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Nonsurgical management of surgical otitis media with effusion

Published online by Cambridge University Press:  29 June 2007

Richard M. Rosenfeld
Richard M. Rosenfeld*
Affiliation:
Division of Pediatric Otolaryngology, State University of New York Health Science Center at Brooklyn and the Long Island College Hospital, Brooklyn, NY, USA.
*
Professor Richard M. Rosenfeld, M.D., M.P.H., Department of Otolaryngology, Long Island College Hospital, 340 Henry Street, Brooklyn, NY 11201, USA.
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Abstract

The objective of this paper was to determine the effectiveness of combined steroid-antimicrobial therapy for otitis media with effusion (OME) of sufficient duration to justify tympanostomy tube insertion.

A consecutive sample of 122 children with bilateral OME of at least three months duration, or unilateral OME of at least six months duration, despite treatment with one or more beta-lactamase stable antibiotics was studied. The treatment group received prednisolone plus a beta-lactamase stable antibiotic for 10 days, with responders receiving an additional six weeks of chemoprophylaxis. The control group received no medication. The child's caregiver decided which group the child should be in.

Resolution of effusion in all affected ears occurred in 32 per cent of steroid-treated children and in 2 per cent of controls (p<0.001) at three to four weeks post-therapy. Relapse of effusion occurred in over 40 per cent of initial responders within six months, reducing the final resolution rate to 25 per cent (95 per cent CI: 15–36 per cent).

It was concluded that treatment with oral steroids should be considered in selected children with chronic OME prior to surgical intervention. One in every four children whose caregiver consents to this therapy may avoid or postpone surgery for at least six months.

Keywords

Otitis media with effusionDrug therapyAdrenal cortex hormonesClinical trials
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 109 , Issue 9 , September 1995 , pp. 811 - 816
Copyright
Copyright © JLO (1984) Limited 1995

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Footnotes

presented in part at the annual meeting of the American Society of Pediatric Otolaryngology, Palm Beach, Florida, May 12, 1994.

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