Acute suppurative otitis media is an acute purulent inflammation of the middle ear mucosa, often caused by acute upper respiratory tract infection, acute infectious disease, improper pinching and puffing or blowing of the nose, or infection due to traumatic tympanic membrane perforation.
Clinical manifestations
The symptoms include ear pain, fever, high amount of pus in the ear, hearing loss or tinnitus, and vertigo.
Hearing examination is mostly conductive deafness, and a few patients may have mixed deafness or sensorineural deafness due to cochlear involvement.
A few patients may have no obvious symptoms, or infants and young children often show fever, crying and restlessness, ear scratching and head shaking, or even gastrointestinal symptoms such as vomiting and diarrhea, which is an important factor for untimely treatment.
Treatment guidelines
1. Systemic treatment Early application of sufficient antibiotics or other antibacterial drugs to control the infection, to ensure a complete cure. Generally, penicillin, cephalosporins and other drugs are available. If early treatment is timely and proper, tympanic membrane perforation can be prevented. After the tympanic membrane is perforated, pus is taken for bacterial culture and drug sensitivity testing, and sensitive antibiotics are used instead with reference to the results. Some patients reject or refuse to use antibiotics because the concept of using antibiotics is not good for the body, or some patients frequently switch to other antibiotics because the effect is not obvious after a few days of continuous use of antibiotics, which are harmful to the treatment of the disease. You should use antibiotics reasonably under the guidance of your doctor, usually for about 10 days, or until the tympanic membrane congestion disappears.
2.Local treatment
(i) Before tympanic membrane perforation.
①1% phenol glycerin ear drops, anti-inflammatory and pain relief
②1% ephedrine solution and antibiotic nasal drops containing hormone can improve the patency of the eustachian tube and reduce local inflammation.
③If local treatment is ineffective and symptoms are severe, or if the perforation is too small and drainage is poor, tympanotomy should be performed to facilitate patency and drainage. If acute mastoiditis is suspected, mastoidectomy and drainage should be performed immediately after confirmation by x-ray or CT scan.
(ii) After tympanic membrane perforation.
① First clean and swab the external ear canal as thoroughly as possible with 3% hydrogen peroxide solution or use an aspirator to aspirate the pus. (Note that the negative pressure of the suction device should not be too high)
②Local use of antibiotic aqueous ear drops, such as 0.3% oxyfloxacin (Telbital) ear drops, compound rifampicin solution, etc. The use of powder is prohibited to avoid clumping with pus and affecting drainage.
③When the pus decreases and the inflammation gradually subsides, use glycerin or ethanol preparations for ear drops; such as 3% boric acid ethanol glycerin, 3% boric acid ethanol, 5% chloramphenicol glycerin, etc.
④After the infection is completely controlled and the inflammation has completely subsided, the tympanic membrane perforation can heal on its own in some patients.
Precautions
1. Milk can flow into the middle ear through the eustachian tube when children suckle, which can easily lead to this disease, so it is necessary to master good feeding skills.
2. Apply sufficient antibiotics or sulfonamides to control the infection as early as possible until 5-7 days after the symptoms have subsided, in order to cure the disease completely. Do not stop the medication after the symptoms subside, so as not to become chronic otitis media.
3. Physical therapy, such as infrared light and ultra-short wave, can help reduce inflammation and relieve pain.
4. Systemic support therapy, pay attention to rest and regulate diet.
5. Local medication should be used in compliance with doctor’s orders and not used indiscriminately.
6. To actively treat chronic diseases of the nose and pharynx, such as adenoid hypertrophy, chronic sinusitis, chronic tonsillitis, etc.
7. Exercise, improve physical fitness, and actively prevent and treat upper respiratory tract infections. Widely carry out vaccination against various infectious diseases, old tympanic membrane perforation or tympanic ventricle tube placement is prohibited from swimming.