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Grommets and Myringotomy (Children)


A grommet is a very small tube that's inserted into the child's ear during surgery.

Myringotomy with or without Grommets

Prior approval from the CCG is be required before any treatment proceeds in secondary care. 

Refer to Secondary Care provider via RSS using the appropriate Prior Approval Referral Form.

Surgical treatment will only be supported in accordance with the care pathway for children with suspected otitis media with effusion (OME) in NICE Clinical Guideline CG60 (February 2008) on “Surgical Management of Otitis media with effusion in Children” Ref: http://guidance.nice.org.uk/CG60.

Referral Criteria

Section a

  • The child has had a specialist audiology and ENT assessment AND
  • The child has had persistent bilateral OME documented over a period of 3 months
  • AND one of the following:

1) The child has a hearing level in the better ear of 25-30 or worse averaged at 0.5, 1, 2 & 4kHz OR

2) The child has persistent bilateral OME with hearing loss less than 25-30dbHL where the impact of hearing loss on a child’s developmental, social or educational status is judged to be significant OR

3) The child’s worse ear averaged at 0.5, 1,2 and 4 kHz (or equivalent dBA where dNHL not available)

Section b

The child cannot undergo standard assessment of hearing thresholds where there is clinical and tympanographic evidence of persistent glue ear and where the impact of the hearing loss on a child’s development, social or educational status is judged to be significant.

Section c

The child has Down’s Syndrome or Cleft Palate and has had a specialist MDT assessment in line with NICE guidance.


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