Farmacoriflessioni
La terapia dell’otite media essudativa
OTITIS MEDIA WITH EFFUSION
FEDERICO MARCHETTI1, ELISABETTA ZOCCONI2
1Clinica Pediatrica, IRCCS “Burlo Garofolo”, Università di Trieste
2Unità Operativa ORL, IRCCS “Burlo Garofolo”, Trieste
Gennaio 2003 - pagg. 47 -51
Abstract
Otitis media with effusion (OME) has a high prevalence in school age children (15%) but in
only 5% its duration is longer than a year. A systematic review shows that antibiotics are effective
in reducing effusion but that their effect does not maintain over time. Similar results are
shown for steroids alone or in association with antibiotics. Antihystamine drugs and mucolytics
are not effective. Autoinflation is an effective option. Surgical treatment (tympanostomy
tubes and adenoidectomy) can improve hearing function but do not seem to be capable of
preventing language disorders.
Parole chiave
Suggerite dall'AI
Classificazione MeSH
Bibliografia
1. Zielhuis GA, Straatman H, Rach GH, van
den Broek P. Analysis and presentation of data
on the natural course of otitis media with effusion
in children. Int J Epidemiol 1990;
19:1037-44.
2. Berman S. Otitis media in children. N Engl J Med 1995; 332:1560-65.
3. Zeilhuis GA, Rach GH, Broek PV. Screening for otitis media with effusion in pre-school children. Lancet 1989;1:311-4.
4. Etzel RA, Pattishall EN, Haley NJ, Fletcher RH, Henderson FW. Passive smoking and middle ear effusion among children in day care. Pediatrics 1992;90:228-32.
5. 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- 33.
6. Friel-Patti S, Finitzo-Hieber T, Conti G, Clinton-Brown K. Language delay in infants associated with middle ear disease and mild, fluctuating hearing impairment. Pediatr Infect Dis J 1982;15:417-21.
7. Abram SS, Walance IF, Gravel JS. Early otitis media and phonological development age 2 years. Laryngoscope 1996;106:727-32.
8. Bennet KE, Haggard MP. Behaviour and cognitive outcomes in middle ear disease. Arch Dis Child 1999;80:28-35.
9. Teele DW, Klein JO, Rosner BA. Otitis media with effusion during the first three years of life and development of speech and language. Pediatrics 1984;74:282-8.
10. Roberts JE, Burchinal MR, Davis BP, Collier AM, Henderson FW. Otitis media in early childhood and later language. J Speech Hear Res 1991;34:1158-68.
11. Roberts JE, Sanyal MA, Burchinal MR, Collier AM, Ramey CT, Henderson FW. Otitis media in early childhood and its relationship to later verbal and academic performance. Pediatrics 1986;78:423-30.
12. Grievink EH, Peters SAF, Bon van WHJ, Schilder AGM. The effect of early bilateral otitis media with effusion on language ability: a prospective cohort study. J Speech Hear Res 1993;36:1002-12.
13. Rovers MM, Straatman H, Ingels K, et al. The effect of ventilation tubes on language development in infants with otitis media with effusion: a randomised trial. Pediatrics 2000; 106(3):e42:1-8.
14. Paradise JL, Feldman HM, Campbell TF, et al. Effect of early or delayed insertion of tympanostomy tubes for persistent otitis media on developmental outcomes at the age of three years. N Engl J Med 2001;344:1179-87.
15. Williamson I. Otitis media with effusion. Clinical Evidence Copyright 2002 BMJ Publishing Group. www.clinicalevidence.com
16. Stool SE, Berg SO, Berman S, et al. Otitis media with effusion in young children: clinical practice guideline number 12. AHCPR Publication 94-0622. Rockville, Maryland: Agency for Health for Health Care Policy and Research. Public Health Service, United States Department of Health and Human Service, July 1994.
17. Williams RL, Chalmers TC, Strange KC, Chalmers FT, Bowlin SJ. Use of antibiotics in preventing recurrent acute otitis media and in treating otitis media with effusion: a metaanalytic attempt to resolve the brouhaha. JAMA 1993;270:1344-51.
18. Post JC, Preston RA, Aul JJ, et al. Molecular analysis of bacterial pathogenes in otitis media with effusion. JAMA 1995;273:1598- 1604.
19. Bluestone CD, Stephenson JS, Martin LM. Ten-year of otitis media pathogenes. Pediatr Infect Dis J 1992;11(8 Suppl):S7-11.
20. Butler CC, van der Voort JH. Steroids for otitis media with effusion. Arch Pediatr Adolesc Med 2001;155:641-7.
21. Pignataro O, Pignataro LD, Gallus G, Calori G, Cordano CI. Otitis media with effusion and S-carboxymethlcysteine and/or its lysine salt: a critical overview. Int J Pediatr Othorhinolaryngol 1996;35:231-41.
22. Reidpath DD, Glasziou PP, Del Mar C. Systematic review of autoinflation for treatment of glue ear in children. BMJ 1999;318:1177-8.
23. University of York. Centre for reviews and Dissemination. 1992. The treatment of persistent glue ear in children. Effective Health Care 1 (4). Search date 1992.
