Fiona Stanley Fremantle Hospitals Group, Perth, Western Australia, Australia; Medical School, Division of Surgery, The University of Western Australia, Perth, Australia; Curtin University, Perth, Australia.
Fiona Stanley Fremantle Hospitals Group, Perth, Western Australia, Australia.
Int J Pediatr Otorhinolaryngol. 2024 Aug;183:112035. doi: 10.1016/j.ijporl.2024.112035. Epub 2024 Jul 9.
Otitis media (OM) has a high prevalence in childhood, and grommet insertion is the most common surgical treatment for OM. The public health system in Australia faces considerable strains, including high demand for Ear, Nose and Throat (ENT) specialists. Extending the scope of practice for audiologists to manage post-operative care for children receiving grommets has the potential to alleviate this burden.
This non-randomised, cross-sectional study investigated the efficacy and feasibility of an audiology-led clinic for managing paediatric patients after grommet insertion at a tertiary teaching hospital in Western Australia. Senior audiologists reviewed children at 6 weeks and 10 months post-operatively, escalating care to an ENT specialist if abnormalities were observed. Children with normal hearing and patent grommets were reviewed and discharged by the audiologist.
A total of 93 children were included (mean age 5.18 ± 2.25 years, range 1.59-11.46 years). At the 6-week review, 72/93 (77 %) presented with in-situ grommets and normal hearing, while 21/93 (22 %) were escalated for immediate ENT care. At the 10-month review, 54/72 (75 %) were discharged without further ENT intervention, and 18/72 (25 %) required additional ENT investigation.
This study demonstrated that an audiology-led follow-up clinic for post-grommet insertion is a viable option, providing efficient, high-quality care. Two-thirds of paediatric patients did not require ENT input or review post-operatively. The results support interdisciplinary models of care, which could help address challenges faced by overburdened ENT services.
中耳炎（OM）在儿童中发病率很高，鼓膜置管术是治疗 OM 的最常见手术。澳大利亚的公共卫生系统面临着相当大的压力，包括对耳鼻喉科（ENT）专家的高需求。扩大听力学家的执业范围，管理接受鼓膜置管术的儿童的术后护理，有可能减轻这种负担。
这项非随机、横断面研究调查了在西澳大利亚州的一家三级教学医院，由听力学家主导的诊所管理鼓膜置管术后儿童的疗效和可行性。高级听力学家在术后 6 周和 10 个月对儿童进行复查，如果发现异常，将护理升级为 ENT 专家。如果听力正常且鼓膜通畅，听力学家将对儿童进行复查和出院。
共纳入 93 名儿童（平均年龄 5.18 ± 2.25 岁，范围 1.59-11.46 岁）。在 6 周复查时，93 例中有 72 例（77%）鼓膜在位且听力正常，21 例（22%）因需要立即进行 ENT 治疗而升级。在 10 个月复查时，72 例中有 54 例（75%）无需进一步 ENT 干预即可出院，18 例（25%）需要进一步 ENT 检查。
本研究表明，鼓膜置管术后由听力学家主导的随访诊所是一种可行的选择，可以提供高效、高质量的护理。三分之二的儿科患者术后不需要 ENT 输入或复查。研究结果支持跨学科的护理模式，这有助于解决 ENT 服务负担过重的问题。
Zotero 插件