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DOI: 10.1055/s-0033-1344499
Chronischer Mittelohrerguss
Publication History
Publication Date:
25 November 2013 (online)
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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.
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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.
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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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