Otitis media - Knowledge

407: 1160: 963:(also called "grommets") are recommended with three or more episodes of acute otitis media in 6 months or four or more in a year, with at least one episode or more attacks in the preceding 6 months. There is tentative evidence that children with recurrent acute otitis media (AOM) who receive tubes have a modest improvement in the number of further AOM episodes (around one fewer episode at six months and less of an improvement at 12 months following the tubes being inserted). Evidence does not support an effect on long-term hearing or language development. A common complication of having a tympanostomy tube is otorrhea, which is a discharge from the ear. The risk of persistent 1275:. Aboriginal children experience middle ear disease for two and a half years on average during childhood compared with three months for non indigenous children. If untreated it can leave a permanent legacy of hearing loss. The higher incidence of deafness in turn contributes to poor social, educational and emotional outcomes for the children concerned. Such children as they grow into adults are also more likely to experience employment difficulties and find themselves caught up in the criminal justice system. Research in 2012 revealed that nine out of ten Aboriginal prison inmates in the 1058: 3423: 45: 597:

perforation, and attempts at repair with granulation tissue and polyps. This can worsen discharge and inflammation, potentially developing into CSOM, often associated with cholesteatoma. Symptoms may include ear discharge or pus seen only on examination. Hearing loss is common. Risk factors include poor eustachian tube function, recurrent ear infections, crowded living, daycare attendance, and certain craniofacial malformations.

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otitis media have more depression/anxiety-related disorders compared to individuals with normal hearing. Once the infections resolve and hearing thresholds return to normal, childhood otitis media may still cause minor and irreversible damage to the middle ear and cochlea. More research on the importance of screening all children under 4 years old for otitis media with effusion needs to be performed.

1223:. If there is enough, this drainage may be obvious. Even though the perforation of the tympanic membrane suggests a highly painful and traumatic process, it is almost always associated with a dramatic relief of pressure and pain. In a simple case of acute otitis media in an otherwise healthy person, the body's defenses are likely to resolve the 288:. In AOM, antibiotics may speed recovery but may result in side effects. Antibiotics are often recommended in those with severe disease or under two years old. In those with less severe disease they may only be recommended in those who do not improve after two or three days. The initial antibiotic of choice is typically 610:

In Britain, 0.9% of children and 0.5% of adults have CSOM, with no difference between the sexes. The incidence of CSOM across the world varies dramatically where high income countries have a relatively low prevalence while in low income countries the prevalence may be up to three times as great. Each

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This hearing loss is mainly due to fluid in the middle ear or rupture of the tympanic membrane. Prolonged duration of otitis media is associated with ossicular complications and, together with persistent tympanic membrane perforation, contributes to the severity of the disease and hearing loss. When

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Risk factors such as season, allergy predisposition and presence of older siblings are known to be determinants of recurrent otitis media and persistent middle-ear effusions (MEE). History of recurrence, environmental exposure to tobacco smoke, use of daycare, and lack of breastfeeding have all been

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in children appears to reduce rates of AOM by 4% and the use of antibiotics by 11% over 6 months. However, the vaccine resulted in increased adverse-effects such as fever and runny nose. The small reduction in AOM may not justify the side effects and inconvenience of influenza vaccination every year

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or another penicillin derivative plus beta lactamase inhibitor is recommended. Taking amoxicillin once a day may be as effective as twice or three times a day. While less than 7 days of antibiotics have fewer side effects, more than seven days appear to be more effective. If there is no improvement

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Worldwide AOM affects about 11% of people a year (about 325 to 710 million cases). Half the cases involve children less than five years of age and it is more common among males. Of those affected about 4.8% or 31 million develop chronic suppurative otitis media. The total number of people

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being Latin for "eardrum"). However, sometimes even examination of the eardrum may not be able to confirm the diagnosis, especially if the canal is small. If wax in the ear canal obscures a clear view of the eardrum it should be removed using a blunt cerumen curette or a wire loop. Also, an upset

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Acute otitis media in children with moderate to severe bulging of the tympanic membrane or new onset of otorrhea (drainage) is not due to external otitis. Also, the diagnosis may be made in children who have mild bulging of the ear drum and recent onset of ear pain (less than 48 hours) or intense

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contrasts. Australian Aboriginal languages thus seem to show similarities to the speech of people with hearing loss, and avoid those sounds and distinctions which are difficult for people with early childhood hearing loss to perceive. At the same time, Australian languages make full use of those

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Periods of conductive hearing loss from otitis media may have a detrimental effect on speech development in children. Some studies have linked otitis media to learning problems, attention disorders, and problems with social adaptation. Furthermore, it has been demonstrated that individuals with

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Chronic suppurative otitis media (CSOM) is a long-term middle ear inflammation causing persistent ear discharge due to a perforated eardrum. It often follows an unresolved upper respiratory infection leading to acute otitis media. Prolonged inflammation leads to middle ear swelling, ulceration,

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Topical antibiotics are of uncertain benefit as of 2020. Some evidence suggests that topical antibiotics may be useful either alone or with antibiotics by mouth. Antiseptics are of unclear effect. Topical antibiotics (quinolones) are probably better at resolving ear discharge than antiseptics.

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or tympanitis) have to be identified; signs of these are fullness, bulging, cloudiness and redness of the eardrum. It is important to attempt to differentiate between acute otitis media and otitis media with effusion (OME), as antibiotics are not recommended for OME. It has been suggested that

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Acute otitis media is very common in childhood. It is the most common condition for which medical care is provided in children under five years of age in the US. Acute otitis media affects 11% of people each year (709 million cases) with half occurring in those below five years. Chronic

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Oral antibiotics should not be used to treat uncomplicated acute tympanostomy tube otorrhea. They are not sufficient for the bacteria that cause this condition and have side effects including increased risk of opportunistic infection. In contrast, topical antibiotic eardrops are useful.

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For bilateral acute otitis media in infants younger than 24 months, there is evidence that the benefits of antibiotics outweigh the harms. A 2015 Cochrane review concluded that watchful waiting is the preferred approach for children over six months with non severe acute otitis media.

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and the ear drum nearly always heals. An option for severe acute otitis media in which analgesics are not controlling ear pain is to perform a tympanocentesis, i.e., needle aspiration through the tympanic membrane to relieve the ear pain and to identify the causative organism(s).

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AOM is far less common in breastfed infants than in formula-fed infants, and the greatest protection is associated with exclusive breastfeeding (no formula use) for the first six months of life. A longer duration of breastfeeding is correlated with a longer protective effect.

190:), typically not associated with symptoms, although occasionally a feeling of fullness is described; it is defined as the presence of non-infectious fluid in the middle ear which may persist for weeks or months often after an episode of acute otitis media. 198:) is middle ear inflammation that results in a perforated tympanic membrane with discharge from the ear for more than six weeks. It may be a complication of acute otitis media. Pain is rarely present. All three types of otitis media may be associated with 2953:

Owen MJ, Baldwin CD, Swank PR, Pannu AK, Johnson DL, Howie VM (November 1993). "Relation of infant feeding practices, cigarette smoke exposure, and group child care to the onset and duration of otitis media with effusion in the first two years of life".

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suppurative otitis media affects about 5% or 31 million of these cases with 22.6% of cases occurring annually under the age of five years. Otitis media resulted in 2,400 deaths in 2013 – down from 4,900 deaths in 1990.

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distinctions, namely place of articulation distinctions, which people with otitis media-caused hearing loss can perceive more easily. This hypothesis has been challenged on historical, comparative, statistical, and medical grounds.

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may be due to the very high presence of otitis media ear infections and resulting hearing loss in their populations. People with hearing loss often have trouble distinguishing different vowels and hearing fricatives and

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As its typical symptoms overlap with other conditions, such as acute external otitis, symptoms alone are not sufficient to predict whether acute otitis media is present; it has to be complemented by visualization of the

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Use of antibiotics for acute otitis media has benefits and harms. As over 82% of acute episodes settle without treatment, about 20 children must be treated to prevent one case of ear pain, 33 children to prevent one

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due to negative pressure produced by dysfunction of the Eustachian tube. This can be associated with a viral upper respiratory infection (URI) or bacterial infection such as otitis media. An effusion can cause

588:, and greater amounts of time spent in group child care, particularly those with a large number of children. These risk factors increase the incidence and duration of OME during the first two years of life. 1655:"Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015" 304:

with CSOM is estimated at 65–330 million people. Before the age of ten OME affects about 80% of children at some point. Otitis media resulted in 3,200 deaths in 2015 – down from 4,900 deaths in 1990.

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Discharge from the ear can be caused by acute otitis media with perforation of the eardrum, chronic suppurative otitis media, tympanostomy tube otorrhea, or acute otitis externa. Trauma, such as a

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called the Galbreath technique was evaluated in one randomized controlled clinical trial; one reviewer concluded that it was promising, but a 2010 evidence report found the evidence inconclusive.

1603:"Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015" 1006:

and decongestants in children with OME. In less severe cases or those without significant hearing impairment, the effusion can resolve spontaneously or with more conservative measures such as

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Antibiotics causes little or no reduction to the chance of experiencing the outcome when compared with placebo for acute otitis media in children. Data are based on high quality evidence.

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Antibiotics causes little or no reduction to the chance of experiencing the outcome when compared with placebo for acute otitis media in children. Data are based on high quality evidence.

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may relieve pain, if present. For people requiring surgery to treat otitis media with effusion, preventative antibiotics may not help reduce the risk of post-surgical complications.

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after 2–3 days of treatment a change in therapy may be considered. Azithromycin appears to have less side effects than either high dose amoxicillin or amoxicillin/clavulanate.

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for this purpose alone. PCV does not appear to decrease the risk of otitis media when given to high-risk infants or for older children who have previously experienced otitis media.

607:, CSOM is a primary cause of hearing loss in children. Adults with recurrent episodes of CSOM have a higher risk of developing permanent conductive and sensorineural hearing loss. 1885: 2489:

Patel MM, Eisenberg L, Witsell D, Schulz KA (October 2008). "Assessment of acute otitis externa and otitis media with effusion performance measures in otolaryngology practices".

718:. A 2023 review found evidence for the effectiveness of single or combinations of oral pain relief in acute otitis media is lacking. Topical agents shown to be effective include 642:(PCV) in early infancy decrease the risk of acute otitis media in healthy infants. PCV is recommended for all children, and, if implemented broadly, PCV would have a significant 4246:

Browning GG, Rovers MM, Williamson I, Lous J, Burton MJ (October 2010). "Grommets (ventilation tubes) for hearing loss associated with otitis media with effusion in children".

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Antibiotics probably reduces the chance of experiencing the outcome when compared with placebo for acute otitis media in children. Data are based on moderate quality evidence.

1244:. Globally approximately 141 million people have mild hearing loss due to otitis media (2.1% of the population). This is more common in males (2.3%) than females (1.8%). 5385:

Gouma P, Mallis A, Daniilidis V, Gouveris H, Armenakis N, Naxakis S (January 2011). "Behavioral trends in young children with conductive hearing loss: a case-control study".

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Antibiotics slightly increases the chance of experiencing the outcome when compared with placebo for acute otitis media in children. Data are based on high quality evidence.

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Antibiotics slightly reduces the chance of experiencing the outcome when compared with placebo for acute otitis media in children. Data are based on high quality evidence.

