Efficacy of crenotherapy by Politzer in the treatment of otitis media with effusion in children with down syndrome

Management outcomes of otitis media with effusion in children with down syndrome: A systematic review

OBJECTIVE

To assesses the current state of uncertainty concerning the management options used for otitis media with effusion (OME) in children with trisomy 21.

REVIEW METHODS

A systematic review of adhering to the PRISMA statement of studies evaluating the management of OME in trisomy 21 children prior to September 2021 was conducted. Studies were identified using the following medical databases: PubMed, Google Scholar, CINAHL, Scopus and Medline. Data extraction was performed by screening of titles and abstracts based on eligibility criteria, followed by full-article analysis of selected records.

RESULTS

Twenty articles were included in this review. Studies showed conflicting outcomes regarding the different interventions used for OME in children with trisomy 21. Of those evaluating pressure equalizing tubes (PET), some studies report pronounced complication rates and recommend using a conservative approach unless complications arise and/or hearing loss is severe. In contrast, other studies reported significantly reduced complication rates and improved hearing with earlier intervention and adaptations to PETs. Hearing aids may be provided after multiple failed PETs.

CONCLUSION

Clinical equipoise still persists regarding the best method to manage children with trisomy 21 who have OME. Although PETs exhibited the lowest complication rates and highest improvement rates, further prospective trials are warranted to assess the various treatment modalities and determine which of them would provide the best outcome while reducing complications as well as the age of treatment.

Otitis media with effusion: Politzer's 100 year legacy

Otitis media with effusion has been the subject of a number of recent studies. It was first recognised during the second half of the 19th century, when Adam Politzer (1835-1920) of Vienna was one of the leading otologists of this period and a founding father of the specialty. He had emphasised in his textbook the importance of tympanoscopy, which had led to the recognition of what was then known as 'catarrh of the middle ear' as a clinical entity. Politzer's original illustrations and concise accounts give a clear image of the contemporary state of knowledge of the condition and its treatment, which includes myringotomy, adenoidectomy and the insertion of tympanostomy tubes. From his textbook we can also glean insight into the evolution of both otology as a specialty and OME in particular.