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Article ; Online: Effect of nasal balloon autoinflation in children with otitis media with effusion in primary care: an open randomized controlled trial.

Williamson, Ian / Vennik, Jane / Harnden, Anthony / Voysey, Merryn / Perera, Rafael / Kelly, Sadie / Yao, Guiqing / Raftery, James / Mant, David / Little, Paul

CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne

2015  Volume 187, Issue 13, Page(s) 961–969

Abstract: ... in a primary care setting.: Methods: We conducted an open, pragmatic randomized controlled trial set in 43 ... years with otitis media with effusion is feasible in primary care and effective both in clearing ... nonsurgical treatment option. We assessed the clinical effectiveness of treatment with a nasal balloon device ...

Abstract Background: Otitis media with effusion is a common problem that lacks an evidence-based nonsurgical treatment option. We assessed the clinical effectiveness of treatment with a nasal balloon device in a primary care setting.
Methods: We conducted an open, pragmatic randomized controlled trial set in 43 family practices in the United Kingdom. Children aged 4-11 years with a recent history of ear symptoms and otitis media with effusion in 1 or both ears, confirmed by tympanometry, were allocated to receive either autoinflation 3 times daily for 1-3 months plus usual care or usual care alone. Clearance of middle-ear fluid at 1 and 3 months was assessed by experts masked to allocation.
Results: Of 320 children enrolled, those receiving autoinflation were more likely than controls to have normal tympanograms at 1 month (47.3% [62/131] v. 35.6% [47/132]; adjusted relative risk [RR] 1.36, 95% confidence interval [CI] 0.99 to 1.88) and at 3 months (49.6% [62/125] v. 38.3% [46/120]; adjusted RR 1.37, 95% CI 1.03 to 1.83; number needed to treat = 9). Autoinflation produced greater improvements in ear-related quality of life (adjusted between-group difference in change from baseline in OMQ-14 [an ear-related measure of quality of life] score -0.42, 95% CI -0.63 to -0.22). Compliance was 89% at 1 month and 80% at 3 months. Adverse events were mild, infrequent and comparable between groups.
Interpretation: Autoinflation in children aged 4-11 years with otitis media with effusion is feasible in primary care and effective both in clearing effusions and improving symptoms and ear-related child and parent quality of life.
Trial registration: ISRCTN, No. 55208702.
MeSH term(s) Child ; Child, Preschool ; Family Practice ; Female ; Humans ; Logistic Models ; Male ; Otitis Media with Effusion/therapy ; Primary Health Care/methods ; Quality of Life ; Treatment Outcome
Language English
Publishing date 2015-07-27
Publishing country Canada
Document type Journal Article ; Pragmatic Clinical Trial ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID 215506-0
ISSN 1488-2329 ; 0008-4409 ; 0820-3946
ISSN (online) 1488-2329
ISSN 0008-4409 ; 0820-3946
DOI 10.1503/cmaj.141608
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