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Efficacy of intranasal corticosteroid sprays in relieving clinical signs of Eustachian tube dysfunction: a systematic review and meta-analysis of randomised, controlled trials

Published online by Cambridge University Press:  29 April 2024

Tara J. Nibhanupudy Open the ORCID record for Tara J. Nibhanupudy [Opens in a new window] ,
Aneesh Patel Open the ORCID record for Aneesh Patel [Opens in a new window] ,
Caroline P. Trinh ,
Elizabeth Jenkins ,
Peter C. Weber  and
Jessica R. Levi
Tara J. Nibhanupudy*
Affiliation:
Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
Aneesh Patel
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Boston Medical Center, Boston, MA, USA
Caroline P. Trinh
Affiliation:
A.T. Still University School of Osteopathic Medicine in Arizona, Mesa, AZ, USA
Elizabeth Jenkins
Affiliation:
Boston University Chobanian & Avedisian School of Medicine Alumni Medical Library, Boston, MA, USA
Peter C. Weber
Affiliation:
Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA Department of Otolaryngology – Head and Neck Surgery, Boston Medical Center, Boston, MA, USA
Jessica R. Levi
Affiliation:
Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA Department of Otolaryngology – Head and Neck Surgery, Boston Medical Center, Boston, MA, USA
*
Corresponding author: Tara J. Nibhanupudy; Email: taran@bu.edu
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Abstract

Objective

Eustachian tube dysfunction is prevalent in both paediatric and adult populations. Current clinical guidelines recommend observation over topical intranasal corticosteroids for Eustachian tube dysfunction management, which remains controversial. This study aimed to systematically review randomised, controlled trials assessing topical intranasal corticosteroid efficacy in Eustachian tube dysfunction, and analyse effect through tympanometric normalisation.

Methods

PubMed, EMBASE, Web of Science and Cochrane Library databases were searched. All randomised, controlled trials assessing intranasal corticosteroids in adult or paediatric Eustachian tube dysfunction patients were included. A meta-analysis of proportions was used to evaluate tympanogram normalisation.

Results

Of 330 results, eight randomised, controlled trials met inclusion criteria and underwent qualitative data synthesis and risk-of-bias analysis. Meta-analysis of tympanometry data from four eligible trials (n = 512 ears) revealed no significant difference in tympanometric normalisation between intranasal corticosteroids and control (odds ratio 1.21, 95% confidence interval 0.65–2.24).

Conclusion

Study results do not strongly support intranasal corticosteroids for Eustachian tube dysfunction. Data were limited, emphasising the need for larger, higher quality, randomised, controlled trials.

Keywords

otitis media with effusioncorticosteroidsotologyEustachian tubesystematic review

Information

Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 138 , Issue 11 , November 2024 , pp. 1065 - 1072
Copyright
Copyright © The Author(s), 2024. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Tara J. Nibhanupudy takes responsibility for the integrity of the content of the paper

Presented at the Association for Research in Otolaryngology (ARO) 46th Annual MidWinter Meeting, 2023 February 11–15, Orlando, FL, USA.

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