Management of chronic otitis media with effusion: The role of glutathione

Background: The inflammatory cells documented in chronic otitis media with effusion (OME) spontaneously release oxidants which can induce middle ear ( ME) epithelial cell damage. Glutathione (GSH), a major extracellular antiox idant in humans, plays a central role in antioxidant defense. Purpose. To e valuate the effects of GSH treatment on chronic otitis media with effusion (OME). Subjects and Intervention Sixty children with chronic OME were enrol led, 30 of whom were randomly assigned to the treatment group and 30 to the placebo group. Patients in the treatment group received 600 mg glutathione in 4 mL saline per day subdivided into five 2-minute administrations given by nasal aerosol every 3 or 4 waking hours for 2 weeks. Patients in the co ntrol group received 4 mL saline per day following the same procedure as fo r GSH treatment. Results: Three months after therapy improvement had occurr ed in 66.6% of patients in the GSH-treated group and in 8% of the control s ubjects (P < .01). Conclusion: On the basis of these results, GSH treatment could be considered for the nonsurgical management of chronic OME.