Etiology and treatment of otitis media

Otitis media is an inflammatory disease that affects all or part of the middle ear.Mainly divided into two categories: non-suppurative and suppurative.Non-suppurative ones include secretory otitis media, baro-injury otitis media, etc. Purulent ones are divided into acute and chronic.

XNUMX. Causes of disease

Acute otitis media is an acute purulent inflammation of the mucosa of the middle ear, most commonly infected by the Eustachian tube.After catching a cold, the inflammation of the pharynx and nose spreads to the Eustachian tube, and the mucosa of the pharyngeal mouth of the Eustachian tube and the lumen appear congestion and swelling, and the movement of cilia is impaired.Common pathogens are mainly pneumococcus, Haemophilus influenzae, etc. Therefore, preventing colds can reduce the chance of otitis media.

In addition, smoking cigarettes, including second-hand smoke, can also cause otitis media.Smoking can cause systemic arteriosclerosis, especially when nicotine in cigarettes enters the bloodstream, causing small blood vessels to spasm and increase viscosity, hardening of the arterioles that supply blood to the inner ear, resulting in insufficient blood supply to the inner ear and severely affecting hearing.Cigarettes not only cause otitis media, but also aggravate the condition of otitis media. In severe cases, patients with otitis media can cause permanent deafness.At the same time, NNK, a strong carcinogen in cigarettes, can cause malignant lesions of otitis media, severely affect the impulse nerve, cause long-term head pain and frequent dizziness, and cause half-body paralysis.Therefore, if there are infants, young children and patients with otitis media in the family, they should not smoke cigarettes and try not to be exposed to second-hand smoke.

There are also long-term use of headphones to listen to large decibels of music. If it is for a long time, it is also easy to cause chronic otitis media, causing tissue damage to the ears, hearing loss in severe cases, and other complications, such as otitis media.

XNUMX. What are the symptoms?

1. Hearing loss:When the head is tilted forward or to the healthy side, hearing can be temporarily improved due to the effusion leaving the cochlea (displacement hearing improvement).When the effusion is viscous, the hearing may not change due to changes in head position.Children are often slow to respond to sounds, lack of concentration, and decline in academic performance. Parents seek medical attention.If one ear is sick and the other ear has normal hearing, it can be undetected for a long time, but is only discovered during physical examination.

2. Earache:Acute patients may have faint earache, which is often the first symptom of the patient, which can be persistent or throbbing pain.Chronic earache is not obvious.This disease is often accompanied by occlusion or swelling in the ear, which can be temporarily relieved by pressing the tragus.

3. Tinnitus:Mostly low-key intermittent, such as “crack”, hum, and running water.When the head is moving, yawning, or blowing the nose, the sound of air and water may appear in the ear, and sometimes it will reappear intermittently.

4. The skin around the patient feels “woody” and mentally depressed.

Three, how to treat

1. Actively treat focal diseases of upper respiratory tract, such as chronic sinusitis and chronic tonsillitis.

2. Drug treatment: simple type is mainly for topical medication: antibiotic aqueous solution or a mixture of antibiotics and steroid hormone drugs, such as 0.25% chloramphenicol solution, chloramphenicol cortisone solution, ofloxacin ear drops, Congcong Ear Oil can treat otitis media and external otitis to prevent recurrence and achieve a radical cure.

3. Precautions for topical medication:

①Clean the external ear canal and the pus in the middle ear cavity before applying the medicine. You can clean it with 3% hydrogen peroxide or boric acid, and then wipe it with a cotton swab or suck up the pus with a suction device before dripping the medicine.

②Water is used when the amount of pus is large, and boric acid alcohol can be used when the amount is small.

4. Ear drip method: The patient takes a sitting or lying position with the affected ear facing upward.Gently pull the auricle upward and backward, and instill 3 to 4 drops of the medicinal solution into the outer ear canal.Then tap the tragus with your finger several times to encourage the liquid to flow into the middle ear through the tympanic membrane perforation.You can change your position after a few minutes.Note that ear drops should be as close to body temperature as possible to avoid dizziness.

5. A large perforation of the tympanic membrane affects hearing. Tympanoplasty or tympanoplasty is feasible about 2 months after dry ears.

6. Osteomyelitis-type otitis media, if the drainage is unobstructed, local medication is the main topic, but regular review should be paid attention to.For patients with poor drainage or suspected complications and cholesteatoma-type otitis media, modified radical mastoidectomy or radical mastoidectomy should be performed as soon as possible to completely remove the lesions and prevent complications.

Fourth, how to prevent and protectReason

Incorrect methods of blowing your nose can also cause otitis media.When some people blow their nose, they often use two fingers to pinch the sides of the nose and blow the nose out.This method of blowing the nose not only cannot completely blow the nose, but it is also very dangerous. The nose contains a lot of viruses and bacteria. If both nostrils are pinched and blow hard, the pressure will force the nose to squeeze out the back of the nose and reach the Eustachian tube. Causes otitis media.Therefore, the correct method of blowing the nose should be promoted: hold one nostril with your fingers, blow out the nasal mucus from 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 nasal discharge is difficult to blow out, you can first use chlor-anaesthetic nasal drops to drip the nose, and then blow the nose after the nasal cavity is ventilated.

When swimming, avoid swallowing water into your mouth to prevent water from entering the middle ear through the nasopharynx and causing otitis media.The perforation of the tympanic membrane caused by trauma is forbidden to drip any watery liquid, so as not to affect the healing of the wound, and the external auditory canal can be blocked with a sterile cotton ball to avoid infection and induce otitis media.

If the infant is feeding on the supine position, because the infant’s Eustachian tube is relatively straight, has a short lumen and a wider inner diameter, milk can choke into the middle ear through the Eustachian tube and cause otitis media.Therefore, the mother should take the sitting position when feeding the baby, pick up the baby in an oblique position, and suck the milk with the head upright.

Acute otitis media can be cured and will not recur if you seek medical treatment in time, but chronic otitis media cannot be cured.

Link:      Etiology and treatment of otitis media

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