Efficacy of continuous positive airway pressure on middle ear atelectasis: A double-blind placebo-controlled clinical trial.

OBJECTIVES/HYPOTHESIS To investigate the effects of continuous positive airway pressure (CPAP) treatment on patients with middle ear atelectasis. STUDY DESIGN Prospective, double-blind, randomized, placebo-controlled study. METHODS Fifty-four patients with middle ear atelectasis were randomized to receive CPAP treatment with a pressure level of either 14 cm H2 O (CPAP group) or 0 cm H2 O (placebo group) once per week for a period of 3 hours for 4 sessions. Outcome measures included otomicroscopic examination as well as tympanometric and audiometric evaluation. Patients were followed for 6 months. RESULTS The CPAP group included 35 atelectatic ears, and the placebo group included 32 atelectatic ears. More ears recovered to normal tympanic membrane or regressed to grade 1 atelectasis in the CPAP group than in the placebo group during all follow-up visits (P < .05). There was a statistically significant increase in the middle ear pressure values of the patients in the CPAP group compared to the placebo group at week 5, month 3, and month 6 (P < .05). There was no significant difference in middle ear pressure values between follow-up visits in the CPAP group (P > .05). Significant improvement of pure-tone air-conduction threshold averages were found in the CPAP group compared to the placebo group at month 6 (P < .05). CONCLUSIONS CPAP is a safe, well-tolerated way of applying positive pressure to the middle ear for patients with middle ear atelectasis. It contributes to significant improvement in middle ear pressure of these patients, also resulting in an improved degree of atelectasis. LEVEL OF EVIDENCE 1b. Laryngoscope, 126:1649-1655, 2016.