Research Progress on Probiotic Nasal Spray Treatment 
for Otitis Media with Effusion in Children

Yangyuan He; Songlin Wu*

doi:10.70711/pmr.v2i8.8273

Research Progress on Probiotic Nasal Spray Treatment for Otitis Media with Effusion in Children

Yangyuan He, Songlin Wu*

Abstract

Secretory otitis media (OME) in children is a common paediatric condition characterised by fluid accumulation in the middle
ear and hearing loss, presenting with high recurrence rates and potential long-term complications. Current treatment strategies, such as
antibiotics and surgery, face limitations including restricted efficacy, multiple side effects, and high recurrence rates. Recent microbiome
research has revealed a strong association between nasopharyngeal dysbiosis and OME pathogenesis, particularly through the excessive
proliferation of opportunistic pathogens affecting the middle ear microenvironment via the Eustachian tube. Consequently, probiotic nasal
sprays have emerged as a novel therapeutic approach, demonstrating therapeutic potential by competitively inhibiting pathogens, modulating immune responses, and remodelling the respiratory microbiome. Animal models and preliminary clinical studies indicate that probiotic
sprays can ameliorate middle ear inflammation, reduce effusion, and lower recurrence rates, demonstrating favourable safety and tolerability. However, their widespread application requires validation through further high-quality randomised controlled trials. This review systematically outlines the mechanisms and research advances of probiotic nasal sprays in treating paediatric OME, offering novel therapeutic
perspectives for clinical practice.

Keywords

Secretory otitis media; Probiotics; Nasal spray; Microbiome; Immunomodulation

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References

[1] WEBSTER K E, MULVANEY C A, GALBRAITH K, et al. Autoinflation for otitis media with effusion (OME) in children [J]. The Cochrane database of systematic reviews, 2023, 9(9): Cd015253.

[2] MULVANEY C A, GALBRAITH K, WEBSTER K E, et al. Topical and oral steroids for otitis media with effusion (OME) in children [J].

The Cochrane database of systematic reviews, 2023, 12(12): Cd015255.

[3] MACKEITH S, MULVANEY C A, GALBRAITH K, et al. Ventilation tubes (grommets) for otitis media with effusion (OME) in children [J]. The Cochrane database of systematic reviews, 2023, 11(11): Cd015215.

[4] MULVANEY C A, GALBRAITH K, WEBSTER K E, et al. Antibiotics for otitis media with effusion (OME) in children [J]. The Cochrane database of systematic reviews, 2023, 10(10): Cd015254.

[5] VENEKAMP R P, SANDERS S L, GLASZIOU P P, et al. Antibiotics for acute otitis media in children [J]. The Cochrane database of

systematic reviews, 2023, 11(11): Cd000219.

[6] MACKEITH S, MULVANEY C A, GALBRAITH K, et al. Adenoidectomy for otitis media with effusion (OME) in children [J]. The

Cochrane database of systematic reviews, 2023, 10(10): Cd015252.

[7] FAN Y, CHEN J, XU S, et al. Bacillus cereus is a key microbial determinant of intractable otitis media with effusion [J]. Communications medicine, 2025, 5(1): 150.

[8] SEPPANEN E J, BAYLISS J, CLARK S L, et al. Haemophilus influenzae remains the predominant otitis media pathogen in Australian

children undergoing ventilation tube insertion in the PCV13 era [J]. The Journal of infection, 2025, 90(4): 106478.

[9] YUAN V G, XIA A, SANTA MARIA P L. Chronic suppurative otitis media: disrupted host-microbial interactions and immune dysregulation [J]. Frontiers in immunology, 2025, 16: 1547206.

[10] VLASTOS I M, TSOTSIOU N, ALMOMANI M, et al. Is Allergic Rhinitis Related to Otitis Media with Effusion in Adults and Children? Applying Epidemiological Guidelines for Causation [J]. Cells, 2025, 14(11).

[11] WANG Y C, YU Y C, CHEN S H, et al. Increased Incidence of Surgical Intervention for Otitis Media With Effusion Among Patients

With Type 2 Inflammatory Diseases [J]. The journal of allergy and clinical immunology In practice, 2025, 13(3): 658-69.

