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

Williamson, Ian; Vennik, Jane; Harnden, Anthony; Voysey, Merryn; Perera, Rafael; Kelly, Sadie; Yao, Guiqing; Raftery, James; Mant, David; Little, Paul

doi:10.1503/cmaj.141608

Cited by 36 publications

(23 citation statements)

References 30 publications

(59 reference statements)

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“…Nasal balloon autoinflation is an effective treatment for school-aged children with otitis media with effusion, helping fill the gap between active surveillance and referring a child for surgery, according to a large open pragmatic randomised trial 1. The procedure involves inflating a purpose-manufactured balloon by blowing through each nostril into a connecting nozzle.…”

Section: Nasal Balloons For Glue Earmentioning

confidence: 99%

DTB Select: 10 | October 2015

2015

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Section: Nasal Balloons For Glue Earmentioning

confidence: 99%

DTB Select: 10 | October 2015

2015

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“…By the age of four years, 80% of children will have had an episode of OME, but the majority resolve spontaneously within three months . Despite the high probability of resolution, 5% of preschool children under the age of 5 years will develop bilateral, persistent disease leading to hearing loss with a potentially detrimental effect on early development in terms of language and social development, behaviour, IQ and reading . Evidence‐based management options for persistent OME, after a 3‐month period of “watchful waiting,” are hearing aids or the surgical insertion of ventilation tubes (VTs) .…”

Section: Introductionmentioning

confidence: 99%

The effect of ventilation tube insertion on quality of life in children with persistent otitis media with effusion

Cannings‐John

Butler

Francis

2020

Clinical Otolaryngology

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Objectives To determine the effect of ventilation tube (VT) surgery on quality of life (QoL) in children with persistent otitis media with effusion (OME). Design Secondary analysis of trial data (oral steroids versus placebo for persistent OME), comparing QoL by history of VT surgery performed between 5 weeks and 12 months post‐randomisation. Multilevel regression models were used to identify the association between VT surgery and QoL scores at 12 months, controlling for pre‐exposure risk factors associated with surgery, including pre‐surgery hearing level. Setting Ear, nose and throat (ENT), paediatric audiology and audiovestibular medicine (AVM) departments in Wales and England. Participants A total of 327 children aged 2‐8 years with OME symptoms for at least three months and audiometry‐proven bilateral hearing loss with VT surgery status. Main outcome measures Otitis Media questionnaire (OM8‐30) and Paediatric Quality of Life Inventory (PedsQL) total and subscale scores, and the Health Utilities Index Mark 3 (HUI3) at 12 months post‐randomisation. Results Participants who had VT surgery had no significant difference in OM8‐30, PedsQL or HUI total scores. OM8‐30 hearing difficulty (HD) subscale scores at 12 months were better in those who had VT surgery (adjusted mean difference (aMD) = −0.46 (95% confidence interval: −0.69 to −0.23), P < .001), and this varied by when the surgery occurred (aMD for surgery between 5 weeks and 6 months = −0.4 [−0.67 to −0.13], P = .004 and between 6 and 12 months = −0.54, [−0.87 to −0.22], P = .001). Conclusion Ventilation tube surgery was associated with an improvement in HD‐related functional health status but no change in overall QoL.

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“…Although the natural history is towards self‐resolution, in some cases, it persists beyond a few months and may require active treatment to prevent language, learning and behavioural problems. Treatment options include hearing aids, ventilation tube insertion or autoinflation …”

Section: Introductionmentioning

confidence: 99%

“…Treatment options include hearing aids, ventilation tube insertion or autoinflation. 3,4 Decisions about treatment in the United Kingdom are supported by NICE guidelines which recommend that ventilation tube insertion should be considered for OME persisting at least 3 months and with hearing loss of 25 to 30 dB HL or worse in the better ear, or if there is a significant impact on the child's social, educational or developmental outcome. 5 Thus, in addition to objective tests such as the pure-tone audiogram, clinical history through parental report is used in decisionmaking, and questionnaires could offer a formalised means for obtaining this information.…”

Section: Introductionmentioning

confidence: 99%

Quality of questionnaires for the assessment of otitis media with effusion in children

Gan

Daniel

Ridley

et al. 2017

Clinical Otolaryngology

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Objectives Audiometric tests provide information about hearing in otitis media with effusion (OME). Questionnaires can supplement this information by supporting clinical history‐taking as well as potentially providing a standardized and comprehensive assessment of the impact of the disease on a child. There are many possible candidate questionnaires. This study aimed to assess the quality and usability of parent / child questionnaires in OME assessment. Design and main outcome measures Fifteen, published questionnaires, commonly used in audiological departments (Auditory Behaviour in Everyday Life (ABEL), Children's Auditory Performance Scale (CHAPS), Children's Home Inventory for Listening Difficulties (CHILD), Children's Outcome Worksheets (COW), Evaluation of Children's Listening and Processing Skills (ECLiPS), Early Listening Function (ELF), Fisher's Auditory Problem Checklist (FAPC), Hearing Loss 7 (HL‐7), Listening Inventory for Education‐ Revised (LIFE‐R Student), Listening Inventory for Education UK Individual Hearing Profile (LIFE‐UK IHP), LittlEARS Auditory Questionnaire (LittlEARS), Listening Situations Questionnaire (LSQ), Otitis Media 6 (OM‐6), Quality of Life in Children's Ear Problems (OMQ‐14), Parents’ Evaluation of Aural/Oral Performance of Children (PEACH) were assessed according to the following 8 criteria: conceptual clarity, respondent burden, reliability, validity, normative data, item bias, ceiling/ floor effects, and administrative burden. Results ECLiPS, LittlEARS and PEACH scored highest overall based on the assessment criteria established for this study. None of the questionnaires fully satisfied all 8 criteria. Although all questionnaires assessed issues considered to be of at least adequate relevance to OME, the majority had weaknesses with respect to the assessment of psychometric properties, such as item bias, floor/ceiling effects or measurement reliability and validity. Publications reporting on the evaluation of reliability, validity, normative data, item bias and ceiling/floor effects were not available for most of the questionnaires. Conclusions This formal evaluation of questionnaires, currently available to clinicians, highlights three questionnaires as potentially offering a useful adjunct in the assessment of OME in clinical or research settings. These were the ECLiPS, which is suitable for children aged 6 years and older, and either the LittlEARS or the PEACH for younger children. The latter two are narrowly focused on hearing, whereas ECLiPS has a broader focus on listening, language and social difficulties.

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

Abstract: Interpretation: Autoinflation in children aged 4-11 years with otitis media with effusion is feasible in primary care and effective both in clearing effusions and improving symptoms and ear-related child and parent quality of life. Trial registration: ISRCTN, No. 55208702. Abstract

Cited by 36 publications

References 30 publications

DTB Select: 10 | October 2015

DTB Select: 10 | October 2015

The effect of ventilation tube insertion on quality of life in children with persistent otitis media with effusion

Quality of questionnaires for the assessment of otitis media with effusion in children

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