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Sekretorisk otitis media (SOM)

Sist oppdatert: Sist revidert:
Sist revidert av:
Definisjon:
Væskeansamling i mellomøret uten at det foreligger akutt infeksjon. Hyppigst etter mellomørebetennelse eller forkjølelse
Forekomst:
Relativt hyppig hos barn i aldersgruppen 2-6 år
Symptomer:
Dottfornemmelse i øret og nedsatt hørsel
Funn:
Ved otoskopi ses væske i mellomøret og nedsatt bevegelighet av trommehinnen
Diagnostikk:
Tympanometri bekrefter væske i mellomøret. Audiometri viser nedsatt hørsel
Behandling:
Avvente spontan tilheling, væsken forsvinner av seg selv hos 80%. Henv. ØNH for vurdering, ev. innleggelse av dren ved plager i mer enn 3-4 måneder
  1. Perera R, Glasziou PP, Heneghan CJ, et al. Autoinflation for hearing loss associated with otitis media with effusion. Cochrane Database of Syst. Rev 2013; 5: CD006285. doi:10.1002/14651858.CD006285.pub2 DOI  
  2. Atkinson H, Wallis S, Coatesworth AP. Otitis media with effusion. Postgrad Med. 2015;127(4):381-385. PMID: 25913597. PubMed  
  3. Simpson SA, Thomas CL, van der Linden M, MacMillan H, van der Wouden JC, Butler CC. Identification of children in the first four years of life for early treatment for otitis media with effusion. Cochrane Database of Systematic Reviews 2007, Issue 1. Art. No.: CD004163. DOI: 10.1002/14651858.CD004163.pub2 DOI  
  4. Helsedirektoratet (2021). Nasjonal faglig retningslinje for antibiotika i primærhelsetjenesten nettdokument. Oslo: Helsedirektoratet (sist faglig oppdatert 16. november 2021, lest 16. november 2021).
  5. van Balen FAM, de Melker RA. Persistent otitis media with effusion: Can it be predicted? A family practice follow-up study in children aged 6 months to 6 years. J Fam Pract 2000; 49:605-611. PubMed  
  6. Williamson I, Vennik J, Harnden A, et al. Effect of nasal balloon autoinflation in children with otitis media with effusion in primary care: an open randomized controlled trial. CMAJ 2015. doi:10.1503/cmaj.141608 DOI  
  7. Venekamp RP, Burton MJ, van Dongen TMA, van der Heijden GJ, van Zon A, Schilder AGM. Antibiotics for otitis media with effusion in children. Cochrane Database of Systematic Reviews 2016, Issue 6. Art. No.: CD009163. DOI: 10.1002/14651858.CD009163.pub3. DOI  
  8. Williamson I, Benge S, Barton S, et al. Topical intranasal corticosteroids in 4-11 year old children with persistent bilateral otitis media with effusion in primary care: double blind randomised placebo controlled trial. BMJ 2010; 340: b4984 BMJ (DOI)  
  9. Simpson SA, Lewis R, van der Voort J, Butler CC. Oral or topical nasal steroids for hearing loss associated with otitis media with effusion in children. Cochrane Database of Systematic Reviews 2011, Issue 5. Art. No.: CD001935. DOI: 10.1002/14651858.CD001935.pub3. DOI  
  10. Griffin G, Flynn CA. Antihistamines and/or decongestants for otitis media with effusion (OME) in children. Cochrane Database of Systematic Reviews 2011, Issue 9. Art. No.: CD003423. DOI: 10.1002/14651858.CD003423.pub3 DOI  
  11. Venekamp RP, Javed F, van Dongen TM, Waddell A, Schilder AG. Interventions for children with ear discharge occurring at least two weeks following grommet (ventilation tube) insertion. Cochrane Database Syst Rev 2016; 11: CD011684. pmid:27854381 PubMed  
  12. Steel D, Adam GP, Di M, et al. Tympanostomy tubes in children with otitis media. Comparative Effectiveness Review No. 185. Rockville (MD): Agency for Healthcare Research and Quality (US); 2017 May. Report No.: 17-EHC003-EF (Systematic Review) legehandboka.no  
  13. Berkman ND, Wallace IF, Steiner MJ, et al. Otitis media with effusion: Comparative effectiveness of treatments. AHRQ Comparative Effectiveness Review. Rockville (MD): Agency for Healthcare Research and Quality (US); 2013 May. Report No.: 13-EHC091-EF.
  14. Browning GG, Rovers MM, Williamson I, Lous J, Burton MJ. Grommets (ventilation tubes) for hearing loss associated with otitis media with effusion in children. Cochrane Database of Systematic Reviews 2010, Issue 10. The Cochrane Library  
  15. Paradise JL, Feldman HM, Campbell TF, et al. Tympanostomy tubes and developmental outcomes at 9 to 11 years of age. N Engl J Med 2007; 356: 248-61. New England Journal of Medicine  
  16. Paradise JL, Campbell TF, Dollaghan CA, et al. Developmental outcomes after early or delayed insertion of tympanostomy tubes. N Engl J Med 2005; 353: 576-86. New England Journal of Medicine  
  17. Rovers MM, Black N, Browning GG, Maw R, Zielhuis GA, Haggard MP. Grommets in otitis media with effusion: an individual patient data meta-analysis. Arch Dis Child 2005; 90: 480-85. PubMed  
  18. Lau L, Mick P, Nunez DA. Grommets (ventilation tubes) for recurrent acute otitis media in children. Cochrane Database of Systematic Reviews 2018, Issue 4. Art. No.: CD004741. DOI: 10.1002/14651858.CD004741.pub3. DOI  
  19. Hoberman A, Preciado D, Paradise JL et al. Tympanostomy Tubes or Medical Management for Recurrent Acute Otitis Media. N Engl J Med. 2021 May 13;384(19):1789-1799. PMID: 33979487. PubMed  
  20. Moualed D, Masterson L, Kumar S, Donnelly N. Water precautions for prevention of infection in children with ventilation tubes (grommets). Cochrane Database of Syst. Rev. 2016, Issue 1. Art. No.: CD010375. DOI: 10.1002/14651858.CD010375.pub2. DOI  
  21. Boonacker CW, Rovers MM, Browning GG, et al. Adenoidectomy with or without grommets for children with otitis media: an individual patient data meta-analysis. Health Technol Assess. 2014 Jan;18(5):1-118. PubMed  
  22. Gouma P, Mallis A, Daniilidis V, et al. Behavioural trends in young children with conductive hearing loss: a case-control study. Eur Arch of Otorhinolaryngol 2011; 268: 63-6. doi:10.1007/s00405-010-1346-4 DOI  
  • Ingard Løge, spesialist allmennmedisin, redaktør NEL

Tidligere fagmedarbeidere

  • Kurt Østhuus Krogh, spesialist i barnesykdommer, Redaksjonsmedarbeider Norsk Helseinformatikk/Overlege Barne-og ungdomsklinikken, St. Olavs Hospital, Trondheim
  • Per Møller, spesialist i øre/nese/hals, Haukeland sykehus og professor ved Universitetet i Bergen