Paediatric post-grommets surgery review: Audiology-led clinic

Int J Pediatr Otorhinolaryngol. 2024 Aug:183:112035. doi: 10.1016/j.ijporl.2024.112035. Epub 2024 Jul 9.

Abstract

Background: Otitis media (OM) has a high prevalence in childhood, and grommet insertion is the most common surgical treatment for OM. The public health system in Australia faces considerable strains, including high demand for Ear, Nose and Throat (ENT) specialists. Extending the scope of practice for audiologists to manage post-operative care for children receiving grommets has the potential to alleviate this burden.

Methods: This non-randomised, cross-sectional study investigated the efficacy and feasibility of an audiology-led clinic for managing paediatric patients after grommet insertion at a tertiary teaching hospital in Western Australia. Senior audiologists reviewed children at 6 weeks and 10 months post-operatively, escalating care to an ENT specialist if abnormalities were observed. Children with normal hearing and patent grommets were reviewed and discharged by the audiologist.

Results: A total of 93 children were included (mean age 5.18 ± 2.25 years, range 1.59-11.46 years). At the 6-week review, 72/93 (77 %) presented with in-situ grommets and normal hearing, while 21/93 (22 %) were escalated for immediate ENT care. At the 10-month review, 54/72 (75 %) were discharged without further ENT intervention, and 18/72 (25 %) required additional ENT investigation.

Conclusion: This study demonstrated that an audiology-led follow-up clinic for post-grommet insertion is a viable option, providing efficient, high-quality care. Two-thirds of paediatric patients did not require ENT input or review post-operatively. The results support interdisciplinary models of care, which could help address challenges faced by overburdened ENT services.

MeSH terms

  • Audiology
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Feasibility Studies
  • Female
  • Humans
  • Infant
  • Male
  • Middle Ear Ventilation*
  • Otitis Media / surgery
  • Postoperative Care / methods
  • Treatment Outcome
  • Western Australia