An alternative treatment approach for patients with resistant otitis media with effusion and dysfunctional Eustachian tube.

ABSTRACT

OBJECTIVES: To determine whether dysfunctional Eustachian tubes of children with resistant otitis media with effusion (OME), ventilation tube placement indication, and maxillary constriction will recover after rapid maxillary expansion (RME). MATERIALS AND METHODS: The RME group consisted of 15 children (mean age 10.07 years) with maxillary constriction, Eustachian tube dysfunction (ETD), and resistant OME. The control group consisted of 11 healthy children (mean age 8.34 years) with no orthodontic and/or rhinologic problems. Recovery of Eustachian tube dysfunction was evaluated by Williams' test at three timepoints before RME/at baseline (T0); after RME (T1); and after an observation period of 10 months (T2). The control group was matched to all these periods, except T1. RESULTS: In the control group, functioning Eustachian tubes were observed in all ears at baseline (T0), and tubes showed no worsening and no change during the observation period (T2) (P > .05). In the RME group, functioning Eustachian tubes were observed in eight of 30 ears and ETD was observed in the remaining 22 ears at baseline (T0). The RME group showed significant improvements in tube functions after RME and the observation period (P < .05). Fifteen of 22 dysfunctional ears recovered (68.2%) and started to exhibit normal Eustachian tube function after RME (T1) and the observation period (T2). CONCLUSIONS: The findings suggest that ears having poorly functioning Eustachian tubes are restored and recovered after RME in most of children with maxillary constriction and resistant OME. Thus, RME should be preferred as a first therapy alternative for children with maxillary constriction and serous otitis media.