Materials and methods
Thirty patients were enrolled. They were aged 12 years or older, and they had presented with aural fullness, hearing loss, ear popping, and/or ear discomfort. Ear microscopy was used by an otologist to establish a diagnosis of OME. Once OME was confirmed, the patients were sent for pure tone audiometry, given 84 tabs of xylitol gum, and requested to chew 2 gums for 5–10 minutes or until they were tasteless, 3 times a day. The patients were also provided with a logbook to record how many gums they used and how frequently they were chewed.
Excluded from the study were patients with craniofacial anomalies, nasopharyngeal lesions, diabetes mellitus, previous ear and/or nasal cavity surgery, prior head and neck radiation, or an inability to chew gum due to a limitation (such as osteoarthritis of the temporomandibular joint).
The follow-up sessions were at 2, 6, and 12 weeks. At each visit, the patients were examined by microscopy by an otologist, and they underwent an audiometric assessment. A package of gum was given along with a new logbook if middle-ear fluid was still confirmed. However, if the fluid was found to have resolved at the subsequent follow-up appointment, the patients were told to cease using the gum. On the other hand, if the middle-ear fluid persisted until the final follow-up at 12 weeks, a myringotomy was performed.