Endoscopic and clinical benefits of hyaluronic acid in children with chronic adenoiditis and middle ear disease.
Hyaluronic acid (HA) is involved in modulating inflammatory airway processes and mucociliary clearance. Some studies have tested the effectiveness of the topical administration of HA in patients with upper airway diseases with positive preliminary results. A prospective, single-blind, 1:1 randomised controlled study was performed to assess the efficacy and safety of the daily topical administration of 9 mg of sodium hyaluronate in 3 mL of a 0.9 % sodium saline solution on the basis of endoscopic and clinical parameters in children with chronic adenoiditis associated with recurrent acute otitis media and otitis media with effusion; age- and gender-matched children receiving normal 0.9 % sodium chloride saline solution were used as controls. Analysis was based on 103 (mean age 63.3 ± 18.2 months; 52 males, 50.5 %) children: 54 in the study group and 49 in the control group. A statistically significant reduction in the mean number of all acute otitis media episodes (AOME) (mean reduction 0.8 ± 0.4 per month; p value 0.05) and AOME without tympanic membrane perforation (mean reduction 0.6 ± 0.3 per month; p value 0.04) after recruitment was documented only in the study group. HA significantly improved all the endoscopic outcomes (p values ranging between 0.05 and <0.01) but one. Nasal washing with saline solution was effective on only three of them (p values ranging between 0.03 and <0.01). No untoward effects were documented. Our results confirm the safety and document the positive effect of topically administered HA solution on children with chronic adenoiditis associated with middle ear disease.
Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy. sara.torretta@gmail.com.
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S
Torretta
Department of Maternal and Pediatric Sciences, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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Marchisio
Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy.
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V
Rinaldi
Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy.
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D
Carioli
Department of Maternal and Pediatric Sciences, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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E
Nazzari
Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy.
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Pignataro
D000234:Adenoids; D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D000287:Administration, Topical; D002675:Child, Preschool; D002908:Chronic Disease; D004724:Endoscopy; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use*; D006984:Hypertrophy / Q000188:drug therapy; D007223:Infant; D008297:Male; D009304:Nasopharyngitis / Q000188:drug therapy*; D010033:Otitis Media / Q000188:drug therapy*; D011446:Prospective Studies; D016037:Single-Blind Method; D014420:Turbinates / Q000473:pathology
D000276:Adjuvants, Immunologic; D006820:Hyaluronic Acid
Adenoids; Children; Hyaluronic acid; Recurrent acute otitis media
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