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Non-surgical treatment of secretory otitis media in children

Secretory Otitis Media (SOM) also called otitis media with effusion or glue ear is a common disease affecting most children in the pre-school age. The condition causes hearing loss and may affect normal speech development and the quality of life in children.

Diagnosis

The condition is diagnosed by a clinical examination of the ear by otoscopy or otomiscroscopy. This might be combined with an examination of the mobility of the ear drum (tympanometry) and hearing tests.


Treatment of SOM with grommets

Most children with SOM receive no active treatment and simply have to wait for spontaneous healing. When SOM and hearing loss is detected in both ears the child is encouraged to wait for at least 3 months. Approximately 10,000 children, 2.5% of all children with SOM, have an operation each year in Sweden. The surgery is performed under general anaesthesia and is not without risks. Some children experience side effects of the general anaesthesia or the surgery. Tympanic membrane alterations or perforations may occur after the surgery and recent studies show that many children acquire a high frequency hearing loss after this surgery. Recurrence after surgery is common and the total health care cost is considerable.

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Moniri® as treatment for SOM

Autoinflation is the only non-surgical method with effect on SOM and hearing loss. Autoinflation (ear clearing manoeuvre) is performed by breathing out with the mouth closed and the nose pinched. The air opens the Eustachian tube, a crackling sound is heard and the liquid behind the ear drum is then ventilated. Despite the international recommendations to perform autoinflation in all children with SOM, the problem has been to teach the maneuver to the children. In 2009 a new device for autoinflation was developed. The device was then tested in a PhD thesis at the Sahlgrenska University hospital, Gothenburg, Sweden during the next years. The results of the clinical studies showed that 8 of 10 children in the waiting list for surgery for hearing loss caused by chronic SOM could avoid surgery only after 4 weeks of treatment with Moniri.

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