians and otolaryngologists from the same Healthcare Area, who have worked to achieve this consensus. Through the published guides and review of the literature on OME, we find his best adaptation to our environment. Results: We expose the necessary steps for the diagnosis, follow-up, referral and documentation of OME in children. Discussion: A correct therapeutic intervention for OME in children involves documenting patient characteristics and clinical findings of the pneumatic otoscopy and tympanometry, perform periodic and vigilant monitoring of potential disruptions, know and apply the reasons for referral to specialized care and maintaining good communication between pediatricians and ENT. Conclusions: The agreement between pediatricians and ENT has helped establish a joint guide of action in children for OME, which together with the improvement of diagnosis, will result in a greater degree of efficiency in the childhood care of OME.
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Benito-Orejas JI, Bachiller-Luque R, Garrido-Redondo M, Velasco-Vicente JV, Mata-Jorge M, Ramírez-Cano B. Uso de la timpanometría en atención primaria. Rev Pediatr Aten Primaria. 2016;18:e37-e46.
Benito-Orejas JI, Garrido-Redondo M, Velasco-Vicente JV, Mata-Jorge M, Bachiller-Luque R, Ramírez-Cano B. Extracción de cera de los oídos. Rev Pediatr Aten Primaria. 2015;17:e223-e231. http://dx.doi.org/10.4321/S1139-76322015000400021
Benito-Orejas JI, Velasco-Vicente JV, Mata-Jorge M, Bachiller-Luque R, Garrido-Redondo M, Ramírez-Cano B. Otoscopia neumática. Rev Pediatr Aten Primaria. 2015;17:e279-e288. http://dx.doi.org/10.4321/S1139-76322015000500017
Coyte PC, Croxford R, Asche CV, To T, Feldman W, Friedberg J. Physician and population determinants of rates of middle-ear surgery in Ontario. JAMA. 2001;286:2128-35. http://dx.doi.org/10.1001/jama.286.17.2128
Haldis TA, Blankenship JC. Telephone reporting in the consultant-generalist relationship. J Eval Clin Pract. 2002;8:31-5. http://dx.doi.org/10.1046/j.1365-2753.2002.00313.x
Hoffman HJ, Daly KA, Bainbridge KE, Casselbrant ML, Homøe P, Kvestad E, et al. Panel 1: Epidemiology, natural history, and risk factors. Otolaryngol Head Neck Surg. 2013;148(4 Suppl):E1-E25. http://dx.doi.org/10.1177/0194599812460984
Kuyvenhoven MM, De Melker RA. Referrals to specialists. An exploratory investigation of referrals by 13 General Practitioners to medical and surgical departments. Scand J Prim Health Care. 1990;8:53-7. http://dx.doi.org/10.3109/02813439008994929
Marchant CD, Shurin PA, Turczyk VA, Wasikowski DE, Tutihasi MA, Kinney SE. Course and outcome of otitis media in early infancy: a prospective study. J Pediatr. 1984;104:826-31. http://dx.doi.org/10.1016/S0022-3476(84)80475-8
MRC Multi-centre Otitis Media Study Group. Risk factors for persistence of bilateral otitis media with effusion. Clin Otolaryngol Allied Sci. 2001;26:147-56. http://dx.doi.org/10.1046/j.1365-2273.2001.00445.x
Paradise JL, Rockette HE, Colborn DK, Bernard BS, Smith CG, Kurs-Lasky M, et al. Otitis media in 2253 Pittsburgh-area infants: prevalence and risk factors during the first two years of life. Pediatrics. 1997;99:318-33. http://dx.doi.org/10.1542/peds.99.3.318
Reichman S. The generalist's patient and the subspecialist. Am J Manag Care. 2002;8:79-82.
Rosenfeld RM, Culpepper L, Doyle KJ, Grundfast KM, Hoberman A, Kenna MA, et al. Subcommittee on Otitis Media with Effusion; American Academy of Family Physicians; American Academy of Otolaryngology--Head and Neck Surgery. Clinical practice guideline: Otitis media with effusion. Otolaryngol Head Neck Surg. 2004 May;130(5 Suppl):S95-118. http://dx.doi.org/10.1016/j.otohns.2004.02.002
Rosenfeld RM, Goldsmith AJ, Tetlus L, Balzano A. Quality of life for children with otitis media. Arch Otolaryngol Head Neck Surg. 1997;123:1049-54. http://dx.doi.org/10.1001/archotol.1997.01900100019002
Rosenfeld RM, Kay D. Natural history of untreated otitis media. Laryngoscope. 2003;113:1645-57. http://dx.doi.org/10.1097/00005537-200310000-00004
Tos M. Epidemiology and natural history of secretory otitis. Am J Otol. 1984;5: 459-62.
Wallace IF, Berkman ND, Lohr KN, Harrison MF, Kimple AJ, Steiner MJ. Surgical treatments for otitis media with effusion: a systematic review. Pediatrics. 2014;133:296-311. http://dx.doi.org/10.1542/peds.2013-3228
Williamson I. Otitis media with effusion in children. BMJ Clin Evid. 2011;2011. pii:0502.
