Antihistamines and/or decongestants for otitis media with effusion (OME) in children

Griffin, Glenn; Flynn, Cheryl A.

doi:10.1002/14651858.cd003423.pub3

Cited by 76 publications

(26 citation statements)

References 53 publications

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“…Similar to our study, they measured tubal patency in both directions, that is, from the middle ear with equalization tests and through the nose/pharynx with the Valsalva maneuver. However, there are long-term studies in the literature that clinically indicate that any longterm effect of such drops or sprays on tube function is very questionable (6). In concordance with the results of Jensen et al (13), we found that nasal decongestion has a benefit on tube opening if higher pressures are applied in the pharynx.…”

Section: Discussionsupporting

confidence: 89%

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Can Nasal Decongestants Improve Eustachian Tube Function?

Óvári

Buhr

Warkentin

et al. 2015

Otology &Amp; Neurotology

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Section: Discussionsupporting

confidence: 89%

“…A meta-analysis of the Cochrane database found no benefit but some harm from the use of antihistamines or decongestants alone or in combination in the management of SOM in children (6). This idea has made the use of nasal drops or sprays very commonVat least in Germany.…”

Section: Discussionmentioning

confidence: 99%

Can Nasal Decongestants Improve Eustachian Tube Function?

Óvári

Buhr

Warkentin

et al. 2015

Otology &Amp; Neurotology

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“…1,12,34,38,64 Furthermore, these interventions are associated with substantial NHS costs. Antibiotic prescription in primary care is rising progressively again, and has now exceeded the peak in the late 1990s, further driving the development of antibiotic resistance, which may lead to serious infections becoming untreatable.…”

Section: Resultsmentioning

confidence: 99%

An open randomised study of autoinflation in 4- to 11-year-old school children with otitis media with effusion in primary care

Williamson

Vennik

Harnden

et al. 2015

Health Technol Assess

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BackgroundOtitis media with effusion (OME) is a very common problem in primary care, but one that lacks an evidence-based non-surgical treatment.ObjectiveTo determine the clinical effectiveness of nasal balloon autoinflation for the treatment of OME in children.DesignA pragmatic, two-arm, open randomised controlled trial.SettingForty-three general practices from 17 UK primary care trusts recruited between January 2012 and February 2013.ParticipantsSchool children aged 4–11 years with a history of OME symptoms or related concerns in the previous 3 months, and a type B tympanogram, diagnostic of a middle ear effusion, in one or both ears.InterventionThree hundred and twenty children were randomised, 160 to each group, using independent web-based computer-generated randomisation (with minimisation based on age, sex and baseline severity of OME) to either nasal balloon autoinflation performed three times per day for 1–3 months plus usual care, or usual care alone.Main outcome measuresThe proportion of children demonstrating clearance of middle ear fluid in at least one ear (with normal tympanograms) at 1 and 3 months, assessed blind to treatment. An ear-related measure of quality of life (QoL) [a 14-point questionnaire on the impact of OME (OMQ-14)], weekly diary recorded symptoms, compliance and adverse events were all secondary outcomes.ResultsAt 1 month, the proportion of children with normal tympanograms was 47.3% (62/131) in those allocated to autoinflation and 35.6% (47/132) in those receiving usual care [adjusted relative risk (RR) 1.36, 95% confidence interval (CI) 0.99 to 1.88]. At 3 months, the proportions were 49.6% (62/125) and 38.3% (46/120), respectively (adjusted RR 1.37, 95% CI 1.03 to 1.83; number needed to treat = 9). The change in OMQ-14 also favoured the intervention arm (adjusted global score difference –0.42;p = 0.001). Reported compliance was good: 89% in the first month and 80% in months 2 and 3. Adverse events included otalgia in 4% of treated children compared with 1% in the control group. Minor nosebleeds (14% vs. 15%) and respiratory tract infections (18% vs. 13%) were noted.ConclusionWe found the use of autoinflation in young children with OME to be feasible in primary care and effective in both clearing effusions and improving child and parent ear-related QoL and symptoms. This method has scope to be used more widely. Further research is needed for very young children, and to inform prudent use in different health settings.Trial registrationCurrent Controlled Trials ISRCTN55208702.FundingThis project was funded by the National institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full inHealth Technology Assessment, Vol. 19, No. 72. See the NIHR Journals Library website for further project information.

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“…A meta-analysis of 16 randomized controlled trials demonstrated no significant benefit from antihistamines, decongestants, or combined antihistamines and decongestants versus placebo for treatment of OME [77]. Intranasal corticosteroids did reduce the need for surgery in a double blind study in which autoinflation of the middle ear was also effective, but the combination of the two was less efficacious [78].…”

Section: Multi-morbidities Of Allergic Rhinitismentioning

confidence: 99%

Multi-morbidities of allergic rhinitis in adults: European Academy of Allergy and Clinical Immunology Task Force Report

Cingi

Gevaert

Mösges

et al. 2017

Clin Transl Allergy

132

121

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This report has been prepared by the European Academy of Allergy and Clinical Immunology Task Force on Allergic Rhinitis (AR) comorbidities. The aim of this multidisciplinary European consensus document is to highlight the role of multimorbidities in the definition, classification, mechanisms, recommendations for diagnosis and treatment of AR, and to define the needs in this neglected area by a literature review. AR is a systemic allergic disease and is generally associated with numerous multi-morbid disorders, including asthma, eczema, food allergies, eosinophilic oesophagitis (EoE), conjunctivitis, chronic middle ear effusions, rhinosinusitis, adenoid hypertrophy, olfaction disorders, obstructive sleep apnea, disordered sleep and consequent behavioural and educational effects. This report provides up-to-date usable information to: (1) improve the knowledge and skills of allergists, so as to ultimately improve the overall quality of patient care; (2) to increase interest in this area; and (3) to present a unique contribution to the field of upper inflammatory disease.

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Antihistamines and/or decongestants for otitis media with effusion (OME) in children

Cited by 76 publications

References 53 publications

Can Nasal Decongestants Improve Eustachian Tube Function?

Can Nasal Decongestants Improve Eustachian Tube Function?

An open randomised study of autoinflation in 4- to 11-year-old school children with otitis media with effusion in primary care

Multi-morbidities of allergic rhinitis in adults: European Academy of Allergy and Clinical Immunology Task Force Report

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