DOCSLIB.ORG

Management of Otitis Media with Effusion Vary with the Age of the Patient, the Guide Focuses on the Age Group at High Risk of Long-Term

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Management of Otitis Media with Effusion Vary with the Age of the Patient, the Guide Focuses on the Age Group at High Risk of Long-Term DOCUMENT RESUME ED 382 306 PS 022 906 TITLE Otitis Media with Effusion in Young Children. Clinical Practice Guideline, Quick Reference Guide for Clinicians,[and] Parent Guide, Consumer Version, Number 12. INSTITUTION Agency for Health Care Policy and Research (DHHS/PHS), Rockville, MD. REPORT NO AHCPR-94-0622-24 PUB DATE Jul 94 NOTE 152p. AVAILABLE FROMAHCPR Publications Clearinghouse, P.O. Box 8547, Silver Spring, MD 20907. PUB TYPE Guides Non-Classroom Use (055) Books (010) EDRS PRICE MF01/PC07 Plus Postage. DESCRIPTORS Child Health; Clinical Diagnosis; *Hearing (Physiology); Hearing Conservation; Hearing Impairments; *Infants; Medical Services; *Toddlers IDENTIFIERS *Otitis Media ABSTRACT Otitis media with effusion and its related hearing loss have been associated with delayed language development, particularly it the disease is recurrent or of long duration, although available data are insufficient to establish a causal linkage. This guide presents recommendations based on extensive reviews of the relevant medical and health-related literature and on expert opinion and consensus of the interdisciplinary panel convened to develop the guide. Because the prevalence, incidence, and management of otitis media with effusion vary with the age of the patient, the guide focuses on the age group at high risk of long-term effects, ages 1 through 3. Recommendations are given for diagnosis and hearing evaluation; control of environmental fat:tors; and sequencing of management interventions, including observation, use of antibiotics or other medications, and the appropriateness and time of surgery. Included are companion quick reference guides: "Managing Otitis Media with Effusion it Young Children" for clinicians; and "Middle Ear Fluid in Young Children" for parents. Contains a glossary and 158 references. (HTH) *********************************************************************** Reproductions supplied by EDRS are the best that can be made from the original document. *********************************************************************** U S DEPARTMENT OFEDUCATION Off*, of Educalmnal Reaarch andImprovement EDUCATIONAL RESOURCESINFORMATION CENTER (ERIC) This document has beenreproduced as recerved born the person ororganization II onginating It O Minor changes have beenmade to improve reproduction quality al Points of view or opinionsstated in this document do not necessarilyrepresent official OER1 position or policy 4 - ti "PERMISSION TO REPRODUCE THI 11/4 MATERIAL HAS BEEN GRANTED B ti TO THE EDUCATIONAL RESOURCES INFORMATION CENTER (ERIC)" Do. .0' 0.. BEST COPY AVAILABL The Agency for Health Care Policyand Research (AHCPR) was established in December 1989 under PublicLaw 101-239 (Omnibus Budget Reconciliation Act of 1989) toenhance the quality, appropriateness, and effectiveness of health careservices and access to these services. AHCPR carries out itsmission by conducting and supporting general health services research,including medical effectiveness research, facilitating development ofclinical practice guidelines, and disseminating research findings and guidelines tohealth care providers, policymakers, and the public. The legislation also established withinAHCPR the Office of the Forum for Quality and Effectivenessin Health Care (the Forum). The Forum has primary responsibility forfacilitating the development, periodic review, and updating of clinical practiceguidelines. The guidelines will assist practitioners in the prevention,diagnosis, treatment, and management of clinical conditions. Other AHCPR components includethe following. The Center for Medical Effectiveness Research hasprincipal responsibility for patient outcomes research and studiesof variations in clinical practice.The Center for General Health Services ExtramuralResearch supports research on primary care, the cost and financingof health care, and access to carefor underserved and rural populations. TheCenter for General Health Services Intramural Research uses large data setsfor policy research on national health care expenditures andutilization, hospital studies, and long-term care. The Center forResearch Dissemination and Liaisonproduces and disseminates findings from AHCPR-supportedresearch, including guidelines, and conducts research ondissemination methods. The Office of Health Technology Assessmentresponds to requests from Federalhealth programs for assessmentof health care technologies. TheOffice of Science and Data Development developsspecialized data bases and enhances techniques for using existing databases for patient outcomes research. Guidelines are available in formatssuitable for health care practitioners, the scientific community,educators, and consumers. AHCPR invites comments andsuggestions from users for consideration in development and updatingof future guidelines. Please send written comments to Director,Office of the Forum for Qualityand Effectiveness in Health Care, AHCPR,Willco Building, Suite 310, 6000 Executive Boulevard,Rockville, MD 20852. 