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Cited by 184Ear Surgery and Otitis MediaSinusitis and nasal conditionsHearing Loss and Rehabilitation

Oral or topical nasal steroids for hearing loss associated with otitis media with effusion in children

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Simpson, Sharon A, Lewis, Ruth, van der Voort, Judith, Butler, Christopher C·2011·Cochrane Database of Systematic Reviews
DOI 10.1002/14651858.cd001935.pub3PMC PMC9829244
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Abstract

BACKGROUND: Otitis media with effusion (OME) is common and may cause hearing loss with associated developmental delay. Treatment remains controversial. OBJECTIVES: To examine the evidence for treating children with hearing loss associated with OME with systemic or topical intranasal steroids. SEARCH STRATEGY: We searched the Cochrane ENT Group Trials Register; CENTRAL; PubMed; EMBASE; CINAHL; Web of Science; BIOSIS Previews; Cambridge Scientific Abstracts; mRCT and additional sources for published and unpublished trials. The date of the most recent search was 26 August 2010. SELECTION CRITERIA: Randomised controlled trials of oral and topical intranasal steroids, either alone or in combination with another agent such as an oral antibiotic. We excluded publications in abstract form only; uncontrolled, non-randomised or retrospective studies; and studies reporting outcomes by ears (rather than children). DATA COLLECTION AND ANALYSIS: The authors independently extracted data from the published reports using standardised data extraction forms and methods. We assessed the quality of the included studies using the Cochrane 'Risk of bias' tool. We expressed dichotomous results as a risk ratio (RR) and continuous data as weighted mean difference (WMD), both with 95% confidence intervals (CI). Where feasible we pooled studies using a random-effects model and performed tests for heterogeneity between studies. In trials with a cross-over design, we did not use post cross-over treatment data. MAIN RESULTS: We included 12 medium to high-quality studies with a total of 945 participants. No study documented hearing loss associated with OME prior to randomisation. The follow-up period was generally limited, with only one study of intranasal steroid reporting outcome data beyond six months. There was no evidence of benefit from steroid treatment (oral or topical) in terms of hearing loss associated with OME. Pooled data using a fixed-effect model for OME resolution at short-term follow up (< 1 month) showed a significant effect of oral steroids compared to control (RR 4.48; 95% CI 1.52 to 13.23; Chi² 2.75, df = 2, P = 0.25; I² = 27%). Oral steroids plus antibiotic also resulted in an improvement in OME resolution compared to placebo plus antibiotic at less than one month follow up, using a random-effects model (RR 1.99; 95% CI 1.14 to 3.49; five trials, 409 children). However, there was significant heterogeneity between studies (P < 0.01, I² = 69%). There was no evidence of beneficial effect on OME resolution at greater than one month follow up with oral steroids (used alone or with antibiotics) or intranasal steroids (used alone or with antibiotics) at any follow-up period. There was also no evidence of benefit from steroid treatment (oral or topical) in terms of symptoms. AUTHORS' CONCLUSIONS: While oral steroids, especially when used in combination with an oral antibiotic, lead to a quicker resolution of OME in the short term, there is no evidence of longer-term benefit and no evidence that they relieve symptoms of hearing loss. We found no evidence of benefit from treatment of OME with topical intranasal steroids, alone or in combination with an antibiotic, either at short or longer-term follow up.

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  • The 2011 Cochrane Review found no evidence of short- or long-term benefit from topical intranasal steroids either alone or in combination with an antibiotic.

    “The authors also found no evidence of short-or long-term benefit from the use of topical intranasal steroids either alone or in combination with an antibiotic.”

    From Topical and oral steroids for otitis media with effusion (OME) in children (2023) · cites this paper as Simpson 2011

  • The conclusions of the review are similar to those of the previous Cochrane Review on this topic, which identified a potential short-term benefit of oral steroids for resolution of OME, but no evidence of benefit for hearing or long-term effects.

    “The conclusions of the review are similar to those of the previous Cochrane Review on this topic, which identified a potential shortterm benefit of oral steroids for 'resolution of OME', but no evidence of benefit for hearing or long-term effects (Simpson 2011).”

    From Topical and oral steroids for otitis media with effusion (OME) in children (2023) · cites this paper as Simpson 2011

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2 of the 65 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. Dengerink JE, Porter JB. Childrens attitudes towards peers wearing hearing aids. Language, Speech and Hearing Services in Schools 1984;205‐9:15. [Google Scholar]

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Authors
Simpson, S. A., Lewis, R., van der Voort, J., & Butler, C. C.
Affiliations
  • Cardiff University (GB)
  • University Hospital of Wales; Department of Paediatric Nephrology; Division of Paediatrics Heath Park Cardiff UK CF4 4XN
ORCID
Venue
Cochrane Database of Systematic Reviews
Publisher
Wiley
Published
2011-05-11
Volume
2011
Issue
5
Pages
CD001935-CD001935
ISSN
  • 1361-6137 (ISSN-L)
  • 1465-1858
DOI
10.1002/14651858.cd001935.pub3
PMC
PMC9829244
OpenAlex
W1846864735
Cited by
184
References
65
Citations by year
2026: 2 · 2025: 5 · 2024: 6 · 2023: 6 · 2022: 7 · 2021: 7 · 2020: 10 · 2019: 8 · 2018: 14 · 2017: 11 · 2016: 12 · 2015: 14 · 2014: 11 · 2013: 8 · 2012: 10
FWCI
2.20
Type
journal article
Language
en
Open access
Locations
  • Cochrane Database of Systematic Reviews (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Otorhinolaryngology › Ear Surgery and Otitis Media
  • Health Sciences › Medicine › Otorhinolaryngology › Sinusitis and nasal conditions
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Hearing Loss and Rehabilitation
Keywords
otitis media with effusion, hearing loss, intranasal corticosteroids, oral corticosteroids, combination antibiotic therapy, children, developmental delay, treatment efficacy, risk of bias, heterogeneity of results, crossover trial, risk of bias assessment, risk of bias summary table
MeSH terms
Administration, Intranasal, Administration, Oral, Anti-Bacterial Agents, Child, Combined Modality Therapy, Deafness, Glucocorticoids, Humans, Otitis Media with Effusion, Randomized Controlled Trials as Topic

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