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Antibiotics slightly reduces the chance of experiencing the outcome when compared with placebo for acute otitis media in children. Data are based on high quality evidence.

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Antibiotics slightly reduces the chance of experiencing the outcome when compared with placebo for acute otitis media in children. Data are based on high quality evidence.

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in children resolve without treatment in three days and 90% resolve in seven or eight days. The use of steroids is not supported by the evidence for acute otitis media.

747:, and 11 children to prevent one opposite-side ear infection. For every 14 children treated with antibiotics, one child has an episode of vomiting, diarrhea or a rash. 548:(OME), also known as serous otitis media (SOM) or secretory otitis media (SOM), and colloquially referred to as 'glue ear,' is fluid accumulation that can occur in the 178:

of rapid onset that usually presents with ear pain. In young children this may result in pulling at the ear, increased crying, and poor sleep. Decreased eating and a

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Children with recurrent episodes of acute otitis media and those with otitis media with effusion or chronic suppurative otitis media have higher risks of developing

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young child's crying can cause the eardrum to look inflamed due to distension of the small blood vessels on it, mimicking the redness associated with otitis media.

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Benninger MS (March 2008). "Acute bacterial rhinosinusitis and otitis media: changes in pathogenicity following widespread use of pneumococcal conjugate vaccine".

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By reflux or aspiration of unwanted secretions from the nasopharynx into the normally sterile middle-ear space, the fluid may then become infected – usually with

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Roberts K (June 1997). "A preliminary account of the effect of otitis media on 15-month-olds' categorization and some implications for early language learning".

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Jacobs J, Springer DA, Crothers D (February 2001). "Homeopathic treatment of acute otitis media in children: a preliminary randomized placebo-controlled trial".

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Bidadi S, Nejadkazem M, Naderpour M (November 2008). "The relationship between chronic otitis media-induced hearing loss and the acquisition of social skills".

5098:"Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010" 4444:

Wallace IF, Berkman ND, Lohr KN, Harrison MF, Kimple AJ, Steiner MJ (February 2014). "Surgical treatments for otitis media with effusion: a systematic review".

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Hum SW, Shaikh KJ, Musa SS, Shaikh N (December 2019). "Adverse Events of Antibiotics Used to Treat Acute Otitis Media in Children: A Systematic Meta-Analysis".

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Laine MK, Tähtinen PA, Ruuskanen O, Huovinen P, Ruohola A (May 2010). "Symptoms or symptom-based scores cannot predict acute otitis media at otitis-prone age".

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Shaikh N, Hoberman A, Kaleida PH, Ploof DL, Paradise JL (May 2010). "Videos in clinical medicine. Diagnosing otitis media – otoscopy and cerumen removal".

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Vos T, Allen C, Arora M, Barber RM, Bhutta ZA, Brown A, et al. (GBD 2015 Disease and Injury Incidence and Prevalence Collaborators) (October 2016).

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Pukander J, Luotonen J, Timonen M, Karma P (1985). "Risk factors affecting the occurrence of acute otitis media among 2–3-year-old urban children".

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associated with increased risk of development, recurrence, and persistent MEE. Pacifier use has been associated with more frequent episodes of AOM.

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Worldwide approximately 11% of the human population is affected by AOM every year, or 709 million cases. About 4.4% of the population develop CSOM.

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Vos T, Barber RM, Bell B, Bertozzi-Villa A, Biryukov S, Bolliger I, et al. (Global Burden of Disease Study 2013 Collaborators) (August 2015).

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after children have grommets inserted may be low. It is still uncertain whether or not grommets are more effective than a course of antibiotics.

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Most children older than 6 months of age who have acute otitis media do not benefit from treatment with antibiotics. If antibiotics are used, a

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bulging of the tympanic membrane is the best sign to differentiate AOM from OME, with a bulging of the membrane suggesting AOM rather than OME.

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Butcher AR (2018). "The special nature of Australian phonologies: Why auditory constraints on human language sound systems are not universal".

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Wang H, Naghavi M, Allen C, Barber RM, Bhutta ZA, Carter A, et al. (GBD 2015 Mortality and Causes of Death Collaborators) (October 2016).

1503: 5479: 3800: 3536:"Paracetamol (acetaminophen) or non-steroidal anti-inflammatory drugs, alone or combined, for pain relief in acute otitis media in children" 1774: 5428:

Yilmaz S, Karasalihoglu AR, Tas A, Yagiz R, Tas M (February 2006). "Otoacoustic emissions in young adults with a history of otitis media".

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Coon ER, Quinonez RA, Morgan DJ, Dhruva SS, Ho T, Money N, et al. (April 2019). "2018 Update on Pediatric Medical Overuse: A Review".

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a cholesteatoma or granulation tissue is present in the middle ear, the degree of hearing loss and ossicular destruction is even greater.

6209: 3752:"No evidence for the effectiveness of systemic corticosteroids in acute pharyngitis, community-acquired pneumonia and acute otitis media" 1877: 5803: 4629:

Blanshard JD, Maw AR, Bawden R (June 1993). "Conservative treatment of otitis media with effusion by autoinflation of the middle ear".

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The decision to treat is usually made after a combination of physical exam and laboratory diagnosis, with additional testing including

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Jung TT, Alper CM, Hellstrom SO, Hunter LL, Casselbrant ML, Groth A, et al. (April 2013). "Panel 8: Complications and sequelae".

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Acuin J, WHO Dept. of Child and Adolescent Health and Development, WHO Programme for the Prevention of Blindness and Deafness (2004).

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Long-term antibiotics, while they decrease rates of infection during treatment, have an unknown effect on long-term outcomes such as

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van den Aardweg MT, Schilder AG, Herkert E, Boonacker CW, Rovers MM (January 2010). "Adenoidectomy for otitis media in children".

245:. Looking at the eardrum is important for making the correct diagnosis. Signs of AOM include bulging or a lack of movement of the 1806: 4296: 1038: 4423: 4006:"Once or twice daily versus three times daily amoxicillin with or without clavulanate for the treatment of acute otitis media" 423:

with a rubber bulb attached to assess the mobility of the tympanic membrane. Other methods to diagnose otitis media is with a

328:, reduced hearing during periods of illness, tenderness on touch of the skin above the ear, purulent discharge from the ears, 6001: 5796: 3039: 3011: 2931: 2808: 2363: 2338: 2311: 2270: 730:, either nasal or oral, are not recommended due to the lack of benefit and concerns regarding side effects. Half of cases of 1187:

Complications of acute otitis media consists of perforation of the ear drum, infection of the mastoid space behind the ear (

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Head K, Chong LY, Bhutta MF, Morris PS, Vijayasekaran S, Burton MJ, et al. (January 2020). Cochrane ENT Group (ed.).

998:. Decongestants, glucocorticoids, and topical antibiotics are generally not effective as treatment for non-infectious, or 484:

erythema (redness) of the ear drum. To confirm the diagnosis, middle-ear effusion and inflammation of the eardrum (called

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da Costa SS, Rosito LP, Dornelles C (February 2009). "Sensorineural hearing loss in patients with chronic otitis media".

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Brennan-Jones CG, Head K, Chong LY, Burton MJ, Schilder AG, Bhutta MF, et al. (Cochrane ENT Group) (January 2020).

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Coleman C, Moore M (July 2008). Coleman C (ed.). "Decongestants and antihistamines for acute otitis media in children".

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Sattout A (February 2008). "Best evidence topic reports. Bet 1. The role of topical analgesia in acute otitis media".

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Head K, Chong LY, Bhutta MF, Morris PS, Vijayasekaran S, Burton MJ, et al. (Cochrane ENT Group) (January 2020).

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Rosenfeld RM, Culpepper L, Yawn B, Mahoney MC (June 2004). "Otitis media with effusion clinical practice guideline".

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as it shows a significant benefit as far as the resolution of middle ear effusion in children with OME is concerned.

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Roberts DB (April 1980). "The etiology of bullous myringitis and the role of mycoplasmas in ear disease: a review".

1833:"Diagnosis, microbial epidemiology, and antibiotic treatment of acute otitis media in children: a systematic review" 332:, ear blocking sensation and diarrhea (in infants). Since an episode of otitis media is usually precipitated by an 1288: 3865:

Venekamp RP, Sanders SL, Glasziou PP, Rovers MM (2023-11-15). "Antibiotics for acute otitis media in children".

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Venekamp RP, Sanders SL, Glasziou PP, Rovers MM (2023-11-15). "Antibiotics for acute otitis media in children".

5471: 5238:"Identification of children in the first four years of life for early treatment for otitis media with effusion" 1272: 639: 1212: 1061: 964: 663: 5287:"Topical antibiotics without steroids for chronically discharging ears with underlying eardrum perforations" 1159: 355:(discharge of CSF from the ear) due to cerebral spinal drainage from the brain and its covering (meninges). 6224: 4928: 620: 5875: 2330:

Nelson Textbook of Pediatrics E-Book: Expert Consult Premium Edition - Enhanced Online Features and Print

4582:"Oral or topical nasal steroids for hearing loss associated with otitis media with effusion in children" 2262:

Fast Facts Handbook for Pediatric Primary Care: A Guide for Nurse Practitioners and Physician Assistants

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Lieberthal AS, Carroll AE, Chonmaitree T, Ganiats TG, Hoberman A, Jackson MA, et al. (March 2013).

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Ranakusuma RW, Pitoyo Y, Safitri ED, Thorning S, Beller EM, Sastroasmoro S, et al. (March 2018).

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Schilder AG, Chonmaitree T, Cripps AW, Rosenfeld RM, Casselbrant ML, Haggard MP, et al. (2016).

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treatments have not been proven to be effective for acute otitis media in a study with children. An

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de Sévaux J, Damoiseaux RA, van de Pol AC, Lutje V, Hay AD, Little P, et al. (18 August 2023).

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Fortanier AC, Venekamp RP, Boonacker CW, Hak E, Schilder AG, Sanders EA, et al. (28 May 2019).

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Simpson SA, Thomas CL, van der Linden MK, Macmillan H, van der Wouden JC, Butler C (January 2007).

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Rosenfeld RM, Schwartz SR, Pynnonen MA, Tunkel DE, Hussey HM, Fichera JS, et al. (July 2013).

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Rosenfeld RM, Schwartz SR, Pynnonen MA, Tunkel DE, Hussey HM, Fichera JS, et al. (July 2013).

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Viral otitis may result in blisters on the external side of the tympanic membrane, which is called

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Rosenfeld RM, Shin JJ, Schwartz SR, Coggins R, Gagnon L, Hackell JM, et al. (February 2016).

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Coker TR, Chan LS, Newberry SJ, Limbos MA, Suttorp MJ, Shekelle PG, et al. (November 2010).

1746: 1268: 1237: 566: 558: 5603:"AAP, AAFP, AAO-HNS release guideline on diagnosis and management of otitis media with effusion" 2867: 394:. The virus that caused the initial upper respiratory infection can itself be identified as the 2025:

Monasta L, Ronfani L, Marchetti F, Montico M, Vecchi Brumatti L, Bavcar A, et al. (2012).

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Venekamp RP, Burton MJ, van Dongen TM, van der Heijden GJ, van Zon A, Schilder AG (June 2016).

