Does Flonase Help Remove Fluid Behind The Eardrum?
In our latest question and answer, the pharmacist discusses whether or not Flonase can help to reduce fluid trapped behind the eardrum.
Can Flonase Sensimist help clear up fluid trapped behind the eardrum? I was told to use this at an urgent care facility.
Jun 26, 2022- Flonase is not recommended for treating fluid behind the eardrum because large studies show it provides no benefit for this condition. Fluid behind the eardrum often goes away on its own within about 3 months, but talk to your doctor about other treatment options if it doesn't improve.
Hello and thanks for your question! Fluid behind the eardrum is also referred to as otitis media with effusion and is more commonly a condition that children have to deal with, but adults can certainly have it as well. In regard to treatment, otitis media with effusion generally resolves on its own, with at least some improvement often seen within a 3-month time frame. However, if there is no improvement over time, or there are complications to consider (e.g. the fluid buildup causing hearing loss), intervention can be taken.
Flonase For Otitis Media With Effusion
Flonase is a 'steroid' nasal spray that contains the glucocorticoid fluticasone. There are actually two forms of Flonase on the market, Flonase, and Flonase Sensimist. They contain two different steroids.
'Regular' Flonase contains fluticasone propionate, while Flonase Sensimist contains fluticasone furoate.
I have written an in-depth article explaining the difference between these two drugs previously.
In regard to using Flonase to treat otitis media with effusion (i.e. fluid behind the eardrum), or using any nasal steroid for that matter, most guidelines recommend against it.
There just appears to be little evidence for benefit.
One of the largest review studies (a Cochrane Review) that evaluated the use of nasal steroids for otitis media with effusion concluded that nasal steroids (referred to as 'topical steroids') had no benefit:
We found no evidence of benefit from treatment of OME with topical intranasal steroids, alone or in combination with an antibiotic, either at short or longer-term follow-up.
Other studies have reported similar findings.
There does appear to be some benefit with nasal steroids, like Flonase, if there are concurrent conditions, like allergies or nasal inflammation. Nasal steroids are very effective for these conditions.
There also doesn't appear to be much of a risk of using nasal steroids. They are generally well-tolerated and have only minor side effects in most individuals.
There could certainly be specific reasons why your provider recommended using Flonase to help with what you are going through, so I encourage you to reach out to them.
They or your primary care doctor are going to be your best resource as they know the most about your medical condition.
Final Words
I mentioned at the beginning of this answer that fluid behind the eardrum generally resolves on its own.
If it does not, there are other treatment options (such as tympanostomy tubes, balloon dilation of the Eustachian tube, adenoidectomy, decongestants, and oral steroids) that you should talk to your doctor about.
Thanks again for your question and feel free to reach out again if anything else comes up!
References & sources
- Oral steroids alone or followed by intranasal steroids versus watchful waiting in the management of otitis media with effusion — PubMed
- Oral or topical nasal steroids for hearing loss associated with otitis media with effusion in children — PubMed
- Oral steroids alone or followed by intranasal steroids versus watchful waiting in the management of otitis media with effusion — PubMed
Glossary — Terms in This Answer
- Otitis media with effusion
- A condition where fluid builds up behind the eardrum, commonly affecting children but also occurring in adults.
- Steroid
- A type of medication that reduces inflammation and immune system activity in the body.
- Glucocorticoid
- A class of steroid hormones that help reduce inflammation and suppress immune responses.
- Fluticasone
- A glucocorticoid medication used to reduce inflammation, available in nasal spray forms like Flonase.
- Topical steroids
- Steroid medications applied directly to a specific area of the body, such as a nasal spray.
- Tympanostomy tubes
- Small tubes surgically placed in the eardrum to help drain fluid and prevent buildup in the middle ear.
- Eustachian tube
- A narrow passage that connects the middle ear to the back of the nose and helps drain fluid and equalize pressure.
- Adenoidectomy
- A surgical procedure to remove the adenoids, small tissues at the back of the throat that can contribute to fluid buildup.