I. Etiology.
The main causative agents are pneumococcus, Haemophilus influenzae, and staphylococcus.
Infection is mainly through 3 routes.
1, pharyngeal route is the most common.
(1) Acute upper respiratory tract infection: Bacteria invade the middle ear via the eustachian tube and cause infection.
(2) Acute infectious diseases such as scarlet fever, measles, and whooping cough can be complicated by this disease through the pharyngeal canal route; acute suppurative otitis media can also be a local manifestation of these infectious diseases. This type of lesion often reaches deep into the bone, resulting in serious necrotic lesions.
(3) Bacteria invade the middle ear through the eustachian tube when swimming or diving in sewage, improper blowing of the eustachian tube, nose blowing or nasal treatment, etc.
(4) Infants and children are more prone to middle ear infection via this route because of the anatomical and physiological characteristics of their eustachian tube. Improper breastfeeding position, such as lying down to suckle, can cause milk to flow into the middle ear via the eustachian tube.
2. Tympanic route of the external ear canal.
Tympanic membrane puncture, tympanic chamber tube placement, and tympanic membrane trauma that do not conform to aseptic operation can cause pathogenic bacteria to invade the middle ear directly from the external ear canal.
3. Bloodstream infection.
Rarely seen.
II. The main symptoms are as follows.
1. Ear pain.
Most patients have severe pain before tympanic membrane perforation and do not sleep; if it is pulsating throbbing pain or stabbing pain, it may radiate to the ipsilateral head or teeth, and the pain is reduced after the tympanic membrane perforation and pus flow. A few patients may have no obvious symptoms of ear pain.
2. Hearing loss and tinnitus.
At the early stage of the disease, patients often have obvious ear stuffiness, low-pitched tinnitus and hearing loss. In the later stage, deafness may be reduced after the tympanic membrane is not perforated. In patients with severe ear pain, hearing impairment can be ignored. Some patients may have vertigo.
3. Pus flow.
After the tympanic membrane is perforated, there is fluid flowing out of the ear, which is initially blood-water pus-like and later becomes purulent secretion.
4. Systemic symptoms.
The severity varies. There may be chills, fever, lethargy, and poor appetite. Pediatric elective deep symptoms are heavier, often accompanied by vomiting, diarrhea and other similar gastrointestinal symptoms. Once the tympanic membrane is perforated, the body temperature will gradually drop and the systemic symptoms will be significantly reduced.
Third, treatment.
Control the infection, unobstructed drainage, remove the cause of its treatment principles.
Fourth, disease prevention.
1.Popularize the hygiene knowledge about correct nose blowing and breastfeeding.
2, active prevention and treatment of upper respiratory tract infections and respiratory infectious diseases.
3, there is a gauge perforation or tympanic tube to avoid participating in useful and other activities that may lead to water in the tympanic chamber.