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Early-onset OME is associated with feeding of infants while lying down, early entry into group

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Kline MW, Blaney SM, Giardino AP, Orange JS, Penny DJ, Schutze GE, et al. (2018-08-21).

2226: 1284: 1264: 944: 532: 525: 217:. Either bacteria or viruses may be involved. Risk factors include exposure to smoke, use of 410:

Perforation of the right tympanic membrane resulting from previous severe acute otitis media

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is not recommended for otitis media with effusion because there is no evidence of benefit.

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Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, et al. (December 2012).

3333:"Antibiotics for the prevention of acute and chronic suppurative otitis media in children" 2890: 2698: 2139: 1057: 8: 6214: 5892: 5666: 1203:. It is estimated that each year 21,000 people die due to complications of otitis media. 66: 4688: 4665: 4030: 4005: 3560: 3535: 3357: 3332: 2385: 2042: 6219: 6079: 5961: 5914: 5788: 5671: 5453: 5410: 5367: 5319: 5286: 5262: 5237: 5180: 5122: 5097: 5075: 5027: 5000: 4956: 4869: 4844: 4820: 4795: 4771: 4746: 4642: 4606: 4581: 4557: 4532: 4469: 4415: 4267: 4176: 4151: 4127: 4079: 4054: 3986: 3938: 3913: 3828: 3776: 3751: 3727: 3702: 3683: 3675: 3608: 3511: 3486: 3462: 3437: 3406: 3381: 3290:

Rovers MM, Numans ME, Langenbach E, Grobbee DE, Verheij TJ, Schilder AG (August 2008).

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are the mainstay for the treatment of pain caused by otitis media. Oral agents include

496: 293: 73: 5695: 5691: 5687: 5683: 5679: 5675: 5113: 4533:"Antihistamines and/or decongestants for otitis media with effusion (OME) in children" 3485:

Scott AM, Clark J, Julien B, Islam F, Roos K, Grimwood K, et al. (18 June 2019).

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supplementation as an effort to reduce otitis rates except maybe in those with severe

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may increase resolution of symptoms, but may cause diarrhoea, vomiting and skin rash.

5716: 5614: 5445: 5402: 5359: 5324: 5306: 5267: 5215: 5172: 5127: 5079: 5067: 5032: 4960: 4948: 4909: 4905: 4874: 4825: 4776: 4724: 4693: 4646: 4611: 4562: 4510: 4461: 4407: 4359: 4259: 4225: 4181: 4131: 4119: 4084: 4035: 3978: 3974: 3943: 3894: 3882: 3833: 3781: 3732: 3703:"Duration of symptoms of respiratory tract infections in children: systematic review" 3658: 3639: 3600: 3565: 3516: 3467: 3411: 3362: 3313: 3264: 3229: 3186: 3151: 3097: 3079: 3035: 3007: 2971: 2909: 2853: 2841: 2804: 2771: 2721: 2630: 2612: 2573: 2555: 2506: 2471: 2428: 2359: 2334: 2307: 2266: 2214: 2151: 2120: 2066: 1992: 1943: 1931: 1854: 1766: 1719: 1684: 1632: 1583: 1470: 1414: 1293: 1011: 960: 647: 553: 473: 416: 261: 246: 61: 53: 5756: 5699: 5457: 5414: 5371: 4419: 4291: 4271: 3990: 3612: 3198: 2783: 2518: 2182: 1731: 6229: 6132: 6094: 5919: 5580: 5437: 5394: 5351: 5314: 5302: 5298: 5257: 5253: 5249: 5207: 5184: 5162: 5154: 5117: 5109: 5059: 5022: 5012: 4940: 4901: 4864: 4860: 4856: 4815: 4811: 4807: 4766: 4762: 4758: 4720: 4716: 4683: 4678: 4673: 4638: 4601: 4597: 4593: 4552: 4548: 4544: 4500: 4473: 4453: 4397: 4385: 4349: 4255: 4251: 4215: 4171: 4167: 4163: 4111: 4074: 4070: 4066: 4025: 4021: 4017: 3970: 3933: 3929: 3925: 3890: 3878: 3874: 3823: 3819: 3815: 3771: 3763: 3722: 3714: 3654: 3650: 3635: 3631: 3592: 3555: 3551: 3547: 3506: 3502: 3498: 3457: 3453: 3449: 3401: 3397: 3393: 3352: 3348: 3344: 3303: 3276: 3256: 3221: 3178: 3169:

Rovers MM, Schilder AG, Zielhuis GA, Rosenfeld RM (February 2004). "Otitis media".

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suffer from significant hearing loss. Andrew Butcher speculates that the lack of

364: 341: 44: 4115: 2996:

Chronic suppurative otitis media : burden of illness and management options

86:

Acute otitis media, otitis media with effusion, chronic suppurative otitis media

6183: 5842: 5776: 5721: 5602: 3060:"Pneumococcal conjugate vaccines for preventing acute otitis media in children" 2717: 1715: 250: 5772: 5768: 5764: 5760: 5441: 5398: 5158: 3767: 3292:"Is pacifier use a risk factor for acute otitis media? A dynamic cohort study" 3225: 3122:"Influenza vaccines for preventing acute otitis media in infants and children" 662:. This method of prevention has been associated with emergence of undesirable 6198: 6137: 5870: 5310: 5063: 4845:"Antibiotics versus topical antiseptics for chronic suppurative otitis media" 4505: 4488: 4402: 4354: 4337: 3886: 3382:"Xylitol for preventing acute otitis media in children up to 12 years of age" 3083: 2616: 2559: 2155: 1935: 1314: 1196: 1018: 1007: 1003: 988: 917: 893: 874: 850: 831: 812: 793: 727: 723: 643: 585: 469: 447: 428: 265: 234: 214: 203: 5656: 5652: 5472:"Damien Howard & Dianne Hampton, "Ear disease and Aboriginal families," 3596: 3308: 3291: 6026: 5966: 5940: 5618: 5449: 5406: 5363: 5328: 5271: 5211: 5176: 5131: 5071: 5036: 5017: 4952: 4913: 4878: 4829: 4780: 4728: 4697: 4666:"Autoinflation for hearing loss associated with otitis media with effusion" 4615: 4566: 4514: 4465: 4457: 4411: 4363: 4263: 4229: 4220: 4203: 4202:

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largely due to the massive incidence of middle ear disease among the young

948: 681: 659: 623:

becomes sucked into the middle-ear space and stuck (i.e., adherent) to the

424: 380: 329: 199: 159: 5219: 4929:"Galbreath technique: a manipulative treatment for otitis media revisited" 4650: 3672:. If this is an intentional citation to a retracted paper, please replace 3268: 3233: 2975: 2775: 2767: 6152: 6109: 6036: 6031: 6010: 5887: 5819: 5740: 4664:

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In more severe cases, such as those with associated hearing loss or high

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may decrease recurrence. In children with otitis media with effusion

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The common cause of all forms of otitis media is dysfunction of the

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Lend Me Your Ears: Otitis Media and Aboriginal Australian languages

3756:

European Journal of Clinical Microbiology & Infectious Diseases

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do not show evidence of preventing acute otitis media in children.

685: 562: 545: 420: 395: 391: 4386:"Clinical Practice Guideline: Otitis Media with Effusion (Update)" 3533: 2697:

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Ear Health 101: The Complete Guide to Understanding Ear Infections

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may reduce infection rates in healthy children who go to daycare.

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The most common bacteria isolated from the middle ear in AOM are

465: 450: 384: 321: 285: 256:

A number of measures decrease the risk of otitis media including

210: 2696: 1558:

GMS Current Topics in Otorhinolaryngology, Head and Neck Surgery

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year 21,000 people worldwide die due to complications of CSOM.

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Principi N, Bianchini S, Baggi E, Esposito S (February 2013).

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Simpson SA, Lewis R, van der Voort J, Butler CC (May 2011).

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can be used to assess for associated complications, such as

237:. OME frequently occurs following AOM and may be related to 5427: 5001:"Effectiveness of manual therapies: the UK evidence report" 3700: 2488: 2088: 1436: 677: 4998: 4796:"Topical antiseptics for chronic suppurative otitis media" 4747:"Topical antibiotics for chronic suppurative otitis media" 4443: 3487:"Probiotics for preventing acute otitis media in children" 2453: 2356:

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American Academy of Otolaryngology–Head and Neck Surgery

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American Academy of Otolaryngology–Head and Neck Surgery

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In severe or untreated cases, the tympanic membrane may

943:

may be associated with more adverse events. If there is

561:

if it interferes with the transmission of vibrations of

202:. If children with hearing loss due to OME do not learn 5144: 5095: 4150:

Venekamp RP, Mick P, Schilder AG, Nunez DA (May 2018).

3379: 2326: 1830: 1064:

for otitis media per 100,000 inhabitants in 2004.

4891: 1751:

International Journal of Pediatric Otorhinolaryngology

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Deaths from otitis media per million persons in 2012

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There is moderate evidence that the sugar substitute

336:(URTI), there are often accompanying symptoms like a 5625: 5284: 4201: 3331:

Leach AJ, Morris PS (October 2006). Leach AJ (ed.).

1393:"The diagnosis and management of acute otitis media" 5523: 4933:

