Problemi correnti
Otite media con effusione
CHRONIC SEROUS OTITIS
ELISABETTA ZOCCONI
Divisione di Otorinolaringoiatria, IRCCS “Burlo Garofolo”, Trieste
Dicembre 1997 - pagg. 639 -642
Abstract
Chronic serous otitis media is present when
the middle ear is persistently filled with sterile
fluid. Main cause are: complete auditory
tube obstruction (often associated with
adenoidal hypertrophy), reduced local production
of surfactant, bacterial infection.
The patient usually complains of hearing
loss. The diagnosis may be confirmed by
pneumatic otoscopy (retracted eardrum
with decreased or absent motility) and tympanometry
(type B pattern i.e. decreased
compliance). The efficacy of various approaches
- such as antibiotics, steroids, autoinflation,
adenoidectomy, tympanostomy
tubes - is discussed as well as the individual
factors that should inform the therapeutic
decisions.
Classificazione MeSH
Bibliografia
Epidemiologia
e interferenza sul linguaggio
1. Northern JL, Dows MP: Hearing in children. The Williams and Wiking Company, Baltimore, Maryland 7, 1, 1978.
2. Fiellau-Nikolaisen M: Timpanometry and secretory otitis media. Acta Otolaryngol 349, suppl. 1, 1983.
3. Escalona SK: Babies at double risk: Early development of infants at biologic and social risk. Pediatrics 70, 670-676, 1982.
4. Roberts JE, Burchinal MR, Koch MA, Footo MM, Henderson FW: Otitis media in early childhood and its relationship to later phonological development. J Speech and Hearing Disorders 53, 416-424, 1988.
5. Roberts JE, Burchinal MR, Davis BP, Collier AM, Henderson FW: Otitis media in early childhood and later language. J Speech and Hearing Research 34, 1158-1168, 1991.
6. Roberts JE, Burchinal MR, Campell F: Otitis media in early childhood and patterns of intellectual development and later academic performance. J of Ped Psycology vol 19, 3, 347- 367, 1994.
7. Friel-Patty: Otitis media with effusion and the development of language. A review ot the evidence. Top Lang Disord 11 (1), 11-22, 1990.
8. Tallal P: Language disabilitis in children: A perceptual or linguistic deficit? J of Psicology 5, 127-140, 1980.
9. Lonigan CJ, Fischel JE, Whithust J, Arnold DS: The role of otitis media in the development of expressive language disorder. Develop Pshicology 28, 3, 430-440, 1992.
10. Wallace IF, Gravel JS, McCarton CM, Ruben RJ: Otitis media and language development at 1 year of age. J Speech and Hearing Disorders 53, 245-251, 1988.
11. Teele DW, Klein JO, Rosner BA: Otitis media with effusion during the first three years of life and development of speech and language. Pediatrics 2, 282-287, 1984.
12. Pagel Paden E, Novak MA, Beiter AL: Predictors of phonological inadequacy in young children prone to otitis media. J Speech and Hearing Disorders 52, 232-242, 1987.
13. Gravel JS, Wallace IF: Listening and language at 4 years of age: effects of early otitis media. J Speech and Hearing Research 35, 588- 595, 1992.
14. Roberts JE, Burchinal MR, Medley LP et al: Otitis media, hearing sensitivity and maternal responsiveness in relation to language during infancy. J Pediatr 126, 481-9, 1995.
15. Hall JW, Grose JH: Effects of otitis media with effusion on comodulation masking release in children. J Speech and Hearing Research 37, 1441-1449, 1994.
16. Casadio P, Caselli MC: Il Primo Vocabolario del bambino. Età evolutiva 33, 33-42, 1989.
17. Caselli MC, Casadio P: Sviluppo del vocabolario e prima grammatica nel secondo anno di vita. Età evolutiva 45, 5-21, 1993. Eziopatogenesi
18. Zocconi E: La ricerca sperimentale in otologia pediatrica. In: Conticello, Mallardi: Attualità nella ricerca sperimentale in otorinolaringoiatria. Monduzzi Editore, 175-181, 1992.
