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Published on: February 27, 2018
The Efficacy of Adjuvant Intratympanic Steroid Treatment for Otitis Media with Effusion in Children
Hazem Saeed Amer1, Mohammad Waheed El-Anwar2, Alaa Eldin Elfeky2
1Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, Zagazig University, Zagazig, Egypt.
Insights
Intratympanic steroid injections combined with ventilation tubes significantly reduce otitis media with effusion recurrence in children. This safe and simple intervention lowers symptom recurrence and complications, making it a recommended treatment.
Area of Science:
- Otolaryngology
- Pediatric Medicine
- Pharmacology
Background:
- Otitis media with effusion (OME) is a primary cause of childhood hearing impairment, necessitating prompt and effective management strategies.
- Early intervention for OME is crucial to prevent long-term effects on hearing and development.
Purpose of the Study:
- To evaluate the effectiveness of intratympanic (IT) steroid injections as a treatment for otitis media with effusion (OME).
- To compare the outcomes of IT steroid injections combined with ventilation tubes versus ventilation tubes alone in managing OME.
Main Methods:
- A study involving 42 children (84 ears) diagnosed with bilateral OME, confirmed by tympanometry.
- Surgical intervention included bilateral myringotomy with ventilation tube (VT) insertion, followed by IT methylprednisolone injection in one ear.
- Weekly IT steroid administrations were given for three consecutive weeks post-insertion.
Main Results:
- Recurrent OME was significantly lower in the group receiving VT combined with steroid administration (4.76%) compared to VT alone (21.4%).
- Postoperative tympanosclerosis occurred in 12.9% of ears with VT alone versus 2.3% in injected ears (p=0.0484).
- Otorrhea rates were non-significantly different between the groups (19% with VT alone vs. 7.1% with IT steroids).
Conclusions:
- Intratympanic steroid injection is a safe and straightforward procedure for OME management.
- This method demonstrates a reduced incidence of symptom recurrence and postoperative complications compared to VT insertion alone.
- The use of IT steroids in conjunction with VTs is recommended for the effective management of otitis media with effusion in children.
Introduction:
Otitis media with effusion (OME) is a leading cause of hearing impairment in children. Therefore, early and proper management is essential.
Objectives:
The objective of this research is to assess the efficacy of intratympanic (IT) steroids injection for management of otitis media with effusion (OME).
Methods:
This study involved 42 children (84 ears) with bilateral OME. We used tympanometry to confirm the childreńs middle ear effusion and pure tone audiometry to determine hearing threshold. We performed myringotomy and inserted ventilation tubes (VTs) bilaterally, followed by a steroid injection of 0.4-0.6 mL methylprednisolone (40 mg/mL) into one randomly selected middle ear. This procedure was followed by once-weekly administration of steroids (0.5 mL methylprednisolone at a concentration of 40 mg/mL) into the middle ear for three consecutive weeks.
Results:
We found recurrent OME after VT alone in nine (21.4%) ears; whereas, after VT combined with steroid administration, we found two (4.76%), with statistically significant difference. We noted tympanosclerosis postoperatively in six (12.9%) ears and in one of the injected ears (2.3%) (p = 0.0484). Otorrhea occurred in eight (19%) ears with VT alone and in three (7.1%) injected ears, with non-significant difference. The duration between VT insertion and its extrusion was 6.6 = 1.1 months for ears with VT alone and 6.95 =1.12 months in injected ears (p = 0.1541 NS).
Conclusion:
IT Steroids injection for treatment of OME is a safe and simple intervention with lower incidence of symptoms recurrence and postoperative complications. Thus, its use in management of OME is recommended.