3 BEST COPY AVAILABLE e Clinical Practice Guideline Number 12 Otitis Media with Effusion in Young Children Otitis Media Guideline Panel Sylvan E. Stool. MD (Co-Chair) Alfred 0. Berg, MD, MPH (Co-Chair) Stephen Berman, MD Cynthia J. Carney James R. Cooley, MD Larry Culpepper, MD, MPH Roland D. Eavey, MD Lynne V. Feagans, PhD Terese Finitzo, PhD, CCC/A Ellen M. Friedman, MD Janice A. Goertz, RN, BS, CPNP Allan J. Goldstein, MD Kenneth M. Grundfast, MD Douglas G. Long, MD Loretta L. Macconi, RN, MSN, CRNP LoBirtha Melton, RN, BSN, MPA Joanne Erwick Roberts, PhD, CCC-SLP & AUD Jessie L. Sherrod, MD, MPH Jane E. Sisk, PhD U.S. Department of 14ealth and Human Services Public Health Service Agency for Health Care Policy and Research Rockville, Maryland AHCPR Publication No. 94-0622 4 July 1994 Guideline Development and Use Guidelines are systematically ueveloped statements to assist practitioner and patient decisions about appropriate health care forspecific clinical conditions. This guideline was written by an independent multidisciplinary' panel of private-sector clinicians e.nd other experts convened by the Agency for Health Care Policy and Research(AHCPR). The panel employed explicit, science-based methods and expertclinical judgment to develop specific statements on patient assessment and management for the clinical condition selected. Extensive literature searches were conducted and critical reviewsand syntheses were used to evaluate empirical evidence and significant outcomes. Peer review and field review wereundertaken to evaluate the validity, reliability, and utility of the guideline in clinical practice.The panel's recommendations are primarily based on the publishedscientific literature. When the scientific literature was incomplete orinconsistent in a particular area, the recommendations reflect the professionaljudgment of panel members and consultants. The guideline reflects the state of knowledge, current at thetime of publication. on effective and appropriate care. Given theinevitable changes in the state of scientific information and technology, periodicreview; updating, and revision will be done. We believe that the AHCPR-assisted clinical guidelineswill make positive contributions to the quality of care in the United States.We encourage practitioners and patients to usethe information provided in this Clinical Practice Guideline. The recommendations may notbe appropriate for use in all circumstances. Decisions to adopt anyparticular recommendation must be made by the practitioner in light ofavailable resources and circumstances presentedby individual patients. Linda K. Dem lo. PhD Acting Administrator Agency for Health Care Policy and Research Publication of this guideline does not necessarily represent endorsement by the U.S. Departmentof Health and Human Services. 5 Foreword The past 15 years have shown a notable increase in the number of children identified as having otitis media (inflammation of the middle ear). According to the National Center for Health Statistics, otitis media is the most common diagnosis for physician office visits by children under age 15. Office visits for otitis media increased by '150 percent between1975 and 1990, to24.5million, with children under age 15 accounting for 81 percent of the visits. Children under age2had the highest rate of visits to physician offices for otitis media, and they also had the greatest increase in visits between1975and1990: 224percent. Otitis; media is a general term for several conditions that can affect the middle ear, ranging from acute to chronic and with or without symptoms. To follow methods for practice guideline development recommended by the Agency for Health Care Policy and Research. the topic of this Guidelinewas narrowed to the management of otitis media with effusion in an otherwise healthy child age I through 3 years with no craniofacial or neurologic abnormalities or sensory deficits. This definition permitted examination of important medical and surgical interventions and their effects on long-term outcomes. In addition, 1 through 3 years is the critical age for development of speech and language, which may be affected by otitis media with effusion. TheGuidelinedoes not apply to children younger than age12months or, unless specifically noted, to children age4 and above. Otitis media with effusion is characterized by the presence of fluid in the middle ear without signs or symptoms of infection. Otitis media with effusion has also been refereed to as noninfected middle ear effusion, secretory otitis media,
Load more

Recommended publications
  • Tympanostomy Tubes in Children Final Evidence Report: Appendices