Williamson IG, Dunleavey J, Bain J, Robinson D. The natural history of otitis media with effusion--a three-year study of the incidence and prevalence of abnormal tympanograms in four South West Hampshire infant and first schools. J Laryngol Otol. 1994;108:930-4. http://dx.doi.org/10.1017/S0022215100128567
Benito-Orejas JI, Garrido-Redondo M, Velasco-Vicente JV, Mata-Jorge M, Bachiller-Luque R, Ramírez-Cano B. Extracción de cera de los oídos. Rev Pediatr Aten Primaria. 2015;17:e223-e231. http://dx.doi.org/10.4321/S1139-76322015000400021
Benito-Orejas JI, Velasco-Vicente JV, Mata-Jorge M, Bachiller-Luque R, Garrido-Redondo M, Ramírez-Cano B. Otoscopia neumática. Rev Pediatr Aten Primaria. 2015;17:e279-e288. http://dx.doi.org/10.4321/S1139-76322015000500017
Coyte PC, Croxford R, Asche CV, To T, Feldman W, Friedberg J. Physician and population determinants of rates of middle-ear surgery in Ontario. JAMA. 2001;286:2128-35. http://dx.doi.org/10.1001/jama.286.17.2128
Haldis TA, Blankenship JC. Telephone reporting in the consultant-generalist relationship. J Eval Clin Pract. 2002;8:31-5. http://dx.doi.org/10.1046/j.1365-2753.2002.00313.x
Hoffman HJ, Daly KA, Bainbridge KE, Casselbrant ML, Homøe P, Kvestad E, et al. Panel 1: Epidemiology, natural history, and risk factors. Otolaryngol Head Neck Surg. 2013;148(4 Suppl):E1-E25. http://dx.doi.org/10.1177/0194599812460984
Kuyvenhoven MM, De Melker RA. Referrals to specialists. An exploratory investigation of referrals by 13 General Practitioners to medical and surgical departments. Scand J Prim Health Care. 1990;8:53-7. http://dx.doi.org/10.3109/02813439008994929
Marchant CD, Shurin PA, Turczyk VA, Wasikowski DE, Tutihasi MA, Kinney SE. Course and outcome of otitis media in early infancy: a prospective study. J Pediatr. 1984;104:826-31. http://dx.doi.org/10.1016/S0022-3476(84)80475-8
MRC Multi-centre Otitis Media Study Group. Risk factors for persistence of bilateral otitis media with effusion. Clin Otolaryngol Allied Sci. 2001;26:147-56. http://dx.doi.org/10.1046/j.1365-2273.2001.00445.x
Paradise JL, Rockette HE, Colborn DK, Bernard BS, Smith CG, Kurs-Lasky M, et al. Otitis media in 2253 Pittsburgh-area infants: prevalence and risk factors during the first two years of life. Pediatrics. 1997;99:318-33. http://dx.doi.org/10.1542/peds.99.3.318
Reichman S. The generalist's patient and the subspecialist. Am J Manag Care. 2002;8:79-82.
Rosenfeld RM, Culpepper L, Doyle KJ, Grundfast KM, Hoberman A, Kenna MA, et al. Subcommittee on Otitis Media with Effusion; American Academy of Family Physicians; American Academy of Otolaryngology--Head and Neck Surgery. Clinical practice guideline: Otitis media with effusion. Otolaryngol Head Neck Surg. 2004 May;130(5 Suppl):S95-118. http://dx.doi.org/10.1016/j.otohns.2004.02.002
Rosenfeld RM, Goldsmith AJ, Tetlus L, Balzano A. Quality of life for children with otitis media. Arch Otolaryngol Head Neck Surg. 1997;123:1049-54. http://dx.doi.org/10.1001/archotol.1997.01900100019002
Rosenfeld RM, Kay D. Natural history of untreated otitis media. Laryngoscope. 2003;113:1645-57. http://dx.doi.org/10.1097/00005537-200310000-00004
Tos M. Epidemiology and natural history of secretory otitis. Am J Otol. 1984;5: 459-62.
Wallace IF, Berkman ND, Lohr KN, Harrison MF, Kimple AJ, Steiner MJ. Surgical treatments for otitis media with effusion: a systematic review. Pediatrics. 2014;133:296-311. http://dx.doi.org/10.1542/peds.2013-3228
Williamson I. Otitis media with effusion in children. BMJ Clin Evid. 2011;2011. pii:0502.
Williamson IG, Dunleavey J, Bain J, Robinson D. The natural history of otitis media with effusion--a three-year study of the incidence and prevalence of abnormal tympanograms in four South West Hampshire infant and first schools. J Laryngol Otol. 1994;108:930-4. http://dx.doi.org/10.1017/S0022215100128567
Benito-Orejas, J. I., Velasco-Vicente, J. V., Garrido-Redondo, M., Bachiller-Luque, R., Mata-Jorge, M., & Ramírez-Cano, B. (2016). Otitis media with effusion (OME) in primary care: follow-up protocol. Revista ORL, 7(4), 211–221. https://doi.org/10.14201/orl.14728
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