Impact of effective health care bulletin on treatment of persistent glue ear in children : time series analysis.

Abstract

During the 1980s, surgery for chronic otitis media with effusion (glue ear) increased greatly without obvious reason.1 "Dry taps"absence of effusion upon incisionwere common, probably because the surgery was performed without the surgeon confirming that the condition had not already resolved.2 An Effective Health Care bulletin on the treatment of persistent glue ear in children was distributed nationally to NHS decision makers in 1992.2 Based on systematic review, the bulletin concluded that surgery should be restricted to children with an extended period of substantial hearing impairment, with persistence and severity established by watchful waiting. We evaluated surgery rates before and after distribution of the bulletin.