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An acute or chronic inflammatory process affecting the middle ear.

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Otitis media with effusion (OME), also known as glue ear or serous otitis media, is a condition in which there is fluid persisting in the middle ear. Many treatments have been suggested. This review summarizes the studies using antihistamines, decongestants or a combination of antihistamines and decongestants and finds no benefit for any of the short or long‐term outcomes including resolution of the fluid, hearing problems or the necessity of additional referral to specialists. Further, using these medications causes significant side effects, such as gastrointestinal upset, irritability, drowsiness or dizziness, in approximately 10% of patients. Therefore antihistamines, decongestants or antihistamine/decongestant combinations are not recommended treatments for OME. Watchful waiting is the best approach with consideration of referral for evaluation by an ENT consultant if symptoms persist beyond 12 weeks.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: September 7, 2011

Acute otitis media (AOM), or middle ear infection, is a common childhood illness, with more than half of all children having at least one infection by the time they are seven. Although otitis media often resolves without treatment, it is frequently treated with antibiotics. The length of treatment varies widely. This review of 49 trials found that treating children with a short course (less than seven days) of antibiotics, compared to treatment with a long course (seven days or greater) of antibiotics, increases the likelihood of treatment failure in the short term. No differences are seen one month later. The amount of gastrointestinal adverse events decreased with a shorter course of antibiotics.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: September 8, 2010

Otitis media with effusion (OME ‐ also known as 'glue ear') is a common condition in children, where sticky fluid accumulates in the middle ear. Although the fluid usually resolves without treatment, it may remain and cause long periods of hearing loss. This may lead to problems with language development and behaviour. Children with OME may show no other symptoms so some have suggested that all children should be checked (screened) for this condition. However, the review of trials in the developed world found that checking children for, and early treatment of, OME before they are four does not result in improved outcomes.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: January 24, 2007

Antibiotics make little difference to children with an uncomplicated ear infection and ear pain. Some advocate ear drops with local anaesthetic such as amethocaine, benzocaine or lidocaine. Five trials (391 participants) were identified; two compared anaesthetic drops to placebo (inactive) drops; and three compared anaesthetic drops to herbal ear drops. There was no strong evidence that herbal ear drops were effective, but anaesthetic drops did provide better pain relief than the inactive drops. Only one trial looked at adverse reactions and reported no cases of ringing in the ears or unsteadiness when walking and three cases of very mild dizziness.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: July 19, 2006

Glue ear (otitis media with effusion ‐ OME) is sticky fluid in the middle ear that does not cause pain or fever but can reduce hearing. Steroid drugs (taken orally or as nose spray) are sometimes used to try to speed up the resolution of effusion and so prevent hearing loss. Other treatment options include oral antibiotics and other medicines, or surgical procedures such as grommets (ventilation tubes). This review of trials found that oral steroids (especially when used in combination with antibiotics) speeded up the resolution of OME in the short term. However, there was no long‐term evidence to show lasting benefit or improved hearing. There was no evidence that using steroid drugs as a nose spray benefited children with OME.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: May 11, 2011

Otitis media with effusion (OME) or 'glue ear' is very common in children and the hearing loss and discomfort, especially where the effusion is bilateral and long‐lasting, may lead to problems with language, development and behaviour. There are a number of treatment options including steroids, antibiotics, decongestants, antihistamines and surgery (the insertion of grommets (ventilation tubes)). Grommet insertion is one of the commonest operations of childhood. The best treatment strategy remains controversial, however, as glue ear often resolves spontaneously within a few months.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: May 31, 2013

Evidence suggests that grommets only offer a short‐term hearing improvement in children with simple glue ear (otitis media with effusion or OME) who have no other serious medical problems or disabilities. No effect on speech and language development has been shown.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: October 6, 2010

We reviewed the effect of influenza vaccine on preventing acute otitis media (AOM) in infants and children.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: October 17, 2017

This review compared the effects of oral antibiotics against placebo, no treatment or other therapies in children with otitis media with effusion (OME) or 'glue ear'.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: June 12, 2016

This review compared 1) the clinical effectiveness and safety of antibiotics against placebo in children with an acute middle ear infection (acute otitis media (AOM)) and 2) the clinical effectiveness and safety of antibiotics against expectant observation (observational approaches in which prescriptions may or may not be provided) in children with AOM.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: June 23, 2015

This SBU report reviews the scientific evidence for tympanostomy tube insertion in the tympanic membrane (eardrum) of children with recurrent acute otitis media (inflammation of the middle ear) or long-term episodes of secretory otitis media (with fluid accumulation in the middle ear). Although these conditions eventually heal, approximately 10,000 Swedish children a year have such severe problems due to episodes of pain, reduced quality of life or hearing loss that tympanostomy tube insertion is considered to be warranted.

Swedish Council on Health Technology Assessment (SBU).

