Leitlinie „Seromukotympanum“ – Langfassung

Lautermann, J.; Begall, K.; Hilger, Gregor; Wilhelm, Thomas; Mir-Salim, Parwis; Kaschke, Oliver; Zahnert, Thomas

doi:10.1007/s00106-012-2512-3

Cited by 8 publications

(7 citation statements)

References 34 publications

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“…Based on these guidelines, adenoidectomy was the standard surgical intervention. These guidelines differ from the German guidelines updated in 2012 [23,24] and the guidelines of the American Academy of Pediatrics (AAP) and American Academy of Family Physicians (AAFP) and their updates [25,26,27]. According to the latter guidelines, active surveillance or ‘watchful waiting' is recommended for at least 3 months with monthly audiometry to assess hearing.…”

Section: Methodsmentioning

confidence: 93%

Integrative versus Conventional Therapy of Chronic Otitis Media with Effusion and Adenoid Hypertrophy in Children: A Prospective Observational Study

Szőke¹,

Maródi²,

Sallay³

et al. 2016

Complement Med Res

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Background: Chronic otitis media with effusion (COME) and adenoid hypertrophy (AH) are common entities in the pediatric population. The conventional treatment approach (conventional medicine; COM) involved mainly surgery after a period of close observation. In this study, we aimed to introduce an integrative, non-invasive approach (integrative medicine; IM) for COME, AH, and associated episodes of recurrent acute otitis media, and compared outcomes with conventional treatment. Methods: We conducted a prospective, non-randomized study in an integrative primary care pediatric practice and a conventional pediatric otolaryngological clinic, where treatment modality was determined by patient preference. Out of a total 101 patients aged 1-8 years, integrative therapy was chosen by 46, and conventional treatment by 55. All patients had COME and AH diagnosed by an otolaryngologist and had moderate to severe hearing impairment. COM treatment was based on close observation over time, nasal decongestants and surgical intervention. In contrast, the IM involved a complex personalized approach with non-invasive interventions, non-allopathic medications, diet and patient education. Results: The number of surgical interventions (adenoidectomy, pressure-equalization tube insertion, myringotomy) was significantly less in the IM cohort (1 of 28 vs. 15 of 35 in the COM group, p < 0.001). The frequency of antibiotic use was significantly less in the IM group (p < 0.001). The frequency of analgesic use was also significantly less in the IM group (p = 0.029). Improvement in tympanometric measures (normal A-type curve) was higher in IM patients compared to expected spontaneous remission during the observation period. Improvement in audiometric measures (intact hearing) of IM patients was also higher than expected compared to spontaneous remission during the observation period. Conclusion: Compared to conventional treatment, integrative treatment of patients with COME and AH showed significantly lower invasive surgical intervention rates and significantly decreased antibiotic and analgesic use. The integrative treatment was effective, safe and well tolerated.

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Section: Methodsmentioning

confidence: 93%

Integrative versus Conventional Therapy of Chronic Otitis Media with Effusion and Adenoid Hypertrophy in Children: A Prospective Observational Study

Szőke¹,

Maródi²,

Sallay³

et al. 2016

Complement Med Res

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“…Davon sollte eine Therapie mit einem Beta-Laktamase-stabilen Antibiotikum für mindestens 2 Wochen erfolgt sein. Bei einer Rezidiventzündung sollte eine Erregerdiagnostik angestrebt werden Schlafstörungen mit Nasenatmungsbehinderung, die mindestens seit 3 Monaten vorliegen: obstruktives Schlafapnoesyndrom (OSAS), sekundäre Enuresis nocturna [ 9 , 13 , 22 , 27 , 52 ] Geschlossenes Näseln, Hyponasalität Otitis media mit Paukenerguss seit über 3 Monaten oder bei gleichzeitig vorliegender Paukendrainage Malokklusion oder orofaziale Wachstumsstörung, die kieferorthopädisch und/oder zahnärztlich dokumentiert ist Kardiopulmonale Komplikationen, inklusive Cor pulmonale, pulmonale Hypertonie und Rechtsherzhypertrophie einhergehend mit oberer Atemwegsobstruktion [ 54 ] Rezidivierende akute und chronische Otitis media mit Paukenerguss bei einem Alter ab 4 Jahren oder älter [ 30 , 39 , 40 ] Chronisch rezidivierende Belüftungsstörungen des Mastoids im Sinne einer akuten und/oder chronischen Mastoiditis oder rezidivierende Mittelohrentzündungen oder Tubenbelüftungsstörungen mit Retraktion des Trommelfells Sekundäre Symptome wie die Facies adenoidea [ 26 , 39 , 62 ] …”

