Zusammenfassung
Unter dem Begriff Otitis media werden die akute Otitis media, die rezidivierende akute
Otitis media, die Otitis media mit Erguss, die chronische Otitis media
mesotympanalis und die chronische Otitis media epitympanalis, das Cholesteatom, zusammengefasst.
Es handelt sich um vielfältige Krankheitsbilder, die teils
ineinander übergehen können und eine individuell angepasste, zielgerichtete Therapie
erfordern.
Abstract
A number of diseases of the middle ear are summed up under the term otitis media:
acute otitis media, recurrent acute otitis media, otitis media with effusion,
chronic suppurative otitis media and chronic otitis media epitympanalis (= cholesteatoma).
Acute otitis media belongs to the most common pediatric diseases and
is often caused by bacterial infection. Since the advent of pneumococcal vaccines
the quantity of AOM caused by pneumococci has declined; vaccination against
NTHi and Moraxella catarrhalis are being developed. Main pillar of conservative treatment
of AOM is symptomatic therapy of otalgia and fever as well as
restoring the Eustachian tubal function. When indicated, amoxicillin represents antibiotic
medication of choice. Acute mastoiditis, facial nerve paresis,
labyrinthitis, Gradenigo syndrome, sinus vein thrombosis, meningitis and brain abscess
belong to the complications of AOM among others. Both innate and adaptive
immune system are involved in recovery of OM with innate immunity playing a critical
role. Dysfunction of the Eustachian tube often underlies OM. Manometric
measurement of Eustachian tube function may be useful for indication of balloon Eustachian
tuboplasty. Several theories explain pathogenesis of cholesteatoma
and multiple pro-inflammatory processes promote its progress in the course of the
disease.
Schlüsselwörter
Otitis media - Tubenmanometrie - Cholesteatom - Tuba Eustachii
Key words
otitis media - tube manometry - cholesteatoma - vaccination - pneumococcus
