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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 in NICE Clinical Guideline CG60 (February 2008) on “Surgical Management of Otitis media with effusion in Children” Ref: http://guidance.nice.org.uk/CG60.

Myringotomy With/Without Grommets for Otitis Media will ONLY be funded in the following circumstances:

  • The child must have had specialist audiology and ENT assessment


  • The child has persistent bilateral OME documented over a period of 3 months


  • A hearing level in the better ear of 25-30 dBHL or worse averaged at 0.5, 1, 2 & 4kHz


  • Persistent bilateral OME with hearing loss lass than 25-30dbHL where the impact of hearing loss on a child’s developmental, social or educational status is judged to be significant


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

Also, children should ONLY be considered for grommet insertion if:

  • 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.
  • 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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