[Tympanic effusion].

Since epidemiologic studies have shown, that the majority of middle ear effusions disappear spontaneously and sequelae a less frequent than expected, a more conservative treatment strategy is advisable. In this review pathogenetic factors are discussed and a treatment policy is recommended as it appears logic to the authors. It is stressed that exact audiologic data are difficult to obtain in children. If an effusion persists at least for 3 months, adenoidectomy, paracentesis and aspiration of the middle ear fluid has to be considered. The insertion of middle ear ventilation tubes is not the first step in our treatment. Special strategies for treatment have to be applied in some groups such as children with Francheschetti or Down Syndrome and children with cleft palates as well as in children with retardation in speech development.