Drug Treatment. Antibiotics and corticosteroids have not proven to be of long-term benefit and are not recommended for routine management of OME. Antihistamines and decongestants are not effective for OME, either when used alone or in combination. At present, there is no compelling evidence to indicate that allergy treatment can assist with OME management nor has a causal relationship between allergies and OME been established.
Surgery. Children may be considered candidates for surgery if they have:
OME lasting longer than 4 months that is accompanied by hearing loss.
OME that is persistent or recurrent (even if there is no hearing loss) and may put the child at risk for developmental delays or structural damage to the ear.
OME and structural damage to the eardrum or middle ear.
The decision to pursue surgery must be determined on an individual basis.
Tympanostomy tube insertion is the first choice for surgical intervention. Approximately 20 - 50% of children who undergo this procedure may have OME relapse and require additional surgery.
Adenoidectomy plus myringotomy, with or without tube insertion, is recommended as a repeat surgical procedure. Tube insertion may be advised for children younger than 4 years of age.
Adenoidectomy is not recommended as an initial procedure unless some other condition (chronic sinusitis, nasal obstruction, adenoiditis) is present.
Neither myringotomy alone or tonsillectomy is recommended for OME treatment.
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