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A NEW AUTOINFLATION DEVICE FOR TREATMENT OF OTITIS MEDIA WITH EFFUSION

Poster
Authors Armin Bidarian-Moniri
João Lino
Mohammed Al-Azzawe
Hasse Ejnell
Published in World Summit on Pediatrics. Porto 23-26 June, 2016
Publication year 2016
Published at Institute of Clinical Sciences, Department of Otorhinolaryngology
Language en
Links www.wsp-congress.com/documenti/Port...
Subject categories Clinical Medicine

Abstract

Objectives: Otitis media with effusion (OME) is caused by accumulation of fluid in the middle ear, without the signs or symptoms of an acute inflammation or infection. OME is the most common cause of hearing impairment in children and the most common cause of surgical intervention under general anaesthesia in children. Autoinflation is an alternative treatment based on the opening of the Eustachian tube, by forced introduction of air either by the Valsalva manoeuvre or the Politzer method. Methods:A new autoinflation device (Moniri‐Otovent ®, Abigo Medical, Askersund, Sweden) for home treatment of children with persistent OME was used in this study. Forty‐four children, aged between two and eight years, with persistent bilateral OME for at least three months and history of subjective hearing loss, waiting for grommet surgery were treated with the autoinflation device during four weeks. Another forty‐five children, aged between three and eight years, submitted to grommet surgery were compared to the autoinflation group. Both groups underwent otomicroscopy, tympanometry and audiometry at inclusion. The exams were repeated at one, six and twelve months in both groups with the exception of tympanometry in the grommet group. Results: In the autoinflation group after four weeks of treatment, the mean hearing level improved from 22 to 16 dB and the number of ears with hearing thresholds of  ≥ 20 dB was reduced from 60 (77%) to 16 (22%). During the follow‐up period, 12 children were treated at least one more time with the device, of which seven were subjected to further follow‐up at the end of the study and five were submitted to grommet surgery. No complications were reported. In the grommet groups the mean hearing threshold improved from 24 to 15 dB and the number of ears with hearing threshold of ≥ 20 dB was reduced from 82 (91%) to 15 (18%). During the follow‐up period a total of 31 (34%) complications were reported related to the grommets. Fourteen ears (16%) presented otorrhea, six ears (7%) early extrusion, four tubes (4%) were obstructed, 12 ears (13%) had recurrence of effusion and one ear (1%) presented persistent perforation after tube extrusion. Conclusions: This study reveals that autoinflation may reduce middle ear effusion and improve hearing in children with OME. Given the non‐invasive character of autoinflation therapy, it may be reasonable to apply this method as a first‐line treatment before considering surgery in children with OME.

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