Does Chewing Gum Help with Middle Ear Effusion?
Chewing gum is not recommended for the treatment of middle ear effusion as there is insufficient scientific evidence documenting its efficacy.
Evidence on Chewing Gum for Middle Ear Effusion
The American Academy of Otolaryngology-Head and Neck Surgery Foundation's clinical practice guideline on otitis media with effusion (OME) makes no recommendation regarding complementary and alternative medicine (CAM) treatments, including chewing gum, due to lack of scientific evidence documenting efficacy and an uncertain balance of harm and benefit 1.
The guideline specifically states that there are no randomized controlled trials with adequate sample size on the efficacy of CAM for OME. While some pilot studies have examined treatments like homeopathy and chiropractic treatments, they failed to show clinically or statistically significant benefits 1.
Pathophysiology and Treatment Approach
Middle ear effusion (MEE) is defined as the presence of fluid in the middle ear without signs or symptoms of acute ear infection. It is extremely common in children, with about 90% experiencing at least one episode by age 2 years 1.
The primary mechanisms of hearing loss in OME are:
- Reduction of the admittance of the middle-ear air space due to displacement of air with fluid
- Increase in tympanic membrane mass by entrained fluid 2
Evidence-Based Management of Middle Ear Effusion
Recommended Approaches:
- Watchful waiting: For children who are not at risk, watchful waiting for 3 months from the date of effusion onset or diagnosis is recommended 2
- Tympanostomy tubes: Consider surgical intervention with tympanostomy tubes for persistent cases when indicated 2
Treatments Not Recommended:
Theoretical Basis for Chewing Gum
Some have proposed that chewing gum might help with middle ear effusion through:
- Active ventilation of the middle ear
- Increasing swallowing frequency
- Activating jaw and palate movements 4
While these mechanisms have physiological plausibility, clinical data supporting the effectiveness of chewing gum for treating middle ear effusion are methodologically weak 4.
Clinical Implications
When managing patients with middle ear effusion:
- Focus on accurate diagnosis using pneumatic otoscopy and tympanometry when appropriate
- Recognize that most cases resolve spontaneously within 3 months
- Consider the patient's risk factors for speech, language, or learning problems
- Obtain age-appropriate hearing tests if OME persists for 3 months or longer
- Consider surgical options (tympanostomy tubes) for persistent cases with hearing loss 3
Conclusion
While chewing gum has been proposed as a functional therapy for middle ear effusion based on physiological mechanisms, there is insufficient clinical evidence to recommend it as an effective treatment. Management should focus on watchful waiting in uncomplicated cases and appropriate surgical intervention when indicated by persistent effusion with associated hearing loss or developmental concerns.