Section: Operative Therapieunclassified

“…In der Literatur konnte der Vorteil der chirurgischen Behandlung bei entzündlichen sekundären Symptomen von adenoiden Vegetationen (nasale Obstruktion, Tubenventilationsstörung, rezidivierende akute Otitis media, Paukenerguss) nachgewiesen werden [ 26 , 31 , 35 , 51 ].…”

Section: Operative Therapieunclassified

Adenoide Vegetationen – Diagnostik und Therapie – die neue S2k-Leitlinie

Ahmad

Krüger

Lautermann

et al. 2023

HNO

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ZusammenfassungEine Hyperplasie der Tonsilla pharyngealis ist als Erkrankung zu bewerten, wenn durch mechanische Obstruktion und/oder chronische Entzündungen des Nasenrachens Krankheitssymptome auftreten. Aus einer chronischen Tubenventilationsstörung können unterschiedliche Mittelohrerkrankungen wie Schallleitungsschwerhörigkeit, Cholesteatom und rezidivierende akute Otitis media entstehen. Während der Inspektion ist das Augenmerk auf das Vorliegen einer Facies adenoidea mit dauerhaft offenem Mund und sichtbarer Zungenspitze zu legen. Bei starken Beschwerden und/oder frustranen konservativen Therapieversuchen erfolgt die Adenotomie in der Regel ambulant. Die herkömmliche Kürettage gilt nach wie vor als etablierte Standardmethode in Deutschland. Bei klinischen Hinweisen auf Mukopolysaccharidose ist die histologische Untersuchung indiziert. Wegen des Blutungsrisikos wird auf den Gerinnungsfragebogen, der obligat vor jedem operativen Eingriff im Kindesalter durchzuführen ist, hingewiesen. Trotz ordnungsgemäßer Adenotomie kann es zu einem Rezidiv der adenoiden Vegetationen kommen. Vor Entlassung in das häusliche Umfeld sollte eine HNO-ärztliche Kontrolle durch Inspektion des Rachens auf Nachblutung und eine anästhesiologische Freigabe erfolgen.

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“…This has led in particular to confusion regarding the indication for antibiotic treatment. There is a consensus that a pure, bland effusion should not be treated with antibiotics, as there is no evidence for this [10,11].…”

Section: Pathophysiology and Disease Patternmentioning

confidence: 99%

Pain Relief by Analgesic Eardrops: Paradigm Shift in the Treatment of Acute Otitis Media?

Michel

2021

Drug Res (Stuttg)

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Acute otitis media is a common middle ear infection in children with the predominant symptoms of hearing impairment and pain. If antibiotics are given, they need time to have an effect on the inflammation, so the focus is on pain control. For pain management local anesthetics have the advantage of lesser systemic side effects but are still subject to scrutiny. In this review the literature between 2000 and 2020 was systematically searched for investigating studies and recommendation in guidelines against the background of the mode of action. 11 clinical studies, 2 guidelines and 5 reports resp. reviews could be identified. Contraindications and side effects were not found in these studies. The analgesic ear drops showed in placebo-controlled studies a relatively short duration of action when applied once but rapid onset of action. There is evidence that analgesic ear drops could provide a first-line analgesia in otitis media without systemic adverse effects such as gastrointestinal disturbance and nausea and could support an antibiotic-saving wait-and-see attitude. The review shows a change in attitude towards the recommendation to include local anesthetics ear drops in otitis media but still there is a lack in treatment protocols which go beyond a single administration. The results do not yet show a significant paradigm shift. The reviews revealed indications that a more adapted galenic preparation could give more effectiveness. Pharmaceutical research in this field should be intensified to exploit the analgesic potential of local anesthetic ear drops in acute otitis media.

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Leitlinie „Seromukotympanum“ – Langfassung

Cited by 8 publications

References 34 publications

Integrative versus Conventional Therapy of Chronic Otitis Media with Effusion and Adenoid Hypertrophy in Children: A Prospective Observational Study

Integrative versus Conventional Therapy of Chronic Otitis Media with Effusion and Adenoid Hypertrophy in Children: A Prospective Observational Study

Adenoide Vegetationen – Diagnostik und Therapie – die neue S2k-Leitlinie

Pain Relief by Analgesic Eardrops: Paradigm Shift in the Treatment of Acute Otitis Media?

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