    Health Technology Assessment Tympanostomy Tubes in Children Final Evidence Report: Appendices October 16, 2015 Health Technology Assessment Program (HTA) Washington State Health Care Authority PO Box 42712 Olympia, WA 98504-2712 (360) 725-5126 www.hca.wa.gov/hta/ [email protected] Tympanostomy Tubes Provided by: Spectrum Research, Inc. Final Report APPENDICES October 16, 2015 WA – Health Technology Assessment October 16, 2015 Table of Contents Appendices Appendix A. Algorithm for Article Selection ................................................................................................. 1 Appendix B. Search Strategies ...................................................................................................................... 2 Appendix C. Excluded Articles ....................................................................................................................... 4 Appendix D. Class of Evidence, Strength of Evidence, and QHES Determination ........................................ 9 Appendix E. Study quality: CoE and QHES evaluation ................................................................................ 13 Appendix F. Study characteristics ............................................................................................................... 20 Appendix G. Results Tables for Key Question 1 (Efficacy and Effectiveness) ............................................. 39 Appendix H. Results Tables for Key Question 2 (Safety) ............................................................................
    [Show full text]
  • Clinical Review Otitis Media
    Clinical Review Otitis Media Jack Froom, MD Stony Brook, New York The spectrum of otitis media includes acute and chronic forms, each of which can be either suppurative of nonsuppurative. In the usual clinical setting distinctions between these several forms can be difficult. Determination of accurate incidence fig­ ures is impeded by the unavailability of universally accepted diagnostic criteria. Risk factors include season of the year, genetic factors, race, preceding respiratory tract infections, cleft palate, and others. The effect of household size and al­ lergy are uncertain. The most common infecting organisms are Streptococcus pneumoniae and Hemophilus influenzae, al­ though in a significant number of cases either the fluid is non- pathogenic or no organisms can be isolated. The effects of several therapies are reviewed, including antibiotics, myrin­ gotomy, steroids, and middle-ear ventilating tubes. Otitis media is one of the most frequent condi­ Incidence tions treated by family physicians and pediatricians. Otitis media ranks as the ninth most frequently Yet there are no standard criteria for diagnosis, made diagnosis for all ambulatory patient visits. In artd several issues regarding therapy are contro­ 1977 it accounted for approximately 11 million vis­ versial. The use of antihistamines, decongestants, its to physicians in the United States.1 For approx­ myringotomy, and even antibiotics are matters of imately one half of these visits the problem was contention, and the current roles of tympanometry new. Although these data give some indication of and tympanostomy tubes need clarification. The the ubiquitous nature of the problem, they do not purpose of this paper is to provide recommenda­ permit calculation of annual incidence by age and tions for diagnosis and management based on re­ sex.
    [Show full text]
  • Management of Acute Otitis Media: Update
    Evidence Report/Technology Assessment Number 198 Management of Acute Otitis Media: Update Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 540 Gaither Road Rockville, MD 20850 www.ahrq.gov Contract No. HHSA 290-2007-10056-I Prepared by: RAND Corporation, Santa Monica, CA 90407 Investigators Paul G. Shekelle, M.D., Ph.D. Glenn Takata, M.D., M.S. Sydne J. Newberry, Ph.D. Tumaini Coker, M.D. Mary Ann Limbos, M.D., M.P.H. Linda S. Chan, Ph.D. Martha M. Timmer, M.S. Marika J. Suttorp, M.S. Jason Carter, B.A. Aneesa Motala, B.A. Di Valentine, J.D. Breanne Johnsen, B.A. Roberta Shanman, M.L.S. AHRQ Publication No. 11-E004 November 2010 This report is based on research conducted by the RAND Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. HHSA 290-2007-10056-I). The findings and conclusions in this document are those of the author(s), who are responsible for its content, and do not necessarily represent the views of AHRQ. No statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services. The information in this report is intended to help clinicians, employers, policymakers, and others make informed decisions about the provision of health care services. This report is intended as a reference and not as a substitute for clinical judgment. This report may be used, in whole or in part, as the basis for the development of clinical practice guidelines and other quality enhancement tools, or as a basis for reimbursement and coverage policies.