Version: September 2008

Study found that adenoidectomy is most beneficial in children with persistent otitis media with effusion aged ≥ 4 years , with a smaller beneficial effect found in children with recurrent acute otitis media aged < 2 years, and that consideration must be given to the balance between benefits and harms.

Health Technology Assessment - NIHR Journals Library.

Version: January 2014

The objectives for the systematic review are to synthesize information on the effectiveness of tympanostomy tubes (TT) in children with chronic otitis media with effusion and recurrent acute otitis media, summarize the frequency of adverse effects or complications associated with TT placement, synthesize information on the necessity for water precautions in children with TT, and assess the effectiveness of available treatments for otorrhea in children who have TT.

Comparative Effectiveness Reviews - Agency for Healthcare Research and Quality (US).

Version: May 2017

Otitis media with effusion (OME) is a condition characterised by a collection of fluid within the middle ear without signs of acute inflammation. It is most common in young children, with a bimodal peak at 2 and 5 years of age. Eighty percent of children will have had a least one episode of OME by the age of 10 years. At age 7–8 years, about 8% of children will have middle ear effusions; this incidence increases in winter. The mean duration of effusions is 6–10 weeks but some cases are more persistent.

NICE Clinical Guidelines - National Collaborating Centre for Women’s and Children’s Health (UK).

Version: February 2008

Acute otitis media (AOM) is a leading cause of visits to physicians and of antibiotic prescriptions for young children. We systematically reviewed studies on all-cause AOM episodes and physician visits in which impact was attributed to pneumococcal conjugate vaccines, either as efficacy or effectiveness. Of 18 relevant publications found, most used the 7-valent pneumococcal conjugate vaccine (7vCRM). The efficacy of 7vCRM against all-cause AOM episodes or visits was 0%-9% in randomized trials and 17%-23% in nonrandomized trials. In observational database studies, physician visits for AOM were already declining in the 3-5 years before 7vCRM introduction (mean change, -15%; range, +14% to -24%) and continued to decline afterward (mean, -19%; range, +7% to -48%). This vaccine provides some protection against OM, but other factors have also contributed to the recent decline in OM incidence. Future effectiveness studies should thus use better-controlled methods to estimate the true impact of vaccination on AOM.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

The most common cause of hearing loss in early childhood is otitis media with effusion (OME). Prevention of OME in preschool children will improve quality of life. The authors aimed to determine, by the best available published evidence, whether vaccination against pneumococci effectively prevents OME. The study design was based on systematic review (SR) of randomized controlled trials (Level 1a evidence). The medical literature available through searching Medline database was reviewed using the following keywords "Otitis media with effusion," "secretory otitis media," or "glue ear," and "vaccination" limiting the search to randomized controlled trials (RCTs) conducted on children (0-18 years), published in English, in the last 10 years. Results of effects of vaccination on prevention of OME from the included RCTs were utilized to conduct a meta-analysis to find out the preventive value of antipneumococcal vaccination. Three RCTs were identified conforming to the inclusion criteria. Meta-analysis of results showed no significant preventive advantage for antipneumococcal vaccination. Based on the results it was confirmed that neither primary nor secondary prevention by antipneumococcal vaccination has a beneficial impact on OME. More RCTs should be conducted to study the effect of vaccination on OME.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

A systematic review was conducted to evaluate evidence regarding xylitol, a sugar alcohol, as a prophylaxis for acute otitis media (AOM) in children. The authors searched PubMed and other databases to identify evidence. Criteria for included studies were: appear in English-language, peer-reviewed journals; at least quasi-experimental designs; use xylitol; and present outcome data. The authors completed evaluation forms for the included studies at all phases of the review. The authors reviewed 1479 titles and excluded 1435. Abstracts and full texts were reviewed for the remaining 44; four randomized controlled trials met inclusion criteria. Xylitol was a generally well accepted prophylaxis for AOM with few side effects when administered via chewing gum or syrup at 10 g/day given five times daily. Meta-analysis revealed significant treatment effects (Risk ratio = 0.68; 95% confidence interval = 0.57 to 0.83). Xylitol can be a prophylaxis for AOM, but warrants further study, especially of vehicles other than chewing gum for young children, and information is needed regarding cost, duration of administration required, and expected long-term effects.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

BACKGROUND AND OBJECTIVE: No consensus has yet been reached with regard to the link between otitis media with effusion (OME), hearing loss, and language development in children with cleft palate. The objective of this study was to address the effectiveness of ventilation tube insertion (VTI) for OME in children with cleft palate.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

BACKGROUND AND OBJECTIVE: No consensus has yet been reached with regard to the link between otitis media with effusion (OME), hearing loss, and language development in children with cleft palate. The objective of this study was to address the effectiveness of ventilation tube insertion (VTI) for OME in children with cleft palate.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

OBJECTIVES: We report the findings of an evidence assessment on the accuracy of methods of diagnosing middle ear effusion in children with otitis media with effusion (OME).

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2003

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