Topical nasal steroids for hearing loss associated with otitis media with effusion in children

Abstract

Background: In the present study, otitis media with effusion (OME) or glue ear, is serous or mucoid, but not mucopurulent, fluid in the middle ear. Children usually present with hearing impairment and speech problems. Hearing impairment is usually mild and often identified when parents express concern regarding their child's behavior, performance at school, or language development. There are many medical treatment options in OME such as systemic antibiotics, oral or topical steroids, anti-histaminics, and decongestants however, there actual role and efficacy is controversial. Topical nasal steroids are one of the better treatment options because of its fewer side-effects compared to oral steroids. Objective: To assess effectiveness of topical nasal steroids (mometosone nasal spray) in hearing loss associated with OME in children. Materials and Methods: One hundred and six children of age group 2-8 years with otoscopy and tympanometry diagnosed cases of OME were enrolled for this study and randomly allocated into two groups, children in the study group were treated with topical nasal steroids (mometosone nasal spray) for period of 3 weeks and children in control group (no treatment) were observed without treatment. On a total of 106 children, 14 lost to follow-up and were excluded from study and the rest of 92 children were studied in this study. Outcome of treatment was measured with closure of air bone gape on pure tone audiometery done after 3 weeks of treatment, 3 weeks after tapering treatment and 3 weeks after stopping treatment. Results: Demographic comparison was insignificant between the two groups. Patients in study group showed significant closure of air bone gape on pure tone audiogram after 3 weeks of treatment, and 3weeks after tapering treatment. Study group patients showed improvement in hearing 3 weeks after stopping treatment but that improvement was not statistically significant. Conclusion: The present study suggested that topical nasal steroids has a role in treatment of OME and can be used as a short-term treatment option until long-term treatment option like myringotomy and ventilation tube insertion is planned and accomplished.