The Journal of the American Osteopathic Association

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Hamilton, London: BC Decker. pp. 1–219. 974: 947:or use of amoxicillin in the last 30 days then 3438:"Zinc supplements for preventing otitis media" 3120:Norhayati MN, Ho JJ, Azman MY (October 2017). 5995: 5804: 5474:Aboriginal and Islander Health Worker Journal 5086: 4984:: CS1 maint: DOI inactive as of March 2024 ( 4372: 3435: 1744: 539: 367:. This is usually due to inflammation of the 320:The primary symptom of acute otitis media is 38:: serous otitis media, secretory otitis media 4530: 4138: 3625: 3020: 2285:: CS1 maint: multiple names: authors list ( 2084: 2082: 2080: 1551: 1490: 1488: 1486: 1484: 1386: 1384: 1382: 1380: 1378: 1376: 1374: 1372: 1370: 1368: 1366: 1364: 1362: 1360: 1358: 182:may also be present. The other main type is 5291:The Cochrane Database of Systematic Reviews 5242:The Cochrane Database of Systematic Reviews 4849:The Cochrane Database of Systematic Reviews 4800:The Cochrane Database of Systematic Reviews 4751:The Cochrane Database of Systematic Reviews 4713:The Cochrane Database of Systematic Reviews 4670:The Cochrane Database of Systematic Reviews 4631:Clinical Otolaryngology and Allied Sciences 4586:The Cochrane Database of Systematic Reviews 4537:The Cochrane Database of Systematic Reviews 4248:The Cochrane Database of Systematic Reviews 4156:The Cochrane Database of Systematic Reviews 4059:The Cochrane Database of Systematic Reviews 4010:The Cochrane Database of Systematic Reviews 3918:The Cochrane Database of Systematic Reviews 3867:The Cochrane Database of Systematic Reviews 3808:The Cochrane Database of Systematic Reviews 3628:The Cochrane Database of Systematic Reviews 3540:The Cochrane Database of Systematic Reviews 3442:The Cochrane Database of Systematic Reviews 3386:The Cochrane Database of Systematic Reviews 3337:The Cochrane Database of Systematic Reviews 3330: 3126:The Cochrane Database of Systematic Reviews 3064:The Cochrane Database of Systematic Reviews 2265:. Springer Publishing Company. p. 28. 1967:The Cochrane Database of Systematic Reviews 1916:The Cochrane Database of Systematic Reviews 1872: 1870: 1868: 1648: 1646: 1356: 1354: 1352: 1350: 1348: 1346: 1344: 1342: 1340: 1338: 6002: 5988: 5811: 5797: 5387:European Archives of Oto-Rhino-Laryngology 5147:European Archives of Oto-Rhino-Laryngology 4740: 4738: 4287: 4285: 4283: 4281: 3686:|...|intentional=yes}} 3115: 3113: 3111: 2653:Viêm tai giữa - Tất cả những điều cần biết 2020: 2018: 2016: 2014: 2012: 2010: 2008: 2006: 1547: 1545: 1543: 1541: 1219:in the middle-ear space to drain into the 43: 5584: 5318: 5261: 5166: 5121: 5026: 5016: 4868: 4819: 4770: 4687: 4677: 4605: 4556: 4504: 4401: 4353: 4219: 4197: 4195: 4175: 4078: 4029: 3937: 3827: 3775: 3726: 3582: 3559: 3510: 3461: 3405: 3356: 3307: 3145: 3091: 2823: 2624: 2567: 2549: 2353: 2208: 2178: 2176: 2114: 2077: 2060: 2050: 1986: 1848: 1824: 1678: 1626: 1594: 1577: 1554:"Diseases of the middle ear in childhood" 1539: 1537: 1535: 1533: 1531: 1529: 1527: 1525: 1523: 1521: 1481: 1464: 1454: 1408: 619:Adhesive otitis media occurs when a thin 268:, and avoiding tobacco smoke. The use of 209:The cause of AOM is related to childhood 4894:The Pediatric Infectious Disease Journal 3029: 2989: 2987: 2985: 2258: 2244:CS1 maint: numeric names: authors list ( 1865: 1643: 1432: 1430: 1428: 1335: 1158: 1056: 614: 405: 311: 206:, it may affect their ability to learn. 5574: 5529: 5197: 4735: 4278: 3491:Cochrane Database of Systematic Reviews 3108: 2753: 2671: 2137: 2003: 1033: 272:for AOM is important. This may include 6197: 5541: 5430:The Journal of Laryngology and Otology 4531:Griffin G, Flynn CA (September 2011). 4192: 2173: 1888:from the original on 10 September 2015 1745:Ruben RJ, Schwartz R (February 1999). 1518: 1039:Complementary and alternative medicine 5983: 5792: 5511:from the original on 6 September 2023 5231: 5229: 4241: 4239: 3246: 3053: 3051: 2998:. Geneve: World Health Organization. 2982: 2934:from the original on 17 February 2017 2930:. U.S. National Library of Medicine. 2878:from the original on 13 November 2012 2735:from the original on October 26, 2020 2383: 1909: 1907: 1905: 1903: 1695: 1506:from the original on 19 February 2015 1425: 508: 307: 5600: 5577:Proceedings of Meetings on Acoustics 5344:Otolaryngology–Head and Neck Surgery 5052:Otolaryngology–Head and Neck Surgery 4493:Otolaryngology–Head and Neck Surgery 4390:Otolaryngology–Head and Neck Surgery 4342:Otolaryngology–Head and Neck Surgery 2826:Otolaryngology–Head and Neck Surgery 2491:Otolaryngology–Head and Neck Surgery 2299: 1704:The Medical Clinics of North America 1066: 955: 664:antibiotic-resistant otitic bacteria 292:. In those with frequent infections 4927:Pratt-Harrington D (October 2000). 2456:The New England Journal of Medicine 1317:for "inflammation of the ear", and 1206: 720:antipyrine and benzocaine ear drops 627:and other bones of the middle ear. 13: 6210:Diseases of middle ear and mastoid 5226: 4643:10.1111/j.1365-2273.1993.tb00827.x 4236: 3436:Gulani A, Sachdev HS (June 2014). 3048: 2800:Rudolph's Pediatrics, 23rd Edition 2747: 2392:from the original on 28 March 2013 2140:"Chronic suppurative otitis media" 1900: 1047:osteopathic manipulation technique 324:; other possible symptoms include 239:viral upper respiratory infections 14: 6241: 5594: 4323:from the original on May 13, 2015 377:upper respiratory tract infection 375:, which can be caused by a viral 334:upper respiratory tract infection 4906:10.1097/00006454-200102000-00012 3975:10.1001/jamapediatrics.2018.5550 3421: 1025:Chronic suppurative otitis media 592:Chronic suppurative otitis media 584:, lack or too short a period of 419:. Examiners may use a pneumatic 225:. It occurs more commonly among 192:Chronic suppurative otitis media 6009: 5558:from the original on 2023-10-10 5535: 5493: 5482:from the original on 2023-10-16 5476:, July-August 2006, 30 (4) p.9" 5464: 5421: 5378: 5335: 5278: 5191: 5138: 5043: 4992: 4967:from the original on 2023-05-24 4920: 4885: 4836: 4787: 4704: 4657: 4622: 4573: 4480: 4437: 4426:from the original on 2019-03-06 4095: 4046: 3997: 3954: 3905: 3858: 3847:from the original on 2020-10-30 3792: 3743: 3694: 3619: 3576: 3527: 3478: 3429: 3373: 3324: 3283: 3162: 2946: 2920: 2860: 2817: 2790: 2665: 2641: 2597:Nature Reviews. Disease Primers 2584: 2525: 2482: 2447: 2404: 2347: 2320: 2293: 2252: 2162:from the original on 2020-10-20 2131: 1954: 1777:from the original on 2018-06-14 1255: 1231: 1014:can be inserted, possibly with 640:Pneumococcal conjugate vaccines 567:vestibulocochlear nerve complex 166:. One of the two main types is 5303:10.1002/14651858.CD004618.pub2 5254:10.1002/14651858.CD004163.pub2 4861:10.1002/14651858.CD013056.pub2 4812:10.1002/14651858.CD013055.pub2 4763:10.1002/14651858.CD013051.pub2 4721:10.1002/14651858.CD007810.pub2 4679:10.1002/14651858.CD006285.pub2 4598:10.1002/14651858.CD001935.pub3 4549:10.1002/14651858.CD003423.pub3 4256:10.1002/14651858.CD001801.pub3 4168:10.1002/14651858.CD012017.pub2 4071:10.1002/14651858.CD001095.pub2 4022:10.1002/14651858.CD004975.pub3 3930:10.1002/14651858.CD003996.pub2 3879:10.1002/14651858.CD000219.pub5 3820:10.1002/14651858.CD012289.pub2 3655:10.1002/14651858.CD001727.pub5 3636:10.1002/14651858.CD001727.pub4 3552:10.1002/14651858.CD011534.pub3 3503:10.1002/14651858.CD012941.pub2 3454:10.1002/14651858.CD006639.pub4 3398:10.1002/14651858.CD007095.pub3 3349:10.1002/14651858.CD004401.pub2 3138:10.1002/14651858.CD010089.pub3 3076:10.1002/14651858.CD001480.pub5 1979:10.1002/14651858.CD009163.pub3 1928:10.1002/14651858.CD000219.pub5 1788: 1738: 737: 253:also indicates the diagnosis. 241:, irritants such as smoke, or 16:Inflammation of the middle ear 1: 5114:10.1016/S0140-6736(12)61729-2 5005:Chiropractic & Osteopathy 3183:10.1016/S0140-6736(04)15495-0 2968:10.1016/S0022-3476(05)80843-1 2201:10.1016/S0140-6736(14)61682-2 2107:10.1016/s0140-6736(15)60692-4 1763:10.1016/S0165-5876(98)00132-3 1671:10.1016/s0140-6736(16)31012-1 1619:10.1016/S0140-6736(16)31678-6 1443:Infection and Drug Resistance 1328: 1062:Disability-adjusted life year 965:tympanic membrane perforation 939:is generally recommended, as 697: 630: 78:Ear pain, fever, hearing loss 5356:10.1016/j.otohns.2008.08.004 4945:10.7556/jaoa.2000.100.10.635 2838:10.1016/j.otohns.2007.11.011 2803:. McGraw Hill Professional. 