The P.E.A.N.U.T. Method: Update on an Integrative System Approach for the Treatment of Chronic Otitis Media with Effusion and Adenoid Hypertrophy in Children

Abstract

Background and objectives: Based on our previous single-center study on optimization of treatment of chronic otitis media with effusion (COME) and adenoid hypertrophy (AH) in children using a noninvasive system approach to lower the necessity of antibiotics, analgesic use, and surgical interventions, we proceeded to perform a multicenter investigation in an outpatient setting. The purpose of the previous prospective study in 2013–2015 was to compare outcomes in the treatment of COME and AH using the noninvasive multimodal integrative method (IM) versus conventional treatment practice (COM). Materials and Methods: In this paper, we retrospectively analyze the data of patients treated with the integrative method between 2017 and 2020 in a multicenter setting and compared the outcomes with data from 2013–2015 in order to evaluate generalizability. In both periods, all eligible and willing participants were included and treated with the IM protocol under real-life conditions. The treatment involved pneumatization exercises, education, an antiallergic diet, nasal hygiene, useful constitutional therapy, and thermal interventions (P.E.A.N.U.T.). A total of 48 versus 28 patients, aged 1–8, were assessed, presenting with COME and AH, with moderate to severe hearing impairment at entry. Results: The significant improvement found in both audiometric measures (intact hearing) and tympanometric measures (normal A-type curve) was similar in both datasets with respect to conventional treatment. The new data confirms that the P.E.A.N.U.T. method results in a significant reduction of antibiotics, analgesic use, and surgical interventions. Conclusion: In this multicenter trial, we confirm the effectiveness of the noninvasive system approach for the treatment of COME in lowering the need for antibiotics and analgesic use and elective surgery. This could be especially important with respect to a generally observed increase in antibiotic resistance. The method is easy to perform in different clinical settings and is effective, safe, and well-tolerated.

Otitis media with effusion in preschool children with adenoid hypertrophy: Risk factors and nursing care

“…The adenoid is located at the connection between the parietal wall and the posterior wall of the nasopharynx and between the pharyngeal recesses on both sides. Adenoids can proliferate and hypertrophy under repeated stimulation of inflammation for different reasons, which has pathological significance and can induce related symptoms (Skoloudik et al., 2018; Szoke et al., 2021). Adenoid hypertrophy is mostly seen in children, especially in children under 10 years of age.…”

Influence of Alternative Lifestyles on Antibiotic Use during Pregnancy, Lactation and in Children

“…At least in the case of some types of otitis media, a multimodal approach that includes several non-invasive supportive therapies (pneumatization exercises, education, an antiallergenic diet, nasal hygiene, useful constitutional therapy and thermal interventions; e.g., P.E.A.N.U.T.) appears to contribute to the success of waiting [29]. The fact that physicians with training in anthroposophic medicine hold longer consultations than is usual in conventional medicine (see [30]) could also contribute to taking the risk of not prescribing antibiotics right away.…”

Anthroposophic Medicinal Products: A Literature Review of Features, Similarities and Differences to Conventional Medicinal Products, Scientific and Regulatory Assessment

“…As a result, individual patients with hay fever will often be prescribed additional AMPs and other non-medication AM therapies, in line with their individualized AM diagnosis. On the other hand, Citrus-Cydonia has been used for other indications with similar pathophysiological profile as that described above, including asthma, 70 rhinosinusitis, 71 otitis media with effusion and adenoid hypertrophy, 72 and Menière's disease. 73…”