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Abstract: Chronic suppurative otitis media is a common disease in otolaryngology, and early examination and early treatment can cure it, even without leaving traces. Many patients do not pay enough attention to it, which leads to a serious condition and affects the treatment effect. The patient presented in this article came to the clinic with recurrent left ear discharge with hearing loss for six months, which did not improve after self-application of antibiotic treatment, and was finally diagnosed with chronic suppurative otitis media. After conservative treatment and tympanic membrane perforation repair surgery, his hearing improved significantly.
Basic information】Male, 57 years old
Disease Type】Chronic suppurative otitis media
Hospital】Northern War Zone General Hospital
Date of Consultation】October 2021
Treatment plan] External ear canal irrigation + medication (boric acid ice drops, levofloxacin hydrochloride ear drops, eucalyptus citrate enteric soft capsules) + surgery (tympanic membrane perforation repair surgery)
Treatment Period】2 months
Results】The tympanic membrane repair was complete and the patient’s hearing improved significantly
I. Initial consultation
The patient was an amateur swimmer who suddenly developed pus in his left ear with hearing loss after swimming half a year ago, but did not care about it. Because of his hobby of swimming, he continued to go into the water every day. After that, the patient repeatedly developed pus and hearing loss in his left ear, which seriously affected his normal life.
II. Treatment history
The patient’s hearing test results indicated a conductive hearing loss in the left ear, with an average hearing threshold of 50 dB. The endoscopy indicated a large perforation of the tense part of the tympanic membrane in the left ear, and a large amount of purulent discharge in the middle ear tympanic chamber and external ear canal. The CT of the middle ear suggested inflammation within the tympanic chamber, but there was no bone destruction. Finally, the patient was recommended to be treated conservatively first, and the external ear canal was flushed daily for one week in our outpatient clinic to remove the purulent secretions, and after cleaning the ear canal, boric acid ice drops and levofloxacin hydrochloride ear drops were applied. During this period, the patient avoided swimming and water in the ear canal, and took eucalyptus pinene enteric soft capsules orally to promote drainage of secretions in the middle ear cavity, and after the ear dried up, the perforated eardrum was repaired surgically.
III. Treatment effect
After 10 days of outpatient treatment, the patient’s ear canal and middle ear cavity were in a dry state, and she was hospitalized in our department for one month to undergo tympanic membrane perforation repair surgery. The tympanic membrane repair material was selected from the cartilage at the ear screen, which did not leave a scar after the operation and did not affect the patient’s aesthetics, and the cartilage at the ear screen was highly supportive. One month after the surgery, the patient’s eardrum was rechecked in our department. The patient’s hearing was significantly improved and his quality of life was greatly enhanced.
IV. Precautions
After the patient went through the process of external ear canal irrigation + medication + surgery, the patient’s hearing and quality of life improved, and I am truly happy for the patient. In addition, the patient needs to pay attention to the following matters.
1. Avoid water in the ear canal to ensure cleanliness.
2. Avoid catching a cold and blowing your nose hard.
3.After tympanic membrane perforation repair, you need to go to the hospital regularly for medication change.
4.After surgery, eat lightly, avoid smoking, drinking, staying up late, and avoid strenuous activities.
V. Personal insight
Although purulent otitis media is very common, it is often because people do not pay attention to this disease and do not carry out early diagnosis and treatment, which eventually leads to a gradual increase in the area of tympanic membrane perforation, and the patient’s hearing decreases, affecting normal work and life. Therefore, it is recommended that if there is pus in the ear canal, hearing loss and other symptoms must be checked and treated early, do not take drugs on your own, so as not to aggravate the condition and prolong the late treatment time.