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153. Roland PS, Kreisler LS, Reese B,Anon JB, Lanier B, Conroy PJ, et al.Topical ciprofloxacin/dexamethasone oticsuspension is superior to ofloxacin oticsolution in the treatment of children withacute otitis media with otorrhea throughtympanostomy tubes. Pediatrics 2004;113:e40-6.154. Ruohola A, Heikkinen T, MeurmanO, Puhakka T, Lindblad N, RuuskanenO. Antibiotic treatment of acute otorrheathrough tympanostomy tube: randomizeddouble-blind placebo-controlled studywith daily follow-up. Pediatrics 2003;111:1061-7.155. Carbonell R, Ruiz-Garcia V. Ventilationtubes after surgery for otitis mediawith effusion or acute otitis media andswimming. Systematic review and metaanalysis.Int J Pediatr Otorhinolaryngol2002;66:281-9.156. Goldstein NA, Mandel EM,Kurs-Lasky M, Rockette HE, CasselbrantML. Water precautions and tympanostomytubes: a randomized, controlledtrial. Laryngoscope 2005;115:324-30.157. Becker GD, Eckberg TJ, GoldwareRR. Swimming and tympanostomytubes: a prospective study. Laryngoscope1987;97:740-1.158. Cohen HA, Kauschansky A,Ashkenasi A, Bahir A, Frydman M,Horev Z. Swimming and grommets.J Fam Pract 1994;38:30-2.159. Gilbert JG. Swimming and grommets:a prospective survey. N Z Med J1994;107:244-5.160. Arcand P, Gauthier P, Bilodeau G,Chapados G, Abela A, Desjardins R, etal. Post-myringotomy care: a prospectivestudy. J Otolaryngol 1984;13:305-8.161. Bonding P, Tos M. Grommets versusparacentesis in secretory otitis media. Aprospective, controlled study. Am J Otol1985;6:455-60.162. Mandel EM, Rockette HE, BluestoneCD, Paradise JL, Nozza RJ. Efficacy of myringotomywith and without tympanostomytubes for chronic otitis media with effusion.Pediatr Infect Dis J 1992;11:270-7.163. Lildholdt T. Ventilation tubes insecretory otitis media. A randomized, controlledstudy of the course, the complications,and the sequelae of ventilation tubes.Acta Otolaryngol Suppl 1983;398:1-28.164. Stenstrom R, Pless IB, Bernard P.Hearing thresholds and tympanic membranesequelae in children managedmedically or surgically for otitis mediawith effusion. Arch Pediatr AdolescMed 2005;159:1151-6.165. Maw AR, Bawden R. Tympanicmembrane atrophy, scarring, atelectasisand attic retraction in persistent, untreatedotitis media with effusion and followingventilation tube insertion. Int J PediatrOtorhinolaryngol 1994;30:189-204.166. Valtonen H, Tuomilehto H,Qvarnberg Y, Nuutinen J. A 14-year prospectivefollow-up study of children treatedearly in life with tympanostomy tubes: Part2: Hearing outcomes. Arch OtolaryngolHead Neck Surg 2005;131:299-303.167. Valtonen HJ, Qvarnberg YH,Nuutinen J. Otological and audiologicaloutcomes five years after tympanostomy inearly childhood. Laryngoscope 2002;112:669-75.212Rörbehandling vid inflammation i mellanörat
168. de Beer B, Snik A, Schilder AG,Graamans K, Zielhuis GA. The effect ofotitis media in childhood on the developmentof middle ear admittance on reachingadulthood. Arch Otolaryngol Head NeckSurg 2005;131:777-81.169. de Beer BA, Schilder AG, Ingels K,Snik AF, Zielhuis GA, Graamans K. Hearingloss in young adults who had ventilationtube insertion in childhood. Ann OtolRhinol Laryngol 2004;113:438-44.170. de Beer BA, Schilder AG, ZielhuisGA, Graamans K. Natural course oftympanic membrane pathology relatedto otitis media and ventilation tubesbetween ages 8 and 18 years. OtolNeurotol 2005;26:1016-21.171. Strachan D, Hope G, Hussain M.Long-term follow-up of children insertedwith T-tubes as a primary procedurefor otitis media with effusion. ClinOtolaryngol Allied Sci 1996;21:537-41.172. Skinner DW, Lesser TH, RichardsSH. A 15 year follow-up of a controlled trialof the use of grommets in glue ear. ClinOtolaryngol Allied Sci 1988;13:341-6.173. Wallace HC, Newbegin CJ. DoesENT outpatient review at 1-week postventilation tube insertion improve outcomeat 1 month in paediatric patients? ClinOtolaryngol Allied Sci 2004;29:595-7.174. Chevretton E, Bingham BJ, FirmanE. The prevention of tympanic membraneperforation following the removal of longtermPaparella type II ventilation tubes.Clin Otolaryngol Allied Sci 1987;12:377-81.175. El-Bitar MA, Pena MT, Choi SS,Zalzal GH. Retained ventilation tubes:should they be removed at 2 years?Arch Otolaryngol Head Neck Surg2002;128:1357-60.176. Lentsch EJ, Goudy S, Ganzel TM,Goldman JL, Nissen AJ. Rate of