Eustachian tube dysfunction is a widely prevalent problem, both in children and adults. In many ways, it affects the quality of life in terms of earaches, feeling of blockage and variable hearing. Use of intranasal corticosteroids is customary but whether it resolves the problem seems to be quite another matter. In this systematic review and meta-analysis of randomised controlled trials involving both adults and children, the authors investigated whether intranasal corticosteroids can cure otitis media with effusion, relieve negative middle ear pressure and alleviate associated symptoms. In a pooled analysis of 512 ears from four trials assessing tympanometric normalisation, there was no significant difference between patients receiving intranasal corticosteroids and those receiving a control treatment. In terms of quantitative synthesis of results, only one out of five studies reported a significant difference in comparison between use of intranasal corticosteroids and placebo saline spray. The risk of bias was also evaluated and found to vary from low to high in the eight studies used, based on randomisation process, deviations from intended intervention, missing outcome data, measurement in the outcome and selection of reported result. Therefore, as clinical guidelines have recommended against medical management of eustachian tube dysfunction, this publication indicates nothing different. However, some relationship between adenoidal hypertrophy and eustachian tube are reasonably considered to exist.
Do intranasal corticosteroids resolve eustachian tube dysfunction?
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