Dosage regimens of intranasal aerosolized surfactant on otitis media with effusion in an animal model

OBJECTIVE: To determine optimal dosage regimens of intranasal metered dose aerosolized surfactant with and without other medications in the treatment of otitis media with effusion (OME). STUDY DESIGN: Resolution of experimental OME in gerbils was determined base d on otomicroscopy and tympanometry. Experimental intranasal drugs were: su rfactant, surfactant with betamethasone, surfactant with phenylephrine, and a normal saline solution placebo. Medications were administered once or tw ice daily via a metered dose inhaler. RESULTS: For twice-daily dosing, mean days to OME resolution were 8.5 for t he aerosolized surfactant, 6.3 for the surfactant with betamethasone, 18.7 for the surfactant with phenylephrine, and 16 each for control and placebo. Resolution with the once-daily dosage was longer for all conditions, Resul ts were comparable using tympanometry. CONCLUSION: OME resolved faster than the natural course when treated with i ntranasal surfactant with and without steroids. Twice-daily dosing was stat istically superior. SIGNIFICANCE: This study reiterates the effectiveness of OME treatment with an aerosolized synthetic surfactant with and without steroids and establis hes a superior twice-daily dosage schedule.