Management of childhood otitis media with effusion by Scottish otolaryngologists.

R P Mills, W S McKerrow
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Abstract

A prospective audit of 5430 initial consultations and 1602 admissions to Scottish hospitals for surgical treatment of otitis media with effusion in childhood in ear, nose and throat departments throughout Scotland has been carried out. The results suggest that Scottish children are assessed by clinicians of appropriate experience when initially seen in outpatients and only a minority (30%) are listed for surgery following their first visit. Not all children have a hearing test at their initial clinic visit. In those cases where surgical treatment is not advised at the first visit, a policy of "watchful waiting" is preferred to medical treatment by most clinicians. Bilateral dry tap rates varied between zero in Forth Valley and 19% in Lanarkshire. Fifty one per cent of operations were carried out by consultants and only 3% by SHOs. "Best practice" for the initial management of childhood ear problems is widespread in Scotland but there is room for improvement. There is a need for review of the availability of paediatric audiology services.

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苏格兰耳鼻喉科医生对儿童中耳炎积液的处理。
对苏格兰医院在苏格兰各地耳、鼻、喉科对儿童积液中耳炎进行外科治疗的5430例初次就诊和1602例入院进行了前瞻性审计。结果表明,苏格兰儿童最初在门诊就诊时,由具有适当经验的临床医生进行评估,只有少数(30%)在第一次就诊后被列为手术。并不是所有的孩子在初次就诊时都进行听力测试。在第一次就诊时不建议进行手术治疗的情况下,大多数临床医生倾向于采取“观察等待”政策,而不是药物治疗。双边干水龙头率从福斯谷的零到拉纳克郡的19%不等。51%的行动是由顾问进行的,只有3%是由医务干事进行的。儿童耳部问题初期管理的“最佳实践”在苏格兰很普遍,但仍有改进的空间。有必要审查儿科听力学服务的可用性。
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