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Autoinflation for hearing loss associated with otitis media with effusion

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Perera, Rafael, Glasziou, Paul P, Heneghan, Carl J, McLellan, Julie, Williamson, Ian·2013·Cochrane Database of Systematic Reviews
DOI 10.1002/14651858.cd006285.pub2PMC PMC11357689
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Abstract

BACKGROUND: This is an update of a Cochrane review first published in The Cochrane Library in Issue 4, 2006.Otitis media with effusion (OME) or 'glue ear' is an accumulation of fluid in the middle ear, in the absence of acute inflammation or infection. It is the commonest cause of acquired hearing loss in childhood and the usual reason for insertion of 'grommets'. Potential treatments include decongestants, mucolytics, steroids, antihistamines and antibiotics. Autoinflation devices have been proposed as a simple mechanical means of improving 'glue ear'. OBJECTIVES: To assess the effectiveness of autoinflation compared with no treatment in children and adults with otitis media with effusion. SEARCH METHODS: We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; EMBASE; CINAHL; Web of Science; BIOSIS Previews; Cambridge Scientific Abstracts; ICTRP and additional sources for published and unpublished trials. The date of the most recent search was 12 April 2013. SELECTION CRITERIA: We selected randomised controlled trials that compared any form of autoinflation to no autoinflation in individuals with 'glue ear'. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed studies for inclusion, assessed risk of bias and extracted data from included studies. MAIN RESULTS: Eight studies, with a total of 702 participants, met the inclusion criteria. Overall, the studies were predominantly assessed as being at low or unclear risk of bias; unclear risk was mainly due lack of information. There was no evidence of selective reporting.Pooled estimates favoured the intervention, but did not show a significant effect on tympanometry (type C2 and B) at less than one month, nor at more than one month. Similarly, there were no significant changes for discrete pure-tone audiometry and non-discrete audiometry. Pooled estimates favoured, but not significantly, the intervention for the composite measure of tympanogram or audiometry at less than one month; at more than one month the result became significant (RRI 1.74, 95% CI 1.22 to 2.50). Subgroup analysis based on the type of intervention showed a significant effect using a Politzer device under one month (RRI 7.07, 95% CI 3.70 to 13.51) and over one month (RRI 2.25, 95% CI 1.67 to 3.04).None of the studies demonstrated a significant difference in the incidence of side effects between interventions. AUTHORS' CONCLUSIONS: All of the studies were small, of limited treatment duration and had short follow-up. However, because of the low cost and absence of adverse effects it is reasonable to consider autoinflation whilst awaiting natural resolution of otitis media with effusion. Primary care could prove a beneficial place to evaluate such interventions and there is ongoing research in this area. Further research should also consider the duration of treatment, the long-term impact on developmental outcomes in children and additional quality of life outcome measures for children and families.

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Crossref · 10.1002/14651858.cd006285.pub2

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  • The previous review authors concluded that autoinflation has a beneficial effect on resolution of OME.

    “The review authors concluded that autoinflation has a beneficial effect on resolution of OME.”

    From Autoinflation for otitis media with effusion (OME) in children (2023) · cites this paper as Perera 2013

    The Discussion says autoinflation appears to benefit resolution of glue ear (OME), so the review supports the direction of the claim. But the Authors’ conclusions say the analysis permits no firm conclusion and that evidence appears favourable at least in the short term; the citing sentence presents that qualified finding as definitive. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • The aim of autoinflation is to introduce air into the middle ear via the Eustachian tube, equalising pressures either side of the tympanic membrane and promoting drainage of fluid.

    “The aim of autoinflation is to introduce air into the middle ear, via the Eustachian tube, thus equalising the pressures either side of the tympanic membrane, and promoting drainage of fluid (Perera 2013).”

    From Autoinflation for otitis media with effusion (OME) in children (2023) · cites this paper as Perera 2013

  • A Cochrane Review assessing the effects of autoinflation on OME for adults and children was published in 2013, updating a review originally published in 2006.

    “A Cochrane Review assessing the effects of autoinflation on OME for adults and children was published in 2013 (Perera 2013), updating a review originally published in 2006.”

    From Autoinflation for otitis media with effusion (OME) in children (2023) · cites this paper as Perera 2013

  • The previous Cochrane Review on this topic included eight studies with a total of 702 participants (Perera 2013).

    “The previous Cochrane Review on this topic included eight studies, with a total of 702 participants (Perera 2013).”

    From Autoinflation for otitis media with effusion (OME) in children (2023) · cites this paper as Perera 2013

  • The previous review authors noted that none of the included studies were rated as high quality, and many effect estimates had wide confidence intervals and failed to reach conventional statistical significance.

    “However, the authors noted that none of the included studies were rated as high quality, and many of the effect estimates had wide confidence intervals and failed to reach conventional statistical significance.”

    From Autoinflation for otitis media with effusion (OME) in children (2023) · cites this paper as Perera 2013

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Cites

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1 of the 61 references couldn’t be matched to a known paper.

Research works printed but not linked: 3

  1. Deeks JJ, Higgins, JPT, Altman DG. Section 8.11.2.2 Approximate analyses of cluster‐randomized trials for a meta‐analysis: effective sample sizes. In: Higgins JPT, Green S editor(s). Cochrane Handbook for Systematic Reviews of Interventions 4.2.5 [updated May 2005]. The Cochrane Collaboration, 2005. [Google Scholar]
  2. Reidpath DD, Glasziou PP, Mar CD. Systemic review of autoinflation for treatment of glue ear. BMJ 1999;318:1177‐8. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). Version 5.2. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2012.

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Authors
Perera, R., Glasziou, P. P., Heneghan, C. J., McLellan, J., & Williamson, I.
Affiliations
  • University of Oxford (GB)
  • Bond University (AU)
  • University of Southampton (GB)
ORCID
Venue
Cochrane Database of Systematic Reviews
Publisher
Wiley
Published
2013-05-31
Volume
2013
Issue
5
Pages
CD006285-CD006285
ISSN
  • 1361-6137 (ISSN-L)
  • 1465-1858
DOI
10.1002/14651858.cd006285.pub2
PMC
PMC11357689
OpenAlex
W1935115161
Cited by
109
References
61
Citations by year
2026: 3 · 2025: 5 · 2024: 2 · 2023: 4 · 2022: 5 · 2021: 11 · 2020: 5 · 2019: 8 · 2018: 5 · 2017: 7 · 2016: 9 · 2015: 12 · 2014: 8 · 2013: 6 · 2012: 2
FWCI
2.47
Type
journal article
Language
en
Open access
Locations
  • Cochrane Database of Systematic Reviews (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • e-publications@bond (Bond University) (submittedVersion)
Topics
  • Health Sciences › Medicine › Otorhinolaryngology › Ear Surgery and Otitis Media
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Hearing Loss and Rehabilitation
  • Health Sciences › Medicine › Oncology › Ear and Head Tumors
Keywords
otitis media with effusion, hearing loss, middle ear effusion, tympanometry, pure tone audiometry, children, adults, treatment effectiveness
MeSH terms
Acoustic Impedance Tests, Adult, Air, Child, Eustachian Tube, Humans, Insufflation, Otitis Media with Effusion, Pressure, Valsalva Maneuver, Randomized Controlled Trials as Topic, Hearing Loss

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