Primary Care Liaison

Otitis media with effusion

  • This pre-referral guideline covers Otitis media with effusion in children of all ages.

    Initial work-up

    • Usually associated with noticeable hearing loss. A middle ear effusion will be present in approximately:
      • 80% of cases at 2 weeks following  ASOM<
      • 40% at 1 month
      • 20% at 2 months
      • 10% at 3 months
    • Audiology (hearing test) if hearing loss is present > 3 months.

    Pre-referral treatment

    • Review at 3 months – for persistent middle ear effusion or hearing loss.
    • For symptomatic cases that have not resolved in 3 months, a prolonged course of antibiotics will result in resolution of a significant proportion. 

    When to refer

    • Child is symptomatic due to hearing loss, and this is thought likely to be present for a significant period of time in the future.
    • Bring audiology test results.

    Referral form (pdf)

    Parent handout (pdf)


    Kids Connect (RCH Primary Care Liaison)

    Kids Health Info (Parent fact sheets online)

    Contact information

    Clinical advice

    Switchboard – ask for ENT specialist consultant or registrar on-call    (03) 9345 5522
    RCH Emergency Department (03) 9345 6477


    Booking enquiries and appointment rescheduling (parents) (03) 9345 6180 
    Rural doctors only (03) 9345 6789 

    Admission enquiries

    General admission enquiries  (03) 9345 6172

    ED admission enquiries 

    (03) 9345 6477
    After hours/switchboard

    (03) 9345 5522


    Seriously unwell child (03) 9345 7007

    RCH Drug info-line 

    (03) 9345 5208


    Paediatric Handbook Ear, Nose and Throat Conditions, Chapter 21 (pp312-324); Robert Berkowitz and Michael Marks; Seventh Edition, Blackwell Publishing. By the staff of the Royal Children's Hospital, Melbourne, Australia

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