Autoinflation compared to ventilation tubes for treating chronic otitis media with effusion

Abstract

Background

Otitis media with effusion (OME) is the most common cause of acquired hearing loss and surgery in children. Autoinflation has been suggested as an alternative treatment for OME.

Objectives

The aim of the study was to compare treatment outcome with a new autoinflation device versus ventilation tube (VT) surgery or watchful waiting in children with chronic bilateral OME from the waiting list for surgery.

Methods

Forty-five children performed autoinflation during four weeks, forty-five were submitted to VT surgery, and twenty-three were enrolled as control group. Tympanometry was performed in the autoinflation and the control groups and audiometry in all groups.

Results

An equivalent hearing improvement was achieved in the autoinflation and the VT group at one (p=.19), six (p=.23) and twelve (p=.31) months with no significant alteration in the control group. In the autoinflation group 80% of the children avoided surgery and no complications were reported compared to 34% complication rate in the VT group.

Conclusion

Autoinflation achieved an equivalent improvement in hearing thresholds compared to VT surgery for treating OME.

Significance

Autoinflation may be a reasonable first-line treatment for children with OME to potentially avoid surgery.

• Article Summary: The Moniri autoinflation device is well tolerated and an effective alternative to ventilation tubes for treatment of chronic otitis media with effusion in young children.

• What’s known on this subject: Previous studies have shown that autoinflation may reduce effusion in children with otitis media with effusion; however limited compliance to treatment, lack of adequate hearing evaluation, short follow-up time and also lack of comparative data to ventilation tube surgery have been reported.

• What this study adds: A new device was developed to allow for the performance of autoinflation in young children. The effect is compared to ventilation tube surgery and equivalent improvement in hearing is achieved in the short and the long-term follow-up.

Chinese Abstract

背景：牙关紧闭是头颈癌 (HNC) 放疗后的一种并发症, 导致疼痛、饮食限制和生活质量下降。然而, 人们对这种病况或牙关紧闭在受辐射人群中的波动情况知之甚少。

目的：前瞻性地绘制接受放疗的 HNC 患者在治疗完成后长达 5 年的牙关紧闭患病率, 包括描述组间最大切面间开口（MIO）的波动。

材料和方法：211 名接受 HNC 治疗性放疗的患者被纳入本前瞻性研究。患者在放疗前（基线）、完成放疗后3、6、12、24、 36 个月和 60 个月接受关于 MIO的随访。

结果：基线时、放疗后 12 个月和 5 年的平均 MIO 分别为 51.5 mm、41.7 mm和 41.3 毫米。放疗后 5 年, 共有 28% (n = 36) 的患者满足牙关紧闭标准。 80% 的患者 (n = 24) 在放疗后 5 年出现牙关紧闭症, 放疗后 12 个月出现牙关紧闭, 而 88-92% 的患者报告, 在与基线相比的任何给定时间点 MIO 降低。 15% 患者的MIO在任何时候都没有超过 >35 mm 。

结论：牙关紧闭是 HNC 及其治疗常见的长期并发症, 似乎不会自然愈合。 MIO 的大部分波动发生在放疗完成后的前 12 个月。

Keywords:

• Otitis media with effusion
• ventilation tubes
• autoinflation
• hearing loss

Author contributions

Armin B Moniri conceived the study hypothesis, carried out the experiments and took the lead in writing the manuscript. Richard M. Rosenfeld contributed to the writing of the manuscript. Luaay Aziz and João Lino adapted and submitted the manuscript to the journal. All authors contributed to the interpretation of the results, provided critical feedback and contributed to the final manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Disclosure statement

Armin B Moniri is the patent holder of the autoinflation device. The other authors have no conflicts of interest to disclose.

Additional information

Funding

This study was partially financed by grants from the Jubilee Fund of Her Majesty Queen Silvia of Sweden. The sponsors played no role in the study design, in the collection, analysis and interpretation of data, in the writing of the manuscript or in the decision to submit the manuscript for publication.