Parameters favoring surgical intervention:
(1) child developmentally at-risk
(2) speech, language or academic achievement abnormal or delayed
(3) tympanic membrane structure abnormal (atelectasis, retraction pocket, thickened, hypervascular)
(4) recurrent acute otitis media
(5) imbalance, clumsiness and/or vertigo present
(6) unfavorable environmental factors (environmental cigarette smoking, group day care, childcare environment unresponsive)
(7) poor quality of life (physical symptoms, sleep disturbances, emotional distress, disability)
Children developmentally at-risk include:
(1) Down's syndrome
(2) autism disorder
(3) attention deficit hyperactivity disorder (ADHD)
(4) cleft palate
(5) craniofacial disorder
(6) sensorineural hearing loss
(7) psychomotor retardation
(8) intellectual impairment
(9) cognitive deficit
(10) problems at school
(11) other developmental disorder
A child with multiple parameters should be considered for surgical intervention. A child with none of the parameters should not be considered for surgery.
