Millions of children each year develop a buildup of thick fluid in the middle ear that can muffle sound and make them cranky and uncomfortable. Now there is new evidence that a simple do-it-yourself home treatment – which involves inflating a balloon by blowing out through the nose – may help clear the fluid without drugs or surgery.
Nasal balloon devices have been around for decades to treat the condition, called otitis media with effusion, or glue ear. But solid evidence of their effectiveness has been lacking.
Now a new clinical trial of 320 children aged 4 to 11 found that after three months of regular use, 49.6 percent of children using the balloon cleared the fluid, compared with 38.3 percent of children in the control group, a statistically significant difference in improvement. Balloon users also were snoring less, sleeping better, doing better in school and were less irritable and withdrawn, said Dr. Ian Williamson of Britain’s University of Southampton, the first author of the paper, which was published in The Canadian Medical Association Journal.
“Right now the only effective treatment for glue ear is to insert grommets, or ear tubes,” Dr. Williamson said. “But otitis media with effusion is so common — you can’t send them all for surgery. You really need a nonsurgical intervention.” Antibiotics, antihistamines, decongestants and steroids are also used to treat the condition, he said, but they are not effective.
The nasal balloon device is a balloon with a short, tubelike nozzle; children block one nostril and blow into the nozzle through the other nostril to inflate the balloon, and then switch nostrils. The practice, called autoinflation, opens up the Eustachian tube that connects the middle ear and the back of the nose, introducing air into the middle ear and allowing the fluid to drain better.
The downside is that children have to do the “treatment” three times a day for at least a month, though they seemed to enjoy the task and treat it like a parlor trick, Dr. Williamson said. And children younger than 4 – who suffer most frequently from ear infections and glue ear because of their small Eustachian tubes – weren’t included in the clinical trial because they were too young to use the balloons properly.
Glue ear usually resolves spontaneously within a few months, said Dr. Richard Rosenfeld, a pediatric otolaryngologist who is lead author of the American Academy of Otolaryngology-Head and Neck Surgery’s guidelines on otitis media with effusion. He noted that the study’s findings were fairly modest.
“This is a great option for people who find it difficult to be patient and do nothing while diseases go away on their own,” Dr. Rosenfeld said, adding that he uses the balloon in his own practice. “It empowers the patient and puts them at ease, and is a terrific adjunct to watching and waiting for parents and clinicians who feel they must do something.”
It is safe, but should not be used if the child has a cold or upper respiratory infection or any pain, he said, since it may worsen these conditions.
If it works, the device is a bargain; the balloon sells for 8.85 British pounds, or less than $15.00.