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Pädiatrie up2date 2013; 08(04): 327-344
DOI: 10.1055/s-0033-1344499
Entwicklung
© Georg Thieme Verlag KG Stuttgart · New York

Chronischer Mittelohrerguss

Markus Jungehülsing
,
Christoph Erle-Bischoff
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Publication Date:
25 November 2013 (online)

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Fazit für die Praxis

  • Paukenergüsse mit einer Persistenz < 3 Monaten müssen nicht therapiert werden. Hier ist eine „Watchful-Waiting“-Strategie indiziert. Der Versuch der Autoinsufflation mit einem Ballonsystem ist aber durchaus empfehlenswert.

  • Paukenergüsse mit einer Persistenz > 3 Monate sollten operativ behandelt werden: Liegt ein vernarbtes, hyperplastisches Adenoid vor, ist eine Adenotomie empfehlenswert. Eine Parazentese mit Absaugen des Sekrets aus dem Mittelohr sollte immer gleichzeitig durchgeführt werden.

  • Die Einlage von Paukenröhrchen wird wegen möglicher Spätfolgen national und international zunehmend zurückhaltend bewertet. Sie sollte nur bei anamnestisch längerdauernden oder rezidivierenden Tubenbelüftungsstörungen durchgeführt werden. Permanente Paukenröhrchen (Stativröhrchen/„T-Tubes“; Abb. [11]) sind nur in problematischen Einzelfällen empfehlenswert.

 

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