Prä- und postoperative Standards in der Ohrchirurgie – interne Umfrage der ADANO Otologie-Fachgruppe

Zusammenfassung

Einleitung

Die perioperative Versorgung in der Ohrchirurgie spielt eine zentrale Rolle für den Behandlungserfolg. Dennoch bestehen möglicherweise erhebliche Unterschiede in den klinischen Standards, zumal evidenzbasierte Leitlinien fehlen. Angesichts der zunehmenden Komplexität ohrchirurgischer Eingriffe und der Bedeutung einer hochwertigen Nachsorge ist die Standardisierung von Maßnahmen essenziell, um Komplikationen zu minimieren und Ergebnisse zu verbessern.

Methoden

Dreißig Multiple-Choice-Fragen zu prä-, peri- und postoperativen Standards in der eigenen Klinik wurden den Mitgliedern der Otologie-Fachgruppe der Arbeitsgemeinschaft Deutschsprachiger Audiologen, Neurootologen und Otologen (ADANO) über einen Online-Fragebogen gestellt.

Ergebnisse

Die Antworten der 14 Teilnehmenden zeigten teils erhebliche Heterogenität in der perioperativen Versorgung. Unterschiedliche Ansätze zeigten sich insbesondere bei der Verwendung von Tamponaden, der Gabe von Antibiotika und Glukokortikoiden sowie bei postoperativen Verhaltensempfehlungen (z.B. sportliche Aktivität, Schutz vor Lärm und Wasser). Postoperative Kontrolluntersuchungen wie der Stimmgabel-Test nach Weber oder die Nystagmusprüfung werden relativ einheitlich angewendet.

Diskussion

Die Ergebnisse verdeutlichen die aktuelle Inhomogenität der prä-, peri- und postoperativen Versorgung in der Ohrchirurgie, selbst in spezialisierten Zentren. Die Umfrage liefert eine Übersicht über gelebte Praktiken im Sinne einer Expertenmeinung, bietet jedoch keine höhere Evidenz. Derzeit gibt es kaum Studien in ausreichender Qualität, die die diskutierten Standards systematisch untersucht hätten – hier besteht klinischer Forschungsbedarf. Von Interesse wäre zudem, die Umfrage auf internationale ohrchirurgische Zentren und Experten auszuweiten.

Abstract

Introduction

Perioperative care in ear surgery plays a central role in treatment success. However, significant differences in clinical standards may exist, especially in the absence of evidence-based guidelines. Given the increasing complexity of otologic procedures and the importance of high-quality postoperative care, standardizing measures is essential to minimize complications and improve outcomes.

Methods

Thirty multiple-choice questions on pre-, peri-, and postoperative standards at participants' clinics were distributed via an online survey to members of the Otology Section of the German-speaking Association of Audiologists, Neurotologists, and Otologists (ADANO).

Results

Responses from 14 participants revealed considerable heterogeneity in perioperative care. Differences were particularly evident in the use of ear packing, administration of antibiotics and glucocorticoids, and postoperative behavioral recommendations (e.g., physical activity, protection from noise and water). Postoperative follow-up examinations such as the Weber tuning fork test or nystagmus assessment are applied relatively uniformly.

Discussion

The results highlight current inhomogeneity in perioperative care in ear surgery, even among specialized centers. The survey outlines current practices as expert opinion but lacks high-level evidence. Few high-quality studies systematically investigate the discussed standards, indicating a clear need for clinical research. Extending the survey to international otologic centers and experts would also be of interest.

Schlüsselwörter

ADANO - Perioperative Standards - Ohrchirurgie - Mittelohrchirurgie - Tamponade

Keywords

ear surgery - perioperative standards - middle ear surgery

Publication History

Received: 07 April 2025

Accepted: 22 May 2025

Article published online:
16 June 2025

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