In 2016/17 we carried out our second formal 'scoping' project to prioritise reviews on interventions for chronic suppurative otitis media. The aim of this work was to identify priority areas for new and updated Cochrane Reviews in patients with chronic otitis media - defined as chronic inflammation of the middle ear and mastoid cavity with persistent or recurrent ear discharge through a tympanic membrane (ear drum) perforation. Chronic otitis media is estimated to have an incidence rate of 31 million episodes a year, affecting children in particular. Although the prevalence varies widely between countries, it disproportionately affects people in low-income and middle-income countries, resource-limited areas, certain indigenous groups and people with specific conditions such as cleft palate and Down Syndrome. Many people who are affected do not have good access to modern primary healthcare, let alone specialised ear, nose and throat (ENT) care.
The chronic otitis media scoping project, which was partly funded by the Australian NHMRC, was carried out by a team comprising clinical experts and systematic reviewers. Key stakeholders were consulted on the draft report.
The scoping project team gathered preliminary input from clinicians, followed by literature searches and reviews of current clinical guidelines and key papers, especially the Cochrane database and major systematic reviews. The project team also conducted searches to identify the number of new trial abstracts, in order to estimate the amount of new evidence available.
The main output of the project was a prioritised list of seven reviews of interventions for chronic otitis media, with a common set of outcome measures. These reviews are now being conducted for Cochrane ENT. Three are complete (see links below) and the remaining four are expected to complete during 2020:
- Topical antibiotics for chronic suppurative otitis media
- Systemic antibiotics for chronic suppurative otitis media (in progress)
- Topical versus systemic antibiotics for chronic suppurative otitis media (in progress)
- Topical antibiotics with steroids for chronic suppurative otitis media (in progress)
- Topical antiseptics for chronic suppurative otitis media
- Antibiotics versus topical antiseptics for chronic suppurative otitis media
- Aural toilet (ear cleaning) for chronic suppurative otitis media (in progress)
Further priority chronic otitis media reviews may include decongestants, antihistamines and surgery.