[12] LIU Z, ZHANG F, JIA F, et al. Lactobacillus Protects Against Chronic Suppurative Otitis Media via Modulating RFTN1/ Lipid Raft /

TLR4-Mediated Inflammation [J]. Biologics: targets & therapy, 2024, 18: 453-68.

[13] SARLIN S, KOSKELA U, HONKILA M, et al. Streptococcus salivarius Probiotics to Prevent Acute Otitis Media in Children: A Randomized Clinical Trial [J]. JAMA network open, 2023, 6(11): e2340608.

[14] BETTOCCHI S, COMOTTI A, ELLI M, et al. Probiotics and Fever Duration in Children With Upper Respiratory Tract Infections: A

Randomized Clinical Trial [J]. JAMA network open, 2025, 8(3): e250669.

[15] THI LE H, THI BICH PHUNG T, THI BUI H, et al. Nasal-spraying Bacillus spore probiotics for pneumonia in children with respiratory

syncytial virus and bacterial co-infections: a randomized clinical trial [J]. Communications medicine, 2025, 5(1): 336.

[16] SCHMID A M, RAZIM A, WYSMOLEK M, et al. Extracellular vesicles of the probiotic bacteria E. coli O83 activate innate immunity

and prevent allergy in mice [J]. Cell communication and signaling: CCS, 2023, 21(1): 297.

[17] KOLANJIYIL A V, WALENGA R, BABISKIN A, et al. Establishing quantitative relationships between changes in nasal spray in vitro

metrics and drug delivery to the posterior nasal region [J]. International journal of pharmaceutics, 2023, 635: 122718.

[18] TEPEKULE B, BARCIK W, STAIGER W I, et al. Computational and in vitro evaluation of probiotic treatments for nasal Staphylococcus aureus decolonization [J]. Proceedings of the National Academy of Sciences of the United States of America, 2025, 122(7):

e2412742122.

[19] OH Y J, LEE J M, YEO J H, et al. Induction of Nitric Oxide and Its Role in Otitis Media [J]. Antioxidants (Basel, Switzerland), 2025,

14(3).

[20] XIAO Y, WANG X, LIU M, et al. Targeting Neutrophil/Eosinophil Extracellular Traps by Aptamer-Functionalized Nanosheets to Overcome Recalcitrant Inflammatory Disorders [J]. Advanced science (Weinheim, Baden-Wurttemberg, Germany), 2025, 12(38): e04210.

[21] SWORDS C, SMITH M E, PATEL A, et al. Balloon dilatation of the Eustachian tube for obstructive Eustachian tube dysfunction in

adults [J]. The Cochrane database of systematic reviews, 2025, 2(2): Cd013429.

[22] CALVO-HENRIQUEZ C, DI CORSO E, ALOBID I, et al. Pathophysiological Link Between Chronic Rhinosinusitis and Ear Disease [J].

Current allergy and asthma reports, 2023, 23(7): 389-97.

[23] LIN E K, CHANG W W, JHONG J H, et al. Lacticaseibacillus paracasei GM-080 Ameliorates Allergic Airway Inflammation in Chil-

dren with Allergic Rhinitis: From an Animal Model to a Double-Blind, Randomized, Placebo-Controlled Trial [J]. Cells, 2023, 12(5).

[24] CHEN A, GONG Y, WU S, et al. Navigating a challenging path: precision disease treatment with tailored oral nano-armor-probiotics [J].

Journal of nanobiotechnology, 2025, 23(1): 72.

[25] CAUWENBERGHS E, DE BOECK I, SPACOVA I, et al. Positioning the preventive potential of microbiome treatments for cystic fibrosis in the context of current therapies [J]. Cell reports Medicine, 2024, 5(1): 101371.

[26] GUAN W, GONG C, WU S, et al. Instant Protection Spray for Anti-Infection and Accelerated Healing of Empyrosis [J]. 2024, 36(3).

[27] SHARIFIAN A, VARSHOSAZ J, ALIOMRANI M, et al. Nose to brain delivery of ibudilast micelles for treatment of multiple sclerosis

in an experimental autoimmune encephalomyelitis animal model [J]. International journal of pharmaceutics, 2023, 638: 122936.

DOI: http://dx.doi.org/10.70711/pmr.v2i8.8273

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