CBO richtlijn otitis media bij kinderen in de tweede lijn. Hoofdstuk 1, 2, 4, 5.
De prevalentie van otitis media is 20 per 1000 patiënten per jaar. De incidentie van otitis media is 25 per 1000 per jaar in de leeftijdsgroep van één tot vier jaar. De CBO-richtlijn is ontwikkeld voor KNO-artsen en richt zich op indicatiestelling, diagnostiek, therapeutische opties, recidiverende acute otitis media, persisterende otitis media en actieve chronische mucosale otitis media. De richtlijn is ook ontwikkeld om aanknopingspunten voor transmurale afspraken of lokale protocollen te maken. De verwijzing voor acute otitis media bij kinderen vindt plaats wanneer alarmsymptomen aanwezig zijn. Echter als kinderen al in de tweede lijn worden behandeld, worden zij onderling doorverwezen naar de tweede lijn. De diagnostiek van otitis media bestaat uit otomicroscopie, audiometrie en tympanometrie. De niet-chirurgische behandeling van OMA bestaat uit logopedische behandeling en geluidsversterkende apparatuur. Ook quinolone oordruppels worden aanbevolen in de behandeling van OMA in de tweede lijn. Als er geen effect is van bovenstaande behandelingen, kan er gestart worden met een cotrimoxazol antibioticumkuur. De chirurgische behandeling van OMA bestaat uit het plaatsen van trommelvliesbuisjes. Deze worden geplaatst bij een gehoorverlies van 25 decibel (dB) of meer.
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