Role of intratympanic steroid injection in treatment of otitis media with effusion: A systematic review/ Meta -Analysis

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ahmed A Mohammed ◽  
Tarek A Hamdy ◽  
Anas M Askoura ◽  
Ahmed M Abdulhakim
Keyword(s):  
Systematic Review ◽  
Medical Treatment ◽  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Good Effect ◽  
Major Health Problem ◽  
Best Medical Treatment ◽  
Intratympanic Injection ◽  
Ventilation Tubes

Abstract Background Otitis media with effusion (OME) is a worldwide major health problem for both children and adult, who have a history of chronic eustachian tube dysfunction. Aim of the Work to review the effect of intratympanic injection of steroids in treatment of chronic otitis media with effusion (persistent more than 3 months after failure to medical treatment [e.g. local & systemic steroids or decongestants] or surgical ventilation tubes). Material and Methods This systematic review was done as a collective analysis of 5 retrospective and prospective cohort studies done on patients with OME. Studies on Patients who were diagnosed with chronic otitis media with effusion not responding to conventional methods of treatment. Results The data analysed and results showed an improvement of 41.2% of the cases treated with intratympanic injection of steroids compared to 11% improvement in cases treated by conventional medical methods with a relative improvement around 6.4 folds to intratympanic injection of steroids over medical treatment. All of these studies have shown that there are more advantages of directed ototopical steroid therapy over systemic therapy. Topical medications often have limited systemic effects due to their limited systemic uptake. It may be less expensive as compared to systemic medications. Conclusion Intratympanic injection of long acting steroids has good effect in management of OME resistant to medical and surgical treatment and has superior effect and high rate of recovery on local nasal steroid spray. In children combination of ventilation tubes and intratymapnic injection of steroids is the best known modality of treatment. Further studies are needed to evaluate the best medical treatment of chronic OME.

scholarly journals Study on otitis media with effusion

1970 ◽  
Vol 15 (2) ◽  
pp. 50-54
Author(s):  
Syed Hasan Imam Al-Masum ◽  
Md Arif Hossain Bhuiyan ◽  
Md Abu Yusuf Fakir
Keyword(s):  
Medical Treatment ◽  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Neck Surgery ◽  
Age Group ◽  
Suppurative Otitis Media ◽  
Presenting Symptoms ◽  
Head Neck Surgery ◽  
Head Neck

Objective: To study the clinical, audiological and radiological characteristics along with the management outcome of chronic otitis media with effusion. Setting: Department of Otolaryngology & Head - Neck Surgery, Dhaka Shishu Hospital and Apollo Hospital's Dhaka, Bangladesh. Materials and Methods: This study included three hundred and thirty patients of chronic Otitis media with effusion that have been treated in the department of Otolaryngology and Head-Neck Surgery, at Dhaka Shishu Hospital and Apollo Hospitals, Dhaka from January, 2007 to July, 2008. The data of patients included age, sex, presenting symptoms and signs, preoperative investigations like pure tone audiometry (PTA) and Impedance test, operation notes, complications of surgery and state at follow up. Results: This study included 198 males and 132 females. 222 patients (67.27%) were in the age group of 2-5 years. Main presenting symptom was fullness of the ear (50.30%) and main presenting sign was dull eardrum (72.18%). Turning fork test and PTA have been done in the age group of 7-10 years. In 166(59.30%) patients Impedence was type B. 222 (66.69%) patients have been cured with medical treatment. 69(20.90%) patients underwent grommet insertion as medical treatment has been failed in those patients. Two patients developed postoperative chronic suppurative otitis media with central perforation and one patient developed thinned tympanic membranes that have been treated conservatively. Conclusion: Chronic otitis media with effusion is usually not a threat to life but result in complications. As long as fluid is present in the middle ear, hearing will be affected. Hearing problems can interfere with language development in children. Any fluid that lasts longer than 3 months should be treated surgically. Keywords: Otitis Media with effusion; myringotomy; audiometry. DOI: 10.3329/bjo.v15i2.5057 Bangladesh J Otorhinolaryngol 2009; 15(2): 50-54

Comparison of the Goode T-tube with the Armstrong tube in children with chronic otitis media with effusion