19. Tos M: Experimental tubal obstruction. Acta Otolaryngol 95, 51-61, 1981.
20. Sakakura Y, Majima Y, Takeuchi K et al: Effects of endotoxin and neutrophil lysate on experimental otitis media with effusion in cats. Acta Otolaryngol (Stockh) supp. 483, 30- 36, 1991.
21. Majiama Y, Takeuchi K, Jin C et al: Rheological properties of middle ear mucosa in relation to globet cell population in cats. Acta Otolaryngol 483 (supp), 11, 1991.
22. Rapport PN, Lim DJ, Weiss HS: Surface active agent in eustachian tube function. Arch Otolaryngol 101, 305, 1975.
23. Bylander A: Comparison of eustachian tube function in children and adult with normal ears. Ann Otol Rhinol Laryngol 89, 20-24, 1980.
24. Blustone CD, Klein JO: Otitis media in infants and children. WB Saunders, Philadelphia, 1988.
25. Riding KH, Blustone CD: Microbiology of recurrent otitis media with effusion. J Ped 93, 739, 1978.
26. Rosenfeld RM, Post JC: Meta-analysis of antibiotics for treatment of otitis media with effusion. Otolaryngol Head Neck Surg 106 (4), 378, 1992.
27. Kraemer MJ, Richardson MA, Weiss NS, et al: Risk factor for persistent middle-ear effusion: Otitis media, catarrh. cigarette smoke exposure and atopy. JAMA 249, 1022, 1983.
28. Paradise JL, Elster BA, Tan L: Evidence in infants with cleft palate that brest milk protect agaist otitis media. Pediatrics 94, 6, 853- 858, 1994.
29. Harabuki Y, Faden H, Yamanaka N et al: Human milk secretory IgA antibody to nontypeable Haemophilus Influentiae: possible protective effects against nasopharyngeal colonization. The J of Pediatrics 124, 2, 193-198, 1994.
30. Niemela M, Uhari M, Mottonen M: A pacifier increases the risk of recurrent acute otitis media in children in day care center. Pediatrics 96, 5, 884-888, 1995.
31. Niemela M, Uhari M, Hannukesela A: Pacifiers and dental structure as risk factors for otitis media. Int J of Ped Otorhinolaryngol 29, 121-127, 1994 Terapia
32. Rosenfelds RM: Comprehensive management of otitis media with effusion. Otolaryngol Clin North Am 27, 3, 443-455, 1994.
33. Voughan-Jones R, Millis RP: The Welch Allyn Audioscope and Microtimp: the accurancy and that of pneumatic otoscopy, tympanometry and pure tone audiometry as predictor of otits media with effusion. J Laryngol Otol 106, 600-602, 1992.
34. Liberman A, Bartal N: Untreated persistent middle ear effusion. J Laringol Otol 100, 875, 1986.
35. Ursino F, Grosjacques M, Matteucci F et al: La rieducazione della disfunzionalità tubarica. Acta Phon Lat 15, 211-217, 1993.
36. Zocconi E: Antibiotici e cortisone nel trattamento dell’otite media con effusione. Ped Med Chir 16, 273-275, 1994.
37. Zocconi E: Protocolli terapeutici (ragionati) dell’otite media con effusione. Atti III Congresso Nazionale di Pediatria Ospedaliera. Torino 1995, 131-135.
38. Zocconi E: Controversie nel trattamento dell’otite media con effusione. Atti Giornate Mediche Glaxo Wellcome, Verona 1996, 85-97.
39. Cantekin EI, Mandel EM, Blustone CD et al: Lack of efficacy of decongestionant-antiistamine for otitis media with effusion. N Eng J Med 308 (6), 297, 1983.
40. Stool SE, Berg AO, Berman S et al: Managing otitis media with effusion in young children. A otitis media guideline panel. Pediatrics 5, 766-773, 1994.
