Discuss about clinical policy

Sydney Children's Hospital

Today discussed for clinical policy with Monica, Sally, Andrew and Broiny.

The focus on the reassessment for the patients with mild conductive hearing loss. In the clinical policy, I recommend a reassessment of tympanometry in 3 months even for SWISH babies. The argue is two: one is for children with speech delay, 3 months reassessment maybe too long to monitor and access to speech pathologist, two is for SWISH babies, 3 reassessment might too early to perform any behavioral heairng test.

For the first argument, I would change the policy that if referral doctor mention the speech delay in the referral letter, we would recommend parents to see an ENT specialist directly. (Monica added if there is any risk factors or certain concerns)

For the second argument, I stand for my opinion, we need retest tympanometry rather at early stage than waiting to 10 months old. If there is still a middle ear involvement at reassessment, we would recommend parents to ENT consultation other than do a VROA test if we think the inner ear function is intact.

Finally we finished the clinical policy, I did almost all of things in this clinical policy, I would like to review it after 12 months. I am happy to make a standard for everyone.