Effect of N-acetylcysteine for the treatment of otitis media with effusion

Year 2014, Volume: 4 Issue: 1, 20 - 24, 01.03.2014

Osman Fatih Boztepe Taylan Gün Özer Erdem Gür Mehmet Fatih Karakuş Nagihan Bilal Hasan Nedim Arda

https://doi.org/10.2399/jmu.2014001005

Abstract

Objective: To show the efficacy of mucopeptid breaking agent N-acetylcysteine on the treatment of otitis media with effusion. Methods: A total of 64 patients who were admitted to our clinic and diagnosed otitis media with effusion were included in the study. The study group of 33 patients were administered antibiotics, decongestants, and N-acetylcysteine. The control group was treated with only antibiotics and decongestants. Both groups of patients were examined with a low-frequency probe tone (226 Hz) device before, one month, three months and 6 months after the treatment. Tympanometric and pure tone audiometric examination of the patients were performed. Results: At the end of the first month, recovery rates of the left and right ears in the study and control groups were 66 and 72% vs. 13 and 22%, respectively. At sixth month, recovery rates for the left and right ears in the study group were 91 and 94%, respectively, while the corresponding recovery rates were 48 and 55% in the control group. Conclusion: N-acetylcysteine can be used in the treatment of otitis media with effusion as a medical agent. However, studies on more patients are needed to evaluate the efficacy and long-term effect of N-acetylcysteine on otitis media with effusion.

Keywords

N-acetylcysteine, otitis media with effusion, medical therapy

Efüzyonlu otitis media tedavisinde N-asetilsisteinin etkisi

Abstract

Amaç: Bu çalışmanın amacı efüzyonlu otitis media tedavisinde mukopeptid kırıcı ajan olan N-asetilsisteinin etkinliğini göstermektir. Yöntem: Kliniğimize başvuran ve efüzyonlu otitis media tanısı konan 64 hasta çalışmaya alındı. Çalışma grubuna dâhil edilen 33 hastaya antibiyotik, dekonjestan ve N-asetilsistein, kontrol grubuna ise sadece antibiyotik ve dekonjestan uygulandı. Her iki grup, düşük frekanslı prob (226 Hz) cihazı ile tedaviden önce ve tedaviden bir ay, üç ay ve 6 ay sonra incelendi. Hastaların timpanometrik ve saf ton odyometrik muayeneleri yapıldı. Bulgular: Birinci ayın sonunda, çalışma ve kontrol gruplarında sol ve sağ kulak iyileşme oranları sırasıyla yüzde %66 ve %72'ye karşılık %13 ve %22 idi. Altıncı ayda, sol ve sağ kulak için çalışma grubu iyileşme oranları sırasıyla %91 ve %94 iken, kontrol grubunda bu oranlar %48 ve % %55 olarak bulundu. Sonuç: N-asetilsistein, effüzyonlu orta kulak iltihabı tedavisinde kullanılabilir. Ancak, N-asetilsisteinin efüzyonlu otitis media üzerindeki etkinliği ve uzun dönem etkilerini değerlendirmek için daha fazla hasta üzerinde çalışmalar yapılması gereklidir.

Keywords

N-asetilsistein, efüzyonlu otitis media, medikal tedavi

References

• Paparella MM, Schachern PA, Yoon TH, Abdelhammid MM, Sahni R, da Costa SS. Otopathologic correlates of the continuum of otitis media. Ann Otol Rhinol Laryngol Suppl 1990;148:17-22.
• Yoon TH, Schachern PA, Paparella MM, Lindgren BR. Morphometric studies of the continuum of otitis media. Ann Otol Rhinol Laryngol Suppl 1990;148:23-7.
• Ovesen T, Bİrglum JD. New aspects of secretory otitis media, Eustachian tube function and middle ear gas. Ear Nose Throat J 1998;77:770-7.
• Ovesen T, Paaske PB, Elbrond O. Local application of N-acetyl- cysteine in secretory otitis media in rabbits. Clin Otolaryngol Allied Sci 1992;17:327-31.
• Ovesen T, Gaihede M, Ledet T. The effect of N-acetylcysteine on the in 6itro growth of normal rabbit middle ear fibroblasts. Clin Otolaryngol Allied Sci 1993;18:400-5.
• Zielhuis GA, Heuvelmans-Heinen EW, Rach GH, van den Broek P. Environmental risk factors for otitis media with effusion in pre- school children. Scand J Prim Health Care 1989;7:33-8.
• FitzGerald JE, Green GG, Birchall JP, Pearson JP. Rheologic studies on middle ear effusions and their mucus glycoproteins. Arch Otolaryngol Head Neck Surg 1989;115:462-8.
• Williamson I. Otitis media with effusion in children. Clin Evid (Online) 2007;2007.pii: 0502.
• Mandel EM, Casselbrant ML. Antibiotics for otitis media with effusion Minerva Pediatr 2004;56:481-95.
• Mandel EM, Rockette HE, Paradise JL, Bluestone CD, Nozza RJ. Comparative efficacy of erythromycin-sulfisoxazole, cefaclor, amoxicillin or placebo for otitis media with effusion in children. Pediatr Infect Dis J 1991;10:899-906.
• Brown DT, Litt M, Potsic WP. A study of mucus glycoproteins in secretory otitis media. Arch Otolaryngol 1985;111:688-95.
• Cayé-Thomasen P, Tos M. Eustachian tube gland changes in acute otitis media. Otol Neurotol 2004;25:14-8.
• FitzGerald JE, Green GG, Stafford FW, Birchall JP, Pearson JP. Characterization of human middle ear mucus glycoprotein in chronic secretory otitis media (CSOM). Clin Chim Acta 1987;169:281-97.
• Hori F, Kawauchi H, Mogi G. Effect of S-carboxymethylcysteine on the clearance of middle ear effusion. An experimental study. Ann Otol Rhinol Laryngol 1994;103:567-75.
• Ovesen T, Felding JU, Tommerup B, Schousboe LP, Petersen CG. Effect of N-acetylcysteine on the incidence of recurrence of otitis media with effusion and re-insertion of ventilation tubes. Acta Otolaryngol Suppl 2000;543:79-81.
• Majima Y, Takeuchi K, Sakakura Y. Effects of myringotomy and orally administered drugs on viscosity and elasticity of middle ear effusions from children with otitis media with effusion. Acta Otolaryngol Suppl 1990;471:66-72.
• Khan JA, Marcus P, Cummings SW. S-carboxymethylcysteine in otitis media with effusion. (A double-blind study). J Laryngol Otol 1981;95:995-1001.
• Kumazawa T, Ushiro K. Clinical evaluation of S-CMC syrup applied in the treatment of otitis media with effusion. Double blind comparative test with placebo. Acta Otolaryngol Suppl 1988;458:56-62.
• Moore RA, Commins D, Bates G, Phillips CJ. S-carboxymethyl- cysteine in the treatment of glue ear: quantitative systematic review. BMC Fam Pract 2001;2:3.
• van der Merwe J, Wagenfeld DJ. The negative effects of mucolyt- ics in otitis media with effusion. S Afr Med J 1987;72:625-6.
• Fitzgerald JE, Green GG, Birchall JP, Pearson JP. Mucolytic agents and otitis media with effusion. Biomed Pharmacother 1988;42:505- 11.
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• Please cite this article as: Boztepe OF, Gün T, Gür ÖE, Karakufl MF, Bilal N, Arda HN. Effect of N-acetylcysteine for the treatment of otitis media
• with effusion. J Med Updates 2014;4(1):20-24.