Effect of topical adrenergic decongestants on middle ear pressure in infants with common colds.
BACKGROUND
Otitis media is frequently a complication of the common cold. Obstruction of the eustachian tube ostia by nasopharyngeal edema has been suggested as a cause of this complication.


OBJECTIVE
To determine the effect of a topical adrenergic decongestant on middle ear pressure in infants with common cold symptoms.


METHODS
The study was conducted with a randomized, double blinded, placebo-controlled design. Middle ear pressure was determined in infants 6 to 18 months old who had common cold symptoms. Infants with abnormal middle ear pressure (< or = -100 mm H2O) in either ear were treated with intranasal phenylephrine drops or placebo. The effect of the treatment on middle ear pressure in ears with abnormal pressure at baseline was determined 1 h later.


RESULTS
Twenty-three of 44 infants with abnormal middle ear pressures received intranasal phenylephrine drops and 21 received placebo. Middle ear pressure remained abnormal after treatment with phenylephrine in 29 of 33 (88%) ears and after treatment with placebo in 26 of 34 (76%). The mean change in middle ear pressure after treatment was +23 mm H2O in the active group and +40 mm H2O in the placebo group.


CONCLUSIONS
Treatment of nasal obstruction with topical adrenergic decongestants does not improve abnormal middle ear pressures during the common cold.
Turner
R B
RB
Department of Pediatrics, Medical University of South Carolina, Charleston 29425, USA. turnerr@musc.edu
Darden
P M
PM
D000281:Administration, Intranasal; D003139:Common Cold / Q000150:complications / Q000188:drug therapy*; D004311:Double-Blind Method; D005064:Eustachian Tube / Q000187:drug effects* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D014663:Nasal Decongestants / Q000008:administration & dosage / Q000627:therapeutic use*; D010033:Otitis Media / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D010656:Phenylephrine / Q000008:administration & dosage / Q000627:therapeutic use*; D011312:Pressure; D016896:Treatment Outcome
D014663:Nasal Decongestants; D010656:Phenylephrine