title: Follow-up care after grommet insertion in children: Review article.
abstract: BACKGROUND
  Grommet insertion is a common procedure in children. A lengthy otolaryngology follow-up can have an adverse impact on clinic waiting times, new patient appointment availability, and pecuniary disadvantage for the hospital.
  
  
  OBJECTIVE
  To consolidate research and opinion concerning follow-up care following grommet insertion in a pediatric population.
  
  
  METHODS
  The literature between January 1990 and September 2015 was searched on MEDLINE (Ovid), Google Scholar, PubMed and Web of Science databases.
  
  
  RESULTS
  Guidelines and consensus of opinion from the United States advocate that an initial post-operative review should take place within 4 weeks, and subsequent appointments every 6 months until grommet extrusion. Recent audit reports from the United Kingdom have shown that some groups arrange their first post-operative review at 3 months, and subsequent appointments vary considerably from no further follow-up to up to 24 months. Up to 75% of follow-up appointments were scheduled despite normal audiometry and clinical findings after grommet insertion, suggesting a large cohort of patients may undergo unnecessary specialist clinic reviews. General practioners (GP), audiologists or specialist nurses are potential alternative providers of regular reviews to ensure normal hearing thresholds and an adequate tympanic membrane healing course.
  
  
  CONCLUSIONS
  Follow-up schedules are largely driven by consensus of opinion. A significant number of follow-up appointments in otolaryngology clinic appear to be redundant. Recently attention has been drawn to earlier discharge from otolaryngology clinic with subsequent follow-up in less resource and cost intensive clinics coordinated by GPs, audiologist or nurses, which may help alleviate some outpatient workload on acute hospital trusts.
authors: Department of Otorhinolaryngology, Russells Hall Hospital, Pensnett Rd, Dudley, DY1 2HQ, UK. Electronic address: zahir5019@gmail.com.
authors: Zahir
authors: Z
authors: Mughal
authors: Department of Otorhinolaryngology, Russells Hall Hospital, Pensnett Rd, Dudley, DY1 2HQ, UK. Electronic address: teeveeraj@yahoo.com.
authors: Vijay
authors: V
authors: Thirunavukarasu
authors: Department of Otorhinolaryngology, Walsall Manor Hospital, Moat Road, Walsall, WS2 9PS, UK. Electronic address: adnandarr@doctors.org.uk.
authors: Adnan
authors: A
authors: Darr
authors: Department of Otorhinolaryngology, Russells Hall Hospital, Pensnett Rd, Dudley, DY1 2HQ, UK. Electronic address: mudit.jindal@dgh.nhs.uk.
authors: Mudit
authors: M
authors: Jindal
mesh_terms: D000359:Aftercare; D002648:Child; D006801:Humans; D008876:Middle Ear Ventilation; D010034:Otitis Media with Effusion / Q000628:therapy
keywords: Appointments; Follow-up; Grommet insertion; Middle ear ventilation tube