Can party balloons replace autoinflation balloons to treat glue ear: technical comparison

BackgroundAutoinflation balloons are used to treat patients with otitis media with effusion to help avoid surgery.AimTo compare the ability of party balloons and Otovent® balloons to produce sufficient pressure for a Valsalva manoeuvre.Design & settingWe used pressure testing to determine the number of times each balloon could produce pressures sufficient for a Valsalva manoeuvre. Subsequently, we compared Otovent® balloons with spherical party balloons in a pilot clinical trial of 12 healthy adults.MethodEach balloon was inflated 20 times and the maximum pressure was recorded. Three balloons of each type were tested to 50 inflations to assess pressures over persistent use.ResultsOtovent® balloons mean inflation pressure was 93 mmHg (95% CI 89–97 mmHg) on first inflation, dropping to 83 mmHg (95% CI 80–86 mmHg) after 20 inflations. Two types of spherical party balloon required mean inflation pressures of 84 mmHg (95% CI 77–90 mmHg) and 108 mmHg (95% CI 97–119 mmHg) on first inflation, dropping to 74 mmHg (95% CI 68–81 mmHg) and 83 mmHg (95% CI 77–88 mmHg) after 20 inflations. In the pilot trial, there was no difference between the ability of Otovent® and spherical balloons (χ2=0.24, P=0.89) to produce the sensation of a Valsalva manoeuvre.ConclusionOtovent® balloons can be used more than the 20 times quoted by the manufacturer. The two spherical balloons produced similar pressures to Otovent® balloons, indicating potentially the same clinical effect. The pilot study suggests a potential use of spherical party balloons instead of Otovent® balloons as a cost-efficient treatment.

Management of conductive deafness from Otitis Media with Effusion (known as ‘glue ear’) in children using bone conduction headsets when grommet operations were unavailable during COVID-19

BackgroundOtitis Media with Effusion (OME) causing hearing impairments affects ∼1 in 10 children starting school in UK/ Europe. 80% have at least one episode with most having conductive hearing loss. Studies showed children with OME hear better with bone conducting headsets. During COVID-19 we investigated whether children with deafness secondary OME, without access to audiology or grommet surgery, could be aided with bone conduction kits and the HearGlueEar app.MethodsStarting July 2020, during COVID-19, children aged 3-11 years with OME and on a grommet waiting list were invited to a single arm, prospective study. They received the kit, instructions and HearGlueEar app by post. By 3 weeks parents were asked to charge and pair the devices, attend a remote consultation and complete an OMQ-14 questionnaire. Remote follow-up lasted 3 months. Outcomes: ability to use the equipment, complete the questionnaire about child’s hearing and behaviour before and with the equipment, declining grommet surgery or where deafness resolved, and give opinion about the intervention.Findings26 children enrolled. Families used the kit at home and school. Most found remote consultations positive and convenient. OMQ-14 responses were 90% positive. Comments were: “Other people have said, wow his speech is clearer.”, “It is making a real difference at home.”, “He said over and over again, “I can hear everybody, wow, wow, wow.”, “It is no exaggeration to say this has made an astronomical improvement to his quality of life”. One child reported “I can hear my best friend again”. “She is getting on really well with the headphones - pairing them with the iPad at home is simply brilliant.” Three families continued with the headset to avoid grommets.InterpretationPosting a bone conduction kit, HearGlueEar app and remote consultation is effective support for children with deafness secondary to OME.FundingNone

Adenoids with Glue Ear: Incidence, Management and Outcome

Background: In the 17th and 18th centuries, Santorini and Wilhem Mayer described the adenoids. Enlarged adenoid or adenoids is a common disorder in children, not only compromise the natural pathway of breathing, but it also obstructs the nasopharyngeal opening of Eustachian tubes. As a result, retention of fluid in the middle ear cavity and the development of glue ear or otitis media with effusion (OME). If it happens, the children present with hearing loss, delayed speech and language, poor social behavior, and may with difficulties of balance. Methods: It is a cohort retrospective study of 251 cases in the Department of Otolaryngology and Head-Neck Surgery, Cumilla Medical College, and Cumilla Medical Centre, Bangladesh, from 01 July 2016 to 31 June 2019. Results: Incidence of adenoids with glue ear, out of total ENT routine operations was 3.54%, and adenoidectomy-tonsillectomy operations were 29.05%. Of them, the male was 102(40.64%), the female was 149(59.36%), 3-5 years were 83(33.07%), 6-10 years 107(42.63%), and 11-15 years 61(24.30%).