A comparative randomized study on the efficacy of a systemic steroid therapy vs. a thermal therapy in otitis media with effusion in children.
BACKGROUND
The aim of this study was to compare the effectiveness of a systemic steroid therapy vs. a thermal therapy based on sulphurous water insufflation. The therapy was performed in Telese Terme Spa based on the Salimbani-Politzer technique on children suffering of otitis media with effusion (OME), using the variations of the tympanogram as objective outcome in a short time follow-up.


METHODS
Eighty children suffering of monolateral or bilateral OME (44 male, 36 female, age 4-12 years, average age 7.2±2.83 ys.), enrolled in ENT or paediatrics offices, have been included in the study. Children were included in a randomization list in order to obtain two therapeutic groups, the first one to be treated through a systemic steroid therapy, the second one to be treated through sulphuruos water insufflation in Telese Spa. Children underwent otoscopic/otomicroscopic visit and tympanometry before the beginning of the therapy (T0), 7 days after the beginning of the therapy (T1), 7-10 days after the end of the therapy (T2), 30-35 days after the end of the therapy (T3). The variation of the type of tympanogram was considered the objective outcome. The shift either from a type B to a type C or o type A tympanogram and from a type C to a type A tympanogram was considered a positive outcome; the persistence either of the same type of tympanogram and the shift from a type C to a type B or from a type A to a type C or a type B were considered a negative outcome.


RESULTS
Thermal therapy showed better outcomes at each time, with differences in improvement and healing often reaching the statistical significance. The most important prognostic indicator was the presence of an initial type B tympanogram, associated to a worst prognosis in both therapeutic groups and in each subgroup of OME.


CONCLUSIONS
Sulphurous water insufflation therapy appeared a good therapeutic choose in the treatment of OME in a pediatric population.
Section Audiology and Phoniatrics, "G. Rummo" Hospital, Benevento, Italy - luigi.califano@tin.it.
Luigi
L
Califano
Francesca
F
Salafia
Salvatore
S
Mazzone
Giovanna
G
D'Ambrosio
Luigi
L
Malafronte
Assunta
A
Vassallo
D000158:Acoustic Impedance Tests; D002648:Child; D002675:Child, Preschool; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007327:Insufflation / Q000379:methods*; D008297:Male; D010034:Otitis Media with Effusion / Q000503:physiopathology / Q000628:therapy*; D038781:Otoscopy; D011379:Prognosis; D013455:Sulfur / Q000737:chemistry*; D013997:Time Factors; D016896:Treatment Outcome
D005938:Glucocorticoids; D013455:Sulfur