Effect of N-acetylcysteine on the incidence of recurrence of otitis media with effusion and re-insertion of ventilation tubes

Previous studies have demonstrated the anti-inflammatory, anti-oxidant, and mucolytic nature of N-acetylcysteine (NAC). Theoretically, these propertie s make the substance ideal for therapeutic use against otitis media with ef fusion (OME). The disease is characterized as a sustained non-specific infl ammation of the middle ear mucosa with secretory. transformation of the epi thelium resulting in accumulation of fluid in the middle ear space. To inve stigate the: effects of instillation of NAC in the middle ear, a double-bli nd, placebo-controlled, randomized trial was carried out. A total of 75 chi ldren who were undergoing their first bilateral insertion of ventilation tu bes (VT) due to OME were randomized to Mucomyst (NAC) or placebo, (the Vehi cle) on one ear in relation to the VT insertion. The contralateral ear unde rwent VT insertion exclusively. Instillation of Mucomyst or placebo was rep eated 3 and 7 days afterwards. The children were followed regularily for 11 -39 months. Episodes of otorrhea the recurrence of OME after VT extrusion a nd re-insertion of VTs were registered as primary outcome parameters. The r esults demonstrated that Mucomyst significantly reduced the recurrence of O ME: and re-insertion of VTs (p < 0.025) and significantly increased the tim e until VT extrusion (p < 0.0167). In addition, the number of episodes of c ar problems and visits at the ENT clinic were reduced significantly by NAC (p < 0.0383).