Conservative treatment of otitis media with effusion by autoinflation of the middle ear

Abstract

A total of 85 children on the waiting list for grommet insertion aged between 3 and 10 years with bilateral chronic otitis media with effusion (OME) were assigned at random to an observation or treatment group. Those in the treatment group were given the Otovent@device to use three times a day for the duration of the study and both groups were then seen at monthly intervals for 3 months for pneumatic otoscopy and tympanometry. Statistically significant improvement was seen in those using the treatment with a compliance of more than 70%. This was detected on the outcome measures of tympanometry and pneumatic otoscopy after 1, 2 and 3 months. No side effects were demonstrated.used regularly under supervision. Keywords OME grommet insertion autoinflation non-surgical treatmentWe conclude that autoinflation is an effective short-term treatment for children with OME when

Effect of nasal balloon autoinflation in children with otitis media with effusion in primary care: an open randomized controlled trial

“…[29][30][31] Evidence of feasibility and effectiveness of autoinflation to inform wider clinical use is lacking. 13,28 Thus we report here the findings of a large pragmatic trial of the clinical effectiveness of nasal balloon autoinflation in a spectrum of children with clinically confirmed otitis media with effusion identified from primary care.…”

“…The most recent Cochrane Review of autoinflation 28 highlighted the need for a large primary care study. The small hospital-based trials available [29][30][31] for meta-analysis did not assess autoinflation in a primary care setting and lack both power and generalizability to the majority of affected children. Adding our data (and unpublished pilot, n = 20) to the meta-analysis more OMQ-14 total score For the child, parent and professional, the main issue is the impact caused by otitis media with effusion.…”

An open randomised study of autoinflation in 4- to 11-year-old school children with otitis media with effusion in primary care

“…16,37 There are no known or reported harms associated with nasal autoinflation to date, with higher respiratory tract infection (RTI) rates (including AOM) noted in the control groups in two studies, making it unlikely that the increased pressure in the nose during autoinflation can spread infections, or that it acts as an object that produces cross-infection. 55,56 Patent details outline advantages of controlled air flow and non-damaging pressures inside the nose (the latest patent was filed in September 2008, patent reference US 20100071707A1).…”

“…The nasal balloon technique using Otovent (ABIGO Medical, Askim, Sweden), which was developed by Professor Stangerup (see Chapter 3, Trial intervention for a full description), and essentially consists in inflating a purpose-manufactured balloon through the nose, and the EarPopper ® (Micromedics, St Paul, MN, USA) (a device operating to give a steady flow of air to the nose, which needs to be co-ordinated with the act of swallowing, which opens up the Eustachian tubes) are the only two purpose-manufactured standardised delivery devices, and appear also to yield the most promising results so far in terms of beneficial ORs. 35 Four small studies [54][55][56]62 (one unpublished except in a review) that used the balloon intervention (Otovent) as the method for autoinflation were the basis of our power calculation. Combining these trials gives a potentially homogeneous total of 336 children and is completely dominated by secondary care studies.…”

“…35,54 In total, seven clinical trials were found suitable to be included in Cochrane. [55][56][57][58][59][60][61] Subsequently, a literature search (search date November 2013), which is an update of the original Cochrane systematic review, was performed using the standard Cochrane search method, as described in full elswehere. 35 Two additional references to clinical trials were found, one of which was a completed RCT carried out on a total sample of 40 children.…”