Biomedical subjects

H E Rockette

Publications and source records attributed to H E Rockette.

75 records · Page 5Linked to original sources

PubMedDate not supplied

Effect of decongestant with or without antihistamine on eustachian tube function.

In an attempt to determine the effect of a decongestant with or without an antihistamine on the ventilatory function of the eustachian tube (ET), two separate studies were conducted in 50 children who had had chronic or recurrent otitis media with effusion (OME) and in whom tympanostomy tubes had been inserted previously. The first was a double-blind study that compared the effect of an oral decongestant, pseudoephedrine hydrochloride, with that of a placebo in 22 children who developed an upper respiratory infection (URI) during an observation period. Certain measures of ET function were significantly elevated above baseline values during the URI, which was attributed to intrinsic mechanical obstruction of the ET. It was found that the oral decongestants tended to alter these parameters of ET function in the direction of the baseline (preURI) values. Even though the effect was statistically significant, the favorable changes in measurements of tubal function were only partial and were more prominent on the second day of the trial after the subjects had received four doses of the decongestant. However, the administration of nasal spray of 1% ephedrine appeared to have no apparent effect on ET function in these children. The second study was a double-blind crossover design. In this study of 28 children who did not have a URI, the effect of a decongestant-antihistamine combination (pseudoephedrine hydrochloride and chlorpheniramine maleate) was compared with that of a placebo. When the subjects were given the decongestant-antihistamine medication, there were favorable changes in certain ET function measures which were not observed when they received the placebo. Again, the response differences between the two groups were statistically significant. Even though these two studies indicated that an oral decongestant appeared to affect favorably the ET function of children who had a URI, and that the combination of an oral decongestant and antihistamine had a similar effect on tubal function in children without a URI, an evaluation of the efficacy of these commonly employed medications must await the results of controlled clinical trials in children with OME.

Adolescent↗

PubMedDate not supplied

Comparison of cefaclor and amoxicillin for acute otitis media with effusion.

A double-blind randomized clinical trial was conducted comparing cefaclor and amoxicillin for the treatment of acute otitis media with effusion in 110 children (150 ears). Each child underwent unilateral or bilateral tympanocentesis and then randomly received a 14-day course of either amoxicillin or cefaclor. Of 57 children in the cefaclor group, only 3 children (5.3%) had persistent or recurrent symptoms during the 14-day course of treatment, as compared to 5 of 53 children (9.4%) in the amoxicillin group, but this difference is not significant. After completion of the 14 days of therapy, 45 of 76 ears (59.2%) of the children in the cefaclor group were effusion-free, as compared to only 28 of 64 ears (43.7%) of the children in the amoxicillin group. When adjusted for age and race, this difference is statistically significant (p = .03). However, the difference between the effect of the two antimicrobials is not statistically significant in children. Cefaclor is a reasonable choice for antimicrobial therapy for acute otitis media with effusion, and from these study findings, it appears that cefaclor may be more effective than amoxicillin in resolving the middle ear effusion at the completion of 14-day therapy.

Acute Disease↗

PubMedDate not supplied

Effect of a topical nasal decongestant on Eustachian tube function in children with tympanostomy tubes.

The effect of a topical nasal decongestant spray on Eustachian tube function was evaluated in 40 children with tympanostomy tubes. Five parameters of tubal function were assessed employing a modified inflation-deflation test and forced response test before and after spraying the nose with either oxymetazoline hydrochloride or a placebo according to a randomized double-blind study design. The results showed no significant differences between the two treatment groups. However, all the children in the study group had severe functional tubal dysfunction, as documented by the increased resistance of the Eustachian tube during swallowing. It is possible that efficacy may be shown in subjects with less severe dysfunction of the Eustachian tube than these involved in this study. It was concluded that further studies of the efficacy of topical decongestants for secretory otitis media and related conditions of Eustachian tube dysfunction are warranted to justify the widespread use of these medications.

Adolescent↗