    [Show full text]
  • Tympanometry in Clinical Practice Janet Shanks and Jack Shohet
    P1: OSO/UKS P2: OSO/UKS QC: OSO/UKS T1: OSO Printer: RRD LWBK069-09 9-780-7817-XXXX-X LWBK069-Katz-Hood-v1 October 1, 2008 11:59 CHAPTER Tympanometry in Clinical Practice Janet Shanks and Jack Shohet HISTORY AND DEVELOPMENT tic impedance instrument to allow for variation in ear-canal ± OF TYMPANOMETRY pressure over a range of 300 mm H2O and described the first“tympanogram”asauniformpattern“. withanalmost Two “must read” articles on the development of clinical tym- symmetrical rise and fall, attaining a maximum at pressures panometry are Terkildsen and Thomsen (1959) and Terkild- equaling middle ear pressures” (p. 413). They further noted sen and Scott-Nielsen (1960). Their interest in estimating that, “. the smallest impedance always corresponded ex- middle-ear pressure and in measuring recruitment with the actly to the zone of maximal subjective perception of the test acoustic reflex had a profound effect on the development tone” (p. 413). In other words, the probe tone was the most of clinical instruments. Each time I read these articles, I am audible and the tympanogram peaked when the pressure was struck first by the incredible amount of information in the equal on both sides of the eardrum. articles, and second, by the lack of scientific data to support In addition, these authors recognized that although the their conclusions. Most amazing of all, however, is that the measure of interest was the acoustic immittance in the plane principles presented in these two articles have stood up for of the eardrum, for obvious reasons, the measurements had nearly 50 years, and provide the basis for commercial instru- to be made in the ear canal.
    [Show full text]
  • Otitis Media and Relevant Clinical Issues
    International Journal of Otolaryngology Otitis Media and Relevant Clinical Issues Guest Editors: Jizhen Lin, Joseph E. Kerschner, Per Cayé-Thomasen, Tetsuya Tono, and Quan-An Zhang Otitis Media and Relevant Clinical Issues International Journal of Otolaryngology Otitis Media and Relevant Clinical Issues Guest Editors: Jizhen Lin, Joseph E. Kerschner, Per Caye-Thomasen,´ Tetsuya Tono, and Quan-An Zhang Copyright © 2012 Hindawi Publishing Corporation. All rights reserved. This is a special issue published in “International Journal of Otolaryngology.” All articles are open access articles distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Editorial Board Rolf-Dieter Battmer, Germany Ludger Klimek, Germany Leonard P. Rybak, USA Robert Cowan, Australia Luiz Paulo Kowalski, Brazil Shakeel Riaz Saeed, UK P. Dejonckere, The Netherlands Roland Laszig, Germany Michael D. Seidman, USA Joseph E. Dohar, USA Charles Monroe Myer, USA Mario A. Svirsky, USA Paul J. Donald, USA Jan I. Olofsson, Norway Ted Tew fik, Canada R. L. Doty, USA Robert H. Ossoff,USA Paul Van de Heyning, Belgium David W. Eisele, USA JeffreyP.Pearson,UK Blake S. Wilson, USA Alfio Ferlito, Italy Peter S. Roland, USA B. J. Yates, USA Contents Otitis Media and Relevant Clinical Issues, Jizhen Lin, Joseph E. Kerschner, Per Caye-Thomasen,´ Tetsuya Tono, and Quan-An Zhang Volume 2012, Article ID 720363, 1 page Pneumococcal Conjugate Vaccines and Otitis Media: An Appraisal of the Clinical Trials, Mark A. Fletcher and Bernard Fritzell Volume 2012, Article ID 312935, 15 pages Mucin Production and Mucous Cell Metaplasia in Otitis Media, Jizhen Lin, Per Caye-Thomasen, Tetsuya Tono, Quan-An Zhang, Yoshihisa Nakamura, Ling Feng, Jianmin Huang, Shengnan Ye, Xiaohua Hu, and Joseph E.
