Alho O P, Läärä E, Oja H
Department of Otolaryngology, University of Oulu, Finland.
J Fam Pract. 1996 Sep;43(3):258-64.
Chemoprophylaxis or tympanostomy tubes are often recommended for recurrent acute otitis media because of the associated morbidity, temporary hearing loss, financial costs, and risks of middle-ear sequelae. The aim of this study was to study the natural course of recurrent acute otitis media in infancy without such prophylactic treatment.
Two hundred twenty-two children who had recurrent acute otitis media and received no prophylaxis were monitored for subsequent acute otitis media and the development of chronic otitis media with effusion.
Only 4% of the 222 infants with recurrent acute otitis media developed chronic otitis media with effusion and an additional 12% continued having recurrent episodes. The most significant factor predicting an increased risk of recurrence was young age (< 16 months of age). Attending day care and having siblings had a less pronounced effect.
Spontaneous recovery from recurrent acute otitis media is common with increasing age. Thus, until reliable causal evidence between recurrent otitis media and developmental disability is presented, chemoprophylaxis or tympanostomy tubes seem superfluous for most infants after the age of 16 months.
由于复发性急性中耳炎会带来相关的发病率、暂时性听力损失、经济成本以及中耳后遗症风险，化学预防或鼓膜置管术常被推荐用于复发性急性中耳炎。本研究的目的是探讨在无此类预防性治疗的情况下，婴儿期复发性急性中耳炎的自然病程。
对222名患有复发性急性中耳炎且未接受预防治疗的儿童进行监测，观察其后急性中耳炎的发生情况以及中耳积液性慢性中耳炎的发展情况。
在222名患有复发性急性中耳炎的婴儿中，只有4%发展为中耳积液性慢性中耳炎，另有12%继续出现复发。预测复发风险增加的最显著因素是年龄较小（<16个月）。上日托以及有兄弟姐妹的影响则不太明显。
随着年龄增长，复发性急性中耳炎自然恢复很常见。因此，在没有出现复发性中耳炎与发育障碍之间可靠的因果证据之前，对于大多数16个月以上的婴儿来说，化学预防或鼓膜置管术似乎是多余的。
