EFFECT OF TOPICAL ADRENERGIC DECONGESTANTS ON MIDDLE-EAR PRESSURE IN INFANTS WITH COMMON COLDS

Background. Otitis media is frequently a complication of the common co ld. Obstruction of the eustachian tube ostia by nasopharyngeal edema h as been suggested as a cause of this complication. Objective. To deter mine the effect of a topical adrenergic decongestant on middle ear pre ssure in infants with common cold symptoms. Methods. The study was con ducted with a randomized, double blinded, placebo-controlled design. M iddle ear pressure was determined in infants 6 to 18 months old who ha d common cold symptoms. Infants with abnormal middle ear pressure (les s than or equal to-100 mm H2O) in either ear were treated with intrana sal phenylephrine drops or placebo. The effect of the treatment on mid dle ear pressure in ears with abnormal pressure at baseline was determ ined 1 h later. Results. Twenty-three of 44 infants with abnormal midd le ear pressures received intranasal phenylephrine drops and 21 receiv ed placebo. Middle ear pressure remained abnormal after treatment with phenylephrine in 29 of 33 (88%) ears and after treatment with placebo in 26 of 34 (76%). The mean change in middle ear pressure after treat ment was +23 mm H2O in the active group and +40 mm H2O in the placebo group. Conclusions. Treatment of nasal obstruction with topical adrene rgic decongestants does not improve abnormal middle ear pressures duri ng the common cold.