    [Show full text]
  • OTITIS MEDIA GUIDELINES for ABORIGINAL and TORRES STRAIT ISLANDER CHILDREN Citation and Links to OM App Download Leach AJ, Morris P, Coates HLC, Et Al
    2020 OTITIS MEDIA GUIDELINES FOR ABORIGINAL AND TORRES STRAIT ISLANDER CHILDREN Citation and links to OM app download Leach AJ, Morris P, Coates HLC, et al. Otitis media guidelines for Australian Aboriginal and Torres Strait Islander children: summary of recommendations. Med J Aust 2021; [in press] Menzies School of Health Research (2020) Otitis Media Guidelines for Aboriginal and Torres Strait Islander children (version 1.1) [Mobile app]. App Store. https://apps.apple.com/au/app/otitis-media-guidelines/id1498170123 AND (version 1.0.23) [Mobile app]. Google Play. https://play.google.com/store/apps/details?id=com.otitismediaguidelines.guidelines Desktop version is available at http://otitismediaguidelines.com Copyright Apart from rights to use as permitted by the Paper-based publications Copyright Act 1968 or allowed by this copyright © Menzies School of Health Research 2020 notice, all other rights are reserved and you are not This work is copyright. You may reproduce the whole allowed to reproduce the whole or any part of this or part of this work in unaltered form work in any way (electronic or otherwise) without for your own personal use or, if you are part of first being given the specific written permission an organisation, for internal use within your from the Menzies School of Health Research to do organisation, but only if you or your organisation do so. Requests and inquiries concerning reproduction not use the reproduction for any commercial and rights are to be sent to the Communications purpose and retain this copyright notice and all Team, Menzies School of Health Research, PO disclaimer notices as part of that reproduction.
    [Show full text]
  • Mcmaster Otolaryngology-Head and Neck Surgery Overall Goals & Objectives & Competencies Canmeds 2015 Residency Five-Year Educational Program
    McMaster Otolaryngology-Head and Neck surgery Overall Goals & Objectives & Competencies CanMEDS 2015 Residency Five-year Educational Program _____________________________________________________________ Overview Upon completion of the 5-year educational residency program, the graduate surgeon will be competent to function as a consultant in Otolaryngology-Head and Neck Surgery and will be eligible for the Fellow Examination of the Royal College of Physicians and Surgeons of Canada. Specifically, in order to complete the 5-year educational residency program and be eligible for the Royal College’s certification examination, a resident must: 1. Successfully complete the 2-year Royal College Surgical Foundations curriculum 2. Successfully complete the Surgical Foundations examination 3. Obtain a Confirmation of Completion of Training from an accreditated program in Otolaryngology-Head and Neck Surgery 4. Participate in a scholarly project related to the Specialty Once all of the above requirements and the Royal College of certification examinations are successfully completed, the resident will attein the Royal College Certification in Otolaryngology-Head and Neck Surgery. Residents will develop clinical competence of detailed knowledge of the scientific rational for the medical and surgical management of Otolaryngology-Head and Neck conditions in the following domains: Head and Neck Surgery Pediatric Otolaryngology Facial Plastic and Reconstructive Surgery Rhinology Laryngology Otology Neurotology General Otolaryngology 1 Residents should have a sound knowledge of the components in Neurosurgery, Plastic Surgery, Anesthesia, Facial Trauma and Oral/Maxillofacial Surgery, and other specialties that relate to the Otolaryngology-Head and Neck Surgery specialty. Residents will collaborate with other physicians such as anesthesiologists, radiation and medical oncologists, intensivists, emergency physicians, respiralogists, pediatricians and other surgical specialists.
