Abstract：
This is an update of the 2015 Guidelines developed by the Japan Otological Society and Oto-Rhino-Laryngeal Society of Japan defining otitis media with effusion (OME) in children (younger than 12 years old) and describing the disease rate, diagnosis, and method of examination. Recommended therapies that received consensus from the guideline committee were updated in consideration of current therapies used in Japan and based on available evidence.
METHODS: Regarding the treatment of OME in children, we developed Clinical Questions (CQs) and retrieved documents on each theme, including the definition, disease state, method of diagnosis, and medical treatment. In the previous guidelines, no retrieval expression was used to designate a period of time for literature retrieval. Conversely, a literature search of publications from March 2014 to May 2019 has been added to the JOS 2015 Guidelines. For publication of the CQs, we developed and assigned strengths to recommendations based on the collected evidence.
RESULTS: OME in children was classified into one group lacking the risk of developing chronic or intractable disease and another group at higher risk (e.g., children with Down syndrome, cleft palate), and recommendations for clinical management, including follow-up, is provided. Information regarding management of children with unilateral OME and intractable cases complicated by adhesive otitis media is also provided.
CONCLUSIONS: In clinical management of OME in children, the Japanese Clinical Practice Guidelines recommends management not only of complications of OME itself, such as effusion in the middle ear and pathologic changes in the tympanic membrane, but also pathologic changes in surrounding organs associated with infectious or inflammatory diseases.
METHODS: Regarding the treatment of OME in children, we developed Clinical Questions (CQs) and retrieved documents on each theme, including the definition, disease state, method of diagnosis, and medical treatment. In the previous guidelines, no retrieval expression was used to designate a period of time for literature retrieval. Conversely, a literature search of publications from March 2014 to May 2019 has been added to the JOS 2015 Guidelines. For publication of the CQs, we developed and assigned strengths to recommendations based on the collected evidence.
RESULTS: OME in children was classified into one group lacking the risk of developing chronic or intractable disease and another group at higher risk (e.g., children with Down syndrome, cleft palate), and recommendations for clinical management, including follow-up, is provided. Information regarding management of children with unilateral OME and intractable cases complicated by adhesive otitis media is also provided.
CONCLUSIONS: In clinical management of OME in children, the Japanese Clinical Practice Guidelines recommends management not only of complications of OME itself, such as effusion in the middle ear and pathologic changes in the tympanic membrane, but also pathologic changes in surrounding organs associated with infectious or inflammatory diseases.
摘要：
这是由日本耳科学学会和日本大黄喉学会制定的2015年指南的更新，该指南定义了儿童（12岁以下）的渗出性中耳炎（OME），并描述了发病率。诊断,和检查方法。在考虑日本目前使用的疗法并基于现有证据的基础上，对获得指南委员会共识的推荐疗法进行了更新。
方法：关于儿童OME的治疗，我们开发了临床问题（CQs）并检索了每个主题的文档，包括定义，疾病状态,诊断方法,和医疗。在以前的指南中，没有使用检索表达式来指定文献检索的时间段.相反，JOS2015指南增加了对2014年3月至2019年5月出版物的文献检索.对于CQ的发布，我们根据收集的证据制定了建议,并为其指定了优势.
结果：儿童的OME被分为一组缺乏患慢性或顽固性疾病的风险，另一组风险较高（例如，患有唐氏综合症的儿童，腭裂)，以及临床管理的建议，包括后续行动，提供。还提供了有关单侧OME儿童和难治性病例并发粘连性中耳炎的管理信息。
结论：在儿童OME的临床管理中，日本临床实践指南不仅建议管理OME本身的并发症，如中耳积液和鼓膜病理变化，以及与感染性或炎性疾病相关的周围器官的病理变化。
方法：关于儿童OME的治疗，我们开发了临床问题（CQs）并检索了每个主题的文档，包括定义，疾病状态,诊断方法,和医疗。在以前的指南中，没有使用检索表达式来指定文献检索的时间段.相反，JOS2015指南增加了对2014年3月至2019年5月出版物的文献检索.对于CQ的发布，我们根据收集的证据制定了建议,并为其指定了优势.
结果：儿童的OME被分为一组缺乏患慢性或顽固性疾病的风险，另一组风险较高（例如，患有唐氏综合症的儿童，腭裂)，以及临床管理的建议，包括后续行动，提供。还提供了有关单侧OME儿童和难治性病例并发粘连性中耳炎的管理信息。
结论：在儿童OME的临床管理中，日本临床实践指南不仅建议管理OME本身的并发症，如中耳积液和鼓膜病理变化，以及与感染性或炎性疾病相关的周围器官的病理变化。