41. Berman S, Nuss R: Efficacia della sommistrazione continua o intermittente di amoxicillina nella prevenzione dell’otite media con effusione Ped Infect Dis J (ed ital), 2, 24, 1992.
42. Principi N, Marchisio P et al: Prophylaxis of recurrent otitis media with effusion. Comparision of amoxicillin with sulfamethoxazole and trimethoprim. AJDC 143, 1414, 1989.
43. Thomsen J, Sederberg-Olson J, Balle V et al: Antibiotic treatment in children with secretory otitis media. Arch Otolaryngol Head Neck Surg 115, 447, 1989.
44. Podoshin L, Fradis M et al: The efficay of oral steroid in the treatment of persistent otitis media with effusion. Arch Otolaryngol Head Neck Surg 116, 1404, 1990.
45. Lambert PR: Oral steroid therapy for cronic middle ear effusion. A double blind crossover study. Otorhinolaryngol Head Neck Surg 95, 193, 1986.
46. Gates GA, Avery CA, Prihoda TJ: Effect of adenoidectomy upon children with chronic otitis media with effusion. Laringoscope 98, 58-63, 1988.
47. Oluwole M, Mills RP: Methods of selection for adenoidectomy in childhood otitis media with effusion. Int J Ped Otorhinolaryngol 32, 120-135, 1995.
48. Sade J, Lunz M, Saba K: Adenoidectomy in otitis media: a review. Ann Otol Rhinol Laryngol 100, 226-231, 1991.
49. van Cauvenberge P, Bellussi L, Maw R, Paradise JL, Solow B: The adenoid as a key factor in upper airway infection. Int J Ped Otorhinolaryngol 32 (supp), 571-580, 1995.
50. McKracken GH: Emergence of resistent Streptococcus pneumoniae: a problem in pediatrics. Ped Infect Dis J 14, 424-8, 1996.
51. Paradise JL: Treatment guidelines for otitis media: the need for breadth and flexibility. Ped Infect Dis J 14, 429-435, 1995.
52. Mandel E, Rockepte H, Blustone CD, Paradise JL, Nozza RJ: Efficacy of miringotomy with and without tympanostomy tubes for chronic otitis media with effusion. Ped Infect Dis J 11, 270-277, 1992.
53. Paradise JL, Rogers KD: On otitis media, child developments and tympanostomy tubes: new answer or old questions? Pediatrics 77, 88-92, 1986.
1. Northern JL, Dows MP: Hearing in children. The Williams and Wiking Company, Baltimore, Maryland 7, 1, 1978.
2. Fiellau-Nikolaisen M: Timpanometry and secretory otitis media. Acta Otolaryngol 349, suppl. 1, 1983.
3. Escalona SK: Babies at double risk: Early development of infants at biologic and social risk. Pediatrics 70, 670-676, 1982.
4. Roberts JE, Burchinal MR, Koch MA, Footo MM, Henderson FW: Otitis media in early childhood and its relationship to later phonological development. J Speech and Hearing Disorders 53, 416-424, 1988.
5. Roberts JE, Burchinal MR, Davis BP, Collier AM, Henderson FW: Otitis media in early childhood and later language. J Speech and Hearing Research 34, 1158-1168, 1991.
6. Roberts JE, Burchinal MR, Campell F: Otitis media in early childhood and patterns of intellectual development and later academic performance. J of Ped Psycology vol 19, 3, 347- 367, 1994.
7. Friel-Patty: Otitis media with effusion and the development of language. A review ot the evidence. Top Lang Disord 11 (1), 11-22, 1990.
8. Tallal P: Language disabilitis in children: A perceptual or linguistic deficit? J of Psicology 5, 127-140, 1980.
9. Lonigan CJ, Fischel JE, Whithust J, Arnold DS: The role of otitis media in the development of expressive language disorder. Develop Pshicology 28, 3, 430-440, 1992.
