From the Guidelines
Patients with chronic otitis media can be discharged from ENT clinic follow-up when they demonstrate complete resolution of symptoms, have a dry and intact tympanic membrane, show normal or stable hearing, and have no evidence of disease progression for at least 6 months, as guided by the principle of surveillance of chronic OME 1.
Discharge Criteria
The discharge criteria for patients with chronic otitis media include:
- Absence of otorrhea (ear discharge)
- No recurrent infections for at least 6 months
- Healed perforations or stable post-surgical outcomes
- Improved or stabilized hearing levels confirmed by audiometry, as recommended for children with OME who have persistent effusion for ≥3 mo or for OME of any duration in an at-risk child 1
- Patient understanding of warning signs requiring return to care, such as new onset of ear discharge, hearing loss, vertigo, or ear pain
Patient Education
Before discharge, patients should receive education about:
- Ear protection strategies, such as avoiding water entry into the ear during bathing or swimming using cotton balls with petroleum jelly or custom ear plugs
- The importance of seeking prompt medical attention if symptoms recur
- The natural history of OME, need for follow-up, and the possible sequelae, as emphasized in the guideline for patient education 1
Special Considerations
Some patients with permanent hearing loss or complex cases may require longer follow-up or periodic monitoring even after symptom resolution, highlighting the need for individualized care and surveillance of chronic OME 1.
From the Research
Discharge Criteria from ENT Clinic Follow-up for Chronic Otitis Media
The provided studies do not directly address the discharge criteria from ENT clinic follow-up for chronic otitis media. However, we can look at the treatment outcomes and efficacy of different antibiotics in the management of acute and chronic otitis media:
- Treatment efficacy:
- Ciprofloxacin was found to be effective in treating chronic otitis media, with a higher bacterial eradication rate compared to amoxycillin/clavulanic acid 2.
- Ceftriaxone was shown to be as effective as amoxicillin/clavulanate in treating acute otitis media in children 3, 4.
- Cefixime had comparable clinical efficacy to amoxicillin/clavulanate in treating acute otitis media, with a better adverse events profile 5.
- Discharge criteria are not explicitly mentioned in the provided studies, but we can infer that discharge from ENT clinic follow-up may be considered when:
- Symptoms have resolved or significantly improved.
- Infection has been eradicated, as evidenced by negative culture results or clinical assessment.
- Patient has completed the prescribed treatment course and shown a satisfactory response.
It is essential to note that the provided studies focus on the treatment of acute and chronic otitis media, rather than the discharge criteria from ENT clinic follow-up. Therefore, the information provided is not directly relevant to answering the question, and more specific studies on discharge criteria would be needed to provide a definitive answer.