Question 1

How often shall one use Moniri?

Accepted Answer

Moniri  is used twice (2) a day, and inflated 5-10 times each session. It takes  approximately 5-10 minutes every day. It is important that the  treatment is fun for both the child as well as the parent. Some children  may require adaptation to the treatment; therefore, the initial goal  could be one (1) inflation per day, and gradually increasing it. Use the  Moniri-calender to motivate and monitor the treatment.

Question 2

Which balloon should be used?

Accepted Answer

Two  (2) balloons with standard pressure follow Moniri. The blue balloon  with a pressure of approximately 40 cmH2O and the red balloon with  approximately 60 cmH2O. The treatment starts with the blue balloon  during four (4) weeks. In case of ineffective results continue  additional four (4) weeks with the red balloon instead. It is essential  to complete the total treatment period.

Question 3

Should the child use the mouth or the nose to inflate the balloon?

Accepted Answer

The treatment can be performed by either one, through the mouth or the nose.

Question 4

What are the major differences between Moniri and other devices for pressure equalization of the ears?

Accepted Answer

This is the only device that is recommended for children under four (4) years old for pressure equalization.

No  other device or treatment except surgery have been able to improve the  hearing of small children with secretory otitis media (SOM, or  inflammation in the middle ear).

There  are three main reasons for the excellent results:  1. Earlier methods  only focus on performing pressure equalization through the nose. This is  difficult, unpleasant and less efficient. With Moniri pressure  equalization can be performed through the mouth and/or the nose.   2.  The Moniri device looks like a toy. The majority of children find the  treatment funny, which increases the success to follow though the  treatment drastically. 3. With the Moniri device, several pressure  equalization games can be performed; with the face mask correctly in  place, the child’s shouting, screaming, laughing or coughing, leads to  the equalization of the ear pressure. Additionally, the parent can  easily add or supply air by squeezing the pump in the frog’s belly. This  allows a good treatment without any active cooperation of the child.

Question 5

My child has a perforated eardrum, can I still use the Moniri device?

Accepted Answer

Children with perforated eardrum should only use the device after discussion with the consulting physician.

Question 6

What are the differences between surgical procedure and Moniri?

Accepted Answer

Clinical  trials have shown equal results regarding improvement of hearing  between Moniri and surgery with the insertion of a plastic tube through  the eardrum. One advantage with the surgical procedure is that the  improvement of hearing is instant. However, surgery is not totally free  of risk. Approximately 1 out of 10 children are expected to have a  complication after surgery. Pain, discomfort, chronic runny ear or a  permanent hole in the eardrum, and relapse is relatively common. Some  complications or relapse require additional and more advanced surgical  procedures.

Question 7

My child is having a cold once a month, how is it possible to succeed with the 4 weeks treatment period?

Accepted Answer

Having  a cold once a month could be a sign of allergic condition or  hypersensitivity. There are no obstacles to use Moniri during periods  where the child is not having a cold. More importantly is to see a  physician to diagnose and eventually treat for allergy or  hypersensitivity. Please consult your physician for diagnosis and  treatment.

Question 8

Can Moniri be used:

Accepted Answer

•    on children with a runny nose?
It  is important that any sign of symptoms from the nose are treated  separately and under control. In case of a runny nose, nasal rinsing and  nasal spray can be used in combination with Moniri. Please see a  physician for diagnosis and treatment. 
    •    on coughing children?
Coughing  could be a sign of bronchitis or laryngitis in a child. There are no  hindrance to use Moniri, however, it is important to go see a physician  for diagnosis and treatment for the cause of the cough.
    •    on children with enlarged nose adenoids, or large tonsils?
Enlarged  adenoids and tonsils mainly leads to snoring and breathing through the  mouth, which in turn also could affect the results of the treatment.  Allergy nasal spray is the first-choice in long term treatment. However,  in case of unsatisfactory results, surgical procedure of  may  become necessary.
    •    on recurrent middle ear infections?
There  are several reasons for recurrent middle ear inflammations. SOM (fluid  behind the eardrum) can be one of the reasons that can be treated with  Moniri. Other reasons include recurrent airway infections, allergies,  bronchitis and asthma. The general concept is the combination of several  different treatments, where Moniri plays an important part. 
    •    if the child complains of discomfort in the ears during treatment?
A  possible reason to SOM is an inflammation of the eardrum  (örontrumpeten) itself. Minor discomfort in the ear during or after the  treatment is common and a sign that both the opening of the eardrum  (örontrumpeten) and the treatment are effective. If the child has  discomfort with the treatment, medication with anti-inflammatory drugs  such as ibuprofen may be considered. The additional treatment with  anti-inflammatory medication is usually only necessary the first few  days, 1 hour prior to the Moniri treatment. NB! In cases of known  medicine allergy, consult your physician.  
    •    during acute middle ear inflammation?
Some  of the clinical signs of acute inflammation of the middle ear are pain  and fewer. Moniri should not be used if there is an acute middle ear  inflammation, however, Moniri can be used as soon as the acute symptoms  are gone. 
    •    during secretion from the ear channel?
Liquid  or pus form the ear channel could be caused by several different  reasons. Go see a physician for correct diagnosis and treatment. 
Is there a risk for reccurent secretetory middle ear inflammation (SEM) after a cold?
Every  infection in the upper airway is a risk for recurrence of secretory  middle ear inflammation (SEM). When the acute symptoms no longer exist, a  new treatment session starts. 
    •    in airplanes?
Moniri  can assist children and adults to perform an effective equalization of  the ear during flights. Especially during take-off and landing, children  may experience discomfort and pain in the ears. Always bring your  Moniri on the plane and start inflate the child when you start to feel a  pressure of the eardrums. This is especially noticeable during take-off  and landing.

Question 9

What do you do if the child does not want to use the device?

Accepted Answer

9  out of 10 children consider Moniri to be a fun toy and perform the  treatment, either autonomously or with the aid of a parent. Just as  children sometimes do not want to put the seat-belt on, or avoid taking  prescribed medications, they may also object to use Moniri. There are  several ways in order to succeed with this:
    •    Inflate the balloon or show how the treatment works on other children in the family.
    •    Use the Moniri-calendar to stimulate the child. 
    •    Try other methods to motive the child with different rewards. 
    •    Count the number of inflations and increase by adding one inflation per day.
To  motivate you as a parent, it is important to understand that the child  is being forced to anesthetics and surgical procedure with a whole in  the eardrum, and an application of a plastic tube is being done with the  risks with anesthesia and surgey. Before a surgical procedure is  carried away, one last try with Moniri should be attempted where both  parents are involved. The child is placed in front of a parent’s lap  with one arm grabing the child’s arms, and with the other arm stabilizes  the head PICTURE. The other parent puts the mask on, covering the  child’s mouth and nose and simultaneously squeezes the frog’s belly  repeatedly to inflate the balloon. The child is then rewarded for being  courageous and the same process is being repeated the following day. By  the third day the child is usually aware that the treatment is painless  and without discomfort and therefore normally cooperates in the ongoing  treatment sessions.
If none of the above works, operation is the last option.

FAQ

Frequently asked questions