2503:10.1016/j.otohns.2008.07.030 2333:. Elsevier Health Sciences. 2144:Continuing Medical Education 2052:10.1371/journal.pone.0036226 1300: 401: 353:cerebrospinal fluid otorrhea 7: 5876:Eustachian tube dysfunction 4116:10.1016/j.jpeds.2019.08.043 2649:"PGS.TS.TTƯT Lê Lương Đống" 1552:Minovi A, Dazert S (2014). 1267:experience a high level of 1052: 10: 6246: 3585:Emergency Medicine Journal 2718:10.1016/j.acap.2012.01.007 1716:10.1016/j.mcna.2018.06.008 1242:sensorineural hearing loss 975:Otitis media with effusion 941:broad-spectrum antibiotics 933:narrow-spectrum antibiotic 676:Evidence does not support 540:Otitis media with effusion 184:otitis media with effusion 112:Vaccination, breastfeeding 36:Otitis media with effusion 6176: 6123: 6050: 6017: 5949: 5928: 5856: 5833: 5731: 5629: 5607:American Family Physician 5442:10.1017/S0022215105004871 5399:10.1007/s00405-010-1346-4 5159:10.1007/s00405-008-0739-0 4104:The Journal of Pediatrics 3768:10.1007/s10096-012-1747-y 3226:10.3109/00016488509104788 2956:The Journal of Pediatrics 2902:American Family Physician 1273:in Aboriginal communities 905: 862: 781: 776: 773: 770: 767: 605:World Health Organization 358: 145: 137: 116: 108: 98: 90: 82: 72: 60: 51: 42: 31: 26: 5881:Patulous Eustachian tube 5064:10.1177/0194599812467425 4506:10.1177/0194599813487302 4403:10.1177/0194599815623467 4355:10.1177/0194599813487302 2874:. Department of Health. 2708:(Submitted manuscript). 2674:"Otitis Media Diagnosis" 2672:BPharm YS (2010-04-27). 2138:Erasmus T (2012-09-17). 1010:. In more severe cases, 516:Streptococcus pneumoniae 4947:(inactive 2024-03-21). 4307:: an initiative of the 3597:10.1136/emj.2007.056648 2908:(12): 2776, 2778–2779. 1269:conductive hearing loss 949:amoxicillin-clavulanate 559:conductive hearing loss 398:causing the infection. 104:Smoke exposure, daycare 5212:10.1044/jslhr.4003.508 5018:10.1186/1746-1340-18-3 4458:10.1542/peds.2013-3228 4221:10.1542/peds.2017-0125 3261:10.1542/peds.79.2.309a 3214:Acta Oto-Laryngologica 2468:10.1056/NEJMvcm0904397 2425:10.1542/peds.2009-2689 2300:Hart KM (2023-07-04). 1850:10.1001/jama.2010.1651 1502:. September 30, 2013. 1410:10.1542/peds.2012-3488 1265:Australian Aboriginals 1201:dural sinus thrombosis 1184: 1156: 863:Abnormal tympanometry 520:Haemophilus influenzae 411: 349:basilar skull fracture 317: 227:indigenous Australians 5905:Middle ear barotrauma 5601:Neff MJ (June 2004). 5058:(4 Suppl): E122–143. 3678:|...}} 3649:(Retracted, see 3309:10.1093/fampra/cmn030 2768:10.1542/peds.65.4.761 2354:Bluestone CD (2005). 1162: 1060: 844:Pain at 10 to 12 days 714:(acetaminophen), and 648:Influenza vaccination 615:Adhesive otitis media 533:Staphylococcus aureus 526:Moraxella catarrhalis 409: 315: 262:influenza vaccination 5898:Gradenigo's syndrome 2609:10.1038/nrdp.2016.63 2551:10.7759/cureus.28019 2386:"Acute Otitis Media" 1884:. November 4, 2013. 1665:(10053): 1459–1544. 1613:(10053): 1545–1602. 1289:Australian languages 1193:bacterial meningitis 1034:Alternative medicine 777:Quality of evidence 774:Findings in numbers 569:that are created by 231:cleft lip and palate 6225:Otorhinolaryngology 4396:(1 Suppl): S1–S41. 3030:Lawrence R (2016). 2706:Academic Pediatrics 2043:2012PLoSO...736226M 1812:on 17 February 2017 920:1.38 (1.19 to 1.59) 896:0.97 (0.76 to 1.24) 877:0.82 (0.74 to 0.90) 853:0.33 (0.17 to 0.66) 834:0.76 (0.63 to 0.91) 825:Pain at 4 to 7 days 815:0.70 (0.57 to 0.86) 806:Pain at 2 to 3 days 796:0.89 (0.78 to 1.01) 431:, or hearing test. 351:, can also lead to 229:and those who have 67:Otorhinolaryngology 5915:Perforated eardrum 5732:External resources 4499:(1 Suppl): S1-35. 4348:(1 Suppl): S1–35. 3713:(dec11 1): f7027. 2237:has generic name ( 2150:(9): 335–336–336. 1456:10.2147/IDR.S39637 1277:Northern Territory 1185: 1157: 1074: no data 1012:tympanostomy tubes 961:Tympanostomy tubes 771:Findings in words 621:retracted ear drum 544:Otitis media with 509:Acute otitis media 497:bullous myringitis 412: 318: 308:Signs and symptoms 294:tympanostomy tubes 168:acute otitis media 141:471 million (2015) 6192: 6191: 5977: 5976: 5786: 5785: 5613:(12): 2929–2931. 5586:10.1121/2.0001004 5542:Fergus A (2019). 5108:(9859): 2163–96. 3719:10.1136/bmj.f7027 3177:(9407): 465–473. 3041:978-0-323-35776-0 3013:978-92-4-159158-4 2810:978-1-259-58860-0 2365:978-1-55009-066-6 2340:978-1-4377-3589-5 2313:978-1-77684-782-2 2272:978-0-8261-5184-1 2195:(9963): 117–171. 2101:(9995): 743–800. 1843:(19): 2161–2169. 1570:10.3205/cto000114 1154: 1153: 956:Tympanostomy tube 929: 928: 911:Diarrhoea or rash 702:Oral and topical 603:According to the 554:mastoid air cells 474:venous thrombosis 417:tympanic membrane 383:, or possibly by 276:(acetaminophen), 247:tympanic membrane 153: 152: 125:(acetaminophen), 54:tympanic membrane 21:Medical condition 6237: 6133:Acute bronchitis 6095:Nasal congestion 6080:Loss of appetite 6004: 5997: 5990: 5981: 5980: 5920:Tympanosclerosis 5893:Bezold's abscess 5813: 5806: 5799: 5790: 5789: 5775:Surgical treat. 5771:Medical treat., 5627: 5626: 5622: 5590: 5588: 5567: 5566: 5564: 5563: 5557: 5550: 5539: 5533: 5527: 5521: 5520: 5518: 5516: 5507:. 4 March 2012. 5497: 5491: 5490: 5488: 5487: 5468: 5462: 5461: 5425: 5419: 5418: 5382: 5376: 5375: 5339: 5333: 5332: 5322: 5282: 5276: 5275: 5265: 5233: 5224: 5223: 5195: 5189: 5188: 5170: 5142: 5136: 5135: 5125: 5093: 5084: 5083: 5047: 5041: 5040: 5030: 5020: 4996: 4990: 4989: 4983: 4975: 4973: 4972: 4924: 4918: 4917: 4889: 4883: 4882: 4872: 4855:(11): CD013056. 4840: 4834: 4833: 4823: 4791: 4785: 4784: 4774: 4742: 4733: 4732: 4708: 4702: 4701: 4691: 4681: 4661: 4655: 4654: 4626: 4620: 4619: 4609: 4577: 4571: 4570: 4560: 4528: 4519: 4518: 4508: 4484: 4478: 4477: 4441: 4435: 4434: 4432: 4431: 4405: 4381: 4370: 4367: 4357: 4331: 4330: 4328: 4322: 4301: 4289: 4276: 4275: 4250:(10): CD001801. 4243: 4234: 4233: 4223: 4214:(6): e20170125. 4199: 4190: 4189: 4179: 4147: 4136: 4135: 4099: 4093: 4092: 4082: 4050: 4044: 4043: 4033: 4016:(12): CD004975. 4001: 3995: 3994: 3958: 3952: 3951: 3941: 3909: 3903: 3902: 3893: 10646935. 3873:(11): CD000219. 3862: 3856: 3855: 3853: 3852: 3846: 3831: 3805: 3796: 3790: 3789: 3779: 3747: 3741: 3740: 3730: 3698: 3692: 3691: 3689: 3687: 3679: 3668:Retraction Watch 3647: 3623: 3617: 3616: 3580: 3574: 3573: 3563: 3531: 3525: 3524: 3514: 3482: 3476: 3475: 3465: 3433: 3427: 3426: 3425: 3419: 3409: 3377: 3371: 3370: 3360: 3328: 3322: 3321: 3311: 3287: 3281: 3280: 3244: 3238: 3237: 3220:(3–4): 260–265. 3209: 3203: 3202: 3166: 3160: 3159: 3149: 3132:(10): CD010089. 3117: 3106: 3105: 3095: 3055: 3046: 3045: 3027: 3018: 3017: 2991: 2980: 2979: 2950: 2944: 2943: 2941: 2939: 2924: 2918: 2917: 2897: 2888: 2887: 2885: 2883: 2864: 2858: 2857: 2821: 2815: 2814: 2794: 2788: 2787: 2751: 2745: 2744: 2742: 2740: 2734: 2703: 2694: 2688: 2687: 2685: 2684: 2669: 2663: 2662: 2660: 2659: 2645: 2639: 2638: 2628: 2588: 2582: 2581: 2571: 2553: 2529: 2523: 2522: 2486: 2480: 2479: 2451: 2445: 2444: 2408: 2402: 2401: 2399: 2397: 2381: 2370: 2369: 2351: 2345: 2344: 2324: 2318: 2317: 2297: 2291: 2290: 2284: 2276: 2256: 2250: 2249: 2242: 2236: 2232: 2230: 2222: 2212: 2180: 2171: 2170: 2168: 2167: 2135: 2129: 2128: 2118: 2086: 2075: 2074: 2064: 2054: 2022: 2001: 2000: 1990: 1958: 1952: 1951: 1942: 10646935. 1922:(11): CD000219. 1911: 1898: 1897: 1895: 1893: 1874: 1863: 1862: 1852: 1828: 1822: 1821: 1819: 1817: 1811: 1805:. Archived from 1800: 1792: 1786: 1785: 1783: 1782: 1742: 1736: 1735: 1710:(6): 1063–1079. 