pulmicort and Otitis-Media-with-Effusion

To assess the longitudinal curative effect and improvement of subjective symptoms by using intratympanic injection of Budesonide(BUD) for otitis media with effusion (OME) patients older than 12 years and adults.. A single-blind, randomized, parallel-controlled prospective study.. Hospital, outpatient.. Ninety patients (112 ears) who were diagnosed as having OME were recruited and then randomized to BUD, dexamethasone (DEX), and sodium chloride (NS) groups, the latter two served as controls.. The randomly allocated patients received intratympanic injection of BUD (0.5 mg/1 ml), DEX (2 mg/1 ml), or 0.9% NS solution (1 ml) once a week.. Survival analysis was applied to compare the longitudinal curative effects among the 3 groups. Meanwhile, the 6 main subjective symptoms were scored by 10-point visual scale, and physician's evaluations were preformed during treatment and follow-up.. After adjustment for course of disease, volume, and characters of effusion, the relative risk (RR) of BUD is 0.139 (95% CI, 0.054-0.358) when compared with NS. Survival curve demonstrated that the rank of longitudinal therapeutic efficacy was BUD, DEX, and NS (p < 0.05). Both BUD and DEX showed improvements in subjective symptoms and quality of life compared with NS (p < 0.05). In the aspect of improving the symptom of stuffy ear, BUD showed advantage over both DEX and NS. During and after treatment, no serious complications or sequelae were observed.. Intratympanic injection with BUD for OME patients showed advantages in improving long-term therapeutic efficacy, it was a safe and effective intervention for adolescents and adults with OME.

Topics: Adolescent; Adult; Anti-Inflammatory Agents; Budesonide; Child; Dexamethasone; Ear, Middle; Female; Follow-Up Studies; Humans; Injections; Kaplan-Meier Estimate; Longitudinal Studies; Male; Middle Aged; Otitis Media with Effusion; Single-Blind Method; Survival Analysis; Treatment Outcome; Young Adult

Otitis media with effusion (OME) is a common pediatric disease and there is great controversy concerning its management. Mechanical, medical and surgical treatments have not proven adequate in resolving the disease and serve mainly to manage complications. Leukotriene inhibitors are new drugs that have been approved recently for the treatment of asthma in children. The aim of this study was to evaluate the impact of leukotriene inhibitor therapy for asthma on the clinical course of OME in children with co-existing disease. Fifty children with bilateral OME and asthma, divided equally into two groups, were studied. The children in the first group were treated with budesonide and terbutaline inhalers together with the leukotriene inhibitor montelukast, whereas the children in the second group were treated with the inhalers alone. Duration of treatment was 30 days. Pneumatic otoscopy, tympanometry and pure-tone audiometry were performed at the beginning and at the end of treatment. Fifteen (60%) of the children receiving inhalers and montelukast and nine (36%) of those receiving only inhalers were found free of OME after 30 days of therapy. Thus, it may be concluded that a statistically significant beneficial effect on the clinical course of OME resulted from the addition of montelukast to the treatment of children with co-existing asthma and OME. Given that no medication has been shown to be effective in OME therapy, further investigation of the possible effects of leukotriene inhibitors is warranted.

Topics: Acetates; Administration, Inhalation; Adolescent; Asthma; Bronchodilator Agents; Budesonide; Child; Cyclopropanes; Drug Therapy, Combination; Humans; Leukotriene Antagonists; Otitis Media with Effusion; Quinolines; Sulfides; Terbutaline

Topics: Anti-Inflammatory Agents; Budesonide; Female; Humans; Male; Otitis Media with Effusion

Topics: Anti-Inflammatory Agents; Budesonide; Female; Humans; Male; Otitis Media with Effusion