    [Show full text]
  • Diseases of the Ear Nose and Throat (ENT)
    STANDARD TREATMENT GUIDELINES Diseases of the Ear Nose and Throat (ENT) DEPARTMENT OF HEALTH AND FAMILY WELFARE GOVERNMENT OF KERALA STANDARD TREATMENT GUIDELINES IN ENT Four sections Section I Common diseases of EAR Section II Common diseases of Nose Section III Common diseases of Throat Section IV ENT emergencies Committee for development of Standard Treatment guidelines ENT CONVENOR Dr. Suchit Roy B R Professor & HOD of ENT, Government Medical College, Thrissur MEMBERS Dr. Satheesh S, Professor & HOD of ENT, GMC, Thiruvananthapuram Dr. Sunil Kumar K P, Professor of ENT, GMC, Kozhikode Dr. Venugopal M, Professor, GMC, Thiruvananthapuram Dr. Shibu George, Professor & HOD of ENT, GMC, Kottayam Dr. Sadarudheen Ahmed, Professor & HOD, GMC Eranakulam Dr. Herman Guild M John, Professor & HOD, GMC Alappuzha Dr. Thulaseedharan S, Additional Professor & HOD, GMC, Kollam Dr. Suma Radhakrishnan, Additional Professor of ENT, GMC, Manjeri, Dr. Binu Raju George, Associate Professor, GMC, Thrissur Dr. Susan James, Associate Professor of ENT, GMC,Thiruvananthapuram Dr. Sindhu V Nath, Associate Professor of ENT, GMC, Thiruvananthapuram Dr. Salima Rema Windsor, Associate Professor of ENT, GMC, Kollam Dr. Divya G M, Assistant Professor of ENT, GMC, Kozhikode Dr. Salil Kumar K, Principal, SUT MC, Thiruvananthapuram Dr. Paul Samuel, Sr Consultant, Cosmopolitan Hospital, Thiruvananthapuram & Secretary, AOI, Thiruvananthapuram Chapter, Kerala State EXTERNAL EXPERT Dr. Rupa Vedantam, Professor & HOD, CMC Vellore “Driven by the inspiration drawn from Shri. Rajeev Sadanandan IAS, Additional Chief Secretary, Department of Health and Family Welfare, Government of Kerala, the process of preparation of Standard Treatment Guidelines (STG) was initiated by the Director of Medical Education Dr. Remla Beevi A.
    [Show full text]
  • Otolaryngology – Head and Neck Surgery Competencies
    Otolaryngology – Head and Neck Surgery Competencies 2017 VERSION 1.0 Effective for residents who enter training on or after July 1st 2017. DEFINITION Otolaryngology – Head and Neck Surgery is the surgical specialty concerned with the screening, diagnosis, and management of medical and surgical disorders of the ear, the upper aerodigestive tract, and related structures of the face, head, and neck, including the special senses of hearing, balance, taste and olfaction. OTOLARYNGOLOGY – HEAD AND NECK SURGERY PRACTICE The practice of Otolaryngology - Head and Neck Surgery (Oto – HNS) entails the provision of medical and surgical care to patients of all ages, in both academic and community settings. Otolaryngology – Head and Neck Surgeons manage the medical and surgical aspects of a variety of patient presentations, including but not limited to: airway conditions; benign and malignant neoplasms of the head and neck; sinonasal and anterior skull base disorders; hearing, balance, and other conditions related to the external, middle and inner ear, and lateral skull base; laryngeal, voice and swallowing disorders; and conditions requiring facial plastic and reconstructive surgery of the head and neck. Oto – HNS surgeons provide initial assessment, operative and followup care, as well as chronic and longitudinal care, as applicable to their patients’ unique needs. To optimize patient care, Oto – HNS Surgeons collaborate with other physicians, including anesthesiologists, radiation and medical oncologists, respirologists, pediatricians, and other
    [Show full text]
  • Infant Hearing Loss
    ACTA OTORHINOLARYNGOLOGICA ItaLICA 2012;32:347-370 Review article Infant hearing loss: from diagnosis to therapy Official Report of XXI Conference of Italian Society of Pediatric Otorhinolaryngology Ipoacusie infantili: dalla diagnosi alla terapia Estratto dalla Relazione Ufficiale del XXI Congresso Nazionale della Società Italiana di Otorinolaringoiatria Pediatrica G. PALUDETTI, G. CONTI, W. DI NARDO, E. DE CORSO, R. ROLESI, P.M. PICCIOTTI, A.R. FETONI Department of Head and Neck Surgery, Institute of Otorhinolaryngology, Catholic University of The Sacred Heart, Rome, Italy SUMMARY Hearing loss is one of the most common disabilities and has lifelong consequences for affected children and their families. Both conductive and sensorineural hearing loss (SNHL) may be caused by a wide variety of congenital and acquired factors. Its early detection, together with appropriate intervention, is critical to speech, language and cognitive development in hearing-impaired children. In the last two dec- ades, the application of universal neonatal hearing screening has improved identification of hearing loss early in life and facilitates early intervention. Developments in molecular medicine, genetics and neuroscience have improved the aetiological classification of hearing loss. Once deafness is established, a systematic approach to determining the cause is best undertaken within a dedicated multidisciplinary set- ting. This review addresses the innovative evidences on aetiology and management of deafness in children, including universal neonatal screening, advances in genetic diagnosis and the contribution of neuroimaging. Finally, therapy remains a major challenge in management of paediatric SNHL. Current approaches are represented by hearing aids and cochlear implants. However, recent advances in basic medi- cine which are identifying the mechanisms of cochlear damage and defective genes causing deafness, may represent the basis for novel therapeutic targets including implantable devices, auditory brainstem implants and cell therapy.
