Marshall S G, Bierman C W, Shapiro G G
Ann Allergy. 1984 Nov;53(5):370-8, 394.
OM and OME are common disorders of childhood. Middle ear disease is related to anatomic abnormalities, prior episodes of AOM, chronic rhinitis, allergy, age, sex, race, season, perinatal factors, viral infections, and irritant exposure. ET dysfunction plays an important role in OME, as does the presence of bacteria or bacterial products in the middle ear. Viral infection, nasal allergy, previous episodes of OM and primary mucosal disease all may contribute to this chronic disorder. Diagnostic evaluation involves an appropriate personal and environmental history, a physical examination, pneumatic otoscopy, tympanometry, pure tone audiometry, and (if indicated) allergic and immunologic evaluation. Treatment may include environmental control, antibiotic therapy, decongestants and/or antihistamines, topical corticosteroids, and possibly immunization or allergic immunotherapy (hyposensitization). In order to facilitate strategies to prevent acute and recurrent OM as well as chronic effusion, further knowledge regarding the etiology, pathogenesis, and risk factors is essential. Well designed, controlled studies are imperative to provide further understanding and more effective treatment of this common, chronic and often very frustrating medical problem.
中耳炎（OM）和中耳积液（OME）是儿童期常见疾病。中耳疾病与解剖异常、急性中耳炎既往发作史、慢性鼻炎、过敏、年龄、性别、种族、季节、围产期因素、病毒感染及接触刺激物有关。咽鼓管功能障碍在OME中起重要作用，中耳内细菌或细菌产物的存在也有此作用。病毒感染、鼻过敏、既往中耳炎发作史及原发性黏膜疾病均可能导致这种慢性疾病。诊断评估包括适当的个人史和环境史、体格检查、鼓气耳镜检查、鼓室导抗图、纯音听力测定，以及（如有指征）过敏和免疫学评估。治疗可能包括环境控制、抗生素治疗、减充血剂和/或抗组胺药、局部用皮质类固醇，以及可能的免疫接种或变应性免疫疗法（减敏疗法）。为了促进预防急性和复发性中耳炎以及慢性积液的策略，进一步了解其病因、发病机制和危险因素至关重要。精心设计的对照研究对于进一步理解和更有效地治疗这一常见、慢性且常常令人沮丧的医学问题必不可少。
