Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-22T13:55:52.486Z Has data issue: false hasContentIssue false
  • English
  • Français

Effectiveness of corticosteroids in otitis media with effusion: an experimental study

Published online by Cambridge University Press:  20 April 2007

H Yaman ,
K Ozturk ,
Y Uyar  and
M Gurbilek
H Yaman*
Affiliation:
Department of Otolaryngology, Meram Medical Faculty, Selcuk University, Konya, Turkey
K Ozturk
Affiliation:
Department of Otolaryngology, Meram Medical Faculty, Selcuk University, Konya, Turkey
Y Uyar
Affiliation:
Department of Otolaryngology, Meram Medical Faculty, Selcuk University, Konya, Turkey
M Gurbilek
Affiliation:
Department of Biochemistry, Meram Medical Faculty, Selcuk University, Konya, Turkey
*
Address for correspondence: Dr Huseyin Yaman, Selcuk Universitesi, Meram Tip Fakultesi, Kulak Burun Bogaz Hastaliklari Anabilim Dali, 42080 Meram, Konya, Turkey. Fax: +90 332 2236181 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

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.

Materials and 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-1β and tumour necrosis factor α 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-1β and tumour necrosis factor α concentrations (p < 0.01). However, there was no significant difference between the 0.5 mg/kg and the 1 mg/kg corticosteroid groups (p > 0.05).

Conclusion:

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-1β and tumour necrosis factor α. 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.

Keywords

Otitis Media with EffusionAcoustic Impedence TestsTumour Necrosis Factor-αInterleukinesCorticosteroids
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 1 , January 2008 , pp. 25 - 30
Copyright
Copyright © JLO (1984) Limited 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented at the XXVIIIth Congress of the Turkish National Otolaryngology and Head and Neck Surgery, 21–26 May 2005, Antalya, Turkey.

References

1Hebda, PA, Piltcher, OB, Swarts, JD, Alper, CM, Zeevi, A, Doyle, WJ. Cytokine profiles in a rat model of otitis media with effusion caused by eustachian tube obstruction with and without Streptococcus pneumoniae infection. Laryngoscope 2002;112:1657–62CrossRefGoogle Scholar
2Butler, CC, van Der Voort, JH. Steroids for otitis media with effusion: a systematic review. Arch Pediatr Adolesc Med 2001;155:641–7CrossRefGoogle ScholarPubMed
3Bluestone, CD. Studies in otitis media: Children's Hospital of Pittsburgh – University of Pittsburgh progress report – 2004. Laryngoscope 2004;114:1–26CrossRefGoogle ScholarPubMed
4Yetiser, S, Satar, B, Gumusgun, A, Unal, F, Ozkaptan, Y. Tumor necrosis factor-alpha and interleukin-1beta levels in recurrent and persistent otitis media with effusion. Otolaryngol Head Neck Surg 2002;126:417–22CrossRefGoogle ScholarPubMed
5Keles, B, Ozturk, K, Gunel, E, Arbag, H, Ozer, B. Pharyngeal reflux in children with chronic otitis media with effusion. Acta Otolaryngol 2004;124:1178–81CrossRefGoogle ScholarPubMed
6Tada, N, Furukawa, M, Ogura, M, Arai, S, Adachi, Y, Ikehara, S et al. Experimental otitis media with effusion induced by leukotriene D4. Auris Nasus Larynx 2002;29:127–32CrossRefGoogle ScholarPubMed
7McCormick, DP, Saeed, K, Uchida, T, Baldwin, CD, Deskin, R, Lett-Brown, MA et al. Middle ear fluid histamine and leukotriene B4 in acute otitis media: effect of antihistamine or corticosteroid treatment. Int J Pediatr Otorhinolaryngol 2003;67:221–30CrossRefGoogle ScholarPubMed
8Macknin, ML, Jones, PK. Oral dexamethasone for treatment of persistent middle ear effusion. Pediatrics 1985;75:329–35CrossRefGoogle ScholarPubMed
9Rosenfeld, RM, Mandel, EM, Bluestone, CD. Systemic steroids for otitis media with effusion in children. Arch Otolaryngol Head Neck Surg 1991;117:984–9CrossRefGoogle ScholarPubMed
10Russell, JD, Giles, SJ. Persistent otitis media with effusion: a new experimental model. Laryngoscope 1998;108:1181–4CrossRefGoogle ScholarPubMed
11Lambert, PR. Oral steroid therapy for chronic middle ear perfusion: a double-blind crossover study. Otolaryngol Head Neck Surg 1986;95:193–9CrossRefGoogle ScholarPubMed
12Berman, S, Casselbrant, ML, Chonmaitree, T, Giebink, GS, Grote, JJ, Ingvarsson, LB et al. Recent advances in otitis media. 9. Treatment, complications, and sequelae. Ann Otol Rhinol Laryngol Suppl 2002;188:102–24Google ScholarPubMed
13Podoshin, L, Fradis, M, Ben-David, Y, Faraggi, D. The efficacy of oral steroids in the treatment of persistent otitis media with effusion. Arch Otolaryngol Head Neck Surg 1990;116:1404–6CrossRefGoogle ScholarPubMed
14Schwartz, RH, Puglese, J, Schwartz, DM. Use of a short course of prednisone for treating middle ear effusion: a double-blind crossover study. Ann Otol Rhinol Laryngol 1980;89:296–300CrossRefGoogle Scholar
15Persico, M, Podoshin, L, Fradis, M. Otitis media with effusion: a steroid and antibiotic therapeutic trial before surgery. Ann Otol Rhinol Laryngol 1978;87:191–6CrossRefGoogle ScholarPubMed