Thursday 01 November 2007, 12:00AM
PEARLS 36, November 2007, written by Brian R
McAvoy
(first published in New Zealand Doctor, 30 January 2008)
Clinical question
Is autoinflation effective for hearing loss in adults and children
with otitis media with effusion?
Bottom line
Evidence for the use of autoinflation in the short term (up to 3
months) is favourable. Given the low cost and absence of adverse
effects it is reasonable to consider autoinflation while awaiting
natural resolution of otitis media with effusion.
Caveat
All of the studies were small, of limited treatment
duration (3 weeks to 3 months) and short follow-up. The long term
effects of this treatment cannot be determined.
Context
Otitis media with effusion ("glue ear") is the most common cause
of acquired hearing loss in children, and can lead to problems of
language, development and behaviour. Although there are a number of
treatment options (steroids, antibiotics, decongestants,
antihistamines and grommet insertion), the best treatment strategy
remains controversial as the condition often resolves spontaneously
within a few months. Autoinflation is a technique whereby the
eustachian tube is reopened by raising pressure in the nose,
encouraging drainage of the fluid.
Cochrane Systematic Review
Perera R et al. Autoinflation for hearing loss associated
with otitis media with effusion. Cochrane Reviews, 2006, Issue 4.
Article No. CD006285. DOI: 1002/14651858.CD005608. Note: This
review contains 6 studies with 558 participants.