24. Maw R, Wilks J, Harvey I, Peters TJ, Golding J. Early surgery compared with watchful waiting for glue ear and effect on language development in preschool children: a randomised trial. Lancet 1999;353:960-3.
25. Kay DJ, Nelson M, Rosenfeld RM. Metaanalysis of tympanostomy tube sequelae. Otolaryngol Head Neck Surg 2000;124:374-80.
26. Maw R, Bawden R. Spontaneous resolution of severe chronic glue ear and the effect of adenoidectomy, tonsillectomy, and insertion of ventilation tubes. BMJ 1993;306:756-60.
2. Berman S. Otitis media in children. N Engl J Med 1995; 332:1560-65.
3. Zeilhuis GA, Rach GH, Broek PV. Screening for otitis media with effusion in pre-school children. Lancet 1989;1:311-4.
4. Etzel RA, Pattishall EN, Haley NJ, Fletcher RH, Henderson FW. Passive smoking and middle ear effusion among children in day care. Pediatrics 1992;90:228-32.
5. 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- 33.
6. Friel-Patti S, Finitzo-Hieber T, Conti G, Clinton-Brown K. Language delay in infants associated with middle ear disease and mild, fluctuating hearing impairment. Pediatr Infect Dis J 1982;15:417-21.
7. Abram SS, Walance IF, Gravel JS. Early otitis media and phonological development age 2 years. Laryngoscope 1996;106:727-32.
8. Bennet KE, Haggard MP. Behaviour and cognitive outcomes in middle ear disease. Arch Dis Child 1999;80:28-35.
9. Teele DW, Klein JO, Rosner BA. Otitis media with effusion during the first three years of life and development of speech and language. Pediatrics 1984;74:282-8.
10. Roberts JE, Burchinal MR, Davis BP, Collier AM, Henderson FW. Otitis media in early childhood and later language. J Speech Hear Res 1991;34:1158-68.
11. Roberts JE, Sanyal MA, Burchinal MR, Collier AM, Ramey CT, Henderson FW. Otitis media in early childhood and its relationship to later verbal and academic performance. Pediatrics 1986;78:423-30.
12. Grievink EH, Peters SAF, Bon van WHJ, Schilder AGM. The effect of early bilateral otitis media with effusion on language ability: a prospective cohort study. J Speech Hear Res 1993;36:1002-12.
13. Rovers MM, Straatman H, Ingels K, et al. The effect of ventilation tubes on language development in infants with otitis media with effusion: a randomised trial. Pediatrics 2000; 106(3):e42:1-8.
14. Paradise JL, Feldman HM, Campbell TF, et al. Effect of early or delayed insertion of tympanostomy tubes for persistent otitis media on developmental outcomes at the age of three years. N Engl J Med 2001;344:1179-87.
15. Williamson I. Otitis media with effusion. Clinical Evidence Copyright 2002 BMJ Publishing Group. www.clinicalevidence.com
16. Stool SE, Berg SO, Berman S, et al. Otitis media with effusion in young children: clinical practice guideline number 12. AHCPR Publication 94-0622. Rockville, Maryland: Agency for Health for Health Care Policy and Research. Public Health Service, United States Department of Health and Human Service, July 1994.
17. Williams RL, Chalmers TC, Strange KC, Chalmers FT, Bowlin SJ. Use of antibiotics in preventing recurrent acute otitis media and in treating otitis media with effusion: a metaanalytic attempt to resolve the brouhaha. JAMA 1993;270:1344-51.
18. Post JC, Preston RA, Aul JJ, et al. Molecular analysis of bacterial pathogenes in otitis media with effusion. JAMA 1995;273:1598- 1604.
19. Bluestone CD, Stephenson JS, Martin LM. Ten-year of otitis media pathogenes. Pediatr Infect Dis J 1992;11(8 Suppl):S7-11.
20. Butler CC, van der Voort JH. Steroids for otitis media with effusion. Arch Pediatr Adolesc Med 2001;155:641-7.
21. Pignataro O, Pignataro LD, Gallus G, Calori G, Cordano CI. Otitis media with effusion and S-carboxymethlcysteine and/or its lysine salt: a critical overview. Int J Pediatr Othorhinolaryngol 1996;35:231-41.
22. Reidpath DD, Glasziou PP, Del Mar C. Systematic review of autoinflation for treatment of glue ear in children. BMJ 1999;318:1177-8.
23. University of York. Centre for reviews and Dissemination. 1992. The treatment of persistent glue ear in children. Effective Health Care 1 (4). Search date 1992.
24. Maw R, Wilks J, Harvey I, Peters TJ, Golding J. Early surgery compared with watchful waiting for glue ear and effect on language development in preschool children: a randomised trial. Lancet 1999;353:960-3.
25. Kay DJ, Nelson M, Rosenfeld RM. Metaanalysis of tympanostomy tube sequelae. Otolaryngol Head Neck Surg 2000;124:374-80.
26. Maw R, Bawden R. Spontaneous resolution of severe chronic glue ear and the effect of adenoidectomy, tonsillectomy, and insertion of ventilation tubes. BMJ 1993;306:756-60.