1990 ◽  
Vol 104 (8) ◽  
pp. 608-610 ◽  
Author(s):  
Eize W. J. Wielinga ◽  
Gordon D. L. Smyth
Keyword(s):  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
The Other ◽  
Duration Of Stay ◽  
T Tube ◽  
Long Duration ◽  
Ventilation Tubes ◽  
Long Term Ventilation

AbstractTreatment of otitis media with effusion is focused on reaeration of the middle ear cavity. In achieving longterm aeration, the insertion of ventilation tubes that have a long duration of stay can be beneficial. The results are presented of a trial in which the Goode T-tube was compared with the Armstrong tube. Fifteen children were treated between 1981 and 1986 with a T-tube in one ear and a conventional tube in the other. The results are different with regard to duration of stay in the tympanic membrane. Re-insertions were necessary in 47 per cent in the Armstrong group and in 20 per cent in the T-tube group. Otorrhoea occurred in 20 per cent of the Armstrong and 13 per cent of the T-tube intubated ears. A persistent perforation was present in 6 per cent of the ears in both groups. It is concluded that the Goode T-tube is indicated primarily in cases when long-term ventilation is needed.

Ventilation Tubes and Prophylactic Antibiotic Eardrops

1992 ◽  
Vol 106 (2) ◽  
pp. 193-195 ◽  
Author(s):  
Ramzi T. Younis ◽  
Rande H. Lazar ◽  
Thomas E. Long
Keyword(s):  
Postoperative Complications ◽  
Prospective Study ◽  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Prophylactic Antibiotic ◽  
Chronic Otitis Media ◽  
Short Term ◽  
Secondary Infections ◽  
Ventilation Tubes ◽  
Short Term Prophylaxis

Insertion of ventilation tubes has successfully remedied chronic otitis media with effusion in millions of children, but the procedure has been complicated by secondary infections and otorrhea in as many as 34% of the cases. Because infection at the time of surgery was suspected as the primary cause of these postoperative complications, short-term prophylaxis with antibiotic eardrops was proposed for averting secondary infections. To evaluate this hypothesis, we conducted a 6-month prospective study in which 200 children had bilateral tube insertions. Antibiotic eardrops were administered to patients’ right ears intraoperatively and for 3 days after surgery; left ears received no eardrops and served as controls. The prophylactic strategy did not significantly decrease the incidence of postoperative otorrhea in treated right ears compared with controls.

scholarly journals Effectiveness of Surgical Approach of Insertion Ventilation Tubes (Tympanostomy) and Adenoidectomy in Comparison with Non-Surgical Approach (Watchful Waiting Approach) in Children at the Age between 1 and 6 and Who Suffer from Otitis Media with Effusion (OME) in 12-Month Period of Observation—The Retrospective Analysis

2021 ◽  
Vol 18 (23) ◽  
pp. 12502
Author(s):  
Magdalena Beata Skarzynska ◽  
Elżbieta Gos ◽  
Natalia Czajka ◽  
Milaine Dominici Sanfis ◽  
Piotr Henryk Skarzynski
Keyword(s):  
Medical History ◽  
Otitis Media ◽  
Surgical Approach ◽  
Watchful Waiting ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media ◽  
Chronic Otitis Media ◽  
Ventilation Tubes ◽  
The Difference ◽  
Surgical Group

(1) Background: Otitis media with effusion (OME) is one of the most common diseases in childhood. The objective was to assess clinically the effectiveness of the surgical approach (tube insertion with adenoidectomy) in comparison with the non-surgical approach (watchful waiting) during a 12-month observation period. (2) Methods: This study was retrospective and obtained approval from the bioethics committee. The criteria of inclusion in the first group (surgical approach) were: (1) a diagnosis of chronic otitis media with effusion in children aged between 1 and 6 years; (2) their medical history showed that they had undergone adenoidectomy and tympanostomy with the insertion of ventilation tubes (VTs). The criteria for inclusion in the second group (non-surgery) were similar to the first group except that their medical history showed they had not undergone adenoidectomy or tympanostomy with the insertion of VTs. There were 422 children included in the surgical group and 50 children in the non-surgical group, and the period of observation was 12 months. (3) Results: For the entire surgical group, the number of healthy days ranged from 20 to 365, with a mean of 328.0 days (SD = 91.4).In the non-surgical group, the number of healthy days ranged from 13 to 365, with a mean of 169.2 days (SD = 127.3). The difference in the number of healthy days was statistically significant (p < 0.001). The certainty of treatment in the first group was higher than in the second group, and the number of days without recurrence was significantly higher than in the second group. In the first group, there were 71 recurrences from 422 children (16.8%), and, in the second subgroup, there were 40 recurrences of acute otitis media (AOM) from 50 children (80%). The RR was 0.21. (4) Conclusions: The surgical approach in children aged 1–6 years who have been diagnosed with otitis media with effusion is reasonable and beneficial for the child.

