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Autoinflation for the Treatment of Persistent Otitis Media With Effusion in Children
Shuixia Liu1, Wenxia Chen2, Yong Zhang3
1Department of Otolaryngology-Head and Neck Surgery, Northwest Women's and Children's Hospital, Xi'an, China.
Insights
Autoinflation is a safe and effective treatment for persistent otitis media with effusion (OME) in children. It offers a low-risk alternative to surgery, though certain risk factors may indicate treatment failure.
Area of Science:
- Pediatric Otolaryngology
- Evidence-Based Medicine
- Clinical Research
Background:
- Otitis media with effusion (OME) is a common pediatric condition that can lead to hearing loss if persistent.
- Effective management strategies for OME are crucial for child development.
Purpose of the Study:
- To evaluate the efficacy and safety of autoinflation for treating persistent OME in children.
- To identify potential risk factors associated with autoinflation treatment failure.
Main Methods:
- A retrospective cohort study involving 131 children with persistent OME.
- Comparison of autoinflation treatment (twice-daily for 1-3 months) plus medical therapy versus medical therapy alone.
Main Results:
- Autoinflation group showed significantly higher cure rates (60.8%) compared to the control group (20.0%) after 3 months.
- Mild, tolerable ear pain was the most common adverse event.
- Recurrent OME and respiratory infections were identified as risk factors for treatment failure.
Conclusions:
- Autoinflation is a safe and effective treatment option for persistent OME in children.
- Identifying risk factors can help guide clinical decisions and patient selection for autoinflation.
- Autoinflation presents a viable, low-risk alternative to surgical interventions for suitable pediatric patients.
Importance:
Otitis media with effusion (OME) is common in children, often persisting for more than 3 months, which can lead to hearing loss. Effective treatments are needed to manage this condition.
Objective:
To evaluate the efficacy and safety of autoinflation for persistent OME in children.
Design:
Retrospective cohort study.
Setting:
The study was conducted at a tertiary pediatric hospital.
Participants:
A total of 131 children with persistent OME were enrolled from January 2020 to July 2025. Seventy-one children received autoinflation treatment, and 60 children were assigned to the control group.Exposure or Intervention:The autoinflation group received twice-daily autoinflation treatment for 1 to 3 months in addition to medical therapy. The control group received only medical therapy.
Main Outcome Measures:
Efficacy was evaluated based on cure rates assessed by tympanometry and otoacoustic emissions before and after treatment. Safety was assessed through the frequency and severity of adverse events.
Results:
In the autoinflation group after 3 months, 60.8% of ears were cured, and 13.3% showed improvement. In the control group, only 20.0% of ears were cured, and 20.0% improved. Univariate analysis indicated that recurrent OME and recurrent/prolonged respiratory tract infections were significant risk factors for autoinflation failure. Approximately half of the children experienced mild ear pain during the first week, which was generally tolerable.
Conclusion:
Autoinflation appears to be safe and effective in children with persistent OME. Treatment failure is more common in children with recurrent/prolonged respiratory infections or recurrent OME, especially in those with a history of middle ear surgery (adenoidectomy with tympanostomy tube insertion). Although autoinflation is a low-risk alternative to surgery for suitable patients, it should be avoided in children with skull base or orbital defects, craniofacial anomalies, or active infection or inflammation.
Relevance:
This retrospective cohort study supports the use of autoinflation as a treatment option for persistent OME. Identifying risk factors for treatment failure may help guide clinical decisions.
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