FAQ

Moniri is used twice (2) a day, and inflated 5-10 times each session. It takes approximately 5-10 minutes every day. It is important that the treatment is fun for both the child as well as the parent. Some children may require adaptation to the treatment; therefore, the initial goal could be one (1) inflation per day, and gradually increasing it. Use the Moniri-calender to motivate and monitor the treatment.

Two (2) balloons with standard pressure follow Moniri. The blue balloon with a pressure of approximately 40 cmH2O and the red balloon with approximately 60 cmH2O. The treatment starts with the blue balloon during four (4) weeks. In case of ineffective results continue additional four (4) weeks with the red balloon instead. It is essential to complete the total treatment period.

The treatment can be performed by either one, through the mouth or the nose.

This is the only device that is recommended for children under four (4) years old for pressure equalization. No other device or treatment except surgery have been able to improve the hearing of small children with secretory otitis media (SOM, or inflammation in the middle ear). There are three main reasons for the excellent results: 
1. Earlier methods only focus on performing pressure equalization through the nose. This is difficult, unpleasant and less efficient. With Moniri pressure equalization can be performed through the mouth and/or the nose. 
2. The Moniri device looks like a toy. The majority of children find the treatment funny, which increases the success to follow though the treatment drastically.
3. With the Moniri device, several pressure equalization games can be performed; with the face mask correctly in place, the child’s shouting, screaming, laughing or coughing, leads to the equalization of the ear pressure. Additionally, the parent can easily add or supply air by squeezing the pump in the frog’s belly. This allows a good treatment without any active cooperation of the child.

Children with perforated eardrum should only use the device after discussion with the consulting physician.

Clinical trials have shown equal results regarding improvement of hearing between Moniri and surgery with the insertion of a plastic tube through the eardrum. One advantage with the surgical procedure is that the improvement of hearing is instant. However, surgery is not totally free of risk. Approximately 1 out of 10 children are expected to have a complication after surgery. Pain, discomfort, chronic runny ear or a permanent hole in the eardrum, and relapse is relatively common. Some complications or relapse require additional and more advanced surgical procedures.

Having a cold once a month could be a sign of allergic condition or hypersensitivity. There are no obstacles to use Moniri during periods where the child is not having a cold. More importantly is to see a physician to diagnose and eventually treat for allergy or hypersensitivity. Please consult your physician for diagnosis and treatment.

• on children with a runny nose? It is important that any sign of symptoms from the nose are treated separately and under control. In case of a runny nose, nasal rinsing and nasal spray can be used in combination with Moniri. Please see a physician for diagnosis and treatment. • on coughing children? Coughing could be a sign of bronchitis or laryngitis in a child. There are no hindrance to use Moniri, however, it is important to go see a physician for diagnosis and treatment for the cause of the cough. • on children with enlarged nose adenoids, or large tonsils? Enlarged adenoids and tonsils mainly leads to snoring and breathing through the mouth, which in turn also could affect the results of the treatment. Allergy nasal spray is the first-choice in long term treatment. However, in case of unsatisfactory results, surgical procedure of may become necessary. • on recurrent middle ear infections? There are several reasons for recurrent middle ear inflammations. SOM (fluid behind the eardrum) can be one of the reasons that can be treated with Moniri. Other reasons include recurrent airway infections, allergies, bronchitis and asthma. The general concept is the combination of several different treatments, where Moniri plays an important part. • if the child complains of discomfort in the ears during treatment? A possible reason to SOM is an inflammation of the eardrum (örontrumpeten) itself. Minor discomfort in the ear during or after the treatment is common and a sign that both the opening of the eardrum (örontrumpeten) and the treatment are effective. If the child has discomfort with the treatment, medication with anti-inflammatory drugs such as ibuprofen may be considered. The additional treatment with anti-inflammatory medication is usually only necessary the first few days, 1 hour prior to the Moniri treatment. NB! In cases of known medicine allergy, consult your physician. • during acute middle ear inflammation? Some of the clinical signs of acute inflammation of the middle ear are pain and fewer. Moniri should not be used if there is an acute middle ear inflammation, however, Moniri can be used as soon as the acute symptoms are gone. • during secretion from the ear channel? Liquid or pus form the ear channel could be caused by several different reasons. Go see a physician for correct diagnosis and treatment. Is there a risk for reccurent secretetory middle ear inflammation (SEM) after a cold? Every infection in the upper airway is a risk for recurrence of secretory middle ear inflammation (SEM). When the acute symptoms no longer exist, a new treatment session starts. • in airplanes? Moniri can assist children and adults to perform an effective equalization of the ear during flights. Especially during take-off and landing, children may experience discomfort and pain in the ears. Always bring your Moniri on the plane and start inflate the child when you start to feel a pressure of the eardrums. This is especially noticeable during take-off and landing.

9 out of 10 children consider Moniri to be a fun toy and perform the treatment, either autonomously or with the aid of a parent. Just as children sometimes do not want to put the seat-belt on, or avoid taking prescribed medications, they may also object to use Moniri. There are several ways in order to succeed with this: • Inflate the balloon or show how the treatment works on other children in the family. • Use the Moniri-calendar to stimulate the child. • Try other methods to motive the child with different rewards. • Count the number of inflations and increase by adding one inflation per day. To motivate you as a parent, it is important to understand that the child is being forced to anesthetics and surgical procedure with a whole in the eardrum, and an application of a plastic tube is being done with the risks with anesthesia and surgey. Before a surgical procedure is carried away, one last try with Moniri should be attempted where both parents are involved. The child is placed in front of a parent’s lap with one arm grabing the child’s arms, and with the other arm stabilizes the head PICTURE. The other parent puts the mask on, covering the child’s mouth and nose and simultaneously squeezes the frog’s belly repeatedly to inflate the balloon. The child is then rewarded for being courageous and the same process is being repeated the following day. By the third day the child is usually aware that the treatment is painless and without discomfort and therefore normally cooperates in the ongoing treatment sessions. If none of the above works, operation is the last option.