Treatment of Otitis Media with Effusion Based on Politzerization with an Automated Device

Abstract

This study evaluated the efficacy of politzerization with an automated, hand-held device that controls volume velocity (airflow) in the treatment of 20 children with otitis media with effusion. Thesepatients underwent politzerization twice a week for up to 6 weeks. Another 20 children with otitis media with effusion who were not treated with politzerization served as controls. Following treatment, resolution of the average air-bone gap to within normal limits was achieved in 70% of the treated group and 20% ofthe controls, which eliminated the need for grommet insertion in these patients. Improvement in tympanometric peak pressure was also significantly greater in the treated group. Politzerization was efficiently and successfully performed in all patients. The automated device's ease ofadministration and its ability to control airflow suggests that it has the potential to be an effective home treatment that can be administered by the parents or guardians of children who have otitis media with effusion .

The Old‐Fashioned Politzer Maneuver: A Video Clip Demonstration

“…Maneuvers that cause retrograde inflation of the middle ear by forcing air through the eustachian tube were first described by Valsalva 1 and Politzer 2 for the treatment of middle ear with effusion and for most eustachian tube dysfunctions. PM involves inserting the tip of a rubber air bulb into a patient's nostril, simultaneously compressing the other nostril with a finger, and having the patient swallow as the rubber bulb is compressed 2,3 . It is a safe and simple treatment and is recommended for both adults and children and is contraindicated only for severe ear and upper respiratory infections 4 …”

“…PM involves inserting the tip of a rubber air bulb into a patient's nostril, simultaneously compressing the other nostril with a finger, and having the patient swallow as the rubber bulb is compressed. 2,3 It is a safe and simple treatment and is recommended for both adults and children and is contraindicated only for severe ear and upper respiratory infections. 4 In accordance with recent studies 5 and our experience, we propose, as a primary option for middle ear with effusion and management of eustachian dysfunction, a conservative treatment based on a cycle of PM over a short period (twice a day, once in the morning and once in the evening for 7-10 wk) with use of a Politzer autoinsufflation device in association with a reduction of environmental risk factors and use of medical drugs such as nasal decongestants and antihistamines.…”

Nonsurgical Home Treatment of Middle Ear Effusion and Associated Hearing Loss in Children. Part I: Clinical Trial

“…We designed a modified Politzer autoinsufflation device that overcomes the aforementioned limitations of extant devices (figure 1).20.21 Our handheld, battery-operated device emits controlled air pressure and flow that can be adjusted according to the patient's age and magnitude of hearing loss.20. 21 We conducted two earlier studies of treatment with a device very similar to this and found that approximately 75% of patients with MEE and associated hearing loss recovered following treatment.P:" However, a major limitation of these studies was that patients were required to come to a physician's office for treatment 2 or 3 times a week over a period of 6 to 7 weeks. This routine placed a burden on patients in terms of convenience and direct and indirect costs.…”

Otitis Media: Treatment With Intranasal Aerosolized Surfactant

“… 50,14 Autoinsufflation is a difficult maneuver to teach to young children and, although suggesting clinical benefit, the studies on this are of variable quality. 6,51,52 Nonetheless, the concept of somehow reinstating normal physiological ET function to treat otitis media nonsurgically remains intriguing. 53,54 …”