Effectiveness of corticosteroids in otitis media with effusion: an experimental study.
OBJECTIVE
The aim of the present study was to investigate the dose-related effectiveness of corticosteroids in the management of otitis media with effusion, by using the objective assessment techniques of tympanometry and cytokine measurement.


METHODS
The eustachian tubes of 42 male rats were obstructed. Thirty-six subjects with effusion were randomly divided into three equal groups: controls; 0.5 mg/kg/day corticosteroid; and 1 mg/kg/day corticosteroid. Concentrations of interleukin-1beta and tumour necrosis factor alpha in the middle-ear effusions were analysed using enzyme-linked immunosorbent assay.


RESULTS
An effusion occurred on the 14th post-operative day and was present on the 30th post-operative day in the control group. Otomicroscopic examination and tympanometric measurement showed an improvement in the intervention groups. There was a significant difference between both intervention groups and the control group for both interleukin-1beta and tumour necrosis factor alpha concentrations (p 0.05).


CONCLUSIONS
The study confirmed a short term beneficial effect of systemic steroids on resolution of otitis media with effusion in a rat model. Our results support the theory that corticosteroids significantly decrease concentrations of both interleukin-1beta and tumour necrosis factor alpha. In our model, the 0.5 mg/kg corticosteroid dose was as effective as the 1 mg/kg corticosteroid dose. Further studies should be carried out to determine the optimal dose and duration of corticosteroids in the treatment of otitis media with effusion.
Yaman
H
H
Department of Otolaryngology, Meram Medical Faculty, Selcuk University, Konya, Turkey. hyaman1975@yahoo.com
Ozturk
K
K
Uyar
Y
Y
Gurbilek
M
M
D000158:Acoustic Impedance Tests; D000818:Animals; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use; D004195:Disease Models, Animal; D004305:Dose-Response Relationship, Drug; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D053583:Interleukin-1beta / Q000378:metabolism; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000627:therapeutic use; D010034:Otitis Media with Effusion / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D051381:Rats; D017207:Rats, Sprague-Dawley; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D053583:Interleukin-1beta; D014409:Tumor Necrosis Factor-alpha; D008775:Methylprednisolone