Otitis media is an inflammatory lesion involving all or part of the middle ear (including the eustachian tube, tympanic cavity, sinus, and mastoid airspace) and is mostly a nonspecific arrangement of inflammation, especially in children. They can be divided into two main categories: nonsuppurative and suppurative. The non-suppurative ones include secretory otitis media and injury otitis media; the suppurative ones have acute and chronic inflammatory diseases such as tuberculous otitis media. Commonly there are secretory otitis media, acute suppurative otitis media, and cholesteatoma type otitis media and pneumatic damage otitis media.
Inflammation of the middle ear is otitis media, which is a common disease. Otitis media often occurs in children under 8 years of age, but also in people of other ages. It is often a painful complication of an upper respiratory tract infection such as the common cold or throat infection.
Pathology
Chronic otitis media is a chronic inflammation of the middle ear mucosa, tympanic membrane or deep into the bone, often in combination with chronic mastoiditis. Chronic otitis media may also develop if acute otitis media is not treated in a timely manner or if the condition is more severe.
Etiology
Acute otitis media is an acute purulent inflammation of the middle ear mucosa, most commonly caused by infection through the eustachian tube. After a cold, inflammation in the pharynx and nose spreads to the eustachian tube, causing congestion and swelling of the mucosa of the pharyngeal opening and lumen of the eustachian tube, and impairment of cilia movement. The common pathogenic bacteria are mainly pneumococcus and Haemophilus influenzae, so preventing colds can reduce the chance of developing otitis media.
Improper nose blowing can also lead to otitis media. Some people tend to use two fingers to pinch both sides of the nose when blowing the nose and forcefully blow out the snot. This method of blowing the nose not only fails to completely blow the nose but is also dangerous, as the nose contains a large number of viruses and bacteria, and if both nostrils are pinched and blown with force, the pressure forces the nose to squeeze out the posterior nostril and reach the eustachian tube, causing otitis media. Therefore, the correct way to blow the nose should be advocated: press one nostril with your finger and blow the nasal snot out of the opposite nostril with a little force, and then blow the other side with the same method. If the nasal cavity is blocked and the snot is not easy to blow out, you can first use chloroma nose drops and then blow the nose after the nasal cavity is aerated.
When swimming, avoid swallowing water into the mouth so that the water does not enter the middle ear through the nasopharynx and cause otitis media. Any watery liquid drops are forbidden for tympanic membrane perforation due to trauma to avoid affecting the healing of the wound, and sterile cotton balls can be used to block the external ear canal to avoid infection induced otitis media.
If an infant is breastfed in the supine position, milk may choke into the middle ear via the eustachian tube and cause otitis media because the eustachian tube is relatively straight, and the lumen is short and the inner diameter is wide. Therefore, mothers should breastfeed their children in a sitting position, holding the baby in an oblique position with the head upright and sucking milk.
In addition, smoking cigarettes, including secondhand smoke, can also cause otitis media. Cigarette smoking can cause systemic atherosclerosis, especially when nicotine from cigarettes enters the bloodstream, causing small blood vessels to spasm and increase in viscosity, causing hardening of the micro-arteries that supply blood to the inner ear, resulting in insufficient blood supply to the inner ear and seriously affecting hearing. Cigarettes not only cause otitis media, but also aggravate the condition of otitis media, and in serious cases, can cause permanent deafness in patients with otitis media. At the same time, NNK, a strong carcinogen in cigarettes, can cause malignant otitis media, which can seriously affect the impulse nerve, causing long-term head pain and frequent dizziness, and can cause hemiplegia. Therefore, if you have infants and children with otitis media, you should not smoke cigarettes and should not be exposed to second-hand smoke as much as possible.
Also, listening to rock music at high decibels with headphones for a long time can cause chronic otitis media, which can cause tissue damage to the ears and, in severe cases, hearing loss and other complications, such as otitis media.
Classification
1. chronic otitis media.
2. acute non-suppurative otitis media.
3.Acute suppurative otitis media.
4.chronic suppurative otitis media.
5. otitis media with bone ulcer.
6. cholesteatoma-type otitis media.
7. aviation otitis media.
8, acute otitis media.
9.Adhesive otitis media.
10.Plasmacytoid otitis media.
Symptoms
Otitis media is characterized by a feeling of stuffiness or blockage in the ear, hearing loss and tinnitus as the most common symptoms. It often occurs after a cold, or unconsciously. Sometimes the hearing can be improved by a change in head position. There is self-hearing enhancement. Some patients have mild ear pain. Children often show dullness in hearing or inattention.
