Legler J D
Department of Family Practice, University of Texas Health Science Center, San Antonio 78284-7795.
J Am Board Fam Pract. 1991 Sep-Oct;4(5):331-9.
Otitis media is one of the most common pediatric diseases encountered by family physicians. While isolated, acute episodes pose little clinical difficulty, recurrent infections and persistent middle ear effusions can be perplexing problems.
This review presents a clinical approach to the management of recurrent and persistent middle ear disease.
Recurrent infections can be treated with a trial of daily prophylactic antibiotics to decrease the rate of recurrence. Should infections continue to recur despite the daily prophylaxis, polyethylene tube placement is warranted to drain surgically the middle ear effusions that give rise to the recurrent infections. Acute episodes of otitis media are commonly followed by prolonged, asymptomatic periods of middle ear effusion. Patients with this disease have decreased hearing leading to potential deficits in their speech and academic development. If such effusions do not spontaneously resolve within 2 months, repeated courses of antibiotics with the possible addition of a course of oral steroids are warranted to speed resolution of the effusion before proceeding to placement of polyethylene tubes.
中耳炎是家庭医生遇到的最常见儿科疾病之一。虽然孤立的急性发作在临床上几乎没有困难，但反复感染和持续性中耳积液可能是令人困惑的问题。
本综述介绍了一种处理反复性和持续性中耳疾病的临床方法。
反复感染可通过每日预防性使用抗生素进行治疗，以降低复发率。如果尽管每日预防仍继续复发感染，则有必要放置聚乙烯管，以通过手术引流导致反复感染的中耳积液。中耳炎急性发作后通常会有较长时间的无症状中耳积液期。患有这种疾病的患者听力下降，导致其言语和学业发展可能出现缺陷。如果此类积液在2个月内未自行消退，则有必要反复使用抗生素疗程，并可能加用一个口服类固醇疗程，以在放置聚乙烯管之前加速积液的消退。
