Are there any specific indications for the use of grommets in children with recurrent OME?

Indications for the use of grommets in children with recurrent otitis media with effusion (OME) include the presence of OME-related hearing loss that significantly impacts the child's developmental, social, or educational status.

Grommets (ventilation tubes) are considered primarily for managing OME-related hearing loss in children, especially when hearing loss is confirmed and persistent.

Referral to an ear, nose, and throat (ENT) specialist is recommended if hearing loss is associated with significant impact or if there are structural abnormalities of the tympanic membrane or other concerning features.

For children with recurrent acute otitis media (AOM) with middle ear effusion, grommets may also be considered, particularly if conservative measures have been ineffective and the episodes meet criteria for recurrence (e.g., three or more episodes in 6 months or four or more in 12 months).

Shared decision-making with the child’s parents or carers is essential, discussing the benefits, risks (such as perforation, tympanosclerosis, infection), and practical considerations of grommet insertion.