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Abstract: Acute tympanitis is an acute general inflammation of the tympanic membrane, mostly due to acute inflammation of the external ear canal spreading to the tympanic membrane, and may also be associated with factors such as foreign bodies in the external ear canal and cerumen embolism. In this case, a 45-year-old female patient came to the clinic with pain in the ear canal for 2 days and worsening symptoms. The diagnosis of acute tympanitis was clearly made by physical examination, routine blood tests, pure tone hearing threshold test, and ultrasound examination of submandibular lymph nodes. She was treated with medication and her symptoms improved, and her condition recovered gradually.
Basic information】Female, 45 years old
Disease Type】Acute tympanitis
Hospital】Northern War Zone General Hospital
Date of consultation】September 2021
Treatment plan】Medication (amoxicillin sodium for injection + lomefloxacin hydrochloride ear drops)
Treatment Period】6 days of outpatient treatment
Effectiveness】After treatment, the symptoms improved, the indicators gradually recovered, and the disease was cured.
I. Initial Consultation
One day in September 2021, a middle-aged female patient was seen in the outpatient clinic. The patient reported that she had developed ear pain two days ago without any obvious cause. The pain was mild and intermittent at first, so she did not pay attention to it. On examination of the patient, it was found that a large amount of cerumen was attached to the external auditory canal, obscuring the eardrum. The cerumen was removed with lance forceps and the deep part of the external auditory canal and its tympanic membrane were significantly congested, with indistinct tympanic membrane markers. The patient was advised to undergo further examination to clarify the diagnosis.
II. Treatment history
After brief communication with the patient, blood tests were recommended, which showed a significant increase in leukocytes and C-reactive protein; pure tone audiometry suggested a conductive hearing loss, and the patient was diagnosed with acute tympanitis. Because of the patient’s pain and other inflammatory reactions, the patient was recommended to receive fluids for treatment. The medication may be considered amoxicillin sodium for injection. At the same time of infusion, the patient was advised to apply topical lomefloxacin hydrochloride ear drops in the ear to reduce inflammation and observe clinical symptoms for 3-5 days with regular medication. The patient had no change of symptoms during the treatment period and the overall trend was good.
III. Treatment effect
The patient was treated for 6 days from the outpatient visit, during which the patient was cooperative and actively treated. The ear pain, hearing loss and tinnitus symptoms at the time of admission disappeared and the patient could work and live normally. Post-treatment checkup revealed that the mandibular lymph nodes disappeared; the tympanic membrane congestion under the endoscope improved significantly. In addition, the patient was advised to stop using lomefloxacin hydrochloride ear drops for 2 days, and the repeat blood test indicated that it had returned to normal. In summary, the symptoms improved after treatment, and the indicators gradually recovered and the condition was cured.
IV. Precautions
The patient recovered from the disease after active treatment, and I was as happy as the patient. However, the end of treatment does not mean that there will never be a relapse, and daily care is equally important. Patients should strengthen nutrition and exercise properly to improve their health and reduce the chance of bacterial and viral infections. During the consolidation of treatment, bathing in public baths is not recommended; pay attention to temperature changes to avoid catching a cold; cerumen secretion is usually high and needs to be cleaned regularly at the hospital.
V. Personal insight
Acute tympanitis is a common clinical disease in otorhinolaryngology with many causes. Clinical symptoms include ear pain, stuffy feeling, tinnitus, etc. Serious cases may induce lymphatic inflammation. For the patient in this case, the main etiology considered the long-term accumulation of cerumen in the patient’s ear canal, which eventually induced infection, showing the importance of regular cerumen cleaning to avoid the formation of embolism. Therefore, if symptoms such as ear pain and ear swelling occur, you should seek medical attention and treat them symptomatically, which usually heals in about 1 week after active treatment. In addition, ensure a positive and optimistic attitude, eat a light diet, and avoid smoking and drinking alcohol.