1. Is otitis media secretory in children a common disease?
Yes, it is. Although, the results of foreign evidence-based medical studies confirm that up to 96% of children have suffered from secretory otitis media and have a high recurrence rate, parents need not be overly concerned. Most acute otitis media can heal on their own, and the vast majority can be completely restored to normal with reasonable treatment, with only a very small number requiring further surgical treatment. Due to the characteristics of growth and development of infants and children, the occurrence and regression of secretory otitis media are different from those of adults and have their own unique characteristics and clinical features. During the growth and development of children, hearing plays an important role in the comprehensive development of children’s cognitive ability and intelligence. Therefore, early diagnosis and reasonable treatment are necessary and urgent. Chronicity can be caused by not receiving timely and appropriate treatment during the acute period, or by repeated attacks and delays. As parents, we should pay attention to the daily behavior of children and strive for early detection, early diagnosis and early treatment.
2. What are the names of otitis media in children?
It is a non-suppurative inflammatory disease of the middle ear characterized by fluid accumulation in the middle ear and hearing loss. Middle ear effusion may be plagioid leaky or exudative fluid, or it may be mucus. Clinicians may call it exudative otitis media, catarrhal otitis media, plasmacytotic otitis media, plasmacytotic mucous otitis media, non-purulent otitis media, etc. For patients, it is actually similar and is now mostly referred to collectively as secretory otitis media.
3. Why do children suffer from such diseases?
The results of medical research have not thoroughly identified the cause, but it is found to be closely related to three major factors, such as pharyngeal duct dysfunction, infection and immune response. Among them, pharyngeal dysfunction is the main cause. In children, adenoid hypertrophy is the most common cause of eustachian tube obstruction or eustachian tube malfunction. In addition, the disease is often secondary to an acute upper respiratory tract infection, most likely a mild or hypotoxic bacterial infection of the middle ear. Finally, because the middle ear is an independent immune defense system that is not yet developed in childhood, this is one of the major reasons why children are susceptible to this disease.
4. What does the eustachian tube do?
The eustachian tube is a muscular tube that connects the middle ear cavity to the nasopharynx. The opening and closing of the lumen of its cartilaginous segment has the function of regulating the air pressure in the middle ear and keeping it in balance with the outside atmosphere. When the eustachian tube is not functioning properly, the outside air cannot enter the middle ear and the gas in the middle ear is gradually absorbed by the mucosa, resulting in negative pressure in the cavity, resulting in swelling of the middle ear mucosa, increased capillary permeability, and leakage of fluid from the tympanic chamber. If the negative pressure persists, the middle ear mucosa may undergo a series of pathological changes, including epithelial thickening, epithelial cell metaplasia, increased cupped cells, increased secretion, pathological gland-like tissue formation under the epithelium, and round cell infiltration around the vessels in the lamina propria, mainly lymphocytes and plasma cells. The glue ear appears in the late stage of chronic otitis media.
5. What are the signs and symptoms of secretory otitis media?
Children often show signs of dullness in listening or inattention. Older children will tell their parents about a feeling of stuffiness or blockage in the ear, hearing loss, and ringing in the ear. It mostly occurs after a cold, or unknowingly.
6.Why must I have a hearing test?
Acoustic impedance-conductance test is the most frequently performed basic audiological diagnostic test and is an important reference for diagnosis. It is also an important basis for determining the degree of recovery from the disease, so doctors will often ask your child to have such a test.
7.How does the doctor diagnose secretory otitis media?
Based on the clinical symptoms of hearing loss, examination reveals signs of tympanic membrane invagination, pink or yellow oil, hairline, etc., and audiological examination reveals B-type tympanic chamber conductivity map, the diagnosis is generally not difficult. However, in rare cases, a diagnostic tympanocentesis under aseptic operation may be required to confirm the diagnosis.
8.What are the methods to treat otitis media with secretion?
(1) Improving middle ear ventilation: Nasal drops containing ephedrine and hormones can be used. In older children, the pinching and puffing method or catheter blowing method can be used.
(2) Removal of middle ear fluid: . Tympanic membrane puncture and aspiration, tympanotomy, tympanic tube placement, etc. Once the tympanic tube is placed, the tube should be removed after the function of the eustachian tube has recovered in about six months.
(3) Find the cause and treat the cause: for adenoid hypertrophy, adenoidectomy is required. Of course, antibiotics can be used to prevent or control the infection during the acute stage.
9.Do I have to undergo surgery for otitis media in children?
(1) First of all, conservative treatment: close observation is required within 3 months of onset. It is recommended to follow up once every 2-4 weeks and treat symptomatically as appropriate. During this period, antibiotics should be used appropriately.
(2) For children with combined rhinitis and nasal obstruction, nasal drops can be used to clear the nasal cavity and use the function of the eustachian tube to recover.
(3) For children suffering from snoring and breath-holding in sleep, surgery of adenoids and tonsils should be actively considered.
(4) Conservative treatment for 3 months without improvement mostly requires tympanotomy placement. In case of nasopharyngeal obstruction or chronic adenoiditis, adenoidectomy is performed.
(5) Re-operation: If the tympanic tube is dislodged or recurs after removal of the tube, re-operation can be performed. When the tube is placed again, adenoidectomy is performed in parallel (except for cleft palate or submucous cleft palate).
10.What do I need to pay attention to during the treatment period?
It is important to standardize the medication, to reduce or avoid the occurrence of colds, and regular follow-up is especially necessary.