Steroids for otitis media with effusion: a systematic review

Area of Science:

• Pediatrics
• Otolaryngology
• Pharmacology

Background:

• Otitis media with effusion (OME) is a prevalent childhood condition.
• OME can lead to hearing loss and delayed language development.
• Current treatment strategies for OME remain a subject of debate.

Purpose of the Study:

• To evaluate the efficacy of systemic or topical nasal steroids in treating OME.
• To synthesize evidence from randomized controlled trials on steroid treatment for OME.

Main Methods:

• Searched major databases (Cochrane, EMBASE, MEDLINE) for relevant randomized controlled trials.
• Included studies investigating oral or topical nasal steroids, alone or with antibiotics.
• Extracted data and assessed methodological quality independently.

Main Results:

• Oral steroids significantly reduced OME persistence in the short-term (OR 0.22).
• Oral steroids combined with antibiotics also showed short-term efficacy (OR 0.32).
• Trends favored steroids in other comparisons, but confidence intervals were not statistically significant for long-term outcomes.

Conclusions:

• Steroids, alone or with antibiotics, accelerate short-term OME resolution.
• No evidence supports long-term benefits of steroids for OME-related hearing loss.
• Current evidence does not support the use of oral or topical nasal steroids for OME treatment.