Systemic steroids for otitis media with effusion in children
Abstract
The role of oral steroids in the treatment of otitis media with effusion in children is the subject of ongoing debate. To critically evaluate the existing evidence, we performed a formal meta-analysis of six randomized clinical trials (n = 264 children) selected from 14 articles and abstracts. Children receiving steroids for 7 to 14 days were 3.6 times more likely than placebo-treated control subjects to have both ears free of effusion at the end of therapy (95% confidence interval, 2.2 to 4.1). This finding was essentially unchanged when the studies were weighted by a quality score, or stratified by use of concurrent antibiotic. The presence of significant heterogeneity among these studies suggests that additional trials will be needed to identify the specific subset(s) of children most likely to benefit from steroid therapy.
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Steroids may have an effect on OME by shrinking peritubal lymphoid tissue, promoting secretion of Eustachian tube surfactant, and reducing the viscosity of middle ear fluid.
“In addition, steroids may have an effect on OME by shrinking peritubal lymphoid tissue, promoting secretion of Eustachian tube surfactant, and reducing the viscosity of middle ear fluid (Rosenfeld 1991).”
From Topical and oral steroids for otitis media with effusion (OME) in children (2023) · cites this paper as Rosenfeld 1991
Steroids may exert a beneficial effect on middle ear effusion by stabilising membrane phospholipid breakdown, thus preventing the formation of arachidonic acid and, in turn, inflammatory mediators.
“Steroids may exert a beneficial effect on middle ear effusion by stabilising membrane phospholipid breakdown, thus preventing the formation of arachidonic acid and, in turn, inflammatory mediators (Rosenfeld 1991).”
From Topical and oral steroids for otitis media with effusion (OME) in children (2023) · cites this paper as Rosenfeld 1991
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- Authors
- Rosenfeld, R. M., Mandel, E. M., & Bluestone, C. D.
- ORCID
- Mandel, E. M.
- Venue
- Archives of Otolaryngology - Head and Neck Surgery
- Publisher
- American Medical Association (AMA)
- Published
- 1991-09-01
- Volume
- 117
- Issue
- 9
- Pages
- 984-989
- ISSN
- 0886-4470 (ISSN-L)
- OpenAlex
- W1996808836
- Cited by
- 99
- References
- 0
- Citations by year
- 2023: 3 · 2022: 1 · 2021: 1 · 2020: 1 · 2019: 1 · 2018: 1 · 2017: 2 · 2016: 2 · 2013: 1 · 2012: 1
- FWCI
- 7.03
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Otolaryngology - Head and Neck Surgery (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Deafness and Other Communication Disorders (DC 00158, DC 00021)
- Topics
- Health Sciences › Medicine › Otorhinolaryngology › Ear Surgery and Otitis Media
- Health Sciences › Medicine › Infectious Diseases › Otolaryngology and Infectious Diseases
- Health Sciences › Medicine › Otorhinolaryngology › Sinusitis and nasal conditions
- Keywords
- otitis media with effusion, systemic corticosteroids, oral corticosteroids, children, antibiotic therapy, treatment efficacy
- MeSH terms
- Adolescent, Anti-Bacterial Agents, Child, Child, Preschool, Drug Therapy, Combination, Glucocorticoids, Humans, Infant, Otitis Media with Effusion, Meta-Analysis as Topic, Outcome Assessment, Health Care
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