A new device for treating fluid in the middle ear

The presence of fluid in the middle ear without signs or symptoms of acute ear infection is called middle ear effusion (MEE). It is also one of the most common reasons why children visit the doctor. In approximately 90 percent of cases, the fluid disappears spontaneously within a few months. But when the fluid persists, it can adversely affect a child's hearing.

Current treatments, including antibiotics, decongestants and antihistamines, have not always been very successful in eliminating the fluid. If the MEE persists, or if there is a conductive hearing loss, an incision on the ear drum, with or without placement of an ear ventilation tube, may be indicated.

A new device that might help

There might be another option, however, a device known as an EarPopper.™ Developed by Daniel Arick, MD, an otolaryngologist at New York Eye and Ear Infirmary in Brooklyn, and Shlomo Silman, PhD, an audiologist, the device involves forcing air under pressure through the nose into a naturally occurring passage at the back of the nose (the eustachian tube) and into the middle ear system. Theoretically, this allows opening of the eustachian tube, normalization of pressure in the ear and elimination of MEE.

Here's how it works: the device delivers a constant flow of air into the nose. The patient then swallows while the device is running. During the act of swallowing the air is diverted up the eustachian tube, clearing and ventilating the middle ear. The EarPopper™ may be used with patients ages four and up. However, it should not be used during acute ear infections.

One study shows good results thus far

In a four-year study sponsored by the National Institutes of Health, Arick and Silman tested the device in a total of 47 children and compared the results to 47 children who were observed without any medical intervention. Seventy-four percent of children who were treated twice a day for seven weeks with the EarPopper™ had restoration of their hearing compared to 27 percent of children who received no treatment. After extending the treatment for four weeks in patients who did not recover within the first seven weeks, the total recovery for the study group was 85 percent. According to Dr. Arick, there were no complications during the study involving ear drum rupture or acute ear infections.

Dr. John Maddalozzo was among the physicians in Children's Memorial Hospital's Division of Otolaryngology who tested the device, which is available by prescription only, and found it simple to use. Treatment only took seconds to perform and was not painful. In their view, the EarPopper™ appears promising, however, long-term effects and efficacy in larger groups have yet to be studied.