1699: 1693: 1692: 1682: 1650: 1641: 1640: 1630: 1598: 1592: 1591: 1581: 1549: 1516: 1515: 1513: 1511: 1496:"Ear Infections" 1492: 1479: 1478: 1468: 1458: 1434: 1423: 1422: 1412: 1388: 1283:and the unusual 1207:Membrane rupture 1180: 1174: 1168: 1147: 1141: 1135: 1129: 1123: 1117: 1109: 1103: 1097: 1091: 1085: 1079: 1073: 1067: 787:Pain at 24 hours 758: 757: 563:middle ear bones 489: 488: 470:bony destruction 459:mastoid effusion 369:mucous membranes 270:pain medications 221:, and attending 162:diseases of the 94:Viral, bacterial 47: 24: 23: 6245: 6244: 6240: 6239: 6238: 6236: 6235: 6234: 6195: 6194: 6193: 6188: 6184:Antiviral drugs 6172: 6119: 6046: 6013: 6008: 5978: 5973: 5945: 5924: 5860: 5852: 5829: 5820:Diseases of the 5817: 5787: 5782: 5781: 5767:with effusion, 5763:complications, 5759: 5727: 5726: 5638: 5597: 5571: 5570: 5561: 5559: 5555: 5548: 5540: 5536: 5528: 5524: 5514: 5512: 5505:, 5 March 2012" 5499: 5498: 5494: 5485: 5483: 5470: 5469: 5465: 5426: 5422: 5383: 5379: 5340: 5336: 5297:(4): CD004618. 5283: 5279: 5248:(1): CD004163. 5234: 5227: 5196: 5192: 5143: 5139: 5094: 5087: 5048: 5044: 4997: 4993: 4977: 4976: 4970: 4968: 4925: 4921: 4890: 4886: 4841: 4837: 4806:(1): CD013055. 4792: 4788: 4757:(1): CD013051. 4743: 4736: 4715:(1): CD007810. 4709: 4705: 4672:(5): CD006285. 4662: 4658: 4627: 4623: 4592:(5): CD001935. 4578: 4574: 4543:(9): CD003423. 4529: 4522: 4485: 4481: 4442: 4438: 4429: 4427: 4382: 4373: 4326: 4324: 4320: 4309:ABIM Foundation 4305:Choosing Wisely 4299: 4290: 4279: 4244: 4237: 4200: 4193: 4162:(6): CD012017. 4148: 4139: 4100: 4096: 4065:(9): CD001095. 4051: 4047: 4002: 3998: 3963:JAMA Pediatrics 3959: 3955: 3924:(3): CD003996. 3910: 3906: 3863: 3859: 3850: 3848: 3844: 3814:(3): CD012289. 3803: 3797: 3793: 3748: 3744: 3699: 3695: 3681: 3673: 3671: 3648: 3630:(3): CD001727. 3624: 3620: 3581: 3577: 3546:(8): CD011534. 3532: 3528: 3497:(6): CD012941. 3483: 3479: 3448:(6): CD006639. 3434: 3430: 3420: 3392:(8): CD007095. 3378: 3374: 3343:(4): CD004401. 3329: 3325: 3296:Family Practice 3288: 3284: 3245: 3241: 3210: 3206: 3167: 3163: 3118: 3109: 3070:(5): CD001480. 3056: 3049: 3042: 3028: 3021: 3014: 2992: 2983: 2951: 2947: 2937: 2935: 2926: 2925: 2921: 2898: 2891: 2881: 2879: 2866: 2865: 2861: 2822: 2818: 2811: 2795: 2791: 2752: 2748: 2738: 2736: 2732: 2701: 2695: 2691: 2682: 2680: 2670: 2666: 2657: 2655: 2647: 2646: 2642: 2589: 2585: 2530: 2526: 2487: 2483: 2452: 2448: 2419:(5): e1154–61. 2409: 2405: 2395: 2393: 2382: 2373: 2366: 2352: 2348: 2341: 2325: 2321: 2314: 2306:. Xspurts.com. 2298: 2294: 2278: 2277: 2273: 2257: 2253: 2243: 2234: 2233: 2224: 2223: 2181: 2174: 2165: 2163: 2136: 2132: 2087: 2078: 2023: 2004: 1973:(6): CD009163. 1959: 1955: 1912: 1901: 1891: 1889: 1876: 1875: 1866: 1829: 1825: 1815: 1813: 1809: 1798: 1794: 1793: 1789: 1780: 1778: 1743: 1739: 1700: 1696: 1651: 1644: 1599: 1595: 1550: 1519: 1509: 1507: 1494: 1493: 1482: 1435: 1426: 1403:(3): e964–999. 1389: 1336: 1331: 1309:is composed of 1303: 1287:inventories of 1258: 1234: 1215:, allowing the 1209: 1183: 1182: 1178: 1176: 1172: 1170: 1166: 1155: 1149: 1145: 1143: 1139: 1137: 1133: 1131: 1127: 1125: 1121: 1119: 1115: 1111: 1107: 1105: 1101: 1099: 1095: 1093: 1089: 1087: 1083: 1081: 1077: 1075: 1071: 1055: 1036: 1027: 977: 958: 740: 700: 633: 617: 594: 542: 511: 486: 485: 404: 365:Eustachian tube 361: 342:nasal discharge 310: 215:immune function 22: 17: 12: 11: 5: 6243: 6233: 6232: 6227: 6222: 6217: 6212: 6207: 6190: 6189: 6187: 6186: 6180: 6178: 6174: 6173: 6171: 6170: 6165: 6160: 6155: 6150: 6145: 6140: 6135: 6129: 6127: 6121: 6120: 6118: 6117: 6112: 6107: 6102: 6097: 6092: 6087: 6082: 6077: 6072: 6067: 6062: 6056: 6054: 6048: 6047: 6045: 6044: 6039: 6034: 6029: 6023: 6021: 6015: 6014: 6007: 6006: 5999: 5992: 5984: 5975: 5974: 5972: 5971: 5970: 5969: 5964: 5953: 5951: 5947: 5946: 5944: 5943: 5938: 5932: 5930: 5926: 5925: 5923: 5922: 5917: 5912: 5907: 5902: 5901: 5900: 5895: 5885: 5884: 5883: 5873: 5867: 5865: 5854: 5853: 5851: 5850: 5845: 5843:Otitis externa 5839: 5837: 5831: 5830: 5816: 5815: 5808: 5801: 5793: 5784: 5783: 5780: 5779: 5748: 5736: 5735: 5733: 5729: 5728: 5725: 5724: 5713: 5702: 5659: 5639: 5634: 5633: 5631: 5630:Classification 5624: 5623: 5596: 5595:External links 5593: 5592: 5591: 5569: 5568: 5534: 5522: 5492: 5463: 5420: 5377: 5334: 5277: 5225: 5190: 5137: 5085: 5042: 4991: 4919: 4900:(2): 177–183. 4884: 4835: 4786: 4734: 4703: 4656: 4621: 4572: 4520: 4479: 4452:(2): 296–311. 4436: 4371: 4369: 4368: 4332:, which cites 4277: 4235: 4191: 4137: 4110:: 139–143.e7. 4094: 4045: 3996: 3969:(4): 379–384. 3953: 3904: 3857: 3791: 3742: 3693: 3618: 3575: 3526: 3477: 3428: 3372: 3323: 3302:(4): 233–236. 3282: 3255:(2): 309–311. 3239: 3204: 3161: 3107: 3047: 3040: 3019: 3012: 2981: 2962:(5): 702–711. 2945: 2919: 2889: 2859: 2832:(3): 274–278. 2816: 2809: 2789: 2762:(4): 761–766. 2746: 2712:(3): 214–218. 2689: 2664: 2640: 2593:"Otitis media" 2583: 2524: 2497:(4): 490–494. 2481: 2446: 2403: 2384:Donaldson JD. 2371: 2364: 2346: 2339: 2319: 2312: 2292: 2271: 2251: 2235:|author1= 2172: 2130: 2076: 2002: 1953: 1899: 1864: 1823: 1787: 1757:(2): 137–140. 1737: 1694: 1642: 1593: 1517: 1480: 1424: 1333: 1332: 1330: 1327: 1325:for "middle". 1302: 1299: 1257: 1254: 1233: 1230: 1208: 1205: 1177: 1171: 1165: 1164: 1152: 1151: 1144: 1138: 1132: 1126: 1120: 1114: 1112: 1106: 1100: 1094: 1088: 1082: 1076: 1070: 1065: 1054: 1051: 1035: 1032: 1026: 1023: 1004:antihistamines 976: 973: 957: 954: 927: 926: 921: 915: 912: 908: 907: 903: 902: 897: 891: 888: 884: 883: 878: 872: 869: 865: 864: 860: 859: 854: 848: 845: 841: 840: 835: 829: 826: 822: 821: 816: 810: 807: 803: 802: 797: 791: 788: 784: 783: 779: 778: 775: 772: 769: 765: 764: 762: 739: 736: 728:antihistamines 699: 696: 632: 629: 616: 613: 593: 590: 541: 538: 510: 507: 403: 400: 360: 357: 309: 306: 284:ear drops, or 251:otitis externa 158:is a group of 151: 150: 147: 143: 142: 139: 135: 134: 120: 114: 113: 110: 106: 105: 102: 96: 95: 92: 88: 87: 84: 80: 79: 76: 70: 69: 64: 58: 57: 49: 48: 40: 39: 33: 29: 28: 20: 15: 9: 6: 4: 3: 2: 6242: 6231: 6228: 6226: 6223: 6221: 6218: 6216: 6213: 6211: 6208: 6206: 6203: 6202: 6200: 6185: 6182: 6181: 6179: 6175: 6169: 6166: 6164: 6161: 6159: 6156: 6154: 6151: 6149: 6146: 6144: 6141: 6139: 6138:Bronchiolitis 6136: 6134: 6131: 6130: 6128: 6126: 6125:Complications 6122: 6116: 6113: 6111: 6108: 6106: 6103: 6101: 6098: 6096: 6093: 6091: 6088: 6086: 6083: 6081: 6078: 6076: 6073: 6071: 6068: 6066: 6063: 6061: 6058: 6057: 6055: 6053: 6049: 6043: 6040: 6038: 6035: 6033: 6030: 6028: 6025: 6024: 6022: 6020: 6016: 6012: 6005: 6000: 5998: 5993: 5991: 5986: 5985: 5982: 5968: 5965: 5963: 5960: 5959: 5958: 5955: 5954: 5952: 5948: 5942: 5939: 5937: 5934: 5933: 5931: 5927: 5921: 5918: 5916: 5913: 5911: 5908: 5906: 5903: 5899: 5896: 5894: 5891: 5890: 5889: 5886: 5882: 5879: 5878: 5877: 5874: 5872: 5871:Cholesteatoma 5869: 5868: 5866: 5864: 5859: 5855: 5849: 5846: 5844: 5841: 5840: 5838: 5836: 5832: 5828: 5824: 5821: 5814: 5809: 5807: 5802: 5800: 5795: 5794: 5791: 5778: 5774: 5770: 5766: 5762: 5758: 5754: 5753: 5749: 5747: 5743: 5742: 5738: 5737: 5734: 5730: 5723: 5719: 5718: 5714: 5712: 5708: 5707: 5703: 5701: 5697: 5693: 5689: 5685: 5681: 5677: 5673: 5669: 5668: 5664: 5660: 5658: 5654: 5650: 5649: 5645: 5641: 5640: 5637: 5632: 5628: 5620: 5616: 5612: 5608: 5604: 5599: 5598: 5587: 5582: 5578: 5573: 5572: 5554: 5547: 5546: 5538: 5531: 5526: 5510: 5506: 5504: 5496: 5481: 5477: 5475: 5467: 5459: 5455: 5451: 5447: 5443: 5439: 5435: 5431: 5424: 5416: 5412: 5408: 5404: 5400: 5396: 5392: 5388: 5381: 5373: 5369: 5365: 5361: 5357: 5353: 5350:(5): 665–70. 5349: 5345: 5338: 5330: 5326: 5321: 5316: 5312: 5308: 5304: 5300: 5296: 5292: 5288: 5281: 5273: 5269: 5264: 5259: 5255: 5251: 5247: 5243: 5239: 5232: 5230: 5221: 5217: 5213: 5209: 5206:(3): 508–18. 5205: 5201: 5194: 5186: 5182: 5178: 5174: 5169: 5164: 5160: 5156: 5152: 5148: 5141: 5133: 5129: 5124: 5119: 5115: 5111: 5107: 5103: 5099: 5092: 5090: 5081: 5077: 5073: 5069: 5065: 5061: 5057: 5053: 5046: 5038: 5034: 5029: 5024: 5019: 5014: 5010: 5006: 5002: 4995: 4987: 4981: 4966: 4962: 4958: 4954: 4950: 4946: 4942: 4939:(10): 635–9. 