Exudative otitis media: symptoms and treatment
Exudative otitis media — pathology of the middle ear, which proceeds without pronounced signs of inflammation, but with the formation of a serous and then purulent exudate in the cavity. This pathology is a kind of otitis media of the middle ear, but it does not show any significant symptoms and with characteristic changes. The most common is exudative otitis media — mostly young children are sick (up to 7 years — 60% of cases, from 10 to 15 years — 10% of cases).
Despite the fact that there is no inflammatory process in this disease, and the tympanic membrane remains intact, the hearing in the child is critically reduced, and if the treatment of the pathology is not started on time, development of third degree hearing loss is possible.
Exudate, formed in this disease in the tympanum, initially has a liquid consistency, but eventually becomes more viscous, and, finally, purulent. The temperature in such pathology as exudative otitis media is absent or subfebrile.
The average otitis media with exudation appears as a result of getting into the infection cavity from the nearby ENT organs. For example, the infection can penetrate into the tympanic cavity with inflammatory processes in the nasopharynx causing mucus edema.
First, the edema of the Eustachian tube occurs, which leads to a narrowing of its lumen and a violation of the outflow of exudate, which normally is produced in the middle ear. Stagnant exudate becomes viscous and its outflow is even more difficult, as a result of which catarrhal otitis develops, which in time assumes exudative form. If the pathology is not treated at this stage of development, exudative otitis media develops, so the slightest hearing impairment and discomfort sensation in the area of the ear canals require a doctor to examine.
Because of the development of the middle ear of inflammation, the fluid that is always produced there, begins to be produced faster, but because of the outflow disturbance it is not excreted, but stagnates. Stagnant exudate is an excellent environment for the reproduction of bacteria and viruses. Over time, the liquid becomes purulent, which leads to a persistent hearing loss, because through purulent exudate sounds can not penetrate into the ear cavity. In a word, any diseases of the nasopharynx should be treated in a timely manner in order to avoid the development of exudative otitis and other complications.
So, the diseases that can lead to the development of this pathology are as follows:
- inflamed or enlarged adenoids
- Nasopharyngeal diseases (rhinitis, tonsillitis, pharyngitis and others)
- allergies to certain substances
- anatomical defects (curvature of the nasal septum)
- common pathologies (typhoid, tuberculosis)
- low immunity.
In addition, a frequent cause of the development of a disease such as exudative otitis in children, is physical pressure, for example, getting into the ear of water.
The exudative form of otitis is difficult to diagnose, because the symptoms of this pathology are either weakly expressed or completely absent. It is especially difficult to identify a disease in a small child who can not tell about his symptoms, so parents should be very careful and follow changes in the behavior of their baby.
The most important symptoms that characterize exudative acute otitis media are:
- feeling of stuffiness in the ear
- impaired perception of sounds (if the otitis has developed in a small child, parents notice that it does not respond to their call the first time)
- nasal congestion.
When the head is tilted, the child feels a splash, as if there is water in his ears, which he can inform his parents about. In addition, the child has a feeling that he hears his own voice in the head, which echoes.
The pain is usually absent with this form of otitis, or is short-lived and not very strong. If the disease in a child or adult is not treated, then after a couple of years, a stable hearing loss develops.
Note that exudative otitis has three stages of flow and can be:
The acute form is said if the disease lasts less than 3 weeks and its symptoms are not expressed, about subacute — when the disease progresses within 3-8 weeks and the chronic form can be said when the duration of the pathology exceeds 8 weeks.
There are also four stages of the disease: primary, secretory, mucous and fibrotic. To treat the disease is easiest at the initial stage, when the symptoms are insignificant — only the ventilation in the Eustachian tube is broken and there is no exudate. At the second, secretory stage, the serous contents are incinerated in the tympanic cavity, causing hearing damage and a feeling of heaviness in the ear. In the third stage, mucous, the exudate becomes a viscous substance. At this time the child is tormented by a sensation of transfusion of fluid in the ear with the bends and turns of the head. The fourth stage is characterized by the development of stable hearing loss and destructive processes in the middle ear, up to the appearance of holes in the tympanic membrane and the development of the choleastomy.
The diagnosis of exudative otitis media is based on the child’s complaints and examination of the patient with the help of an otoscope. Also shown the conduct of radiography, CT of the ear, endoscopy — the choice of the method of diagnosis is determined by the attending physician.
Treatment of this pathology in a child or adult is conservative or surgical. Conservative treatment is the use of certain medications:
- vasoconstrictive drops to facilitate breathing through the nose
- mucolytic agents for liquefaction of mucus;
- antiallergic drugs, allowing to remove puffiness
- antibiotics, to eliminate the attached infection.
Also, the treatment involves taking vitamins to restore and strengthen the protective functions of the body.
Surgical treatment is carried out in two ways: by conducting a one-time procedure of myringotomy (for outflow of exudate) or by installing a reusable catheter for draining the tympanum and injecting its antibacterial agents into it. The second method is used more often and is more effective. Also, treatment requires carrying out physiotherapeutic procedures, such as magnetotherapy, ultrasound, electrophoresis and Polytzer blowing.