Reviewed on : 2 Feb 2022

Reviewed by : GP Gateway Editor

Expires : 2 Feb 2024

Grommets / Myringotomy for adults

Indication: Otitis media with effusion (OME)

Referral Criteria

Surgical treatment for adults to be supported subject to policy criteria.

Myringotomy With/Without Grommets for Otitis Media will ONLY be funded for adults meeting at least one of the following criteria:

• Persistent hearing loss for at least 3 months with hearing levels of 25dB or worse on pure tone audiometry; OR
• Recurrent acute otitis media – 5 or more episodes in the preceding 12 month period; OR
• Eustachian tube dysfunction causing pain; OR
• Atelectasis of the tympanic membrane where development of cholesteatoma or erosion of the ossicles is a risk; OR
• As a conduit for drug delivery direct to the middle ear; OR
• In the case of conditions (e.g. nasopharyngeal carcinoma, ethmoidal cancer, maxillectomy, olfactory neuroblastoma, sinonasal cancer and complications relating to its treatment (including radiotherapy)) if judged that the benefit/s of treatment outweigh the risk/s by the responsible clinician; OR
• Part of a more extensive procedure at consultant’s discretion, such as tympanoplasty, acute otitis media with facial palsy.

Prior approval from the Clinical Commissioning Group will be required before any treatment proceeds in secondary care unless an alternative contract arrangement has been agreed with the CCG that does not necessitate the requirement of prior approval before treatment.