An otovent consists of a nose piece and a balloon and is considered suitable for use for children over 3 years of age.  The nose piece is placed against the nostril whilst the other nostril is held closed and the balloon is inflated by blowing with the nose.  This procedure helps to open the eustachian tube, equalise the air pressure and allow the fluid in the middle ear to drain down the back of the throat.  It is recommended to be used 3 times a day with 1 inflation through each nostril on each occasion.

left: Blowing balloons ‘treats Glue Ear’ (Source: BBC News, 2015)  right: otovent

Left: Blowing balloons ‘treats Glue Ear’ (Source: BBC News, 2015) and right:an otovent

The Cochrane review in 2013 considered trials of auto-inflation and concluded that it seemed to have a beneficial effect on the resolution of otitis media with effusion and could be considered as a treatment during the observation period.

A number of studies have taken place to evaluate the effectiveness of autoinflation.  In 2015, Williamson’s study was funded by the National Institute for Health Research. Over a thousand school age children were screened for eligibility and children were selected with a recent history of hearing loss and Glue Ear confirmed by otoscopy and tympanometry.  Children selected to take part were randomly assigned to standard care or autoinflation and standard care and those using autoinflation used an otovent three times a day for 1 month.

Of the 320 children enrolled, those having auto-inflation were more likely to have normal tympanograms at 1 month than those having standard care alone.

The conclusion of this study was that autoinflation is a “feasible, safe and effective” way to clear effusions and a wider use of nasal balloon autoinflation was suggested.

Further trials have shown that the otovent device leads to significant improvements in middle ear function and also reduced the need for grommet insertion.  These studies considered children who were presenting with Otitis Media with Effusion for the first time and not those with persistent Glue Ear.

Blowing balloons ‘treats Glue Ear’ (Source: BBC News, 2015)

In 2015, the BBC reported on the outcomes of Williamson’s study (2015).

The Nice guidelines published in 2016 state that the otovent is a non surgical drug free option to help avoid the need for surgery.

The National Institute for Health and Care Excellence (NICE) published a Medteach innovation briefing in 2016 about the use of the Otovent for the treatment of Glue Ear.

This animation and video shows how an Otovent can be used to treat Glue Ear.

More information about using nasal balloon treatment can be read here.

Moniri Otovent

A new device suitable for younger children has been trialled in a Swedish study and has shown to improve hearing thresholds after use for four weeks (Bidarian-Moniri et al. 2014).  With a mask covering the mouth and nose, a pump is used to assist a young child who would not be able to inflate a balloon independently. This device has been developed and is now available to purchase in the UK.  Further information about this device can be read on the Kestrel Medical Limited website.

Child friendly Swedish Otovent device (frog toy) with mask covering the mouth and nose, a pump is used to assist a young child who would not be able to inflate a balloon independently

An updated Moniri device will be launched in early 2019.  This device will be suitable for hospitals and will be a pump, mouth piece and balloon without the frog attachment.


Ercan, I., Cakir B., Kayaoglu S., Turgut S. (2005) ‘Long term effect of autoinflation in the treatment of otitis media with effusion.’ KBB Forum 2005;4 (4):166–70

Gallagher.J. (2015) Blowing balloons ‘treats Glue Ear

Kestrek Medical (2018) Moniri Otovent [Online image] [ Accessed: 27 May 2021]

National Institute for Health and Care Excellence Medtech innovation briefing (MIB 59): Otovent nasal balloon for otitis media with effusion Published date: March 2016  [Accessed: 27 May 2021]

Perera R., Glasziou PP., Heneghan CJ., McLellan J., Williamson I. (2013) Autoinflation for hearing loss associated with otitis media with effusion. Cochrane Database of Systematic Reviews, Issue 5. Art. No.: CD006285

Williamson, I., Vennik, J., Harnden, A., Voysey, M., Perera, R., Kelly, S., Yao, G., Raftery, J., Mant, D., Little, P. (2015) ‘Effect of nasal balloon autoinflation in children with otitis media with effusion in primary care: an open randomized controlled trial.’ Canadian Medical Association Journal. Vol. 187 no.13. pp 961-969