Nasal Balloons Help Treat 'Glue Ear' in Children
Written by Editor   
Thursday, July 30, 2015 10:01 AM
Non-surgical nasal balloons are helpful in “glue ear” (otitis media with effusion– OME).

Observations:  This report notes that "many physicians prescribe antibiotics, intranasal steroids, and/or antihistamines and decongestants -- all of which have been proven ineffective at treating OME,” and that nonsurgical interventions are  underrepresented in clinical practice because "getting the message to clinicians about effective nondrug treatments is much harder than it is for drug treatments."

"Far too many doctors still use ineffective treatments for OME despite the research that says they shouldn't, but it's not clear why. He suspects that some clinicians might not be keeping up with new research and guidelines,” the article notes.

Potential actions: 

  • Research “non-surgical” interventions for improving musculoskeletal function. 

  • Take time to share proven or promising non-surgical interventions with other doctors in your area.

 

For the many children who sometimes suffer from otitis media with effusion (OME), also known as "glue ear," autoinflation using nasal balloons might be the first evidence-based, non-surgical treatment option, an open-label study indicated.

Among 320 children ages 4 to 11 with OME randomized to treatment with nasally inflated Otovent balloons three times daily plus usual care, or to usual care alone, 49.6% of the balloon-treated group had improvements in their tympanograms after 3 months, compared with 38.3% of the control group. 

The balloon procedure is intended to reduce the middle-ear effusion. The child inserts the $15 balloon's nozzle into the ipsilateral nostril and inflates the balloon, which helps to open the Eustachian tube to promote drainage.

Nasal balloons have been around for more than a decade, but the treatment hasn't been widely implemented as a medical intervention due to scant supporting evidence.

There were a few mild, infrequent and statistically insignificant adverse effects reported during the trial. More respiratory infections occurred in the balloon treatment group than in the control group (15% versus 10%). Eight patients receiving autoinflation experienced ear pain, and five had episodes of acute ear infections.

Balloon treatment also correlated with improved quality of life scores.  When compared to their baseline ratings, children who used the nasal balloons for 3 months saw a greater change in quality of life than the control group.

Because surgery has long been the only evidence-based, effective treatment, it's important to develop nonsurgical treatment methods, the author states. "So many children get glue ear who don't get any treatment. They're not really bad enough to warrant an operation, but it's bad enough to affect their hearing and warrant some medical intervention.”  Surgery for OME involves placement of tubes that allow air to flow to the eardrums. Most doctors will recommend watchful waiting to see if the ears will naturally heal themselves, which they often do. But many physicians prescribe antibiotics, intranasal steroids, and/or antihistamines and decongestants -- all of which have been proven ineffective at treating OME.

This report states  that autoinflation is often underrepresented in clinical practice because "getting the message to clinicians about effective nondrug treatments is much harder than it is for drug treatments." Clinicians first have to know about the details of how the treatment works, but they also need to have the proper resources, they noted.  Far too many doctors still use ineffective treatments for OME despite the research that says they shouldn't, but it's not clear why. He suspects that some clinicians might not be keeping up with new research and guidelines.


Source:  http://www.medpagetoday.com/Surgery/Otolaryngology/52812