Acute otitis media

Acute otitis media is caused by the penetration of infection primarily through the Eustachian tube into the middle ear in acute or exacerbation of chronic inflammation of the mucous membranes of the nose and throat (acute rhinitis, influenza, etc.). There are catarrhal and purulent forms of the disease. The breakdown of the ventilation function of Eustachian tube promotes venous stasis in the mucous membrane of the tympanic cavity and the formation of transudate. Serous inflammation caused slabovirulentnoy infection, penetrating from the upper respiratory tract, the weakening of the body's defenses. Otitis media occurs in newborns as a result of contact with the amniotic fluid in the middle ear during passage through the birth canal. It is also important the anatomical structure of the auditory tube (in children it is wider and shorter). There are three stages of acute otitis media: I stage - the emergence of inflammation, the formation of exudate (acute catarrhal otitis media); Stage II - perforation of the tympanic membrane and suppuration (acute purulent otitis media); Stage III - remission of inflammation, reduction and cessation of suppuration, the fusion of the edges of the perforation of the eardrum. The duration of the disease from a few days to a few weeks.

Symptoms depend on the stage during the inflammatory process. In stage I - severe pain in the ear, radiating to the corresponding half of the head, teeth, high body temperature (38-39 degrees Centigrade.), A significant hearing loss by injury type conductive apparatus. At otoscopy early inflammation seen dilated blood vessels, then a flushing of the eardrum, its contours are smoothed. At the end of this stage, the protrusion of the eardrum. In the blood leukocytosis, elevated erythrocyte sedimentation rate. In stage II there is suppuration due to perforation of the eardrum, the pain of this subsides, but can be resumed at a delay of pus drainage. The general condition is improved, the body temperature to normal. At otoscopy at this stage is visible pus, reducing bulging tympanic membrane, but still flushing and smoothness of its contours. In stage III after cessation of suppuration leading complaint can be hearing loss.

The clinical picture of acute otitis media in infants and infants is somewhat different from that of adults. Acute otitis in infants often occur imperceptibly until the appearance of suppuration. In marked otitis baby wakes up at night, restless, cries, wagging his head, the third patient's ear on the pillow, pulled his hand to his ear, refuses the breast (ear pain is amplified due to the increase in middle ear pressure during sucking and swallowing). Usually there nasopharyngitis. Often acute otitis media is combined with meningeal symptom.

Treatment. Bed rest, on the testimony of antibiotics (when suppuration is necessary to determine the sensitivity to them microflora), sulfa drugs, antiseptics. At high temperatures Amidopyrine, acetylsalicylic acid. Locally applied hot compress, heating pad, physiotherapy (solljuks, UHF currents). Vasoconstrictive nose drops. To reduce pain in the ear in the form of heat instilled 96% alcohol or droplets consisting of carbolic acid 0.5 g and 10 g glycerol. When suppuration instillation into the ear stop. In the absence of effect of conservative treatment produces paracentesis of the tympanic membrane. When the suppuration of the external auditory canal is necessary to ensure that it is a good outflow. If after the termination of purulent discharge from the ear and eardrum scarring hearing is reduced, shown blowing, pneumatic massage and UHF-therapy to the area of ​​the ear.