Zocconi E
Istituto per l'Infanzia, Trieste, Italia.
Pediatr Med Chir. 1994 May-Jun;16(3):273-5.
Persistent otitis media with effusion (OME) is a pathology very frequent in the first year of life and causes hearing loss which can be a negative factor in language and cognitive development and may result in disturbances in psychological adjustment. Generally OME has spontaneous resolution but if it persist for more than 3 months a medical or surgical treatment is compulsory. OME is frequently a result of recurrent otitis media and bacterial infection is considered to play a definitive causative role in the development of this pathology. A wide variety of medical treatments (antibiotics, aerosolized corticosteroids, oral antihistamine-decongestants, mucolytics) is indicative of lake of success. We have treated 60 children with OME with antibiotics (amoxicillin or cefaclor for 1 month) and oral steroids (prednisone for 7 days). All patients had a history for more than 3 months, without adenoid hypertrophy. Diagnosis of OME was established after pneumatic otoscopy, tympanometry and audiometry. Following the therapeutical association 53 patients showed a complete resolution of the effusion. At the follow-up after 2 months, 4 children had a recurrence of effusion. We consider this treatment with a short course of steroids and antibiotics and effective method before referral for tube placement.
持续性中耳积液(OME)是一种在出生后第一年非常常见的病症,会导致听力损失,而听力损失可能是语言和认知发展的负面因素,并可能导致心理调适障碍。一般来说,OME会自行消退,但如果持续超过3个月,则必须进行药物或手术治疗。OME通常是复发性中耳炎的结果,细菌感染被认为在这种病症的发展中起决定性的致病作用。各种各样的药物治疗(抗生素、雾化皮质类固醇、口服抗组胺减充血剂、黏液溶解剂)表明疗效不佳。我们用抗生素(阿莫西林或头孢克洛,疗程1个月)和口服类固醇(泼尼松,疗程7天)治疗了60例OME患儿。所有患者病程均超过3个月,无腺样体肥大。通过鼓气耳镜检查、鼓室图和听力测定确诊为OME。经过联合治疗,53例患者积液完全消退。在2个月后的随访中,4例患儿积液复发。我们认为这种短期使用类固醇和抗生素的治疗方法是在转诊进行置管治疗之前的一种有效方法。