Oral steroids alone or followed by intranasal steroids versus watchful waiting in the management of otitis media with effusion
Abstract
Objective To evaluate the effects of oral steroids alone or followed by intranasal steroids versus watchful waiting on the resolution of otitis media with effusion in children aged 2-11 years. Methods A total of 290 children with bilateral otitis media with effusion were assigned to 3 groups: group A was treated with oral steroids followed by intranasal steroids, group B was treated with oral steroids alone and group C was managed with watchful waiting. Patients were evaluated with audiometry and tympanometry. Results The complete resolution rates of otitis media with effusion were higher in groups A and B than in group C at six weeks. There were no significant differences in otitis media with effusion resolution rates between the groups at three, six and nine months. Conclusion Oral steroids lead only to a quick resolution of otitis media with effusion, with no long-term benefits. There was no benefit of using intranasal steroids in the management of otitis media with effusion.
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Since the 2011 Cochrane Review, findings from a number of randomised controlled trials have been published, including the OSTRICH study and a second RCT evaluating oral and intranasal steroids.
“Since the Cochrane Review was published in 2011, the findings from a number of randomised controlled trials (RCTs) have been published, including those from the OSTRICH study (Francis 2018), a randomised study of the effects of a short course of oral steroids for hearing loss in 389 children with persistent OME, and from a second RCT that evaluated the effects of oral and intranasal steroids in 2”
From Topical and oral steroids for otitis media with effusion (OME) in children (2023) · cites this paper as Hussein 2017
Acharya 2020 and Hussein 2017 stated that no adverse effects of oral steroids were reported in study participants; Choung 2008 did not report on adverse events.
“Both Acharya 2020 and Hussein 2017 stated that no adverse effects of oral steroids were reported in study participants.Choung 2008 did not report on adverse events.”
From Topical and oral steroids for otitis media with effusion (OME) in children (2023) · cites this paper as Hussein 2017
For Hussein 2017, allocation concealment was at unclear risk of bias.
“Allocation concealment (selection bias) Unclear risk No information provided.”
From Topical and oral steroids for otitis media with effusion (OME) in children (2023) · cites this paper as Hussein 2017
For Hussein 2017, plausible loss to follow-up is reported.
“Plausible loss to follow-up is reported”
From Topical and oral steroids for otitis media with effusion (OME) in children (2023) · cites this paper as Hussein 2017
For Hussein 2017, incomplete outcome data was at low risk of bias.
“Incomplete outcome data (attrition bias) All outcomes Low risk Relatively few dropouts, insufficient numbers to substantially alter conclusions.”
From Topical and oral steroids for otitis media with effusion (OME) in children (2023) · cites this paper as Hussein 2017
For Hussein 2017, no implausible results were noted.
“No implausible results were noted”
From Topical and oral steroids for otitis media with effusion (OME) in children (2023) · cites this paper as Hussein 2017
For Hussein 2017, other bias was at low risk of bias.
“Other bias Low risk No concerns.”
From Topical and oral steroids for otitis media with effusion (OME) in children (2023) · cites this paper as Hussein 2017
For Hussein 2017, identical numbers were randomised to each group, with no report of blocked randomisation.
“Identical numbers were randomised to each group, with no report of blocked randomisation”
From Topical and oral steroids for otitis media with effusion (OME) in children (2023) · cites this paper as Hussein 2017
For Hussein 2017, no prospective trial registration was identified.
“No prospective trial registration was identified”
From Topical and oral steroids for otitis media with effusion (OME) in children (2023) · cites this paper as Hussein 2017
For Hussein 2017, no information is presented on baseline characteristics.
“No information is presented on baseline characteristics”
From Topical and oral steroids for otitis media with effusion (OME) in children (2023) · cites this paper as Hussein 2017
For Hussein 2017, no retractions or expressions of concern were noted.
“No retractions or expressions of concern were noted”
From Topical and oral steroids for otitis media with effusion (OME) in children (2023) · cites this paper as Hussein 2017
For Hussein 2017, blinding of participants and personnel was at high risk of bias.
“Blinding of participants and personnel (performance bias) All outcomes High risk Participants were aware of treatment allocation.”
From Topical and oral steroids for otitis media with effusion (OME) in children (2023) · cites this paper as Hussein 2017
For Hussein 2017, selective reporting was at unclear risk of bias.
“Selective reporting (reporting bias) Unclear risk No protocol available to compare.”
From Topical and oral steroids for otitis media with effusion (OME) in children (2023) · cites this paper as Hussein 2017
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- Authors
- Hussein, A., Fathy, H., Amin, S. M., & Elsisy, N.
- Affiliations
- Cairo University (EG)
- Fayoum University (EG)
- Corresponding author
- Hussein, A
- ORCID
- Amin, S M
- Venue
- The Journal of Laryngology & Otology
- Publisher
- Cambridge University Press (CUP)
- Published
- 2017-08-15
- Volume
- 131
- Issue
- 10
- Pages
- 907-913
- ISSN
- 0022-2151 (ISSN-L)
- 1748-5460
- OpenAlex
- W2746660923
- Cited by
- 13
- References
- 39
- Citations by year
- 2025: 1 · 2023: 1 · 2022: 1 · 2021: 1 · 2020: 2 · 2019: 3 · 2018: 3 · 2017: 1
- FWCI
- 2.20
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Laryngology & Otology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Otorhinolaryngology › Ear Surgery and Otitis Media
- Health Sciences › Medicine › Otorhinolaryngology › Sinusitis and nasal conditions
- Health Sciences › Medicine › Infectious Diseases › Otolaryngology and Infectious Diseases
- Keywords
- otitis media with effusion, oral corticosteroids, intranasal corticosteroids, expectant management, children, tympanometry, audiometry, bilateral otitis media
- MeSH terms
- Acoustic Impedance Tests, Administration, Intranasal, Administration, Oral, Audiometry, Child, Child, Preschool, Female, Glucocorticoids, Humans, Male, Otitis Media with Effusion, Prospective Studies, Single-Blind Method, Treatment Outcome, Watchful Waiting
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