Oral or topical nasal steroids for hearing loss associated with otitis media with effusion in children

Activation of epithelial sodium channel in human middle ear epithelial cells by dexamethasone

“…The long term effect of glucocorticoids in treatment of otitis media with effusion is still controversial, but short-term resolution of middle ear effusion may be accelerated by steroids. (Thomas et al, 2006). Mechanisms proposed for the action of corticosteroids in otitis media with effusion include: (1) a direct anti-inflammatory action on the middle ear and Eustachian tube by reducing arachidonic acid concentration, thereby inhibiting the cyclo-oxygenase and lipooxygenase pathways for synthesis of inflammatory mediators; (2) an increase in Eustachian tube surfactant concentration, facilitating better tube function; (3) shrinkage of peritubal lymphoid tissue, again allowing better tube function; and (4) reduction of middle ear fluid viscosity via an effect on mucoproteins.…”

Diagnóstico y tratamiento de la otitis media secretora infantil: recomendaciones CODEPEH 2016

“…Más recientemente, la Agencia para la Investigación y Calidad Sanitaria (AHRQ) examinó la eficacia de los esteroides orales en el tratamiento de la OMS y demostró que no son útiles ni beneficiosos para la resolución del derrame o en la mejora de la pérdida auditiva (Berkman et al, 2013) y que, añadiendo antibióticos, no mejoran los resultados en comparación con los pacientes de control, que se dejaron sin tratar o se trataron sólo con antibióticos (Thomas et al, 2006;Simpson et al, 2007).…”

Commentary on ‘Antihistamines and/or decongestants for otitis media with effusion (OME) in children’, with a reply from the review author

“…Further research into the treatment of OME is most likely to be useful in the child who has or develops bilateral hearing loss (>40dB), language delay or tympanic membrane abnormalities. It is in this subset of children that useful results may come from examining more apparently successful therapies such as ventilation tubes, nasal steroids or newer antihistamines (1,8,19).…”