I. Acute otitis media Zhao Haiyuan, Department of Otolaryngology, Kaifeng Downtown Hospital
1.Acute non-suppurative otitis media
2.Acute purulent otitis media
3.Acute necrotizing otitis media
4.Acute mastoiditis
Chronic otitis media
1.Chronic non-suppurative otitis media
2.Chronic purulent otitis media (including mastoiditis)
Cholesteatoma otitis media (excluding congenital middle ear cholesteatoma)
1.Acquired primary cholesteatoma
2.Acquired secondary cholesteatoma
4.Otitis media sequelae
1. Tympanic membrane perforation
2.Adhesive otitis media
3.Sclerosis of the tympanic chamber
Surgery for otitis media by type
I. Tympanoplasty
Type I: ① Type I a: tympanoplasty: patch test air conduction (hearing level) is raised to within 30 dB, or hearing loss is below 30 dB, CT examination suggests that the auditory chain is intact, and the tympanic chamber and the auditory chain do not need to be explored during surgery.
② Type I b: the tympanic chamber and auditory chain must be explored, all 3 auditory tuberosities are present, the lever is intact, and the formed tympanic membrane and hamate bone are connected.
Type II: necrosis of the hammer bone stem, graft attached to the anvil bone or hammer bone head, forming a new tympanic membrane.
Type III: ① Type IIIa: supra-stirrup structures are present, the stirrup base plate is mobile, and the tympanic membrane is connected to the stirrup head or to a raised structure on the stirrup head.
② Type IIIb: no suprastapedial structures, movable stapes floor, and the tympanic membrane is connected to the floor by a reconstructed auditory tuberosity.
Type Ⅳ: stirrup base plate is fixed, regardless of the presence of supra-stirrup structures; if the tympanic membrane is intact, a bottom plate opening is performed to reconstruct the sound transmission system; if the tympanic membrane is perforated, the tympanic membrane needs to be repaired after the second stage surgery.
2.Papillary lesion excision
1.Radical mastoidectomy
2.Modified radical mastoidectomy
3.Simple mastoid excision
Papillary lesion excision + tympanoplasty