Secretory otitis media, also known as exudative otitis media, catarrhal otitis media, middle ear effusion, and glue ear, is a non-suppurative inflammatory disease of the middle ear that is an important cause of deafness in children and has a significant impact on speech, language, and cognitive development in infants and young children. The incidence of otitis media is on the rise, reaching 27%, and approximately 70% of children under 5 years of age have had a single episode of otitis media. Malfunction of the eustachian tube from various causes, incomplete treatment of acute inflammation of the middle ear, upper respiratory tract metaplasia, endocrine or immune dysfunction can all lead to this disease. Recurrent otitis media should identify the foci and their associated diseases, such as some lesions of the nose, sinuses, and oropharynx, especially chronic focal infections and obstructions, such as adenoid hypertrophy, nasopharyngeal carcinoma, allergic rhinitis, chronic sinusitis, cleft palate, middle ear pneumatic trauma, as well as upper sensation and certain acute infectious diseases such as influenza and measles can trigger middle ear effusion.
Family self-diagnosis points
1. Earache, ear stuffiness or ear swelling pain appears soon after a cold.
2. Hearing impairment continues insidiously, with infants showing poor response to speech and older children having difficulty concentrating in class and having to adjust the volume when watching TV.
3. Hearing test is conductive deafness, acoustic impedance test is type “B” or “C” (negative pressure over 150mmHg).
Treatment method
The principle of treatment is to remove the middle ear fluid, improve the function of the eustachian tube, and eliminate the cause of the disease.
Internal treatment: This is the first and most common treatment for this disease.
Antibiotics, effective antibiotics should be used early and treated with adequate doses until the effusion disappears and the tympanic membrane and hearing return to normal. The average duration is 7 to 14 days.
Adrenal corticosteroids, which should be used in short courses during the acute phase.
Nasal drops to promote contraction of the mucous membrane of the nasal cavity and eustachian tube, which facilitates middle ear ventilation and drainage. For example, Daphnin. In case of allergic rhinitis, spray with Cochlear nasal spray once a day.
In the acute stage, it is recommended to clear the wind and heat, promote lung circulation, permeate dampness and open the orifices. Use Yinhua, forsythia, orris, peppermint, thorny mustard, scutellaria, mulberry peel, psyllium, zedoary, licorice decoction for internal use. In the chronic stage, it is recommended to strengthen the spleen, benefit the lung, dry dampness, resolve phlegm, invigorate blood and open the orifices. Use Chai Hu, Xiang Fu, Chuan Xiong, Poria, Astragalus, Red Peony, Shi Calamus, Atractylodes, Licorice. Decoction of water for internal use. All for one dose daily.
Surgical treatment.
1, tympanic membrane puncture for fluid extraction and drug injection, suitable for those whose tympanic fluid is thin.
2, tympanotomy placement, by internal therapy for 2 to 3 months the effect is not obvious can consider tympanotomy and implantation of middle ear ventilation tube, especially suitable for glue ear, generally maintain more than 3 months, can be up to 1 year.
3. Tympanostomy: The application of laser tympanostomy can prolong the ventilation time of the tympanic membrane perforation hole, which is conducive to the recovery of middle ear lesions and can eliminate the trouble of tube placement and removal and reduce the chance of secondary infection.
4. Eustachian tube treatment: After the elimination of acute upper respiratory tract infection, it is feasible to blow the eustachian tube to promote the development of the eustachian tube.
5, lesion removal: such as adenoids scraping, tonsil removal, nasal septum correction, etc. Children with cleft palate should be repaired early.
Family care and prevention
Strengthen physical exercise, enhance the body’s resistance and actively prevent colds. The most prominent points in the etiology of secretory otitis media are infectious metaplasia, adjacent infectious lesions, adenoid hypertrophy and eustachian tube dysfunction.
When the child’s hearing is duller than before after a cold or when the child’s academic performance decreases, the child should not simply be blamed, but should consult an otolaryngologist as soon as possible. The diagnosis can be confirmed with an early acoustic impedance test of type “B”.
Early active prevention and treatment of otitis media can prevent the occurrence of deafness.