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Published byIsaac Whitaker Modified over 10 years ago
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ENT Procedures of limited clinical value?
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Several PCTs have lists NHS Bradford and Airedale doesn't ENT related conditions that are included are: – Tonsillectomy and adenoidectomy – Grommets – snoring
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Tonsillectomy SIGN guidance 2010 HSJ report 2010 Cochrane 2009
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Sore throats are due to tonsillitis Episodes are disabling and prevent normal functioning (missing work or school etc) 7 or more well documented, clinically significant sore throats in the preceding year 5 or more such episodes in each of the preceding 2 years 3 or more such episodes in each of the preceding 3 years Is frequency decreasing or increasing? HSJ report – increased admissions over last few years
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Grommets NICE guidance 2008 and 2000 Cochrane review 2005
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Background >50 % glue ear resolves by 3/12 >80% resolves at 9/12 Grommets improving hearing on a PTA Little long term evidence that they effect development Varying impact of glue ear on each individual
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NICE 2008 Hearing assessment Watch and wait Reassess at 3 months Consider Grommets if persistent hearing loss >25dB in the worse ear
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Management in primary care Clinical history and examination Tympanogram and PTA School nurse
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