A study has just established that oral steroids (prednisolone) were not effective in treating children with otitis media with effusion and hearing loss.
Serous otitis is a very common disease in children aged 1 to 8 years. Between 15 and 40% are affected before 5 years. This is a persistent (more than 2 months) effusion of serous fluid behind the eardrum.
Researchers wanted to determine whether a short course of oral steroids (prednisolone) would achieve “acceptable” hearing in children with otitis media with effusion and hearing loss. To do this, they recruited children aged 2 to 8 years with symptoms attributable to otitis media with effusion for at least 3 months and confirmed bilateral hearing loss.
Participants were recruited from 20 outpatient ENT, pediatric audiology and audio-vestibular medicine departments in England and Wales. Between March 20, 2014 and April 5, 2016, 1,018 children were screened, of which 389 were randomized. 200 were assigned to receive oral steroids and 189 were assigned to receive placebo. Hearing at 5 weeks was evaluated in 183 children in the oral steroid group and 180 in the placebo group. “Fair” hearing was observed in 73 children (40%) in the oral steroid group and 59 (33%) in the placebo group.
“No significant difference in adverse events”
“There was no significant difference in adverse events or measures of quality of life between the groups,” note the researchers. “Oral prednisolone is not an effective treatment for most children aged 2 to 8 with persistent otitis media with effusion, but it is well tolerated. One in 14 children may improve their hearing, but not the quality of their hearing. of life “, they continue.
Effects on the acquisition of speech and learning
“In most children, otitis serum mucosa usually heals spontaneously within a few months but its course can be fluctuating and dragging. Complications can occur, especially in risky situations such as pre-existing deafness or velar pathology. . The most frequent of these complications is the decrease in hearing with a risk in children of repercussions on the acquisition of speech and learning “, explains Dr Nathalie Poutignat, of the evaluation service of the relevance of care and improvement. practices and routes (HAS). The treatment is then surgical.
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