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Pädiatrie up2date 2013; 08(04): 327-344
DOI: 10.1055/s-0033-1344499
Entwicklung
© Georg Thieme Verlag KG Stuttgart · New York

Chronischer Mittelohrerguss

Markus Jungehülsing
,
Christoph Erle-Bischoff
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Publication History

Publication Date:
25 November 2013 (online)

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Fazit für die Praxis

  • Paukenergüsse mit einer Persistenz < 3 Monaten müssen nicht therapiert werden. Hier ist eine „Watchful-Waiting“-Strategie indiziert. Der Versuch der Autoinsufflation mit einem Ballonsystem ist aber durchaus empfehlenswert.

  • Paukenergüsse mit einer Persistenz > 3 Monate sollten operativ behandelt werden: Liegt ein vernarbtes, hyperplastisches Adenoid vor, ist eine Adenotomie empfehlenswert. Eine Parazentese mit Absaugen des Sekrets aus dem Mittelohr sollte immer gleichzeitig durchgeführt werden.

  • Die Einlage von Paukenröhrchen wird wegen möglicher Spätfolgen national und international zunehmend zurückhaltend bewertet. Sie sollte nur bei anamnestisch längerdauernden oder rezidivierenden Tubenbelüftungsstörungen durchgeführt werden. Permanente Paukenröhrchen (Stativröhrchen/„T-Tubes“; Abb. [11]) sind nur in problematischen Einzelfällen empfehlenswert.

 