1. Hearing loss.
Hearing loss, self-hearing enhancement. When the head is tilted forward or to the healthy side, the hearing can be temporarily improved because of the fluid leaving the cochlea (varicose hearing improvement). When the fluid is viscous, the hearing may not change with the change of head position. Children are often brought to the doctor by their parents because they are slow to respond to sound, inattentive, and have decreased academic performance. If one ear is diseased and the other ear has normal hearing, it may go undetected for a long time and be discovered during a physical examination.
2. Earache.
In acute cases, there may be vague ear pain, which is often the first symptom of the patient and may be continuous or throbbing. In chronic cases, the ear pain is not obvious. The disease is often accompanied by a feeling of occlusion or stuffiness in the ear, which can be temporarily relieved after pressing the ear screen.
3. Tinnitus.
It is mostly low-pitched and intermittent, such as “popping” sound, buzzing sound and running water sound. When the head moves or yawns or blows the nose, the sound of air passing through water in the ear may appear again sometimes intermittently.
Hazards
In addition, if chronic rhinitis, chronic sinusitis and chronic tonsillitis are present, bacteria may repeatedly invade the middle ear cavity and cause chronic otitis media by latent otitis media.
Chronic otitis media is divided into three types according to the duration and severity of the disease: simple, abscess and cholesteatoma. The common manifestation of all of them is that they all have pus in the ear, which is repeated, and sometimes the pus is mixed with bloody secretions; in addition, there is tinnitus and hearing loss, and if complications arise, there is vertigo and headache.
Although ear pus and hearing loss are annoying, they are not the most important thing for patients with chronic otitis media. The most worrying thing is the emergence of complications, which the patient often feels nothing before they appear, but if they appear, then the condition is often serious, and in some cases even life-threatening, and therefore requires immediate hospitalization.
What are the complications of chronic suppurative otitis media? Briefly, they can be divided into extracranial complications and intracranial complications.
Examination
The doctor will use an otoscope to examine the child’s ear. If there are exudates in the ear, they may be collected to identify the organisms causing the symptoms; the child may be put on a course of antibiotics; and the child’s hearing may be rechecked three months after the otitis media has occurred to confirm that it is back to normal. If the child still has hearing problems, the cause may be wet ear.
Treatment
1. Active treatment of focal diseases of the upper respiratory tract, such as chronic sinusitis and chronic tonsillitis.
2.Medication: Simple type is mainly 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.
3.Precautions for local medication.
①Clean the pus in the external ear canal and middle ear cavity before applying medication.
When the amount of pus is large, use water, and when the amount is small, use boric acid alcohol.
4.Ear drip method: The patient takes a sitting or lying position with the affected ear facing upward. Gently pull the auricle backward and upward, and put 3-4 drops of medicine into the external ear canal. Then gently press the ear screen several times with your fingers to encourage the fluid 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.
5. If a large tympanic membrane perforation affects hearing, tympanic membrane repair or tympanoplasty is feasible about 2 months after dry ear.
6.For osteoid otitis media with clear drainage, local medication should be used mainly, but attention should be paid to regular review. For those with poor drainage or suspected complications and cholesteatoma-type otitis media, modified mastoid radical surgery or mastoid radical surgery should be performed early to completely remove the lesion and prevent complications.
Post-treatment observation
Symptoms of otitis media.
The juice exuded from the ear may sometimes remain in the ear for up to 3 months, so the affected child may still have partial hearing loss. A cracked eardrum heals in about a week or so. The eustachian tube widens as the child grows, making it easier for the fluid to drain. As a result, the middle ear is less likely to become infected. After the child is seven or eight years old, otitis media is less likely to recur.
Care
1. Pay attention to rest and ensure sleep time.
2. Pay attention to indoor air circulation and keep the nasal passages clear.
3.Actively treat nasal diseases. Blowing the nose should not be done with force or by pressing both nostrils closed at the same time, but by cross unilateral blowing.
4.Let the water in the ear flow out after swimming. Those suffering from chronic otitis media should not swim.
5.Actively prevent and treat colds.
Precautions
1.When taking off or descending from an airplane, you can eat snacks and use swallowing, soft palate movement and jaw movement to reduce the chance of getting sick.
2.After getting sick, you can do self-eustachian tube blowing, regardless of the time and number of times.
3.Try to rest more and keep the surrounding environment quiet.
4.Keep your mood stable and take your medication on time.
5.If there is tympanic membrane damage, pay attention to keep the external ear canal clean and dry, and also use disinfectant cotton loosely plugged in the external ear canal mouth.
6.If you have tympanic membrane damage, pay attention to prevent water intrusion when showering or shampooing. Swimming is forbidden.
Dietary contraindications
1.No smoking or alcohol.
2, contraindicated spicy, spices and other stimulating food.
3, contraindicated to take hot tonic, such as ginseng, cinnamon, sago, antler, whip, tonic cream and so on.
4, avoid seafood and other fishy food.