title: Panel 7: Otitis Media: Treatment and Complications.
abstract: Objective We aimed to summarize key articles published between 2011 and 2015 on the treatment of (recurrent) acute otitis media, otitis media with effusion, tympanostomy tube otorrhea, chronic suppurative otitis media and complications of otitis media, and their implications for clinical practice. Data Sources PubMed, Ovid Medline, the Cochrane Library, and Clinical Evidence (BMJ Publishing). Review Methods All types of articles related to otitis media treatment and complications between June 2011 and March 2015 were identified. A total of 1122 potential related articles were reviewed by the panel members; 118 relevant articles were ultimately included in this summary. Conclusions Recent literature and guidelines emphasize accurate diagnosis of acute otitis media and optimal management of ear pain. Watchful waiting is optional in mild to moderate acute otitis media; antibiotics do shorten symptoms and duration of middle ear effusion. The additive benefit of adenoidectomy to tympanostomy tubes in recurrent acute otitis media and otitis media with effusion is controversial and age dependent. Topical antibiotic is the treatment of choice in acute tube otorrhea. Symptomatic hearing loss due to persistent otitis media with effusion is best treated with tympanostomy tubes. Novel molecular and biomaterial treatments as adjuvants to surgical closure of eardrum perforations seem promising. There is insufficient evidence to support the use of complementary and alternative treatments. Implications for Practice Emphasis on accurate diagnosis of otitis media, in its various forms, is important to reduce overdiagnosis, overtreatment, and antibiotic resistance. Children at risk for otitis media and its complications deserve special attention.
authors.affiliation: 1 evidENT, Ear Institute, University College London, London, United Kingdom.|2 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: Anne G M
authors.initials: AG
authors.lastname: Schilder
authors.affiliation: 3 Department of Otolaryngology-Head and Neck Surgery, Assaf Harofeh Medical Center, Faculty of Medicine, Tel Aviv University, Zerifin, Israel.
authors.forename: Tal
authors.initials: T
authors.lastname: Marom
authors.affiliation: 4 Royal National Throat Nose and Ear Hospital, London, United Kingdom.
authors.forename: Mahmood F
authors.initials: MF
authors.lastname: Bhutta
authors.affiliation: 5 Division of Pediatric Otolaryngology, Children's Hospital of Pittsburgh of UPMC, Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
authors.forename: Margaretha L
authors.initials: ML
authors.lastname: Casselbrant
authors.affiliation: 6 Department of Otolaryngology, School of Paediatrics and Child Health, The University of Western Australia, Nedlands, WA, Australia.
authors.forename: Harvey
authors.initials: H
authors.lastname: Coates
authors.affiliation: 7 Department of Clinical Sciences, Division of Otorhinolaryngology, Head and Neck Surgery, Lund University Hospital, Lund, Sweden.
authors.forename: Marie
authors.initials: M
authors.lastname: Gisselsson-Solén
authors.affiliation: 8 University Hospitals Bristol NHS Foundation Trust and School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Hall
authors.affiliation: 9 Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Marchisio
authors.affiliation: 10 Department of Pediatrics, University of Turku, Turku, Finland.
authors.forename: Aino
authors.initials: A
authors.lastname: Ruohola
authors.affiliation: 2 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: Roderick P
authors.initials: RP
authors.lastname: Venekamp
authors.affiliation: 5 Division of Pediatric Otolaryngology, Children's Hospital of Pittsburgh of UPMC, Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
authors.forename: Ellen M
authors.initials: EM
authors.lastname: Mandel
mesh_terms: D000233:Adenoidectomy; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003226:Congresses as Topic; D006801:Humans; D008876:Middle Ear Ventilation / Q000009:adverse effects; D010033:Otitis Media / Q000150:complications / Q000628:therapy*; D012008:Recurrence; D018058:Tympanic Membrane Perforation / Q000209:etiology
chemical_list: D000900:Anti-Bacterial Agents
keywords: adenoidectomy; guidelines; mastoiditis; otitis; otitis media; otorrhea; perforation; tympanostomy tube