  • Literatur

  • 1 Williamson I. Otitis media with effusion in children. Clin Evid (Online) 2011; Jan 12: 0502
  • 2 Zahnert T, Mir-Salim P, Kaschke O et al. Leitlinie Seromukotympanum. AWMF Leitlinien 2011; 017/004: 1-10
    Search in Google Scholar
  • 3 Pau HW. Middle ear retractions – the role of predamaged tympanic membranes. Int J Pediatr Otorhinolaryngol 1995; 32: 163-166
    CrossrefSearch in Google Scholar
  • 4 Pau HW. Seröse Otitis Media Und Seromukotympanon. Monatsschr Kinderheilkd 2008; 156 : 550-560
    CrossrefSearch in Google Scholar
  • 5 Williamson IG, Dunleavey J, Bain J et al. The natural history of otitis media with effusion – a three-year study of the incidence and prevalence of abnormal tympanograms in four South West Hampshire infant and first schools. J Laryngol Otol 1994; 108: 930-934
    CrossrefPubMedSearch in Google Scholar
  • 6 Paradise JL, Rockette HE, Colborn DK et al. Otitis media in 2253 Pittsburgh-area infants: prevalence and risk factors during the first two years of life. Pediatrics 1997; 99: 318-333
    CrossrefPubMedSearch in Google Scholar
  • 7 Teele DW, Klein JO, Rosner B. Epidemiology of otitis media during the first seven years of life in children in greater Boston: a prospective, cohort study. J Infect Dis 1989; 160: 83-94
    CrossrefSearch in Google Scholar
  • 8 Leuwer R, Schubert R, Wenzel S et al. New aspects of the mechanics of the auditory tube. HNO 2003; 51: 431-437
    CrossrefSearch in Google Scholar
  • 9 Arnold W. The reactions of human middle ear mucous membrane (author’s transl). Arch Otorhinolaryngol 1977; 216: 369-473
    Search in Google Scholar
  • 10 Price DL, Orvidas LJ, Weaver AL et al. Efficacy of adenoidectomy in the treatment of nasal and middle ear symptoms in children with Down syndrome. Int J Pediatr Otorhinolaryngol 2004; 68: 7-13
    CrossrefSearch in Google Scholar
  • 11 Murakami A, Tutumi T, Watanabe K. Middle ear effusion and fungi. Ann Otol Rhinol Laryngol 2012; 121: 609-614
    Search in Google Scholar
  • 12 Bakaletz LO. Immunopathogenesis of polymicrobial otitis media. J Leukoc Biol 2010; 87: 213-222
    CrossrefSearch in Google Scholar
  • 13 Hall-Stoodley L, Hu FZ, Gieseke A et al. Direct detection of bacterial biofilms on the middle-ear mucosa of children with chronic otitis media. JAMA 2006; 296: 202-211
    CrossrefSearch in Google Scholar
  • 14 Saylam G, Tatar EC, Tatar I et al. Association of adenoid surface biofilm formation and chronic otitis media with effusion. Arch Otolaryngol Head Neck Surg 2010; 136: 550-555
    CrossrefSearch in Google Scholar
  • 15 Thornton RB, Rigby PJ, Wiertsema SP et al. Multi-species bacterial biofilm and intracellular infection in otitis media. BMC Pediatr 2011; 11: 94
    CrossrefSearch in Google Scholar
  • 16 Ikeda R, Oshima T, Oshima H et al. Management of patulous eustachian tube with habitual sniffing. Otol Neurotol 2011; 32: 790-793
    CrossrefSearch in Google Scholar
  • 17 Falk B, Magnuson B. Eustachian tube closing failure in children with persistent middle ear effusion. Int J Pediatr Otorhinolaryngol 1984; 7: 97-106
    CrossrefSearch in Google Scholar
  • 18 Miura MS, Mascaro M, Rosenfeld RM. Association between otitis media and gastroesophageal reflux: a systematic review. Otolaryngol Head Neck Surg 2012; 146: 345-352
    CrossrefSearch in Google Scholar
  • 19 Tasker A, Dettmar PW, Panetti M et al. Reflux of gastric juice and glue ear in children. Lancet 2002; 359: 493
    CrossrefSearch in Google Scholar
  • 20 Klokkenburg JJ, Hoeve HL, Francke J et al. Bile acids identified in middle ear effusions of children with otitis media with effusion. Laryngoscope 2009; 119: 396-400
    CrossrefSearch in Google Scholar
  • 21 Bluestone CD. Studies in otitis media: Children’s Hospital of Pittsburgh-University of Pittsburgh progress report – 2004. Laryngoscope 2004; 114: 1-26
    Search in Google Scholar
  • 22 Post JC. Genetics of otitis media. Adv Otorhinolaryngol 2011; 70: 135-140
    Search in Google Scholar
  • 23 Hafren L, Kentala E, Jarvinen TM et al. Genetic background and the risk of otitis media. Int J Pediatr Otorhinolaryngol 2012; 76: 41-44
    CrossrefSearch in Google Scholar
  • 24 Rye MS, Warrington NM, Scaman ES et al. Genome-wide association study to identify the genetic determinants of otitis media susceptibility in childhood. PLoS One 2012; 7: e48215
    CrossrefSearch in Google Scholar
  • 25 Martins L, Guimaraes RE, Becker HM et al. Low prevalence of middle ear disease in cystic fibrosis patients. J Pediatr (Rio J ) 2011; 87: 80-83
    CrossrefSearch in Google Scholar
  • 26 Bennett KE, Haggard MP. Behaviour and cognitive outcomes from middle ear disease. Arch Dis Child 1999; 80: 28-35
    CrossrefSearch in Google Scholar
  • 27 Fiellau-Nikolajsen M. Serial tympanometry and middle ear status in 3-year-old children. ORL J Otorhinolaryngol Relat Spec 1980; 42: 220-232
    CrossrefSearch in Google Scholar
  • 28 Zielhuis GA, Rach GH, van den Broek P. The natural course of otitis media with effusion in preschool children. Eur Arch Otorhinolaryngol 1990; 247: 215-221
    Search in Google Scholar
  • 29 Cantekin EI, McGuire TW, Griffith TL. Antimicrobial therapy for otitis media with effusion (‘secretory’ otitis media). JAMA 1991; 266: 3309-3317
    CrossrefSearch in Google Scholar
  • 30 Thomas CL, Simpson S, Butler CC et al. Oral or topical nasal steroids for hearing loss associated with otitis media with effusion in children. Cochrane Database Syst Rev 2006; CD001935
    Search in Google Scholar
  • 31 Williamson I, Benge S, Barton S et al. Topical intranasal corticosteroids in 4–11 year old children with persistent bilateral otitis media with effusion in primary care: double blind randomised placebo controlled trial. BMJ 2009; 339: b4984
    CrossrefSearch in Google Scholar
  • 32 Griffin GH, Flynn C, Bailey RE et al. Antihistamines and/or decongestants for otitis media with effusion (OME) in children. Cochrane Database Syst Rev 2006; CD003423
    Search in Google Scholar
  • 33 Pignataro O, Pignataro LD, Gallus G et al. Otitis media with effusion and S-carboxymethylcysteine and/or its lysine salt: a critical overview. Int J Pediatr Otorhinolaryngol 1996; 35: 231-241
    CrossrefSearch in Google Scholar
  • 34 Reidpath DD, Glasziou PP, Del MC. Systematic review of autoinflation for treatment of glue ear in children. BMJ 1999; 318: 1177
    CrossrefSearch in Google Scholar
  • 35 Perera R, Haynes J, Glasziou P et al. Autoinflation for hearing loss associated with otitis media with effusion. Cochrane Database Syst Rev 2006; CD006285
    Search in Google Scholar
  • 36 Leunig A, Mees K. Middle ear ventilation with the Otovent latex membrane system. Laryngorhinootologie 1995; 74: 352-354
    Thieme ConnectSearch in Google Scholar
  • 37 Drago L, De Vecchi E, Torretta S et al. Biofilm formation by bacteria isolated from upper respiratory tract before and after adenotonsillectomy. APMIS 2012; 120: 410-416
    CrossrefSearch in Google Scholar
  • 38 Kadhim AL, Spilsbury K, Semmens JB et al. Adenoidectomy for middle ear effusion: a study of 50,000 children over 24 years. Laryngoscope 2007; 117: 427-433
    CrossrefSearch in Google Scholar
  • 39 Zahnert T, Kaschke O, Begall K et al. Leitlinien Adenoide Vegetationen. Leitlinie Adenoide Vegetation/Rachenmandelhyperplasie 2011; 017/021: 1-15
    Search in Google Scholar
  • 40 Sedlmaier B, Blodow A, Schonfeld U et al. The CO2 laser otoscope. A new application device for paracentesis. HNO 1998; 46: 870-875
    CrossrefSearch in Google Scholar
  • 41 Valtonen H, Tuomilehto H, Qvarnberg Y et al. A 14-year prospective follow-up study of children treated early in life with tympanostomy tubes: Part 1: Clinical outcomes. Arch Otolaryngol Head Neck Surg 2005; 131: 293-298
    CrossrefSearch in Google Scholar
  • 42 McCoul ED, Goldstein NA, Koliskor B et al. A prospective study of the effect of gastroesophageal reflux disease treatment on children with otitis media. Arch Otolaryngol Head Neck Surg 2011; 137: 35-41
    CrossrefSearch in Google Scholar
  • 43 Lack G, Caulfield H, Penagos M. The link between otitis media with effusion and allergy: a potential role for intranasal corticosteroids. Pediatr Allergy Immunol 2011; 22: 258-266
    CrossrefSearch in Google Scholar