Otovent Autoinflation Device - Clinically Effective Treatment for Glue Ear

Product Information

This large, pragmatic randomised controlled trial included 320 children aged 4 to 11 recruited from 43 general practices in the UK, representing a reliable source of evidence. The children were randomly allocated to one of two groups: usual care only, or usual care plus autoinflation using a nasal balloon three times a day for one to three months. It was not possible to hide treatment allocation from the children or nurses delivering the treatment, but the researchers assessing the results were kept unaware of treatment allocations to avoid bias. The success rate is related to using the mouth for auto-inflation instead of the nose, which was the only described method previously, and by creating auto-inflation games adapted to the age and collaboration of the child to make it fun. Adding a pump also allows for gradual pressure increase without the active collaboration of the child. The Otovent ® balloon can be bought online and is a non-invasive way to treat persistent glue ear, with no known risks. Grommets are tiny plastic tubes that are put in the eardrum. They allow air to circulate in the middle ear and help to reduce the fluid from further building up. This is usually done as a day case and is a short operation in hospital under general anaesthetic. The grommets are inserted after the fluid in the middle ear has been drained away.

Testing for allergies: Many common allergens are known causes of swelling of the Eustachian tubes. These include pollen, dust mites and fur. Ask your child’s healthcare provider about allergy testing if you think this might be the cause of your child’s glue ear. The pressure of blowing a balloon up with the nose opens the Eustachian tubes. This lets air in to the middle ear and allows fluid to drain out. Regular nasal balloon treatment can help your child's hearing to return to normal. What is the evidence? Autoinflation helps expel the accumulated fluid in your ear canal. As a result, it alleviates the fluid build-up and clears your Eustachian tube. Surgery

In autoinflation, your child blows up a balloon using a nose-piece attached to one nostril. They close their mouth and the other nostril. This can help to open their eustachian tube and let air into the middle ear so that fluid can drain out. Yes. All children should have a routine hearing test shortly after birth. However, most cases of glue ear develop in children aged 2-5 years. Therefore, hearing may have been fine at the routine hearing test but then become dulled at a later time. Hearing tests are also performed routinely in many areas of the UK when children enter school (in state education settings), although this is not universal. See a doctor if you suspect your child has dulled hearing at any age. How long does glue ear last? One study (n=320) reported that children having auto‑inflation were more likely to have normal tympanograms at 1 month (47.3% compared with 35.6%; relative risk 1.36) and 3 months (49.6% compared with 38.3%; relative risk 1.37) than those having standard care alone. Auto‑inflation also produced greater improvements in ear‑related quality of life assessed using a validated tool (the OMQ‑14). After randomisation 29 children in the nasal balloon group and 28 in the usual care group were excluded mainly because data was missing or uninterpretable. The analysis at one month included data from the remaining 131 and 132 children respectively. The specialist will examine your child’s ears using a tympanometry test. This type of test measures how well your child’s eardrums can move. They’ll place a special device with a microphone and a sound source into your child’s ear canal. Sound waves bounce off your child’s eardrum as the device compares the pressure in their ear canal. If your child has fluid in their middle ears, their eardrums won’t move correctly. The specialist uses a graph called a tympanogram to see the results.

Children are particularly prone to glue ear due to the shape and position of their eustachian tubes. In adults, the eustachian tubes are wide with a steeper angle but in children they are narrow and more horizontal so they do not drain as effectively as in adults. How common is glue ear? They also found that viral infections may harm the pathogens living in your nasal cavities, causing an imbalance in your nasal microbiota. This causes the pathogens to overgrow, leading to glue ear. Xylitol is a plant-based product, which is usually used as a sweetener in food. It’s lower in calories than sugar and can be used by diabetics. Xylitol has been shown to inhibit the type of bacteria that can be a cause of tooth decay and ear infections. Perera R, Glasziou PP, Heneghan CJ et al. Autoinflation for hearing loss associated with otitis media with effusion. Cochrane Database Syst Rev. 2013;(5):CD006285.

Other Useful Info

Rarely, long-term glue ear may lead to middle ear damage and some permanent hearing loss. Can glue ear be prevented?

The new generation devices, which look like a toy, allow children as young as one year to be treated for chronic glue ear, with up to 80% of patients getting significant relief from the symptoms. Williamson I, Vennik J, Harnden A, et al. Effect of nasal balloon autoinflation in children with otitis media with effusion in primary care: an open randomized controlled trial. CMAJ. 2015 Jul 27. pii: cmaj.141608. This project was funded by the National Institute for Health Research Health Technology Assessment Programme (project number 09/01/27). Our comic for children under 10, Harvey Gets Grommets, explains why Harvey gets grommets, what happens when he visits the doctor, and what happens at the hospital when the grommets are put in. Swimming and bathing with grommets Other symptoms that can affect both adults and children include a feeling of fullness inside your ear, mild earache and hearing ‘popping’ in your ear. You or your child may have problems with balance too.

Treatments for Eustachian tube dysfunction

This treatment could potentially reduce the number of surgical interventions required as a higher proportion of children will have restored hearing within three months. However it may not be suitable for very young children as they might not be able to use the nasal balloon device. Runny noses have been reported in a small number of children using the nasal balloon. When should my child NOT use the nasal balloon? The Otovent method can be divided into two phases. Both phases allow the opening of the Eustachian tube.