Dijagnostika i liječenje sekretornog otitisa

master's thesis

• Title (english): Otitis media with effusion - evaluation and therapy
• Author: Tonći Batinić
• Mentor: Srećko Branica (mentor)
• Committee member: Mario Bilić (predsjednik povjerenstva)
• Committee member: Mirko Ivkić (član povjerenstva)
• Committee member: Srećko Branica (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Othorhinolaryngology and Head and Neck Surgery); Zagreb
• Defense date and country: 2015-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Otorhinolaryngology

Abstract

Sekretorna upala srednjega uha odnosi se na negnojnu sekreciju iza intaktnog bubnjića koja nije povezana s akutnim simptomima upale uha ili sistemnim znakovima upale. Sekret je gotovo sterilan. Proces se može podijeliti na akutni (sekrecija traje do tri tjedna), subakutni (sekrecija traje do tri mjeseca) i kronični (sekrecija traje dulje od tri mjeseca). Sekretorni otitis media je najčešća bolest uha u djece vrtićke i školske dobi te jedna od najčešćih bolesti uopće. Bolest je najčešće samolimitirajuća, ali može utjecati na razvoj sluha i govora. U prosjeku 3 – 4 % djece ima kroničnu formu sekretorne upale uha (Probst et al, 2006). Glavni uzroci sekretornog otitisa slabija su funkcija Eustahijeve cijevi i povećana mukolitička aktivnost žlijezda. Dva su vrška pojavnosti – dvije i pet godina (Graham et al, 2007). Najčešće je razdoblje pojavljivanja ove bolesti zimski period. Simptomi su kod djece često odsutni, a glavni simptom, na koji se djeca rijetko žale, gubitak je sluha. Starija djeca se žale na bolnost i pucketanje uha. Dio djece ima problema sa spavanjem i koncentracijom. Dijagnoza se postavlja otoskopski, pri čemu bubnjić bude žućkast ili plavičast, slabo mobilan te se vide krvne žilice po bubnjiću, zatim timpanometrijom, gdje se uočava ravna krivulja na timpanogramu i audiometrijom. U odraslih, bolest je ista kao kod djece, s tim da treba pomisliti i na neke druge uzroke, koji se neće naći kod djece, primjerice „sleep apnea“ sindrom ili tumor nazofarinksa. Stoga je potrebna i dodatna dijagnostička obrada. Liječenje kod akutnih i subakutnih oblika većinom je konzervativno, dok liječenje kroničnog oblika u slučaju gubitka sluha treba biti kirurški, paracentezom i ugradnjom ventilacijskih cjevčica, ako se smatra da je tako najbolje za dijete nakon razdoblja „pažljivog nadgledanja“.

Abstract (english)

Otitis media with effusion refers to nonpurulent secretion behind an intact tympanic membrane that is not associated with acute otologic symptoms or systemic signs. Secretion is almost sterile. The process may be classified as acute (effusion lasting up to 3 weeks), subacute (up to 3 months), or chronic (more than 3 months). Otitis media with effusion is the most common ear disease in preschool-age children and one of the most common diseases altogether. Approximately 3 – 4 % of children have a chronic form (Probst et al, 2006). The main causes od OME are malfunctioning of Eustachian tube and increased mucolytic activity of glands. There are two peaks of distribution, 2 years and 5 years (Graham et al, 2007). The most common period of appearance is during the winter. There is usually a lack of symptoms in children, and the main symptom, which children rarely complain of, is hearing loss. Older children usually complain of pain and crackling in the ear. Some children have problems with sleeping or concentration. Diagnosis is made otoscopically, where gold or bluish colouration of the tympanic membrane, low mobility and small blood vessels can be found, tympanometrically, with a flat curve on the tympanogram and audiometrically. In adults, the disease is the same as in children, but it is important to think about some other causes, which won't be found in children, such as sleep apnea syndrome or nasopharyngeal tumors, so additional diagnostic tests should be done. The treatment of acute and subacute types is conservative, while the treatment of chronic type in situations of hearing loss should be surgical - paracentesis and implantation of ventilation tubes, if it is considered to be the best way, after a period of „careful observation“.

• Keywords: sekretorni otitis; gubitak sluha; konzervativno liječenje; kirurško liječenje
• Keywords (english): otitis media with effusion; hearing loss; conservative treatment; surgical treatment
• Language: croatian
• URN:NBN: urn:nbn:hr:105:637529
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2016-04-08 12:31:36