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Laryngorhinootologie 2016; 95(S 01): S136-S154
DOI: 10.1055/s-0041-108952
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Evidenz und Evidenzlücken zur Behandlung der gestörten Mittelohrbelüftung sowie der Otitis media

Evidence and Evidence Gaps in the Treatment of Eustachian Tube Dysfunction and Otitis Media
M. Teschner
1   Klinik und Poliklinik, Hals-, Nasen-, Ohrenheilkunde, Medizinische Hochschule Hannover Direktor: Prof. Prof. h.c. Dr. med. T. Lenarz
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Publikationsdatum:
29. April 2016 (online)

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Zusammenfassung

Evidenzbasierte Medizin bedeutet, im Rahmen einer medizinischen Behandlung eine patientenorientierte Entscheidung auf der Grundlage von empirisch nachgewiesener Wirksamkeit zu treffen. Hierzu existieren Klassifizierungen, in welchen nach definierten Vorgaben Studien und damit Therapieoptionen hinsichtlich ihrer Evidenz eingeteilt werden können.

Die Tuba eustachii verbindet den Nasopharynx mit dem Mittelohr. Ihre Hauptaufgabe ist die Gewährleistung der Belüftung des Mittelohres. Ist diese Belüftungsfunktion eingeschränkt, resultieren entzündliche Erkrankungen des Mittelohres.

Für die Behandlung der gestörten Mittelohrbelüftung sowie der Otitis media sind bisher zahlreiche Therapieoptionen evidenzbasiert. Ein wesentlicher Therapieansatz ist die antibiotische Therapie. Aber auch neuere Verfahren wie die Tubenballondilatation zeigen erste Erfolge, müssen jedoch hoch hinsichtlich ihrer Evidenz weiter evaluiert werden. Weiter liegt z. T. für langjährig etablierte Verfahren keine Evidenz vor. Die Klassifikation einer Evidenz für die unterschiedlichen therapeutischen Ansätze ist aufgrund vielfältiger Variablen sehr diversifiziert zu betrachten.

Daher sind für die Evidenz der Behandlung der gestörten Mittelohrbelüftung sowie der Otitis media zahlreiche evidenzbeitragende Studien notwendig, um bestehende und auch zukünftige Therapiekonzepte zu evaluieren. Wird dieses angegangen, sind im Laufe der kommenden Jahre zahlreiche Implikationen für therapeutische Ansätze zu erwarten.

Abstract

Evidence and Evidence Gaps in the Treatment of Eustachian Tube Dysfunction and Otitis Media

Evidence-based medicine is an approach to medical treatment intended to optimise patient-oriented decision-making on the basis of empirically proven effectiveness. For this purpose, a classification system has been established to categorise studies – and hence therapy options – in respect of associated evidence according to defined criteria.

The Eustachian tube connects the nasopharynx with the middle ear cavity. Its key function is to ensure middle ear ventilation. Compromised ventilation results in inflammatory middle ear disorders. Numerous evidence-based therapy options are available for the treatment of impaired middle ear ventilation and otitis media, the main therapeutic approach being antibiotic treatment. More recent procedures such as balloon dilation of the Eustachian tube have also shown initial success but must undergo further evaluation with regard to evidence. There is, as yet, no evidence for some of the other long-established procedures.

Owing to a multitude of variables, the classification of evidence levels for various treatment approaches calls for highly diversified assessment. Numerous evidence-based studies are therefore necessary in order to evaluate the evidence pertaining to existing and future therapy solutions for impaired middle ear ventilation and otitis media. If this need is addressed, a wealth of implications can be expected for therapeutic approaches in the years to come.

Schlüsselwörter

Otitis media - Tubenbelüftungsstörung - Evidenz - Evidenzlücken - antibiotische Therapie

Key words

Otitis Media - Eustachian Tube Dysfunction - Evidence - Evidence Gaps - Antibiotic Therapy
 

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