The Effect of Desloratadine on Chronic Otitis Media with Effusion in Children Requiring Grommet
Objectives: Otitis media with effusion is the most common cause of acquired hearing loss in the pediatric population, however best medical treatment is unknown. The main objective of this article is to assess the role of desloratadine in avoiding the need for grommets in children with chronic otitis media with effusion (COME), in relieving the effusion and its associated hearing loss.
Study design: Study design involved retrospective review of case series of children with COME referred for grommets. Age, gender, presenting signs and symptoms were recorded. Pre, post treatment and Audiological results were performed in most of the cases. Response to treatment was measured as clinical and or audiological improvement, along with this the effect of co-existing recurrent otitis media (ROM) and the use of nasal steroids also assessed. Children not responding to a 4-week course underwent were grommets’ insertion. Those responding received a longer treatment until the resolution of the signs and symptoms, up to 3 months.
Results: We included 138 children (1-13y, mean 3.6y, 127 <7 yo) among 34.8% had coexisting ROM, 18.1% nasal obstruction, and 34.1% significant hearing loss. All received desloratadine; 63% received intranasal steroids. Grommets were not needed anymore in 52.2%, one month after initiating the treatment. None of the studied variables affected the outcome. No benefit from adding intranasal steroids to the treatment.
Conclusion: Desloratadine seems to be effective in treating children with COME, accelerating the resolution of effusion and its associated hearing loss, sparing a good number of children the need for grommets. It would be important in the future to conduct placebo controlled trials to confirm these results