10. Wallace IF, Gravel JS, McCarton CM, Ruben RJ: Otitis media and language development at 1 year of age. J Speech and Hearing Disorders 53, 245-251, 1988.
11. Teele DW, Klein JO, Rosner BA: Otitis media with effusion during the first three years of life and development of speech and language. Pediatrics 2, 282-287, 1984.
12. Pagel Paden E, Novak MA, Beiter AL: Predictors of phonological inadequacy in young children prone to otitis media. J Speech and Hearing Disorders 52, 232-242, 1987.
13. Gravel JS, Wallace IF: Listening and language at 4 years of age: effects of early otitis media. J Speech and Hearing Research 35, 588- 595, 1992.
14. Roberts JE, Burchinal MR, Medley LP et al: Otitis media, hearing sensitivity and maternal responsiveness in relation to language during infancy. J Pediatr 126, 481-9, 1995.
15. Hall JW, Grose JH: Effects of otitis media with effusion on comodulation masking release in children. J Speech and Hearing Research 37, 1441-1449, 1994.
16. Casadio P, Caselli MC: Il Primo Vocabolario del bambino. Età evolutiva 33, 33-42, 1989.
17. Caselli MC, Casadio P: Sviluppo del vocabolario e prima grammatica nel secondo anno di vita. Età evolutiva 45, 5-21, 1993. Eziopatogenesi
18. Zocconi E: La ricerca sperimentale in otologia pediatrica. In: Conticello, Mallardi: Attualità nella ricerca sperimentale in otorinolaringoiatria. Monduzzi Editore, 175-181, 1992.
19. Tos M: Experimental tubal obstruction. Acta Otolaryngol 95, 51-61, 1981.
20. Sakakura Y, Majima Y, Takeuchi K et al: Effects of endotoxin and neutrophil lysate on experimental otitis media with effusion in cats. Acta Otolaryngol (Stockh) supp. 483, 30- 36, 1991.
21. Majiama Y, Takeuchi K, Jin C et al: Rheological properties of middle ear mucosa in relation to globet cell population in cats. Acta Otolaryngol 483 (supp), 11, 1991.
22. Rapport PN, Lim DJ, Weiss HS: Surface active agent in eustachian tube function. Arch Otolaryngol 101, 305, 1975.
23. Bylander A: Comparison of eustachian tube function in children and adult with normal ears. Ann Otol Rhinol Laryngol 89, 20-24, 1980.
24. Blustone CD, Klein JO: Otitis media in infants and children. WB Saunders, Philadelphia, 1988.
25. Riding KH, Blustone CD: Microbiology of recurrent otitis media with effusion. J Ped 93, 739, 1978.
26. Rosenfeld RM, Post JC: Meta-analysis of antibiotics for treatment of otitis media with effusion. Otolaryngol Head Neck Surg 106 (4), 378, 1992.
27. Kraemer MJ, Richardson MA, Weiss NS, et al: Risk factor for persistent middle-ear effusion: Otitis media, catarrh. cigarette smoke exposure and atopy. JAMA 249, 1022, 1983.
28. Paradise JL, Elster BA, Tan L: Evidence in infants with cleft palate that brest milk protect agaist otitis media. Pediatrics 94, 6, 853- 858, 1994.
29. Harabuki Y, Faden H, Yamanaka N et al: Human milk secretory IgA antibody to nontypeable Haemophilus Influentiae: possible protective effects against nasopharyngeal colonization. The J of Pediatrics 124, 2, 193-198, 1994.
30. Niemela M, Uhari M, Mottonen M: A pacifier increases the risk of recurrent acute otitis media in children in day care center. Pediatrics 96, 5, 884-888, 1995.
31. Niemela M, Uhari M, Hannukesela A: Pacifiers and dental structure as risk factors for otitis media. Int J of Ped Otorhinolaryngol 29, 121-127, 1994 Terapia
32. Rosenfelds RM: Comprehensive management of otitis media with effusion. Otolaryngol Clin North Am 27, 3, 443-455, 1994.
