Hearing management

Updated 07 December 2017

Nasal balloon a possible solution for 'glue ear'

For kids with a common hearing problem, a 'nasal balloon' may be an alternative to antibiotics and drainage tubes.


A simple procedure using what's known as a "nasal balloon" can treat hearing loss in children with a common middle-ear problem, preventing unnecessary and ineffective treatment with antibiotics, according to a new study.

'Glue ear'

Many young children develop a condition in which the middle ear fills with thick fluid – so-called "glue ear". Often, children have no symptoms and parents seek medical help only when they notice that youngsters have hearing problems.

Dr Jordan Josephson is an ear, nose and throat specialist at Lenox Hill Hospital in New York City. He said that kids are much more prone to glue ear because "the eustachian tube – which is the tube that connects the ear to the back of the nose – gets clogged," often during a sinus infection, allergy or even pollution-linked inflammation.

Read: Ear infections

Right now, treatments such as "antibiotics, antihistamines, decongestants and intranasal steroids are ineffective and have unwanted effects, and therefore cannot be recommended," wrote a team of British researchers led by Dr Ian Williamson of the University of Southampton in England.

In certain cases, drainage tubes can help some children with glue ear, the study authors said.

However, in the new study, Williamson's team assessed another glue ear treatment – "autoinflation" with a nasal balloon – in a group of 320 children aged 4 to 11 years. During the treatment, the child blows through each nostril into a nozzle to inflate the balloon.

The children were randomly assigned to either use the balloon treatment three times a day for one to three months, or to undergo standard care.

Compared to those in the standard-care group, children who used the balloon treatment were more likely to have normal middle-ear pressure at one month (about 36 percent versus 47 percent, respectively), and at three months (about 38 percent versus 50 percent, respectively). They also had fewer days with symptoms, the researchers reported.

Read: Otitis media

"Autoinflation is a simple, low-cost procedure that can be taught to young children in a primary-care setting with a reasonable expectation of compliance," according to the study authors, who believe the treatment should be used more widely in children over age 4.

One expert in the United States said the technique is really nothing new.

The nasal balloon "has been around for decades," Josephson said. "When I treat children with these problems, I tell the parents to have the child blow up balloons and squeeze their nose and try to pop their ears," he explained.

"This treatment is similar to popping your nose when your ears get clogged on airplanes," he said.

But another expert stressed that the balloon technique isn't always the answer.

"While autoinflation presents a non-invasive option in some cases, it cannot always do away with the need for further intervention," said Dr Joseph Bernstein, chief of paediatric otolaryngology at Mount Sinai Health System in New York City. He also believes that more study is needed into the effectiveness of the nasal balloon, and possible risks or side effects.

The study was published in the CMAJ (Canadian Medical Association Journal).

Read  more:

Glue ear

Thwart middle-ear infection

Answer: What's your diagnosis? – Case 18

Image: Ear examination from Shutterstock


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Hearing Expert

Dr Kara Hoffman graduated from UCT in 2004, thereafter she completed her year of community service in Durban. In 2010 she completed her Masters Degree in Paediatric Aural Rehabilitation from UKZN. In 2016, she became a Doctor of Audiology through the University of Arizona (ATSU). Dr Hoffman and her partner Lauren Thompson opened a fully diagnostic audiology practice called Thompson & Hoffman Audiology Inc. In 2011 with world-class technology and equipment to be able to offer the broad public all hearing-related services including hearing testing for adults and babies, vestibular (balance) assessments and rehabilitation, industrial audiology, hearing devices, central auditory processing assessments for school-aged children, school screening, neonatal hearing screening programmes at Alberlito and Parklands Hospital, cochlear implants and other implantable devices, medicolegal assessments and advanced electroacoustic assessments of hearing. Thompson and Hoffman Audiology Inc. are based at Alberlito Hospital in Ballito, St Augustines Hospital in Durban and at 345 Essenwood Road, Musgrave. The practices are all wheelchair friendly. There are three audiologists that practice from Thompson & Hoffman – including Dr Kara Hoffman, Lauren Thompson & Minette Lister. The practice boasts professional, highly qualified, and extensive diagnostic services where all your hearing healthcare needs can be met. The additional licensing in vestibular assessment and rehabilitation, paediatric rehabilitation and cochlear implantation places this practice in one of the top specialist audiological positions in South Africa, with a wealth of experience in all clinical areas of audiology and is a very well respected and sought-after practice.

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