Chronic suppurative otitis media is a chronic purulent inflammation of the middle ear mucosa, periosteum or deep bone, often in combination with chronic mastoiditis. It is often delayed or improperly treated due to acute suppurative otitis media and becomes chronic; or it is a direct continuation of acute necrotizing otitis media. The presence of chronic lesions in the nose and pharynx is also an important cause. Generally, 6 to 8 weeks after the start of acute inflammation, middle ear inflammation still exists and is collectively referred to as chronic. It is characterized clinically by recurrent pus in the ear, perforation of the eardrum, and hearing loss. Some cases of otitis media can cause serious intracranial and extracranial complications that can be life-threatening. It is classified into three types according to pathology and clinical manifestations.
Simple type, bone ulcer type, and cholesteatoma type. Guidelines for consultation: 1. Determine the type of otitis media. (1) Simplex type: The most common type, mostly appearing after upper respiratory tract infection, with ear pus, mostly intermittent, mucopurulent or mucopurulent, and generally not smelly. The amount varies, and the amount of pus increases in the case of upper respiratory tract infection, and the examination reveals a perforation of the central part of the tympanic membrane (lower left figure). (2) Bone ulcer type: Also known as necrotic or granulomatous type, it is mostly extended from acute necrotic otitis media. Tissue destruction is more extensive, characterized by ear pus flowing mostly continuously, with blood between the pus (3) Cholesteatoma type, but not true tumor, with low amount of pus flowing in the ear, which may have white scales, bean residue-like material and malodor. Sometimes there may be headache and significant hearing loss. 2.A detailed examination of the ear by an otorhinolaryngologist should be requested to distinguish the above types. 3.Actively treat focal diseases of the upper respiratory tract, such as chronic sinusitis and chronic tonsillitis. 4.Medication: Simple types are mainly treated with local medication: aqueous antibiotics or a mixture of antibiotics and steroid hormones, such as 0.25% chloramphenicol solution, chloramphenicol cortisone solution, and oxyfluoxacin ear drops, are available. (1) Clean the pus in the external ear canal and middle ear cavity before using the medication, and use 3% hydrogen peroxide or boric acid water to clean it. (2) When the amount of pus is large, use water, and when the amount is small, use boric acid alcohol. 6.Ear drip method: The patient takes a sitting or lying position with the affected ear facing upward. Gently pull the auricle backwards and upwards and put 3 to 4 drops of medicine into the external ear canal. Then gently press the ear screen several times with your fingers to encourage the drug to flow into the middle ear through the tympanic membrane perforation. Change position only after a few minutes. Note that the ear drops should be as close to the body temperature as possible to avoid vertigo. 7. If a large tympanic membrane perforation affects hearing, tympanic membrane repair or tympanoplasty is feasible about 2 months after dry ear. 8.For osteoid otitis media with clear drainage, local medication should be used mainly, but attention should be paid to regular review. In cases of poor drainage or suspected complications and cholesteatoma-type otitis media, a modified mastoid root canal should be performed early. Modified mastoid radical surgery or mastoid radical surgery should be performed as early as possible to completely remove the lesion and prevent complications.