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 ingress of bacteria into the middle ear region through the Eustachian tube. In addition, such 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.
- Congenital defects of the nasal septum.
- Sudden pressure drops.
- Passive smoking.
- Mechanical damage to the auricle.
- Chronic allergic rhinitis.
- Inflammation of the adenoids.
- Improper or excessive use of antibacterial agents.
- General hypothermia.
In the presence of exudative otitis media in children, the diagnosis is difficult, since they cannot accurately describe their feelings.
Symptomatology
It is problematic to determine the presence of exudative otitis media in children, and the clinical picture is not very pronounced, and the child can not always explain his feelings. However, it is necessary to pay attention to such manifestations:
- Gradual decrease in auditory function.
- Aching, mild pain in the ear.
- Sensation of stuffiness in the auditory organ, as well as the nasal passages.
- It may seem to a child that he hears his own voice in his head.
- When tilting or turning in the ear, a splash of fluid is felt. Over time, the exudate begins to stand out.
In general, pain for this disease is rare. The baby does not even 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 media, it is necessary to determine its type. It depends on what drugs will be prescribed. By the duration of the pathological process, these types of disease are distinguished:
- Acute (lasts up to 21 days).
- Subacute (the course of the disease stretches 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 the changes occurring in the mucous membrane of the ear: initial, secretory, productive and degenerative-secretory.
Otitis development stages
Exudative otitis media in a child or adult develops gradually. On this path, it goes through several stages:
- Catarrhal. This is the initial degree of pathology, on which the main symptom appears - congestion in the ear. This stage lasts 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 excreted naturally through the Eustachian tube.
- Mucous. The exudate collected in the middle ear begins to condense, becomes viscous. The sensation of fluid transfusion is gone, the child or adult begins to hear worse. The duration of this stage reaches 2 years.
- Fibrous. Symptoms here are almost completely gone. In the internal structures of the auditory organ, destructive processes begin. Changes at this stage are irreversible.
In each patient, the development of pathology has its own characteristics. Acute exudative otitis media is characterized by a more vivid manifestation of symptoms.
Pathology diagnostics
Treatment of exudative otitis media 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 serious complications increases significantly.
Diagnostics provides for such research methods:
- Visual inspection 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 multi-frequency sounds).
- Endoscopy Here, not only the region of the middle ear is examined, but also the pharyngeal part.
- Roentgenography.
- CT of the temporal bone. This technique is often indicated if there are difficulties in making a diagnosis.
Often, a specialist makes a puncture of the eardrum to obtain the contents and its further study in the laboratory.
Conservative treatment
If the patient has symptoms of exudative otitis media, the fight must be immediately started with the disease. Treatment is prescribed strictly individually. The stage of development of the pathology, the cause of the occurrence, age and characteristics of the patient's body are taken into account. Therapy is carried out using drugs, physiotherapeutic procedures. In difficult cases, surgical intervention will be required.
As for medications, the following drugs can be prescribed to the patient:
- Vasoconstrictor drops: Sanorin, Nazivin. They help eliminate swelling, relieve nasal breathing. They are not buried in the ear.
- Antibiotics: Normax, Sumamed, Amoxiclav. It is possible to use the funds presented only after the sowing on the pathogenic microflora is carried out. Care must be taken with antibiotics to treat children.
- Combined glucocorticosteroids: Hydrocortisone, Sofradex. They are used in severe cases of the disease, characterized by vivid symptoms.
- NSAIDs: Otipax.
- Antihistamines: Cetrin, Loratadine.
In addition to the treatment of exudative otitis media with medications, the patient is prescribed a rehabilitation of inflammatory foci.
Physiotherapeutic procedures
Exudative otitis media can be treated in an adult patient or child not only with drugs. There are effective physiotherapeutic procedures that help not only restore auditory 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 used to improve the mobility of the eardrum.
- Laser Therapy This method of treatment contributes to the activation of biochemical processes in the structures of the middle ear.
- Blowing and catheterization. All these procedures are carried out in the field of the Eustachian tube. Blowing will give a good effect if the disease is not started. Otherwise, it is useless. With a complex course of pathology, a catheter is inserted into the nose, which connects to the opening of the auditory tube. By means of a tube, a corticosteroid is poured inside. After several procedures, the patient feels relief, so all the mucus is washed out. However, the installation of a catheter is contraindicated if perforation of the eardrum is present.
The doctor prescribes physiotherapeutic procedures after evaluating the clinical picture and the effectiveness of the use of drugs.
Surgical intervention
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 relapse of otitis media. The type of operation depends on the severity of the pathology. The following interventions may be prescribed to the patient:
- Myringotomy. During this operation, a small incision is made at the eardrum. Intervention is carried out with preliminary local or general anesthesia. Exudate is removed by syringe, after which the ear cavity is rinsed with hydrocortisone.
- Tympanostomy. A catheter is inserted into an existing opening in the membrane. Such an operation makes it possible to rinse the ear cavity with antibiotics and corticosteroids. Depending on the severity of the disease, the tube may be left in the body for several months.
It is best not to bring to surgery, as the development of complications is possible.
Alternative methods of treatment
Folk remedies are not a panacea, but they can significantly improve the effect of conservative therapy. Such recipes will be useful:
- Chamomile broth. The patient needs to insert turunds moistened in this fluid into the ear canal.
- Baked onion juice. Half the vegetable must be filled with caraway seeds and put in the oven for 10 minutes. After that, juice is squeezed from the onion, which is buried in the sore ear.
- Peppermint Basil Oil. It can be instilled into the ear canal two drops several times a day. The liquid must first be heated. Most often, this type of therapy will be effective in the acute form of exudative otitis media.
Before using folk remedies, you must always consult a doctor.
Complications
Treatment of exudative otitis media and reviews about it are different, it must be carried out immediately after the onset of the first symptoms. In the absence of effective therapy, the patient develops such complications:
- Changes in the structure of the tympanic membrane, the formation of calcareous plaques on it.
- An increase in the volume of connective tissue in the mucous membrane of the middle ear. And it ossifies over time.
- Atrophy of the tympanic membrane, its scarring, damage to its integrity.
- Necrosis of middle ear structures.
- Sustained hearing loss.
Some of these complications cannot be resolved. If the patient later consulted a doctor or the treatment was ineffective, then he may become disabled and may lose his hearing.
Disease prevention
You can prevent the development of the disease by observing such measures:
- Boosting immunity. To do this, the body needs to be tempered, not neglected physical activity, eat vitamins, eat right.
- Visit sanatoriums and resorts where they struggle with ear pathologies.
- Periodically undergo preventive examinations at the ENT.
- Time to get rid of infections and inflammatory processes in the throat, ear, nose.
People who have a problem of exudative otitis media should be registered with a doctor. And do not self-medicate.