persistentperforation after elective tympanostomytube removal in pediatric patients. IntJ Pediatr Otorhinolaryngol 2000;54:143-8.177. Iwaki E, Saito T, Tsuda G, SugimotoC, Kimura Y, Takahashi N, et al. Timingfor removal of tympanic ventilationtube in children. Auris Nasus Larynx1998;25:361-8.178. Nichols PT, Ramadan HH, Wax MK,Santrock RD. Relationship between tympanicmembrane perforations and retainedventilation tubes. Arch Otolaryngol HeadNeck Surg 1998;124:417-9.179. Saito T, Iwaki E, Kohno Y, OhtsuboT, Noda I, Mori S, et al. Prevention of persistentear drum perforation after long-termventilation tube treatment for otitis mediawith effusion in children. Int J PediatrOtorhinolaryngol 1996;38:31-9.180. Bingham BJ, Gurr PA, Owen G. Tympanicmembrane perforation following theremoval of ventilation tubes in the pres ence of persistent aural discharge. ClinOtolaryngol Allied Sci 1989;14:525-8.181. Ilicali OC, Keles N, Deger K, Savas I.Relationship of passive cigarette smokingto otitis media. Arch Otolaryngol HeadNeck Surg 1999;125:758-62.182. Ilicali OC, Keles N, De er K, Sa unOF, Guldiken Y. Evaluation of the effect ofpassive smoking on otitis media in childrenby an objective method: urinary cotinineanalysis. Laryngoscope 2001;111:163-7.kapitel 3 • Resultat av litteraturgranskningen 213
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SBU utvärderar sjukvårdens metode
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InnehållSBU:s sammanfattning och s
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5.1.3 Enkät till öron-näsa-hals-
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SBU:s sammanfattningoch slutsatserS
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långvarig vätska i mellanörat (E
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FörekomstAkut och sekretorisk medi
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MetodikUrval av studierDet vetenska
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EvidensgraderingDe studier som uppn
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Är rörbehandling effektivare än
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Två studier med högt och sju med
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örbehandling på barn med Downs sy
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1008060SOMrAOM40200Otoskopi + Siegl
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Indikationen för rörbehandling vi
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InledningSedan drygt 50 år tillbak
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1. BakgrundFaktaruta 1 Definitioner
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Hos barn som inte tillfrisknar spon
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De visar på en total samhällsekon
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Enbart randomiserade studier accept
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2.4 MetodproblemDe viktigaste probl
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Tidig postoperativ rörflytning har
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terade studier där barnen haft fä
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Ytterligare ett alternativ skulle k
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Två studier med medelhögt bevisv
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Maw och medarbetare inkluderade 182
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tagit hänsyn till graden av hörse
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Sammantaget talar en studie med hö
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ehandling [101,102]. Acceptansen va
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Några studier har undersökt effek
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åtgärd [126]. Detta stöds av en
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Sexton studier som uppfyllde inklus
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I Sverige används inte preparat me
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Tre studier undersökte trumhinnef
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av övriga trumhinneförändringar
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• Det finns inte tillräckligt ve
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adenoidektomi utfördes vid behov.
