Smoker's Kids Have More Ear Infections

Although not entirely new news... a new review paper which collated the results of 61 past studies has reaffirmed that smoking around kids increases their risk of ear infections dramatically.

Just how much?

Kids living with a smoker had a:

• 37 percent higher risk of ear infections and hearing problems
• 62 percent higher risk of ear problems if the household smoker was their mom
• 86 percent more likely to undergo ear surgery than kids without secondhand smoke exposure

Read a MSNBC story on this here.

So don't smoke for your own health as well as your kids' health!!!

Reference:
Parental Smoking and the Risk of Middle Ear Disease in Children. Arch Pediatr Adolesc Med. Published online September 5, 2011. doi:10.1001/archpediatrics.2011.158

Novel Treatment for Glue Ear?

Glue ear is the layman's term for thick mucoid effusion of the middle ear, usually due to chronic ear infections.

The fluid itself is like maple syrup and usually treated with ear tube placement followed by suctioning as much of the fluid out as possible. However, given there is always some residual present, antibiotic ear drops with steroids is often prescribed.

Unfortunately, these patients are at higher risk of requiring repeated sets of tubes after the body spits them out.

Why?

Because of a phenomenon called biofilms... Think of it as teflon armour made of slime for infections. You can put antibiotics and steroids on it, but they kind of just slip off. Such biofilms make infections nearly 1000 times LESS susceptible to medications. In order to truly eradicate the biofilm (and underlying "hidden" infection), you either have to "scrape" it off which is not possible in the middle ear or use very high concentrations of antibiotics... much greater than that obtained using oral or IV antibiotics.

Though ear drops containing high concentrations of antibiotics are possible, the drops tend to come out of the ear just as easily as they go in preventing prolonged and enduring contact.

That's were the recent innovation comes in...

Scientists in England have developed a biodegradable antibiotic "pellet" that can be inserted into the middle ear during surgery where it will slowly release high concentrations of antibiotics to target any infections present (active or inactive) over 3 weeks continuously. Furthermore, the pellet contains N-acetylcysteine which effectively breaks apart the biofilm.

In essence, this pellet is like an armour-piercing bullet.

Of course, it is not available in the US yet... nor is it FDA approved.

Read more about this here.

Xylitol (Natural Compound) to Prevent Recurrent Sinus and Ear Infections?

I only recently became aware of a natural sugar compound called "Xylitol" from a colleague's blog, BoogorDoctor, managed by Dr. Russell Faust. I certainly have never heard of it during medical school or surgical training.

This naturally-occurring sugar substitute apparently has all sorts of anti-bacterial as well as anti-fungal properties and has been known to doctors and scientists but hardly marketed or promoted in any fashion.

However, the importance of this compound is that it DOES appear to significantly decrease the incidence of ear infections and sinus infections when used regularly (in essence, xylitol mixed in with salt-water sprayed into the nose several times a day).

It's cheap (around $10) and at least from the studies I've reviewed, does seem to work. However, to be fair, it only works when given regularly even if healthy. If given when sick, it does not work (see this study). Also to be fair, there are some studies that suggest that xylitol does NOT work at all.

However, given there are minimal (if any) side effects, it is certainly something worth trying before surgical consideration, especially in children.

Why is this compound not more well-known?

Probably because it's cheap and therefore not a money-maker... which means not a lot of dollars goes into marketing the product whether directly to patients or doctors.

In any case, you can get it on Amazon.com here (or possibly at a local pharmacy).

I should also mention that Xlear is the only product series that uses the optimal concentration xylitol (others use only the bare minimum concentration to meet ingredient inclusion).




References:
A Story About a Sugar: The X-Factor. Blog by Dr. Faust

Xylitol as a prophylaxis for acute otitis media: systematic review. Int J Audiol. 2010 Oct;49(10):754-61.

A novel use of xylitol sugar in preventing acute otitis media. Pediatrics. 1998 Oct;102(4 Pt 1):879-84.

Xylitol chewing gum in prevention of acute otitis media: double blind randomised trial. BMJ. 1996 Nov 9;313(7066):1180-4.

Failure of xylitol given three times a day for preventing acute otitis media. Pediatr Infect Dis J. 2007 May;26(5):423-7.

Xylitol administered only during respiratory infections failed to prevent acute otitis media. Pediatrics. 2002 Feb;109(2):E19.