33. Voughan-Jones R, Millis RP: The Welch Allyn Audioscope and Microtimp: the accurancy and that of pneumatic otoscopy, tympanometry and pure tone audiometry as predictor of otits media with effusion. J Laryngol Otol 106, 600-602, 1992.
34. Liberman A, Bartal N: Untreated persistent middle ear effusion. J Laringol Otol 100, 875, 1986.
35. Ursino F, Grosjacques M, Matteucci F et al: La rieducazione della disfunzionalità tubarica. Acta Phon Lat 15, 211-217, 1993.
36. Zocconi E: Antibiotici e cortisone nel trattamento dell’otite media con effusione. Ped Med Chir 16, 273-275, 1994.
37. Zocconi E: Protocolli terapeutici (ragionati) dell’otite media con effusione. Atti III Congresso Nazionale di Pediatria Ospedaliera. Torino 1995, 131-135.
38. Zocconi E: Controversie nel trattamento dell’otite media con effusione. Atti Giornate Mediche Glaxo Wellcome, Verona 1996, 85-97.
39. Cantekin EI, Mandel EM, Blustone CD et al: Lack of efficacy of decongestionant-antiistamine for otitis media with effusion. N Eng J Med 308 (6), 297, 1983.
40. Stool SE, Berg AO, Berman S et al: Managing otitis media with effusion in young children. A otitis media guideline panel. Pediatrics 5, 766-773, 1994.
41. Berman S, Nuss R: Efficacia della sommistrazione continua o intermittente di amoxicillina nella prevenzione dell’otite media con effusione Ped Infect Dis J (ed ital), 2, 24, 1992.
42. Principi N, Marchisio P et al: Prophylaxis of recurrent otitis media with effusion. Comparision of amoxicillin with sulfamethoxazole and trimethoprim. AJDC 143, 1414, 1989.
43. Thomsen J, Sederberg-Olson J, Balle V et al: Antibiotic treatment in children with secretory otitis media. Arch Otolaryngol Head Neck Surg 115, 447, 1989.
44. Podoshin L, Fradis M et al: The efficay of oral steroid in the treatment of persistent otitis media with effusion. Arch Otolaryngol Head Neck Surg 116, 1404, 1990.
45. Lambert PR: Oral steroid therapy for cronic middle ear effusion. A double blind crossover study. Otorhinolaryngol Head Neck Surg 95, 193, 1986.
46. Gates GA, Avery CA, Prihoda TJ: Effect of adenoidectomy upon children with chronic otitis media with effusion. Laringoscope 98, 58-63, 1988.
47. Oluwole M, Mills RP: Methods of selection for adenoidectomy in childhood otitis media with effusion. Int J Ped Otorhinolaryngol 32, 120-135, 1995.
48. Sade J, Lunz M, Saba K: Adenoidectomy in otitis media: a review. Ann Otol Rhinol Laryngol 100, 226-231, 1991.
49. van Cauvenberge P, Bellussi L, Maw R, Paradise JL, Solow B: The adenoid as a key factor in upper airway infection. Int J Ped Otorhinolaryngol 32 (supp), 571-580, 1995.
50. McKracken GH: Emergence of resistent Streptococcus pneumoniae: a problem in pediatrics. Ped Infect Dis J 14, 424-8, 1996.
51. Paradise JL: Treatment guidelines for otitis media: the need for breadth and flexibility. Ped Infect Dis J 14, 429-435, 1995.
52. Mandel E, Rockepte H, Blustone CD, Paradise JL, Nozza RJ: Efficacy of miringotomy with and without tympanostomy tubes for chronic otitis media with effusion. Ped Infect Dis J 11, 270-277, 1992.
53. Paradise JL, Rogers KD: On otitis media, child developments and tympanostomy tubes: new answer or old questions? Pediatrics 77, 88-92, 1986.