Topical Intranasal Corticosteroids Compared with Systemic Steroids in the Treatment of Eustachian Tube Dysfunction in Children

Background: Using corticosteroids in treatment of ETD has been the focus of various studies in which many of them suggested that either topical intranasal corticosteroids or systemic oral steroids are helpful in the management of ETD. The aim of the work was for comparing the efficacy of topical intranasal corticosteroids with that of systemic oral steroids in the treatment of ETD. Patients and Methods: prospective trial on 100 consecutive patients in the age group of 6- 12 years with an intact TM as to be documented on otoscopic examination and with an ETD as to be documented with a tympanogram type C. Subjects were allocated equally into two groups group 1: had intranasal corticosteroids and group 2:  had systemic oral steroids. Data such as ear complaint, patient history, general investigation, otorhinolaryngological clinical check, tympanometry, pure tone audiometry and treatment, if taken were collected from all the patients. Results: The decrease in tympanograms type C after treatment was correlated with the increase in type A tympanograms which indicate complete resolution of the condition in both tested groups of both treatment arms. Difference between the two study groups regarding tympanogram type C normalization shows no statistically significant difference between each treatment arm. Pure tone audiometry results indicate an improvement in the subjects HL after management in both examined groups, but results weren’t statistically significant. Conclusions: Using corticosteroids, whether oral or intranasal, in the management of ETD is effective in resolving the condition, but there is no significant difference between the two in the outcome results and so oral steroid complications could be avoided by using local steroid spray.