For children with a common middle-ear problem, a simple procedure with a nasal balloon can help clear out fluid without the use of antibiotics.
With otitis media with effusion (OME), also known as “glue ear,” the middle ear fills with thick fluid that can affect hearing development. There are frequently no symptoms and parents seek medical help for their children only when hearing difficulties become apparent.
Approximately 200,000 children in the UK are treated for OME each year—there is a four in five chance a child will get an ear effusion in the first 10 years of their life.
“Unfortunately, all available medical treatments for otitis media with effusion such as antibiotics, antihistamines, decongestants, and intranasal steroids are ineffective and have unwanted effects, and therefore cannot be recommended,” says coauthor Ian Williamson, from primary care and population sciences at the University of Southampton.
Researchers conducted an open randomized controlled trial to determine if autoinflation with a nasal balloon could be used on a large scale to benefit children in primary care settings.
To use the method, a child blows through each nostril into a nozzle to inflate the balloon, which then sends air into the middle ear helping to return the pressure to normal, which clears the fluid build-up. The effectiveness of this procedure has been shown only in small trials in hospitals.
The latest trial, reported in the Canadian Medical Association Journal, involved 320 children aged 4 to 11 years from 43 family practices in the UK who had recent histories of OME with confirmed fluid in one or both ears.
Simple and low-cost
The children were randomly assigned to either a control group that received standard care or a group that received standard care with autoinflation three times a day for one to three months. The children receiving autoinflation were more likely than those in the control group to have normal middle-ear pressure at both one month (47.3 percent and 35.6 percent, respectively) and three months (49.6 percent and 38.3 percent, respectively) and have fewer days with symptoms.
“Autoinflation is a simple, low-cost procedure that can be taught to young children in a primary care setting with a reasonable expectation of compliance,” Williamson says. “We have found use of autoinflation in young, school-aged children with otitis media with effusion to be feasible, safe, and effective in clearing effusions, and in improving important ear symptoms, concerns, and related quality of life over a three-month watch-and-wait period.”
The treatment should be used more widely in children over the age of four to manage OME and help treat the associated hearing loss, researchers say.
“At last, there is something effective to offer children with glue ear other than surgery. Surgery to insert drainage tubes can help a select minority of children,” write Chris Del Mar and Tammy Hoffman from the Centre for Research in Evidence-Based Practice at Bond University in Queensland, Australia, in a related commentary.
“Autoinflation is one of a number of effective nondrug interventions typically underrepresented in research and clinical practice.”
Source: University of Southampton