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No effect of a nasal decongestant on eustachian tube function in children with ventilation tubes
Niels van Heerbeek1, Koen J A O Ingels, Gerhard A Zielhuis
1Department of Otorhinolaryngology, University Medical Center Nijmegen, The Netherlands. N.vanHeerbeek@kno.azn.nl
Insights
Topical decongestants like xylometazoline do not improve eustachian tube function in children with ventilation tubes. This study found no benefit, suggesting their use for otitis media with effusion is not recommended.
Area of Science:
- Otolaryngology
- Pediatric Medicine
- Pharmacology
Background:
- Persistent otitis media with effusion (OME) in children often necessitates ventilation tube insertion.
- Eustachian tube dysfunction is a key factor in the development and persistence of OME.
- Topical decongestants are sometimes considered to improve eustachian tube function.
Purpose of the Study:
- To evaluate the efficacy of intranasal xylometazoline hydrochloride in improving eustachian tube function in pediatric patients with ventilation tubes.
- To determine if topical decongestants offer a therapeutic benefit for children experiencing persistent OME.
Main Methods:
- A randomized, double-blinded, placebo-controlled trial was conducted.
- Eighty children with ventilation tubes for OME received either 0.05% xylometazoline or a placebo intranasally.
- Eustachian tube function was assessed before and after treatment administration.
Main Results:
- Intranasal xylometazoline hydrochloride demonstrated no significant effect on the ventilatory function of the eustachian tube.
- The protective function of the eustachian tube remained unchanged following xylometazoline administration.
- No measurable improvement in eustachian tube function was observed in the treatment group compared to placebo.
Conclusions:
- Topical decongestants, specifically xylometazoline, are ineffective in enhancing eustachian tube function in children.
- The routine use of topical decongestants for preventing or treating OME in pediatric populations is not supported by this evidence.
- Clinical recommendations should discourage the use of topical decongestants for managing OME in children.
Objective:
The aim of the study was to assess the effect of a topical decongestant on eustachian tube function in children with ventilation tubes because of persistent otitis media with effusion.
Study Design:
A randomized, double-blinded, placebo-controlled study.
Methods:
At the outpatient departments of a secondary referral hospital and a tertiary referral hospital, eustachian tube function was measured before and after intranasal administration of five drops of 0.05% xylometazoline hydrochloride or placebo in 80 randomly selected children with ventilation tubes because of otitis media with effusion.
Results:
Xylometazoline nose drops had no effect on the ventilatory or the protective function of the eustachian tube.
Conclusions:
Topical decongestants do not have a positive effect on eustachian tube function in children. Therefore, the use of topical decongestants to prevent or treat otitis media with effusion in children is not justified and should be discouraged.