ConclusionS -carboxymethylcysteine is effective in the treatment of children with glue ear .
Objective To establish the clinical relevance of S-carboxymethylcysteine in the treatment of glue ear in children using measures approximating those saving a child from operation for grommet insertion .
Randomised controlled trial of early surgery versus watchful waiting for glue ear: the effect on behavioural problems in pre-school children.
This trial was design ed to compare early surgery with watchful waiting for persistent bilateral otitis media with effusion ( OME ) in terms of hearing loss and behavioural problems in pre-school children . A r and omised controlled trial compared the effects of early treatment with ventilation tubes versus watchful waiting for 9 months . Results were analysed by intention-to-treat . One hundred and eighty-two pre-school children ( date of birth between 1 April 1991 and 31 December 1992 ) , mean age of 2.9 years ( SD 0.85 ) with at least a 3-month history of bilateral OME and hearing loss of greater than 25 dB were treated in Bristol Children 's Hospital between November 1993 and January 1996 .  Bilateral ventilation tubes were inserted within 6 weeks of r and omisation or within 6 weeks of re assessment after 9 months of watchful waiting , with a final assessment at 18 months . The main outcome measures were behavioural problems , measured by the Richman Behaviour Checklist , and hearing loss at 4000 Hz in the better hearing ear . Early surgical intervention significantly reduced behavioural problems by 17 % ( 95 % CI , 2 % - 33 % ) . This difference was largely mediated by concurrent hearing loss . After 18 months , there was no longer a significant difference ( 95 % Cl , -19 % to + 10 % ) . However , the majority ( 85 % ) of the Watchful Waiting group had required surgery and 22 % of all children still had behavioural problems
ConclusionS -carboxymethylcysteine is effective in the treatment of children with glue ear .
Objective To establish the clinical relevance of S-carboxymethylcysteine in the treatment of glue ear in children using measures approximating those saving a child from operation for grommet insertion .