Dieses Update zum Thema der chronischen mesotympanalen Otitis media (CMOM) gibt einen
Einblick zu neuen Erklärungsmodellen der Pathogenese des Krankheitsbildes, fasst die
häufigsten Ursachen zusammen und bildet den aktuellen Stand in der Diagnostik und
Therapie ab. Herauszuheben sind dabei neue Erkenntnisse zur Physiologie der Mittelohrschleimhaut,
zur Pathogenese von Biofilmen und der aktuelle Stellenwert konservativer Therapieverfahren.
Der Schwerpunkt mikrochirurgischer und minimalinvasiver Therapieverfahren soll nachfolgend
in einem 2. Teil publiziert werden.
Abstract
Chronic mesotympanal otitis media (CMOM) is a well-developed clinical presentation
that is established in diagnostics and therapy. On closer inspection, however, this
principle cannot be confirmed in all its facets. Already the physiology and pathophysiology
of the middle ear mucosa leave questions unanswered, starting with the distribution
of the ciliated epithelium in the middle ear and mastoid to the function of gas exchange.
In addition, there are new diagnostic and therapeutic approaches. In the future, optical
coherence tomography could help to determine the status of the middle ear mucosa.
In addition, there are new findings on the effectiveness of local and systemic antibiotics
as well as antiseptics in chronic otorrhea. Other new developments include minimally
invasive surgical procedures using endoscopic techniques. All this gives reason to
provide an update on the topic of chronic mesotympanal otitis media, which should
contribute in preparation for the specialist examination or refreshing.
Basics of physiology and pathophysiology as well as new diagnostic approaches and
medical treatment were covered in Part 1 of this paper. In Part 2, in addition to
established methods, new developments in surgical therapy with minimally invasive
surgical procedures are described in more detail.
Schlüsselwörter
Chronische mesotympanale Otitis media - CMOM - Antibiotika - Antiseptika - Keimspektrum
- Trommelfelldefekt - Tympanoplastik
Keywords
Chronic mesotympanal otitis media - CMOM - tympanic membrane defect - tympanoplasty