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Autoinflation for treatment of persistent otitis media with effusion in children: A cross-over study with a 12-month follow-up

Artikel i vetenskaplig tidskrift
Författare Armin Bidarian-Moniri
M. J. Ramos
Hasse Ejnell
Publicerad i International Journal of Pediatric Otorhinolaryngology
Volym 78
Nummer/häfte 8
Sidor 1298-1305
ISSN 0165-5876
Publiceringsår 2014
Publicerad vid Institutionen för kliniska vetenskaper, Avdelningen för öron-, näs- och halssjukdomar
Sidor 1298-1305
Språk en
Länkar dx.doi.org/10.1016/j.ijporl.2014.05...
Ämnesord Otitis media with effusion, Autoinflation, Non-invasive conservative treatment, Politzer, Valsalva, MIDDLE-EAR, HEARING, RECOGNITION, TRIAL, NOISE, Otorhinolaryngology, Pediatrics
Ämneskategorier Oto-rino-laryngologi, Pediatrik

Sammanfattning

Objectives: The aims of the present study were to evaluate the efficacy of and compliance with a new device for autoinflation in the treatment of persistent otitis media with effusion (OME) in young children. Methods: Forty-five children with persistent OME with a bilateral type B or C2 tympanogram for at least three months and history of subjective hearing loss, waiting for grommet surgery, were randomised to a treatment and a control group. Twenty-three children aged between three and eight years started as the treatment group with the new device for autoinflation. Another 22 children, aged between two and eight years were included as controls. After a period of four weeks, a cross-over was performed. Both groups underwent otomicroscopy, tympanometry and audiometry at inclusion and after one and two months for the evaluation of treatment efficiency. The primary outcome measurements were improvement in middle-ear pressure and hearing thresholds at eight weeks. Both groups were then followed up for another 10 months. Results: In the treatment group, the mean middle-ear pressure for both ears and the mean hearing thresholds for the best ear improved by 166 daPa (p <0.0001) and 6 dB (p <0.0001), respectively after four weeks, while in the control group, non-significant alterations were observed. After the cross-over of the control group to treatment, equivalent improvements in the mean middle-ear pressure and the mean hearing thresholds of 187 daPa (p <0.0001) and 7 dB (p <0.01), respectively were achieved also in this group. After treatment in both groups at eight weeks, four of 45 children were submitted to grommet surgery. During the long-term follow-up another five children were submitted to surgery due to recurrence of disease. All the children managed to perform the manoeuvre and no side-effects were detected. Conclusion: The device demonstrated efficiency in improving both middle-ear pressure and hearing thresholds in most children after four weeks of treatment. It might therefore be possible to consider this method of autoinflation in children with persistent OME during the watchful waiting period. (C) 2014 Published by Elsevier Ireland Ltd.

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