{ "schema_version": 1, "kind": "condition", "id": "otitis-media-with-effusion", "name": "Otitis Media with Effusion (Glue ear)", "category": "chronic", "sources": "Otitis Media With Effusion - StatPearls (NCBI Bookshelf NBK538293) - https://www.ncbi.nlm.nih.gov/books/NBK538293/: \"For most children diagnosed with OME, conservative treatment with watchful waiting is recommended within the first 3 months of diagnosis.\" and \"Autoinsufflation involves forcing air from the nose and throat into the middle ear to equalize pressure and promote drainage.\" · No labelled dose - isotonic saline irrigation, used as often as it helps", "review_status": "reviewed", "verified_against": "Otitis Media With Effusion - StatPearls (NCBI Bookshelf NBK538293) - https://www.ncbi.nlm.nih.gov/books/NBK538293/: \"For most children diagnosed with OME, conservative treatment with watchful waiting is recommended within the first 3 months of diagnosis.\" and \"Autoinsufflation involves forcing air from the nose and throat into the middle ear to equalize pressure and promote drainage.\" · No labelled dose - isotonic saline irrigation, used as often as it helps · Otitis Media with Effusion (Glue ear) - disease-level clinical article (otitis-media-with-effusion-full.txt)", "verified_date": "2026-08", "treatments": [ { "id": 1327, "generic": "No drug therapy in primary care (Active Observation & Autoinflation)", "line": 1, "is_adjunct": false, "form": null, "strength_mg": null, "adult_dose": "Active observation for 3 months, then reassess hearing. Consider autoinflation (blowing up a balloon through the nostril) in a child old enough to engage with it. Refer for formal hearing assessment when OME is clinically suspected.", "adult_duration": "3 months, then reassess", "dose_source": "Otitis Media With Effusion - StatPearls (NCBI Bookshelf NBK538293) - https://www.ncbi.nlm.nih.gov/books/NBK538293/: \"For most children diagnosed with OME, conservative treatment with watchful waiting is recommended within the first 3 months of diagnosis.\" and \"Autoinsufflation involves forcing air from the nose and throat into the middle ear to equalize pressure and promote drainage.\"", "rationale": "Most glue ear resolves on its own. NG233 replaced CG60 in 2023 and offers no medicine for it - the treatment is time, a hearing test, and referral if it does not settle.", "cautions": [ "Do NOT offer antibiotics for OME (NG233 1.5.2).", "Do NOT offer oral or nasal corticosteroids for OME or the hearing loss it causes (NG233 1.5.3).", "Do NOT offer antihistamines, montelukast, mucolytics, PPIs or anti-reflux drugs, or decongestants (NG233 1.5.4).", "Persistent hearing loss past 3 months needs audiometry and ENT assessment - grommets are decided there, not here.", "RED FLAG - An adult with OME on one side only is not a candidate for watchful waiting. Examine the head and neck properly, with nasopharyngoscopy and, where indicated, imaging - the question being malignancy (nasopharyngeal carcinoma above all) or other disease of the nose and nasopharynx." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Reassess hearing after 3 months in bilateral OME with hearing loss. In children who are experiencing hearing difficulties that significantly affect day-to-day living, consider intervening earlier than the 3-month reassessment.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [], "condition_id": "otitis-media-with-effusion" }, { "id": 1328, "generic": "Sodium chloride", "line": 1, "is_adjunct": true, "form": "nasal", "strength_mg": null, "adult_dose": "Instil 1-2 sprays of 0.9% nasal saline spray into each nostril 3-4 times daily", "adult_duration": "As needed for nasal comfort", "dose_source": "No labelled dose - isotonic saline irrigation, used as often as it helps", "rationale": "Salt water for a blocked nose, nothing more. It does not clear the fluid behind the eardrum and does not shorten glue ear - NICE lists no medical treatment that does.", "cautions": [ "This treats a blocked nose, not the effusion. Do not let it stand in for the hearing reassessment at 3 months.", "Saline has no licensed dose - it is salt water. Use it as often as it clears the nose." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "1-2 drops/sprays into each nostril before feeds or bedtime", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "SOFIMER 0.9% MINI ISOTONIC NASAL SPRAY 30 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "> SOFICOPHARM", "price_egp": 170.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SOFIMER 0.9% ISOTONIC NASAL SPRAY 100 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "> SOFICOPHARM", "price_egp": 290.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "POLYMER BABY ISOTONIC 0.9% NASAL SPRAY 100ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UK MEDICA LIMITED > WALFARM", "price_egp": 300.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SODIUM CHLORIDE 0.9% (EL NASR) IRRIGAATION SOLN. 3000 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NASR", "price_egp": 22.5, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PHYSIOMER NORMAL JET NASAL SPRAY 135ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "LABORATOIRE DE LA MER > STAR INTERNATIONAL COMPANY", "price_egp": 300.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PHYSIOMER BABY MIST NASAL SPRAY 115ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "LABORATOIRE DE LA MER > STAR INTERNATIONAL COMPANY", "price_egp": 400.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "UNIMER BABY 9% NASAL SOLUTION UNITDOSE 12*5ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "LDPSA > WALFARM", "price_egp": 54.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "UNIMER BABY 9% NASAL SOLUTION UNITDOSE 50*5ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "LDPSA > WALFARM", "price_egp": 150.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "otitis-media-with-effusion" } ] }