Follow-up care after grommet insertion in children: Review article

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• 作者：Zahir Mughal^a ; ^{zahir5019@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Vijay Thirunavukarasu^a ; ^{teeveeraj@yahoo.com" class="auth_mail" title="E-mail the corresponding author} ; Adnan Darr^b ; ^{adnandarr@doctors.org.uk" class="auth_mail" title="E-mail the corresponding author} ; Mudit Jindal^a ; ^{mudit.jindal@dgh.nhs.uk" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Grommet insertion ; Middle ear ventilation tube ; Appointments ; Follow-up
• 刊名：International Journal of Pediatric Otorhinolaryngology
• 出版年：2016
• 出版时间：September 2016
• 年：2016
• 卷：88
• 期：Complete
• 页码：25-29
• 全文大小：220 K

文摘

Grommet insertion is a common procedure in children. A lengthy otolaryngology follow-up can have an adverse impact on clinic waiting times, new patient appointment availability, and pecuniary disadvantage for the hospital.

Objective of review

To consolidate research and opinion concerning follow-up care following grommet insertion in a pediatric population.

Search strategy

The literature between January 1990 and September 2015 was searched on MEDLINE (Ovid), Google Scholar, PubMed and Web of Science databases.

Results

Guidelines and consensus of opinion from the United States advocate that an initial post-operative review should take place within 4 weeks, and subsequent appointments every 6 months until grommet extrusion. Recent audit reports from the United Kingdom have shown that some groups arrange their first post-operative review at 3 months, and subsequent appointments vary considerably from no further follow-up to up to 24 months. Up to 75% of follow-up appointments were scheduled despite normal audiometry and clinical findings after grommet insertion, suggesting a large cohort of patients may undergo unnecessary specialist clinic reviews. General practioners (GP), audiologists or specialist nurses are potential alternative providers of regular reviews to ensure normal hearing thresholds and an adequate tympanic membrane healing course.

Conclusion

Follow-up schedules are largely driven by consensus of opinion. A significant number of follow-up appointments in otolaryngology clinic appear to be redundant. Recently attention has been drawn to earlier discharge from otolaryngology clinic with subsequent follow-up in less resource and cost intensive clinics coordinated by GPs, audiologist or nurses, which may help alleviate some outpatient workload on acute hospital trusts.