Nasal balloon for otitis media with effusion (OME)
A Subcommittee of the American Academies of Pediatrics (AAP), Family Physicians (AAFP), and Otolaryngology-Head and Neck Surgery (AAO-HNS) have published clinical guidelines for the non-surgical management of the child with OME.
In summary they include:
Otitis media in children
Documenting side, duration and severity of symptoms at each assessment.
Identify the child at risk for speech, language or learning problems and promptly evaluate the effect and need for intervention.
For those not at risk for the above, manage with "watchful waiting" for 3 months from onset, and re-examine at 3-6 months' intervals until effusion is no longer present (or hearing loss or structural abnormalities are suspected).
Test hearing if OME persists for >3 months or hearing loss, language problems or learning difficulties suspected.
A meta-analysis from 6 randomized control studies of nasal autoinflation in children to enhance effusion clearance suggests a benefit.
An open randomized control trial of 320 children aged 4-11 years with a confirmed effusion compared nasal autoinflation with a rubber nasal balloon (3 times/day for 3 months) to standard care. Significant improvement occurs by 1 month and continues for 3 months with no significant adverse effects.