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Oral steroids alone or followed by intranasal steroids versus watchful waiting in the management of otitis media with effusion

Published online by Cambridge University Press:  15 August 2017

A Hussein*
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, Cairo University, Egypt
H Fathy
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, Cairo University, Egypt
S M Amin
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, Fayoum University, Al Fayoum, Egypt
N Elsisy
Affiliation:
Department of Otorhinolaryngology, Student Hospital, Cairo University, Egypt
*
Address for correspondence: Dr Ahmed Hussein, Department of Otorhinolaryngology, Faculty of Medicine, Cairo University, Cairo, Egypt E-mail: [email protected]

Abstract

Objective:

To evaluate the effects of oral steroids alone or followed by intranasal steroids versus watchful waiting on the resolution of otitis media with effusion in children aged 2–11 years.

Methods:

A total of 290 children with bilateral otitis media with effusion were assigned to 3 groups: group A was treated with oral steroids followed by intranasal steroids, group B was treated with oral steroids alone and group C was managed with watchful waiting. Patients were evaluated with audiometry and tympanometry.

Results:

The complete resolution rates of otitis media with effusion were higher in groups A and B than in group C at six weeks. There were no significant differences in otitis media with effusion resolution rates between the groups at three, six and nine months.

Conclusion:

Oral steroids lead only to a quick resolution of otitis media with effusion, with no long-term benefits. There was no benefit of using intranasal steroids in the management of otitis media with effusion.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2017 

