Autoinflation for the Treatment of Persistent Otitis Media With Effusion in Children

IMPORTANCE: Otitis media with effusion (OME) is common in children, often persisting for more than 3 months, which can lead to hearing loss. Effective treatments are needed to manage this condition. OBJECTIVE: To evaluate the efficacy and safety of autoinflation for persistent OME in children. DESIGN: Retrospective cohort study. SETTING: The study was conducted at a tertiary pediatric hospital. PARTICIPANTS: A total of 131 children with persistent OME were enrolled from January 2020 to July 2025. Seventy-one children received autoinflation treatment, and 60 children were assigned to the control group.Exposure or Intervention:The autoinflation group received twice-daily autoinflation treatment for 1 to 3 months in addition to medical therapy. The control group received only medical therapy. MAIN OUTCOME MEASURES: Efficacy was evaluated based on cure rates assessed by tympanometry and otoacoustic emissions before and after treatment. Safety was assessed through the frequency and severity of adverse events. RESULTS: In the autoinflation group after 3 months, 60.8% of ears were cured, and 13.3% showed improvement. In the control group, only 20.0% of ears were cured, and 20.0% improved. Univariate analysis indicated that recurrent OME and recurrent/prolonged respiratory tract infections were significant risk factors for autoinflation failure. Approximately half of the children experienced mild ear pain during the first week, which was generally tolerable. CONCLUSION: Autoinflation appears to be safe and effective in children with persistent OME. Treatment failure is more common in children with recurrent/prolonged respiratory infections or recurrent OME, especially in those with a history of middle ear surgery (adenoidectomy with tympanostomy tube insertion). Although autoinflation is a low-risk alternative to surgery for suitable patients, it should be avoided in children with skull base or orbital defects, craniofacial anomalies, or active infection or inflammation. RELEVANCE: This retrospective cohort study supports the use of autoinflation as a treatment option for persistent OME. Identifying risk factors for treatment failure may help guide clinical decisions.