Drugs affecting clearance of middle ear secretions: a perspective for the management of otitis media with effusion.
Otitis media with effusion (OME) is characterized by the production and accumulation in the middle ear of mucus secretions, whose physicochemical properties are an important feature in the etiology and treatment of the disease. Many types of pharmaceutical agents, including anti-inflammatory agents, antihistamines, antibiotics, and mucolytics, have been used in attempts to improve the clinical status of patients with OME. This study critically reviews the literature from the point of view of possible changes induced by these agents in the physicochemical properties of the secretions and hence their clearance from the middle ear. In vitro studies on mucociliary clearance of respiratory (tracheobronchial) secretions and middle ear effusions are cited as the basis for analyzing the important parameters expected to govern middle ear clearance and to determine the rationale for use (or nonuse) of various classes of drugs. It is expected that this analysis will prove useful in the design of properly controlled trials of such agents.
Brown
D T
DT
Potsic
W P
WP
Marsh
R R
RR
Litt
M
M
D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D000893:Anti-Inflammatory Agents / Q000494:pharmacology; D001964:Bromhexine / Q000494:pharmacology; D002923:Cilia / Q000502:physiology; D004432:Ear, Middle / Q000378:metabolism* / Q000502:physiology; D004487:Edema / Q000188:drug therapy; D005100:Expectorants / Q000494:pharmacology; D005938:Glucocorticoids / Q000494:pharmacology; D006634:Histamine H1 Antagonists / Q000494:pharmacology; D006801:Humans; D009092:Mucous Membrane / Q000502:physiology; D009093:Mucus / Q000187:drug effects* / Q000378:metabolism; D010033:Otitis Media / Q000188:drug therapy*; D010034:Otitis Media with Effusion / Q000188:drug therapy*; D010447:Peptide Hydrolases / Q000494:pharmacology; D012212:Rheology; D013438:Sulfhydryl Compounds / Q000494:pharmacology; D013439:Sulfhydryl Reagents / Q000494:pharmacology; D014508:Urea / Q000494:pharmacology
D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D005100:Expectorants; D005938:Glucocorticoids; D006634:Histamine H1 Antagonists; D013438:Sulfhydryl Compounds; D013439:Sulfhydryl Reagents; D014508:Urea; D010447:Peptide Hydrolases; D001964:Bromhexine