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som inte används i Sverige. Samman
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Table 3.1.1 Effect of ventilation t
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Table 3.1.2.1 Long-term antibiotics
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Table 3.1.2.1 continuedAuthorYearRe
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Table 3.1.2.2 Effect of short-term
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Table 3.1.2.3 Effect of pneumococca
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Table 3.1.3 Effects of adenoidectom
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Table 3.1.3 continuedAuthorYearRefe
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Table 3.2.1 Ventilation tubes compa
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Table 3.2.2 Effects of ventilation
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Table 3.2.3.1 Effect of adenoidecto
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Table 3.2.3.2 Effects of myringotom
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Table 3.2.4 Effects of autoinflatio
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Table 3.3.1 Ventilation tube types
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Table 3.3.2 Surgical procedures - e
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Table 3.3.3 Anaesthetic complicatio
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Table 3.4.1 Effects of prophylaxis
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Table 3.4.2 Effect of treatment of
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Page 160 and 161: Table 3.4.3 Risk for otorrhea relat
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Page 180 and 181: Table 3.6 Retention and extraction
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Page 190 and 191: Table 3.7.1 Environmental factors i
Page 192 and 193: Table 3.7.2 Effects of ventilation
Page 196 and 197: Table 3.7.3 Effects of ventilation
Page 198 and 199: Table 3.8 Economic evaluation studi
Page 200 and 201: Referenser1. Hermerén G. Riktlinje
Page 202 and 203: children, and significance of myrin
Page 204 and 205: lin treatment in recurrent acute ot
Page 206 and 207: early surgery versus watchful waiti
Page 208 and 209: 121. Poetker DM, Lindstrom DR, Pate
Page 212 and 213: 183. Praveen CV, Terry RM. Does pas
Page 214 and 215: 217. Baker RS, Chole RA. A Randomis
Page 216 and 217: eller fallit ut) blir det vanligen
Page 219 and 220: 5. PraxisundersökningDet finns ing
Page 221 and 222: Det vanligaste sättet att diagnost
Page 223 and 224: Andel ÖNH-specialister5040302010
Page 225 and 226: 100Rör per 10 000 barn806040200Got
Page 227 and 228: de mellan 6,5 och 21,5 procent mell
Page 229: Tabell 5.3 Förväntade kostnader o
Page 232 and 233: Tabell 6.1 Nytta och risker för ol
Page 234 and 235: Barn med ökad benägenhet för SOM
Page 236 and 237: Med modellen som utgångspunkt ser
Page 238 and 239: Referens1. Hermerén G. Riktlinjer
Page 240 and 241: Projektet har inte gjort någon sys
Page 242 and 243: Följderna blir att barn besparas e
Page 245 and 246: 8. ForskningsbehovTrots att rörbeh
Page 247: Antal ingående patienter: För en
Page 250 and 251: MyringotomiNNTOMEOR, odds ratio,ell
Page 252 and 253: Systematisk översiktTympanometriTy
Page 254 and 255: Marie RydingMedicine doktor, överl
Page 257 and 258: Bilaga 1. Diagnostiska metoderSymto
Page 259 and 260: I studier, där myringotomi har anv
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Kombination av metodernaEn kombinat
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SpråkbedömningDet finns ett stort
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effusion. MRC Multi-centre otitis m
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Öron-näsa-hals-klinikBarn som haf
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Bilaga 3. Omgivningsfaktorer för r
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Tillgång till sjukvård och andra
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Bilaga 4. Hälsoekonomisk modellana
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BILAGA 4 • Hälsoekonomisk modell
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SannolikhetFörväntadkostnadFörv
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är uppskattningar på en skala mel
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fler läkarbesök och mer frånvaro
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Förväntad kostnadParameterVärdeP
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Angivna kostnader avser år 2006 oc
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Tabell 1 fortsättningStrategi/utfa
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Rapporter publicerade av SBUGula ra
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Smärtor i bröstet: Operation, bal
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Hysterectomy - Ratings of Appropria
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