Exudative otitis media is an inflammatory lesion localized in the middle ear and characterized by the formation of exudate. It represents the second stage of the inflammatory process. Most often, the disease is diagnosed in children 3-7 years old. This is due to the structural features of the hearing aid.
Causes of the disease
The main reason for the development of exudative otitis media is the entry of bacteria into the middle ear area through the Eustachian tube. In addition, the following negative factors contribute to the pathological process:
- Weakening of the body's defenses due to infectious and inflammatory diseases.
- Cold water entering the ear cavity.
- Birth defects of the nasal septum.
- Sudden pressure drops.
- Passive smoking.
- Mechanical damage to the auricle.
- Chronic allergic rhinitis.
- Inflammation of the adenoids.
- Misuse or overuse of antibacterials.
- General hypothermia.
In the presence of exudative otitis media in childrendiagnosis is difficult as they cannot accurately describe how they feel.
Symptomatics
It is problematic to determine the presence of exudative otitis media in children, and the clinical picture is not expressed very clearly, and the child cannot always explain his feelings. However, it is necessary to pay attention to such manifestations:
- Gradual decline in hearing function.
- Aching, mild pain in the ear.
- Feeling of congestion in the auditory organ, as well as nasal passages.
- Child may think he hears his own voice in his head.
- When you tilt or turn, you feel a splash of liquid in your ear. Over time, the exudate begins to stand out.
In general, pain for this disease is rare. The baby does not always have a fever. However, if you miss the moment of the initial manifestations of the disease, then after a few months the patient will develop hearing loss.
Forms of pathology
Before treating exudative otitis, it is necessary to determine its type. It depends on what drugs will be prescribed. According to the duration of the pathological process, the following types of disease are distinguished:
- Acute (lasts up to 21 days).
- Subacute (the course of the disease is extended for up to 8 weeks).
- Chronic. In this case, the duration of otitis is more than 2 months.
You can also classify the pathology according to changes occurring in the mucous membrane of the ear: initial, secretory, productive and degenerative-secretory.
Stages of development of otitis media
Exudative otitis in a child or adult develops gradually. Along the way, he goes through several stages:
- Catarrhal. This is the initial degree of pathology, at which the main symptom appears - congestion in the ear. This stage lasts for about a month.
- Secretory. At this stage, fluid accumulates in the ear, so the baby is able to hear gurgling in the head. Exudate cannot be expelled naturally through the Eustachian tube.
- Mucosal. Exudate, collected in the middle ear, begins to thicken, becomes viscous. The sensation of fluid transfusion goes away, the child or adult begins to hear worse. The duration of this stage reaches 2 years.
- Fibrous. The symptoms are almost completely gone. Destructive processes begin in the internal structures of the auditory organ. Changes at this stage are irreversible.
Each patient has its own characteristics of pathology development. Acute exudative otitis is characterized by a more pronounced manifestation of symptoms.
Diagnosis of pathology
Treatment of exudative otitis should not be carried out independently. First you need to visit a doctor and make sure the diagnosis is correct. Otherwise, the risk of developing severe complications increases significantly.
Diagnosis provides for the following research methods:
- Visual examination of the patient. Using a special device, the doctor assesses the condition of the ear cavity,as well as the Eustachian tube.
- Checking the mobility of the membrane. This procedure is called tympanometry. To obtain a result, a certain pressure is created in the ear canal.
- Audiometry (measurement of hearing level under the influence of sounds of different frequencies).
- Endoscopy. Here, not only the middle ear area is examined, but also the pharyngeal part.
- X-ray.
- CT of the temporal bone. This technique is more often indicated if there are difficulties in making a diagnosis.
It is not uncommon for a specialist to puncture the eardrum to obtain the contents and further study them in the laboratory.
Conservative treatment
If a patient has symptoms of exudative otitis media, the disease must be fought immediately. Treatment is prescribed strictly individually. The stage of development of the pathology, the cause of occurrence, the age and characteristics of the patient's body are taken into account. Therapy is carried out using medicines, physiotherapy procedures. In difficult cases, surgery will be required.
As for medications, the following remedies can be prescribed to the patient:
- Vasoconstrictive drops: "Sanorin", "Nazivin". They help eliminate swelling, facilitate nasal breathing. They are not buried in the ear.