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References

1 Stool, SE, Berg, AO, Berman, S, Carney, CJ, Cooley, JR, Culpepper, L et al. Otitis Media with Effusion in Young Children, Clinical Practice Guideline Number 12. Rockville, MD: US Department of Health and Human Service, Public Health Center, 1994;192208 Google Scholar
2 MacArthur, CJ, Pillers, DA, Pang, J, Kempton, JB, Trune, DR. Altered expression of middle ear and inner ear cytokines in mouse otitis media. Laryngoscope 2011;121:365–71CrossRefGoogle ScholarPubMed
3 Kubba, H, Pearson, JP, Birchall, JP. The aetiology of otitis media with effusion: a review. Clin Otolaryngol Allied Sci 2000;25:181–94Google Scholar
4 Rovers, MM, Schilder, AG, Zielhuis, GA, Rosenfeld, RM. Otitis media. Lancet 2004;363:465–73CrossRefGoogle ScholarPubMed
5 Saafan, ME, Ibrahim, WS, Tomoum, MO. Role of adenoid biofilm in chronic otitis media with effusion in children. Eur Arch Otorhinolaryngol 2013;270:2417–25CrossRefGoogle ScholarPubMed
6 Tasker, A, Dettmar, PW, Panetti, M, Koufman, JA, Birchall, JP, Pearson, JP. Reflux of gastric juice and glue ear in children. Lancet 2002;359:493 Google Scholar
7 Li, JD, Hermansson, A, Ryan, AF, Bakaletz, LO, Brown, SD, Cheeseman, MT et al. Panel 4: Recent advances in otitis media in molecular biology, biochemistry, genetics, and animal models. Otolaryngol Head Neck Surg 2013;148:E5263 Google Scholar
8 Preciado, D, Kuo, E, Ashktorab, S, Manes, P, Rose, M. Cigarette smoke activates NFκB-mediated TNF-α release from mouse middle ear cells. Laryngoscope 2010;120:2508–15CrossRefGoogle ScholarPubMed
9 Kiris, M, Muderris, T, Kara, T, Bercin, S, Cankaya, H, Sevil, E. Prevalence and risk factors of otitis media with effusion in school children in Eastern Anatolia. Int J Pediatr Otorhinolaryngol 2012;76:1030–5Google Scholar
10 Xenellis, J, Paschalidis, J, Georgalas, C, Davilis, D, Tzagaroulakis, A, Ferekidis, E. Factors influencing the presence of otitis media with effusion 16 months after initial diagnosis in a cohort of school-age children in rural Greece: a prospective study. Int J Pediatr Otorhinolaryngol 2005;69:1641–7Google Scholar
11 Duffy, LC, Faden, H, Wasielewski, R, Wolf, J, Krystofik, D. Exclusive breastfeeding protects against bacterial colonization and day care exposure to otitis media. Pediatrics 1997;100:E7 Google Scholar
12 Martines, F, Bentivegna, D, Maira, E, Sciacca, V, Martines, E. Risk factors for otitis media with effusion: case-control study in Sicilian schoolchildren. Int J Pediatr Otorhinolaryngol 2011;75:754–9Google Scholar
13 Gultekin, E, Develioglu, ON, Yener, M, Ozdemir, I, Kulekci, M. Prevalence and risk factors for persistent otitis media with effusion in primary school children in Istanbul, Turkey. Auris Nasus Larynx 2010;37:145–9CrossRefGoogle ScholarPubMed
14 Chadha, SK, Agarwal, AK, Gulati, A, Garg, A. A comparative evaluation of ear diseases in children of higher versus lower socioeconomic status. J Laryngol Otol 2006;120:1619 Google Scholar
15 Berkman, ND, Wallace, IF, Steiner, MJ, Harrison, M, Greenblatt, AM, Lohr, KN et al. Otitis Media with Effusion: Comparative Effectiveness of Treatments. Comparative Effectiveness Review No. 101. AHRQ publication 13-EHC091-EF. Rockville, MD: Agency for Healthcare Research and Quality, 2013 Google Scholar
16 Rosenfeld, RM, Shin, JJ, Schwartz, SR, Coggins, R, Gagnon, L, Hackell, JM et al. Clinical practice guideline: otitis media with effusion (update). Otolaryngol Head Neck Surg 2016;154:S141 Google Scholar
17 Baggett, H, Prazma, J, Rose, A, Lane, A, Pillsbury, H. The role of glucocorticoids in endotoxin-mediated otitis media with effusion. Arch Otolaryngol Head Neck Surg 1997;123:41–6Google Scholar
18 Yaman, H, Ozturk, K, Uyar, Y, Gurbilek, M. Effectiveness of corticosteroids in otitis media with effusion: an experimental study. J Laryngol Otol 2008;122:2530 Google Scholar
19 Buchman, CA, Levine, JD, Balkany, TJ. Infections of the ear. In: Lee, KJ, ed. Essential Otolaryngology. New York: McGraw Hill, 2003;483 Google Scholar
20 Inglis, AF, Gates, GA. Acute otitis media and otitis media with effusion. In: Cummings, CW, ed. Otolaryngology, Head & Neck Surgery, 4th edn. Philadelphia: Elsevier Mosby, 2005;4445–68Google Scholar
21 Lack, G, Caulfield, H, Penagos, M. The link between otitis media with effusion and allergy: a potential role for intranasal corticosteroids. Pediatr Allergy Immunol 2011;22:258–66Google Scholar
22 Bhargava, R, Chakravarti, A. A double-blind randomized placebo-controlled trial of topical intranasal mometasone furoate nasal spray in children of adenoidal hypertrophy with otitis media with effusion. Am J Otolaryngol 2014;35:766–70CrossRefGoogle ScholarPubMed
23 Cengel, S, Akyol, MU. The role of topical nasal steroids in the treatment of children with otitis media with effusion and/or adenoid hypertrophy. Int J Pediatr Otorhinolaryngol 2006;70:639–45Google Scholar
24 Zielhuis, GA, Rach, GH, van den Bosch, A, van den Broek, P. The prevalence of otitis media with effusion: a critical review of the literature. Clin Otolaryngol Allied Sci 1990;15:283–8CrossRefGoogle ScholarPubMed
25 Jerger, J. Clinical experience with impedance audiometry. Arch Otolaryngol 1970;92:311–24Google Scholar
26 Rosenfeld, RM. A Parent's Guide to Ear Tubes. Hamilton, Ontario: BC Decker, 2005 Google Scholar
27 Tos, M. Epidemiology and natural history of secretory otitis. Am J Otol 1984;6:459–62Google Scholar
28 Mandel, EM, Doyle, WJ, Winther, B, Alper, CM. The incidence, prevalence and burden of OM in unselected children aged 1–8 years followed by weekly otoscopy through the “common cold” season. Int J Pediatr Otorhinolaryngol 2008;72:491–9Google Scholar
29 Williamson, I, Benge, S, Mullee, M, Little, P. Consultations for middle ear disease, antibiotic prescribing and risk factors for re-attendance: a case linked cohort study. Br J Gen Pract 2006;56:170–5Google Scholar
30 Al-Rowaily, MA, AlFayez, AI, AlJomiey, MS, AlBadr, AM, Abolfotouh, MA. Hearing impairments among Saudi preschool children. Int J Pediatr Otorhinolaryngol 2012;76:1674–7CrossRefGoogle ScholarPubMed
31 Zakzouk, SM, AbdulJawad, KA. Point prevalence of type B tympanogram in children. Saudi Med J 2002;23:708–10Google Scholar
32 Humaid, AH, Ashraf, AH, Masood, KA, Nuha, AH, Saleh, AD, Awadh, AM. Prevalence and risk factors of otitis media with effusion in school children in Qassim region of Saudi Arabia. Int J Health Sci (Qassim) 2014;8:325–34Google Scholar
33 El-Sayed, Y, Zakzouk, S. Point prevalence of type B tympanogram in Riyadh. Int J Pediatr Otorhinolaryngol 1995;31:5361 CrossRefGoogle ScholarPubMed
34 Abolfotouh, MA, Ghieth, MM, Badawi, IA. Hearing loss and other ear problems among schoolboys in Abha, Saudi Arabia. Ann Saudi Med 1995;15:323–6Google Scholar
35 Rosenfeld, R, Mandel, E, Bluestone, C. Systemic steroids for otitis media with effusion in children. Arch Otolaryngol Head Neck Surg 1991;117:984–9Google Scholar
36 Simpson, SA, Lewis, R, Van Der Voort, J, Butler, CC. Oral or topical nasal steroids for hearing loss associated with otitis media with effusion in children. Cochrane Database Syst Rev 2011;(5):CD001935Google Scholar
37 MacArthur, CJ, DeGagne, JM, Kempton, JB, Trune, DR. Steroid control of acute middle ear inflammation in a mouse model. Arch Otolaryngol Head Neck Surg 2009;135:453–7Google Scholar
38 Rosenfeld, RM, Kay, D. Natural history of untreated otitis media. Laryngoscope 2003;113:1645–57Google Scholar
39 Thomsen, J, Tos, M. Spontaneous improvement of secretory otitis: a long-term study. Acta Otolaryngol 1981;92:493–9Google Scholar
40 Fiellau-Nikolajsen, M, Lous, J. Tympanometry in three-year old children. A cohort study on the prognostic value of tympanometry and operative findings in middle ear effusion. ORL J Otorhinolaryngol Relat Spec 1979;41:1125 CrossRefGoogle ScholarPubMed