Topical intranasal corticosteroids for otitis media with effusion in primary care

BMJ 2010; 340 doi: https://doi.org/10.1136/bmj.b5380 (Published 07 January 2010) Cite this as: BMJ 2010;340:b5380
  1. Roger A M J Damoiseaux, general practitioner1,
  2. Maroeska M Rovers, clinical epidemiologist2
  1. 1General Practice “de Hof van Blom,” 8051 JT Hattem, Netherlands
  2. 2Julius Center of Health Sciences and Primary Care, University Medical Centre Utrecht, 3508 GA Utrecht, Netherlands
  1. rdamoiseaux{at}hotmail.com

    Are ineffective, and active observation is the best policy

    Otitis media with effusion refers to an accumulation of fluid in the middle ear cavity behind an intact tympanic membrane with no signs or symptoms of an acute infection. It is one of the most common diseases of childhood. The condition can cause conductive hearing loss, which can result in impairments of speech, language, and cognitive development.1 The effusion often resolves spontaneously within three months, and this needs to be taken into account when managing the condition.

    In the linked randomised controlled trial (doi:10.1136/bmj.b4984), Williamson and colleagues assessed the effectiveness of topical intranasal corticosteroids compared with placebo in 217 children with bilateral otitis media with effusion. They found no significant difference between the two groups at one or three months.2

    Recent guidance from the National Institute for Health and Clinical Excellence (NICE) recommends active observation for three months before intervention is considered.3 …

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