- Antibiotics: "Normax", "Sumamed", "Amoxiclav". You can use the presented funds only after sowing onpathogenic microflora. Be careful when using antibiotics in children.
- Combined glucocorticosteroids: Hydrocortisone, Sofradex. They are used in a severe course of the disease, characterized by vivid symptoms.
- NSAID: Otipax.
- Antihistamine drugs: Cetrin, Loratadine.
In addition to the treatment of exudative otitis media with medicines, the patient is prescribed sanitation of inflammatory foci.
Physiotherapy treatments
It is possible to treat exudative otitis in an adult patient or a child not only with the help of medicines. There are effective physiotherapy procedures that help not only restore hearing function, but also remove exudate, accelerate the regeneration of damaged tissues, and prevent the development of complications.
The most effective among them are:
- Electrophoresis. To achieve a positive effect, the electrode must be placed in the ear canal. Additionally, the drug "Lidase" is applied to it. Electrophoresis improves blood microcirculation. The patient will need at least 12 sessions, the duration of which is 20 minutes.
- Pneumatic massage. It is carried out using a special device in a hospital or at home. A procedure is applied to improve the mobility of the eardrum.
- Laser therapy. This type of treatment promotesbiochemical processes in the structures of the middle ear.
- Inflation and catheterization. All these procedures are performed in the area of the Eustachian tube. Blowing will give a good effect if the disease is not running. Otherwise, it is useless. With a complex course of pathology, a catheter is inserted into the nose, which is connected to the opening of the auditory tube. A corticosteroid is infused through a tube. After several procedures, the patient feels relieved, so all the mucus is washed out. However, placement of a catheter is contraindicated if there is a perforation of the tympanic membrane.
The doctor prescribes physiotherapeutic procedures after evaluating the clinical picture and the effectiveness of the drugs.
Surgery
If there is no effect from conservative treatment, then the patient is prescribed surgery. Thanks to him, the doctor eliminates the exudate that has accumulated in the middle ear, and also restores normal auditory functions. Intervention can prevent the development of recurrence of otitis media. The type of operation depends on the severity of the pathology. The following interventions may be prescribed for the patient:
- Myringotomy. During this operation, a small incision is made in the eardrum. The intervention is performed under local or general anesthesia. The exudate is removed with a syringe, after which the ear cavity is washed with hydrocortisone.
- Tympanostomy. The catheter is inserted into an existing hole in the membrane. This operation makes it possible to wash the ear cavityantibiotics and corticosteroids. Depending on the severity of the disease, the tube may be left in the organ for several months.
It is best not to bring to surgery, as complications may develop.
Folk treatments
Folk remedies are not a panacea, but they can significantly improve the effect of conservative therapy. The following recipes will be useful:
- Chamomile decoction. The patient needs to insert turundas soaked in this liquid into the ear canal.
- Baked onion juice. Half of the vegetable should be filled with cumin seeds and put in the oven for 10 minutes. After that, the juice is squeezed out of the onion, which is buried in the sore ear.
- Mint-leaved basil oil. It can be instilled into the ear canal, two drops several times a day. The liquid needs to be warmed up first. Most often, this type of therapy will be effective in the acute form of exudative otitis media.
Before using folk remedies, be sure to consult a doctor.
Complications
Treatment of exudative otitis and reviews about it are different, it must be carried out immediately after the first symptoms appear. In the absence of effective therapy, the patient develops the following complications:
- Changes in the structure of the eardrum, the formation of calcareous plaques on it.
- Increase in the volume of connective tissue in the mucous membrane of the middle ear. And sheossifies over time.
- Atrophy of the tympanic membrane, its scarring, damage to its integrity.
- Necrosis of the structures of the middle ear.
- Persistent hearing loss.
Some of these complications will not be eliminated. If the patient turned to the doctor late or the treatment was ineffective, then he may become disabled and lose his hearing.
Disease prevention
You can prevent the development of the disease by observing the following measures:
- Increasing immunity. To do this, the body needs to be tempered, do not neglect physical activity, take vitamins, eat right.
- Visit sanatoriums and resorts where they struggle with ear pathologies.
- Periodically undergo preventive examinations at the ENT.
- Timely get rid of infections and inflammatory processes in the throat, ear, nose.
People who have a problem with exudative otitis should be registered with a doctor. And don't self-medicate.
