Low-cost nasal balloon procedure can help treat children's hearing loss: study
In this screengrab, a child demonstrates autoinflation of a nasal balloon. (From CMAJ)
Published Monday, July 27, 2015 12:00PM EDT
Last Updated Monday, July 27, 2015 1:06PM EDT
A simple procedure using a nasal balloon can help reduce the impact of hearing loss in children and potentially avoid unnecessary ear-tube surgery and antibiotics, according to a new study.
The study, published Monday in the Canadian Medical Association Journal, looked at children who have a history of otitis media with effusion, commonly known as "glue ear."
Otitis media with effusion is an inflammatory disease affecting the middle ear. It is often associated with a viral infection. Children who develop otitis media, see a thick build-up of fluid in the middle ear, which makes hearing difficult.
There are few symptoms when it first starts, and parents typically only seek medical help when their child begins to develop hearing problems. This is concerning to many parents, as it may interfere with language acquisition, behaviour and education.
Treating otitis media with effusion is tricky, with about a third of cases showing recurrence, the study said. Treatment options include ventilation tube surgery, antibiotics, steroids and antihistamines. In many cases, the problem will naturally resolve itself with time. But for some extreme cases surgery is the only effective treatment.
The study also noted that antibiotics are largely ineffective and "resistance to them poses a major threat to public health."
The study’s lead author, Dr. Ian Williamson, said autoinflation is an ideal treatment for standard cases as it is non-surgical and relatively inexpensive.
"We think it's well worth trying it, because there simply aren't any effective treatments other than surgery," he told CTVNews.ca in a phone interview from the U.K.
Williamson and his team from the University of Southampton conducted a randomized controlled trial of 320 school-aged children, to see if inflating a nasal balloon could be used to treat otitis media with effusion. Previously, the simple low-cost procedure had been used in a small number of hospital-based trials.
During the trial, half the children were asked by a medical professional to inflate a balloon with their nostrils three times a day for between one to three months. Both the children receiving autoinflation and the controls were assessed at one and three months.
Disclaimer: Before undertaking any procedures, consult with a qualified medical professional.
The researchers found that the children receiving autoinflation were more likely than the controls to have normal middle-ear pressure at one month (47.3 per cent compared to 35.6 per cent), and at three months (49.6 per cent compared to 38.3 per cent).
This group also had fewer days where they had symptoms compared to the control group.
The study concluded that autoinflation is a practical procedure that can be used to treat middle ear infections.
"We have found use of autoinflation in young, school-aged children with otitis media with effusion to be feasible, safe and effective in clearing effusions, and in improving important ear symptoms, concerns and related quality of life over a 3-month watch-and-wait period," the study said.
The authors of the study suggest that autoinflation should be used more widely to treat children with "glue ear."
Reducing the need for surgery
In a separate commentary, researchers from Australia's Bond University say that autoinflation may help reduce the need for costly tube surgeries.
"Autoinflation is one of a number of effective nondrug interventions typically underrepresented in research and clinical practice," the commentary said.
"Getting the message to clinicians about effective nondrug treatments is much harder than it is for drug treatments."
Williamson said while the intervention is not meant to be a replacement for tube surgery, it can be used to treat standard cases.
In standard cases, many doctors take a "watch and wait" approach, as many children get better on their own, he said. "But there's a lot of children who are impacted, who have hearing problems, speech development issues, and repeated ear infections," he added, noting that for these children the intervention is "worth a try" to get the fluid in the ear cleared.
"It's an important age for children at school, and you'd want to give them the best learning opportunities," Williamson said.
The nasal balloon used in the U.K. clinical trial is the Otovent Glue Ear Treatment Pack, which is available for purchase in Canada.