4938: 4934: 4930: 4923: 4915: 4911: 4907: 4903: 4899: 4895: 4888: 4880: 4876: 4871: 4866: 4862: 4858: 4854: 4850: 4846: 4839: 4831: 4827: 4822: 4817: 4813: 4809: 4805: 4801: 4797: 4790: 4782: 4778: 4773: 4768: 4764: 4760: 4756: 4752: 4748: 4741: 4739: 4730: 4726: 4722: 4718: 4714: 4707: 4699: 4695: 4690: 4685: 4680: 4675: 4671: 4667: 4660: 4652: 4648: 4644: 4640: 4637:(3): 188–92. 4636: 4632: 4625: 4617: 4613: 4608: 4603: 4599: 4595: 4591: 4587: 4583: 4576: 4568: 4564: 4559: 4554: 4550: 4546: 4542: 4538: 4534: 4527: 4525: 4516: 4512: 4507: 4502: 4498: 4494: 4490: 4483: 4475: 4471: 4467: 4463: 4459: 4455: 4451: 4447: 4440: 4425: 4421: 4417: 4413: 4409: 4404: 4399: 4395: 4391: 4387: 4380: 4378: 4376: 4365: 4361: 4356: 4351: 4347: 4343: 4339: 4334: 4333: 4319: 4315: 4311: 4310: 4306: 4298: 4294: 4288: 4286: 4284: 4282: 4273: 4269: 4265: 4261: 4257: 4253: 4249: 4242: 4240: 4231: 4227: 4222: 4217: 4213: 4209: 4205: 4198: 4196: 4187: 4183: 4178: 4173: 4169: 4165: 4161: 4157: 4153: 4146: 4144: 4142: 4133: 4129: 4125: 4121: 4117: 4113: 4109: 4105: 4098: 4090: 4086: 4081: 4076: 4072: 4068: 4064: 4060: 4056: 4049: 4041: 4037: 4032: 4027: 4023: 4019: 4015: 4011: 4007: 4000: 3992: 3988: 3984: 3980: 3976: 3972: 3968: 3964: 3957: 3949: 3945: 3940: 3935: 3931: 3927: 3923: 3919: 3915: 3908: 3900: 3896: 3892: 3888: 3884: 3880: 3876: 3872: 3868: 3861: 3843: 3839: 3835: 3830: 3825: 3821: 3817: 3813: 3809: 3802: 3795: 3787: 3783: 3778: 3773: 3769: 3765: 3762:(2): 151–60. 3761: 3757: 3753: 3746: 3738: 3734: 3729: 3724: 3720: 3716: 3712: 3708: 3704: 3697: 3685: 3677: 3670: 3669: 3664: 3660: 3656: 3652: 3645: 3641: 3637: 3633: 3629: 3622: 3614: 3610: 3606: 3602: 3598: 3594: 3590: 3586: 3579: 3571: 3567: 3562: 3557: 3553: 3549: 3545: 3541: 3537: 3530: 3522: 3518: 3513: 3508: 3504: 3500: 3496: 3492: 3488: 3481: 3473: 3469: 3464: 3459: 3455: 3451: 3447: 3443: 3439: 3432: 3424: 3417: 3413: 3408: 3403: 3399: 3395: 3391: 3387: 3383: 3376: 3368: 3364: 3359: 3354: 3350: 3346: 3342: 3338: 3334: 3327: 3319: 3315: 3310: 3305: 3301: 3297: 3293: 3286: 3278: 3274: 3270: 3266: 3262: 3258: 3254: 3250: 3243: 3235: 3231: 3227: 3223: 3219: 3215: 3208: 3200: 3196: 3192: 3188: 3184: 3180: 3176: 3172: 3165: 3157: 3153: 3148: 3143: 3139: 3135: 3131: 3127: 3123: 3116: 3114: 3112: 3103: 3099: 3094: 3089: 3085: 3081: 3077: 3073: 3069: 3065: 3061: 3054: 3052: 3043: 3037: 3033: 3026: 3024: 3015: 3009: 3005: 3001: 2997: 2990: 2988: 2986: 2977: 2973: 2969: 2965: 2961: 2957: 2949: 2933: 2929: 2923: 2915: 2911: 2907: 2903: 2896: 2894: 2877: 2873: 2869: 2863: 2855: 2851: 2847: 2843: 2839: 2835: 2831: 2827: 2820: 2812: 2806: 2802: 2801: 2793: 2785: 2781: 2777: 2773: 2769: 2765: 2761: 2757: 2750: 2731: 2727: 2723: 2719: 2715: 2711: 2707: 2700: 2693: 2679: 2675: 2668: 2654: 2650: 2644: 2636: 2632: 2627: 2622: 2618: 2614: 2610: 2606: 2602: 2598: 2594: 2587: 2579: 2575: 2570: 2565: 2561: 2557: 2552: 2547: 2544:(8): e28019. 2543: 2539: 2535: 2528: 2520: 2516: 2512: 2508: 2504: 2500: 2496: 2492: 2485: 2477: 2473: 2469: 2465: 2461: 2457: 2450: 2442: 2438: 2434: 2430: 2426: 2422: 2418: 2414: 2407: 2391: 2387: 2380: 2378: 2376: 2367: 2361: 2357: 2350: 2342: 2336: 2332: 2331: 2323: 2315: 2309: 2305: 2304: 2296: 2288: 2282: 2274: 2268: 2264: 2263: 2255: 2247: 2240: 2228: 2220: 2216: 2211: 2206: 2202: 2198: 2194: 2190: 2186: 2179: 2177: 2161: 2157: 2153: 2149: 2145: 2141: 2134: 2126: 2122: 2117: 2112: 2108: 2104: 2100: 2096: 2092: 2085: 2083: 2081: 2072: 2068: 2063: 2058: 2053: 2048: 2044: 2040: 2037:(4): e36226. 2036: 2032: 2028: 2021: 2019: 2017: 2015: 2013: 2011: 2009: 2007: 1998: 1994: 1989: 1984: 1980: 1976: 1972: 1968: 1964: 1957: 1949: 1945: 1941: 1937: 1933: 1929: 1925: 1921: 1917: 1910: 1908: 1906: 1904: 1887: 1883: 1879: 1873: 1871: 1869: 1860: 1856: 1851: 1846: 1842: 1838: 1834: 1827: 1808: 1804: 1797: 1791: 1776: 1772: 1768: 1764: 1760: 1756: 1752: 1748: 1741: 1733: 1729: 1725: 1721: 1717: 1713: 1709: 1705: 1698: 1690: 1686: 1681: 1676: 1672: 1668: 1664: 1660: 1656: 1649: 1647: 1638: 1634: 1629: 1624: 1620: 1616: 1612: 1608: 1604: 1597: 1589: 1585: 1580: 1575: 1571: 1567: 1563: 1559: 1555: 1548: 1546: 1544: 1542: 1540: 1538: 1536: 1534: 1532: 1530: 1528: 1526: 1524: 1522: 1505: 1501: 1497: 1491: 1489: 1487: 1485: 1476: 1472: 1467: 1462: 1457: 1452: 1448: 1444: 1440: 1433: 1431: 1429: 1420: 1416: 1411: 1406: 1402: 1398: 1394: 1387: 1385: 1383: 1381: 1379: 1377: 1375: 1373: 1371: 1369: 1367: 1365: 1363: 1361: 1359: 1357: 1355: 1353: 1351: 1349: 1347: 1345: 1343: 1341: 1339: 1334: 1326: 1324: 1320: 1316: 1315:Ancient Greek 1312: 1308: 1298: 1295: 1290: 1286: 1282: 1278: 1274: 1270: 1266: 1262: 1253: 1249: 1245: 1243: 1239: 1229: 1226: 1222: 1218: 1214: 1204: 1202: 1198: 1197:brain abscess 1194: 1190: 1161: 1148: > 50 1113: 1080: < 10 1069: 1068: 1063: 1059: 1050: 1048: 1044: 1040: 1031: 1022: 1020: 1019:adenoidectomy 1017: 1013: 1009: 1008:autoinflation 1005: 1001: 997: 993: 990: 989:temporal bone 986: 982: 972: 968: 966: 962: 953: 950: 946: 942: 938: 934: 925: 922: 919: 916: 913: 910: 909: 904: 901: 898: 895: 892: 889: 886: 885: 882: 879: 876: 873: 870: 867: 866: 861: 858: 855: 852: 849: 846: 843: 842: 839: 836: 833: 830: 827: 824: 823: 820: 817: 814: 811: 808: 805: 804: 801: 798: 795: 792: 789: 786: 785: 780: 766: 763: 760: 759: 756: 752: 750: 746: 735: 733: 729: 725: 724:Decongestants 721: 717: 713: 709: 705: 695: 693: 689: 687: 683: 679: 674: 672: 667: 665: 661: 656: 652: 649: 645: 644:public health 641: 637: 628: 626: 622: 612: 608: 606: 601: 598: 589: 587: 586:breastfeeding 583: 579: 574: 572: 568: 564: 560: 555: 551: 547: 537: 535: 534: 529: 527: 522: 521: 517: 506: 503: 499: 498: 492: 481: 479: 475: 471: 467: 464: 463:subperiosteal 460: 456: 452: 449: 448:temporal bone 445: 441: 437: 432: 430: 429:reflectometry 426: 422: 418: 408: 399: 397: 393: 388: 386: 382: 378: 374: 370: 366: 356: 354: 350: 345: 343: 339: 335: 331: 327: 323: 314: 305: 301: 299: 295: 291: 287: 283: 279: 275: 271: 267: 266:breastfeeding 263: 259: 254: 252: 248: 244: 240: 236: 235:Down syndrome 232: 228: 224: 220: 216: 212: 207: 205: 204:sign language 201: 197: 193: 189: 185: 181: 177: 173: 169: 165: 161: 157: 148: 144: 140: 136: 132: 128: 124: 121: 119: 115: 111: 107: 103: 101: 97: 93: 89: 85: 81: 77: 75: 71: 68: 65: 63: 59: 55: 50: 46: 41: 37: 34: 30: 25: 19: 6168:Strep throat 6148:Otitis media 6147: 6090:Muscle aches 5967:tympanometry 5941:Hearing loss 5910:Otitis media 5909: 5750: 5739: 5715: 5704: 5661: 5642: 5610: 5606: 5576: 5560:. Retrieved 5544: 5537: 5530:Butcher 2018 5525: 5513:. Retrieved 5502: 5495: 5484:. Retrieved 5473: 5466: 5436:(2): 103–7. 5433: 5429: 5423: 5390: 5386: 5380: 5347: 5343: 5337: 5294: 5290: 5280: 5245: 5241: 5203: 5199: 5193: 5168:10183/125807 5153:(2): 221–4. 5150: 5146: 5140: 5105: 5101: 5055: 5051: 5045: 5008: 5004: 4994: 4980:cite journal 4969:. Retrieved 4936: 4932: 4922: 4897: 4893: 4887: 4852: 4848: 4838: 4803: 4799: 4789: 4754: 4750: 4712: 4706: 4669: 4659: 4634: 4630: 4624: 4589: 4585: 4575: 4540: 4536: 4496: 4492: 4482: 4449: 4445: 4439: 4428:. Retrieved 4393: 4389: 4345: 4341: 4325:, retrieved 4303: 4247: 4211: 4207: 4159: 4155: 4107: 4103: 4097: 4062: 4058: 4048: 4013: 4009: 3999: 3966: 3962: 3956: 3921: 3917: 3907: 3870: 3866: 3860: 3849:. Retrieved 3811: 3807: 3794: 3759: 3755: 3745: 3710: 3706: 3696: 3682:{{ 3674:{{ 3667: 3665:, 3627: 3621: 3591:(2): 103–4. 3588: 3584: 3578: 3543: 3539: 3529: 3494: 3490: 3480: 3445: 3441: 3431: 3389: 3385: 3375: 3340: 3336: 3326: 3299: 3295: 3285: 3252: 3248: 3242: 3217: 3213: 3207: 3174: 3170: 3164: 3129: 3125: 3067: 3063: 3031: 2995: 2959: 2955: 2948: 2936:. Retrieved 2922: 2905: 2901: 2880:. Retrieved 2871: 2862: 2829: 2825: 2819: 2799: 2792: 2759: 2755: 2749: 2737:. Retrieved 2709: 2705: 2692: 2681:. Retrieved 2678:News-Medical 2677: 2667: 2656:. Retrieved 2652: 2643: 2603:(1): 16063. 2600: 2596: 2586: 2541: 2537: 2527: 2494: 2490: 2484: 2459: 2455: 2449: 2416: 2412: 2406: 2394:. Retrieved 2388:. Medscape. 2355: 2349: 2329: 2322: 2302: 2295: 2261: 2254: 2227:cite journal 2192: 2188: 2164:. Retrieved 2147: 2143: 2133: 2098: 2094: 2034: 2030: 1970: 1966: 1956: 1919: 1915: 1890:. Retrieved 1881: 1840: 1836: 1826: 1814:. Retrieved 1807:the original 1802: 1790: 1779:. 