Oral steroids not effective for most children with glue ear

4 September 2018

Ear examination

A new study by researchers at Cardiff University and the University of Oxford shows that a 1-week course of oral steroid tablets does not result in large benefits for most 2-8 year old children who have had glue ear with hearing loss for at least 3 months.

Glue ear, otherwise known as otitis media with effusion, is the most common cause of hearing loss in children and one of the most common reasons for children to have surgery (insertion of grommets). Most cases get better within a few weeks or months, but some children can experience prolonged hearing loss that can affect their learning, language development, confidence and mental health.

The OSTRICH study is the largest ever trial of using oral steroids for children with glue ear. 389 children with glue ear and hearing loss in both ears for at least 3 months were randomly allocated to take steroid tablets once a day for one week or a matched dummy tablet (placebo) for the same amount of time. They completed a symptom diary for 5 weeks and had their hearing assessed 5 weeks, 6 months and 12 months after being entered into the study.

The study found that children who took the steroid tablets were more likely to have satisfactory hearing by 5 weeks, but the difference was small and may have just been a chance finding.

Cardiff University’s Professor Nick Francis, who co-led the study with Professor Chris Butler at the University of Oxford, said: “Our study shows that a glue ear often gets better by itself – 1 in 3 of these children with prolonged glue ear, and who took placebo tablets, had satisfactory hearing by 5 weeks.

“We found limited evidence of benefit from steroid tablets for most children, but it is possible that around 1 in 14 will get better more quickly following a 1-week course of tablets.

“We didn’t include younger children (under 2) in our study, so can’t say whether steroids would be more or less effective in these children.”

The OSTRICH study was funded by the NIHR Health Technology Assessment Programme and led by Cardiff University and the University of Oxford.