Introduction
Otitis media with effusion (OME) is a condition in which the middle ear
contains fluid but without any signs or symptoms of an acute infection.
It may occur following an upper respiratory tract infection or
spontaneously due to poor eustachian-tube function.1
Finkelstein et al.2 found that the incidence of
adult-onset OME is far less than in children, and that it commonly
follows rhinosinusitis, nasopharyngeal lymphatic tissue hypertrophy, and
smoking, resulting in an inflammation of the eustachian tube
lumen.3 According to our electronic database, an
average of 100 patients per year were diagnosed with OME at our clinic
during 2011–2016. Of those, 50%–60% were aged 12 years or older.
OME and eustachian tube dysfunction lead to hearing impairments ranging
from normal hearing to a moderate hearing loss (0–55 dB HL), with an
average hearing threshold of 28 dB.1 In addition,
chronic OME without treatment may result in retraction of the tympanic
membrane, atelectatic ear, ossicular erosion, tympanic membrane
perforation, or even cholesteatoma formation.1,4Therefore, patients with OME should receive proper management in order
to prevent such complications.
Regarding the results from previous literature, conservative treatment
by medical therapies (such as antihistamines, decongestants, antireflux
therapy, and topical nasal steroids) is ineffective in both the short
and long term.5
As for adult OME, the aim of treatment is to eliminate the cause of
eustachian tube dysfunction and to restore eustachian tube function.
Swallowing and chewing are two possibilities that can help to recover
normal tube function. Nevertheless, no previous studies have
investigated the relationship between the applicable use of gum-chewing
and OME in adults.
Gum-chewing activates jaw movement and induces frequent swallowing. In
the resting position, the eustachian tube is collapsed due to the
passive effect of the cartilage, the elastic fibers, and the pressure of
the surrounding tissues.6,7 In contrast, the
activation of 2 peritubal muscles—the levator veli palatini and the
tensor veli palatini—stimulates the swallowing mechanism, thereby
opening the eustachian tube.8
Gum is easily obtained in the marketplace and is low-priced. It is made
from the resin of a tree, to which a variety of ingredients, including
xylitol, are added to sweeten its flavor. Xylitol has long been used in
food, pharmaceutical, and oral-health products.9 It
has minimal effect on blood sugar and insulin levels, with 40% fewer
calories than regular gum and a low glycemic index. Xylitol is safe for
consumption by diabetic patients.9