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Retrieved 1499: 1446: 1442: 1400: 1396: 1318: 1310: 1307:otitis media 1306: 1304: 1263: 1259: 1256:Epidemiology 1250: 1246: 1235: 1232:Hearing loss 1210: 1186: 1037: 1028: 978: 969: 959: 930: 868:2 to 4 weeks 753: 741: 704:pain killers 701: 690: 682:malnutrition 675: 668: 660:hearing loss 657: 653: 638: 634: 618: 609: 602: 599: 595: 575: 543: 531: 524: 514: 512: 501: 495: 493: 482: 433: 425:tympanometry 413: 389: 381:strep throat 362: 346: 330:irritability 319: 316:Otitis media 302: 258:pneumococcal 255: 208: 200:hearing loss 195: 191: 187: 183: 171: 167: 160:inflammatory 156:Otitis media 155: 154: 149:3,200 (2015) 100:Risk factors 35: 27:Otitis media 18: 6153:Pharyngitis 6110:Sore throat 6037:Enterovirus 6032:Coronavirus 6011:Common cold 5888:Mastoiditis 5741:MedlinePlus 5515:6 September 5393:(1): 63–6. 3004:10665/42941 2938:17 February 2872:NHS Choices 2739:November 3, 2462:(20): e62. 1892:14 February 1510:14 February 1189:mastoiditis 1142: 46–50 1136: 42–46 1130: 38–42 1124: 34–38 1118: 30–34 1110: 26–30 1104: 22–26 1098: 18–22 1092: 14–18 1086: 10–14 1043:Homeopathic 985:tympanogram 937:amoxicillin 745:perforation 738:Antibiotics 712:paracetamol 580:, parental 571:sound waves 468:formation, 444:tympanogram 373:nasopharynx 298:antibiotics 290:amoxicillin 274:paracetamol 123:Paracetamol 32:Other names 6215:Pediatrics 6199:Categories 6100:Rhinorrhea 6042:Rhinovirus 6027:Adenovirus 5858:Middle ear 5848:Otomycosis 5827:middle ear 5717:DiseasesDB 5562:2023-09-06 5486:2023-09-06 4971:2023-05-24 4446:Pediatrics 4430:2019-03-05 4208:Pediatrics 3851:2019-12-16 3249:Pediatrics 2882:3 November 2868:"Glue Ear" 2756:Pediatrics 2683:2024-07-15 2658:2024-07-15 2413:Pediatrics 2166:2019-08-07 1781:2021-09-27 1397:Pediatrics 1329:References 1281:fricatives 1238:conductive 981:audiometry 945:resistance 749:Analgesics 698:Management 692:Probiotics 631:Prevention 578:child care 550:middle ear 487:myringitis 478:meningitis 440:audiometry 282:benzocaine 164:middle ear 131:benzocaine 118:Medication 109:Prevention 52:A bulging 6220:Audiology 6163:Sinusitis 6158:Pneumonia 5962:pneumatic 5835:Outer ear 5757:emerg/351 5752:eMedicine 5311:1469-493X 5080:206466859 4961:245177279 4327:August 1, 4132:203580952 3887:1469-493X 3684:retracted 3676:retracted 3084:1469-493X 2854:207300175 2617:2056-676X 2560:2168-8184 2281:cite book 2156:2078-5143 1936:1469-493X 1564:: Doc11. 1449:: 15–24. 1305:The term 1301:Etymology 1285:segmental 1225:infection 1221:ear canal 1213:perforate 1181: 2–4 906:Vomiting 708:ibuprofen 646:benefit. 402:Diagnosis 385:allergies 278:ibuprofen 243:allergies 219:pacifiers 176:infection 138:Frequency 133:ear drops 127:ibuprofen 62:Specialty 6115:Weakness 6105:Sneezing 6075:Headache 6052:Symptoms 5957:Otoscope 5936:Ear pain 5929:Symptoms 5777:ped/1689 5619:15222658 5553:Archived 5509:Archived 5480:Archived 5458:23668097 5450:16359151 5415:24611204 5407:20665042 5372:37667672 5364:18984261 5329:16235370 5272:17253499 5177:18629531 5132:23245607 5072:23536529 5037:20184717 5011:(1): 3. 4965:Archived 4953:11105452 4914:11224838 4879:31902139 4830:31902140 4781:31896168 4729:20091650 4698:23728660 4689:11357689 4616:21563132 4567:21901683 4515:23818543 4466:24394689 4424:Archived 4420:33459167 4412:26832942 4364:23818543 4318:archived 4272:43568574 4264:20927726 4230:28562283 4186:29741289 4124:31561959 4089:20824827 4040:24338106 4031:10960641 3991:73495617 3983:30776069 3948:15266512 3899:37965923 3842:Archived 3838:29543327 3786:22993127 3737:24335668 3663:21412874 3644:18646076 3613:34753900 3605:18212148 3570:37594020 3561:10436353 3521:31210358 3472:24974096 3416:27486835 3367:17054203 3358:11324013 3318:18562333 3199:30439271 3191:14962529 3156:29039160 3102:31135969 2932:Archived 2914:15222643 2876:Archived 2846:18312870 2784:31536385 2730:Archived 2726:22459064 2635:27604644 2578:36134092 2519:24036039 2511:18922333 2476:20484393 2433:20368317 2396:17 March 2390:Archived 2219:25530442 2160:Archived 2125:26063472 2071:22558393 2031:PLOS ONE 1997:27290722 1948:37965923 1886:Archived 1859:21081729 1775:Archived 1771:10206361 1732:53045631 1724:30342609 1689:27733281 1637:27733282 1588:25587371 1504:Archived 1475:24453496 1419:23439909 1053:Outcomes 1016:adjuvant 887:3 months 857:Moderate 768:Outcome 761:Summary 732:ear pain 686:marasmus 684:such as 625:ossicles 546:effusion 421:otoscope 396:pathogen 392:bacteria 379:(URTI), 322:ear pain 74:Symptoms 6230:Otology 6085:Malaise 6065:Fatigue 6019:Viruses 5863:mastoid 5773:ent/211 5769:ent/212 5765:ent/209 5761:ent/426 5711:D010033 5503:The Age 5320:6669264 5263:8765114 5220:9210110 5185:2932807 5123:6350784 5028:2841070 4870:6956626 4821:6956662 4772:6956124 4651:8365006 4607:9829244 4558:7170417 4474:2355197 4177:6494623 4080:7052812 3939:9037065 3829:6492450 3777:7087613 3728:3898587 3512:6580359 3463:9392835 3407:8485974 3277:1350590 3269:3808812 3234:4061076 3147:6485791 3093:6537667 2976:8229477 2776:7367083 2626:7097351 2569:9471510 2210:4340604 2116:4561509 2062:3340347 2039:Bibcode 1988:7117560 1882:cdc.gov 1680:5388903 1628:5055577 1579:4273172 1500:cdc.gov 1466:3894142 1294:voicing 1175: 1 1169: 0 716:opiates 671:xylitol 582:smoking 565:to the 502:myringa 466:abscess 371:in the 286:opioids 223:daycare 211:anatomy 6205:Otitis 5746:000638 5672:017.40 5617: 5551:(BA). 5456: 5448: 5413: 5405: 5370: 5362: 5327: 5317: 5309: 5270: 5260: 5218: 5183: 5175: 5130: 5120: 5102:Lancet 5078: 5070: 5035: 5025: 4959: 4951: 4912: 4877: 4867: 4828: 4818: 4779: 4769: 4727: 4696: 4686: 4649: 4614: 4604: 4565: 4555: 4513: 4472: 4464: 4418: 4410: 4362: 4270: 4262: 4228: 4184: 4174: 4130: 4122: 4087: 4077: 4038: 4028: 3989: 3981: 3946: 3936: 3897: 3885: 3836: 3826: 3784: 3774: 3735: 3725: 3661: 3657:, 3642: 3611: 3603: 3568: 3558: 3519: 3509: 3470: 3460: 3414: 3404: 3365: 3355: 3316: 3275: 3267: 3232: 3197: 3189: 3171:Lancet 3154: 3144: 3100: 3090: 3082: 3038: 3010: 2974: 2912: 2852: 2844: 2807: 2782: 2774: 2724: 2633: 2623: 2615: 2576: 2566: 2558: 2538:Cureus 2517: 2509: 2474: 2441:709374 2439: 2431: 2362: 2337: 2310: 2269: 2217: 2207: 2189:Lancet 2154: 2123: 2113: 2095:Lancet 2069: 2059: 1995: 1985: 1946: 1934: 1857: 1816:12 May 1769: 1730: 1722: 1687: 1677: 1659:Lancet 1635: 1625: 1607:Lancet 1586: 1576: 1473: 1463: 1417: 1311:otitis 1179: 1173: 1167: 1150: 1146: 1140: 1134: 1128: 1122: 1116: 1108: 1102: 1096: 1090: 1084: 1078: 1072: 1000:serous 359:Causes 174:), an 146:Deaths 91:Causes 6177:Drugs 6143:Croup 6070:Fever 6060:Cough 5950:Tests 5823:outer 5722:29620 5696:381.4 5692:381.3 5688:381.2 5684:381.1 5680:381.0 5676:055.2 5556:(PDF) 5549:(PDF) 5454:S2CID 5411:S2CID 5368:S2CID 5181:S2CID 5076:S2CID 4957:S2CID 4470:S2CID 4416:S2CID 4321:(PDF) 4300:(PDF) 4268:S2CID 4128:S2CID 3987:S2CID 3845:(PDF) 3804:(PDF) 3680:with 3609:S2CID 3273:S2CID 3195:S2CID 2850:S2CID 2780:S2CID 2733:(PDF) 2702:(PDF) 2515:S2CID 2437:S2CID 1810:(PDF) 1799:(PDF) 1728:S2CID 1323:Latin 1319:media 1199:, or 935:like 782:Pain 436:fever 338:cough 326:fever 180:fever 83:Types 5861:and 5825:and 5706:MeSH 5667:9-CM 5615:PMID 5517:2023 5446:PMID 5403:PMID 5360:PMID 5325:PMID 5307:ISSN 5295:2005 5268:PMID 5246:2010 5216:PMID 5173:PMID 5128:PMID 5068:PMID 5033:PMID 4986:link 4949:PMID 4910:PMID 4875:PMID 4826:PMID 4777:PMID 4725:PMID 4694:PMID 4647:PMID 4612:PMID 4590:2011 4563:PMID 4541:2011 4511:PMID 4462:PMID 4408:PMID 4360:PMID 4329:2013 4260:PMID 4226:PMID 4182:PMID 4120:PMID 4085:PMID 4063:2010 4036:PMID 3979:PMID 3944:PMID 3922:2010 3895:PMID 3883:ISSN 3834:PMID 3812:2018 3782:PMID 3733:PMID 3659:PMID 3640:PMID 3601:PMID 3566:PMID 3544:2023 3517:PMID 3495:2019 3468:PMID 3446:2014 3412:PMID 3390:2016 3363:PMID 3341:2013 3314:PMID 3265:PMID 3230:PMID 3187:PMID 3152:PMID 3130:2017 3098:PMID 3080:ISSN 3036:ISBN 3008:ISBN 2972:PMID 2940:2017 2910:PMID 2884:2012 2842:PMID 2805:ISBN 2772:PMID 2741:2018 2722:PMID 2631:PMID 2613:ISSN 2574:PMID 2556:ISSN 2507:PMID 2472:PMID 2429:PMID 2398:2013 2360:ISBN 2335:ISBN 2308:ISBN 2287:link 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