    [Show full text]
  • Pathway of Competency Requirements in Otolaryngology - Head and Neck Surgery (2017)
    PATHWAY OF COMPETENCY REQUIREMENTS IN OTOLARYNGOLOGY - HEAD AND NECK SURGERY (2017) 2017 VERSION 1.0 Effective for residents who enter training on or after July 1st 2017 MEDICAL EXPERT MILESTONES: RESIDENCY Transition to discipline Foundations of discipline Core of discipline Transition to practice 1. Practice medicine within their defined scope of practice and expertise Comment [FV2]: TTP 1 ab, TTP 2 Demonstrate compassion and Demonstrate a 1.1. Demonstrate a a commitment to high-quality commitment to high- commitment to high- care and for patients quality care of their quality care of their Comment [FV1]: F 9 patients patients Explain how the Intrinsic Demonstrate the application Integrate the CanMEDS Intrinsic 1.2. Integrate the CanMEDS Roles need to be integrated of the CanMEDS Intrinsic Roles into their practice of Intrinsic Roles into their in practice of Otolaryngology Roles when managing Otolaryngology – Head and Neck practice of – Head and Neck Surgery to patients under supervision Surgery Otolaryngology – Head deliver optimal patient care and Neck Surgery Comment [FV3]: C 11 a Comment [FV40]: TTP 2 , TTP 3 , TTP 6 1.3. Demonstrate the Apply the competencies of Consolidate the competencies of Comment [FV4]: F 1 a, F 2 a, F 3 a, F 4 a, competencies of Surgical Surgical Foundations Surgical Foundations F 6 , F 7ab, F 8 , F 10 a, F 11, F 12 Foundations Comment [FV28]: C 4 C 8 a , C 15 a, C 16 a, C 20 a, C 21 , C 22 a, C 25 a, C 26 Demonstrate an a , C 27 a 1.4. Apply knowledge of the Apply knowledge of clinical Apply a broad base
    [Show full text]
  • Surgical Management of Otitis Media with Effusion in Children
    Surgical management of otitis media with effusion in children Surgical management of otitis media with effusion in children National Collaborating Centre for Women’s and Children’s Health Other NICE guidelines produced by the National Collaborating Centre for Women’s and Children’s Health include: • Antenatal care: routine care for the healthy pregnant woman • Fertility: assessment and treatment for people with fertility problems • Caesarean section • Type 1 diabetes: diagnosis and management of type 1 diabetes in children and young people • Long-acting reversible contraception: the effective and appropriate use of long-acting reversible contraception • Urinary incontinence: the management of urinary incontinence in women • Heavy menstrual bleeding • Feverish illness in children: assessment and initial management in children younger than 5 years • Urinary tract infection in children: diagnosis, treatment and long-term management • Intrapartum care: care of healthy women and their babies during childbirth • Atopic eczema in children: management of atopic eczema in children from Surgical management of birth up to the age of 12 years Surgical management of Guidelines in production include: • Antenatal care (update) otitis media with effusion • Diabetes in pregnancy • Induction of labour (update) • Surgical site infection • Diarrhoea and vomiting in children under 5 in children • When to suspect child maltreatment • Meningitis and meningococcal disease in children • Neonatal jaundice • Idiopathic constipation in children • Hypertension in pregnancy Enquiries regarding the above guidelines can be addressed to: National Collaborating Centre for Women’s and Children’s Health King’s Court Fourth Floor 2–16 Goodge Street London W1T 2QA [email protected] A version of this guideline for parents/carers and the public is available from the NICE website (www.nice.org.uk/CG060) or from the NHS Response Line (0870 1555 455); quote reference Clinical Guideline number N1462.
    [Show full text]