Surgical Advances in Treating Otitis Media

1994 ◽  
Vol 103 (5_suppl) ◽  
pp. 49-53 ◽  
Author(s):  
Michael M. Paparella ◽  
Oleg Froymovich
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Combined Approach ◽  
Radical Mastoidectomy ◽  
Closed Cavity ◽  
Surgical Methods ◽  
Ventilation Tubes

Surgical methods of treating otitis media and its sequelae are discussed, according to the classification of otitis media presented in an earlier report Surgical management of otitis media with effusion and recurrent purulent otitis media includes myringotomy and use of ventilation tubes. Occasionally, otitis media with effusion will lead to structural and other pathologic changes in the middle ear, and conservative treatments such as use of medication or tubes will not suffice. Indications and methods for exploratory tympanotomy and reconstruction of the middle ear are discussed. In such instances, tympanoplasty can be used to the patient's benefit Chronic otitis media with mastoiditis, defined by the presence of intractable pathologic tissue, generally requires surgical correction. Classic methods include simple mastoidectomy, modified radical (Bondy) mastoidectomy, and radical mastoidectomy. Current classifications of procedures would also include closed-cavity tympanomastoidectomy, open-cavity tympanomastoidectomy, and intact-bridge tyrnpanomastoidectomy (a combined approach). The diagnostic and surgical approach to silent or subclinical otitis media is discussed. Diagnosis and treatment of sequelae of otitis media, including sequelae in the middle ear and, less commonly, in the inner ear, are discussed.

Impact of Patient Socioeconomic Disparities on Time to Tympanostomy Tube Placement

2021 ◽  
pp. 000348942110157
Author(s):  
Jennifer L. McCoy ◽  
Ronak Dixit ◽  
R. Jun Lin ◽  
Michael A. Belsky ◽  
Amber D. Shaffer ◽  
...  
Keyword(s):  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Private Insurance ◽  
Chronic Otitis Media ◽  
The United States ◽  
Socioeconomic Disparities ◽  
Tube Placement ◽  
Median Income ◽  
Public Insurance ◽  
Tympanostomy Tubes

Objectives: Extensive literature exists documenting disparities in access to healthcare for patients with lower socioeconomic status (SES). The objective of this study was to examine access disparities and differences in surgical wait times in children with the most common pediatric otolaryngologic surgery, tympanostomy tubes (TT). Methods: A retrospective cohort study was performed at a tertiary children’s hospital. Children ages <18 years who received a first set of tympanostomy tubes during 2015 were studied. Patient demographics and markers of SES including zip code, health insurance type, and appointment no-shows were recorded. Clinical measures included risk factors, symptoms, and age at presentation and first TT. Results: A total of 969 patients were included. Average age at surgery was 2.11 years. Almost 90% were white and 67.5% had private insurance. Patients with public insurance, ≥1 no-show appointment, and who lived in zip codes with the median income below the United States median had a longer period from otologic consult and preoperative clinic to TT, but no differences were seen in race. Those with public insurance had their surgery at an older age than those with private insurance ( P < .001) and were more likely to have chronic otitis media with effusion as their indication for surgery (OR: 1.8, 95% CI: 1.2-2.5, P = .003). Conclusions: Lower SES is associated with chronic otitis media with effusion and a longer wait time from otologic consult and preoperative clinic to TT placement. By being transparent in socioeconomic disparities, we can begin to expose systemic problems and move forward with interventions. Level of Evidence: 4

scholarly journals Determinants of chronic otitis media with effusion in preschool children: a case–control study

2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Rebecca E. Walker ◽  
Jim Bartley ◽  
David Flint ◽  
John M. D. Thompson ◽  
Edwin A. Mitchell
Keyword(s):  
Preschool Children ◽  
Otitis Media ◽  
Case Control Study ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Case Control ◽  
Control Study
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