Researchers successfully tested a non-surgical, non-drug treatment for glue ear where the patient blows into a balloon through the nose.
Image credit: CMAJ
It is common for young children to be affected by otitis media with effusion (OME), whereby the middle ear becomes inflamed and filled with fluid that does not drain away as it should. While the condition can sometimes remain after an ear infection or lead to one, it does necessarily mean there is an infection.
OME, also referred to as "glue ear," often has no symptoms, but can affect hearing development, and sometimes it is only when parents notice this that they seek medical help.
According to the Agency for Health Care Research and Quality in the US, OME occurs commonly during childhood, with as many as 90% of children having at least one episode before their 10th birthday.
There is an urgent need to find new ways to deal with OME that avoid unnecessary and ineffective use of antibiotics, as co-author Ian Williamson, an associate professor in the faculty of medicine, explains:
"Unfortunately, all available medical treatments for otitis media with effusion such as antibiotics, antihistamines, decongestants and intranasal steroids are ineffective and have unwanted effects, and therefore cannot be recommended."
In the Canadian Medical Association Journal, the researchers describe how they undertook an open, randomized controlled trial to find out if the simple "nasal balloon autoinflation" procedure can be used on a large scale to treat children with OME in primary care settings.
During the procedure, the child blows through each nostril into a nozzle to inflate a balloon. This process sends air into the middle ear and helps return the pressure back to normal, clearing the built-up fluid.
The trial included 320 children aged 4-11 treated at 43 family practices in the UK. All participants had recent histories of OME and exams showed they had fluid in one or both ears.
Each child was randomly assigned to either a control group or a treatment group. The control group received standard care while the treatment group received standard care plus nasal balloon autoinflation three times a day for 1-3 months.
The results showed that children receiving autoinflation were more likely than the control group children to have normal middle-ear pressure after 1 month and 3 months.
After 1 month, 47% of children treated with autoinflation had normal middle ear pressure compared to 35.6% of the control group, and after 3 months these figures were 49.6% and 38.3% respectively. The children in the autoinflation group also had fewer days with symptoms.
'Effective alternative to surgery'
Prof. Williamson says the procedure is simple and inexpensive, and can be taught to young children in a primary care setting with a reasonable expectation that they will carry on and do it correctly at home. He notes:
"We have found use of autoinflation in young, school-aged children with otitis media with effusion to be feasible, safe and effective in clearing effusions, and in improving important ear symptoms, concerns and related quality of life over a three-month watch-and-wait period."
He and his colleagues suggest the autoinflation procedure should be offered more widely to children over the age of 4 to help them manage OME and reduce associated hearing loss.
In the following video, co-author Jane Vennik, a researcher in primary care at Southampton, and a young volunteer demonstrate the nasal balloon autoinflation procedure:
Currently, in severe cases of OME, doctors perform a surgical procedure that cuts a hole in the ear drum in order to let the fluid drain.
In an article accompanying the study paper, Drs. Chris Del Mar and Tammy Hoffman from Bond University in Queensland, Australia, comment that:
"At last, there is something effective to offer children with glue ear other than surgery."
This study was conducted for Otovent - the makers of the balloon.
Meanwhile, Medical News Today has reported on another study that found an anti-stroke drug may be an effective treatment for middle ear infection, also addressing the urgent need for non-antibiotic treatments that reduce inflammation without side effects.