Most otitis media are caused by pneumococci, Haemophilus influenzae, and Streptococcus haemolyticus. Acute suppurative otitis media occurs in children. The germs can invade the middle ear through the eustachian tube route. When the tympanic membrane is ruptured and perforated, external germs can enter the middle ear through the external ear canal and become inflamed. In children, the eustachian tube is relatively flat and shorter than in adults, making it easier for germs to enter the middle ear cavity. If left untreated, otitis media can lead to acute mastoiditis or intracranial or extracranial complications in weaker patients. Acute otitis media with untreated tympanic membrane perforation can become chronic suppurative otitis media. Chronic otitis media lesions that go beyond mucosal tissue and cause necrosis of the auditory bone and large perforations of the tympanic membrane result in more severe hearing loss. It has an impact on work and life.
Symptom presentation.
In the early stage of acute suppurative otitis media, before the tympanic membrane is perforated, in addition to severe ear pain, it is accompanied by chills and fever.
When the tympanic membrane is perforated, the pain is suddenly relieved, but pus flows from the middle ear into the external ear canal, and the typical symptoms of pus flowing from the ear appear, which is initially bloody and purulent and later turns into pus.
In the early stage, the ear feels stuffy and the hearing gradually decreases, accompanied by tinnitus.
Chronic suppurative otitis media is characterized by intermittent pus flow, which can be mucopurulent, mucopurulent and mucoid pus.
In cholesteatoma otitis media, the pus flow is persistent, the amount of pus is small, it has a corrosive stench, and the pus is mixed with beanbag-like or onion skin-like secretions, which is called cholesteatoma.
Treatment.
The first thing is anti-inflammatory, and antibiotics can be used orally or by injection.
Before the tympanic membrane is perforated, i.e., before the ear pus flows, 2% phenol glycerin ear drops can be used due to ear pain.
Anti-inflammatory ear drops containing antibiotics can be used as water baths or ear drops 3 times a day.
The course of treatment for chronic suppurative otitis media is to make the ear flow from more to less pus until the ear is dry.
Conductive deafness caused by tympanic membrane perforation or hearing bone chain mutilation can be treated surgically with tympanic membrane repair or tympanoplasty to improve hearing and restore practical auditory function.
In cases of poor drainage of middle ear pus, suspected complications or diagnosis of cholesteatoma-type otitis media, radical mastoid surgery is required.
What conditions require medical attention.
Children who cry day and night, rub their ears and turn their heads with their small hands, refuse to take milk, and have a high fever. Individual children may experience nausea, vomiting, and diarrhea.
Persistent pus flowing from the ear with foul-smelling pus.
Headache, high fever above 40 degrees, fear of cold, shivering, temperature dropping again after a few hours, but soon fever and fear of cold again, 1-2 episodes a day, this kind of condition occurs in those who have pus from the ear for a long time. Diffuse headache, high fever, fear of cold, nausea and jet vomiting, irritability, agitation, neck straightening, babbling and delirium should be treated promptly and urgently if there is a history of otitis media. Otherwise, life is at risk.
Patients with otitis media may suffer from severe vertigo, feeling spinning, walking unsteadily, or even falling down, accompanied by nausea and vomiting.
If a patient with otitis media has a crooked mouth and the corners of the mouth deviate towards the healthy ear, he should be treated promptly and if necessary, surgery is required.
In cases of conductive deafness caused by perforation of the tympanic membrane in both ears or a defective auditory chain, which affects normal work and life, tympanoplasty can be performed.
Tip.
The ear drops should be applied in a sitting or lying position with the diseased ear facing upwards, the auricle should be gently pulled backwards and upwards, 3-5 drops of the solution should be injected into the external ear canal, and then the ear screen should be gently pressed with the fingers several times to encourage the solution to flow into the middle ear via the tympanic membrane perforation, and the position should be changed only after 5-10 minutes.
Make the temperature of the ear drops as close to the body temperature as possible to avoid vertigo. A simple way to avoid vertigo is to put the ear drops in your underwear pocket for 10 minutes.