Exudative otitis media (ESO ) is called chronic form Otitis media, in which pathological fluid (exudate) accumulates in the middle ear as a result of damage to its mucous membrane. In ESO, integrity eardrum is not disturbed and in the absence of an inflammatory process in the nasal cavity, nasopharynx and oropharynx, infection of the middle ear does not occur, despite the fact that the formed exudate is a favorable environment for the development of viruses and bacteria, since it is a protein environment.
Precisely because the exudate contains a large amount of protein, over time it changes its physical properties(thickens, becomes viscous), which leads to a long and severe course of the disease.
Pain is one of the signs of inflammation. The absence of inflammatory changes in the middle ear explains that ESO is painless. This is the insidiousness of this pathology.
In the medical literature you can find other names for this common disease, namely: “ exudative otitis media», « secretory», « mucosal otitis media», « effusion otitis media", "gleu ear" - "sticky ear".
Causes of exudative otitis media in children
The main reasons contributing to the development of ESO are:
Changes in the mucous membrane auditory tube against the background of acute and chronic inflammatory diseases of the nose, paranasal sinuses and nasopharynx as a result of decreased immunity,
Dysfunction of the auditory tube, due to dysfunction of the muscles that open it,
Obturation of the mouth of the auditory tube with adenoid vegetations (growths), hyperplastic (enlarged) tubal tonsil, cicatricial changes, benign and malignant neoplasms nasopharynx,
Ineffective treatment of acute otitis media,
Anatomical and physiological characteristics development of the auditory tube in childhood.
It should be noted that one of the predisposing factors for the occurrence of ESO is visiting a children's day care center. At the age of 2 to 7 years, the development of this pathology may be preceded by an acute viral infection, chronic adenoiditis, and acute catarrhal otitis media. In children aged 8 to 15 years, the development of exudative otitis media occurs against the background of vasomotor rhinitis or chronic rhinosinusitis.
Types of exudative otitis media in children
According to their duration, ESO is divided into three shapes currents: acute (up to 3 weeks), subacute (3 to 8 weeks) and chronic (more than 8 weeks).
According to the nature of the changes occurring in the mucous membrane of the middle ear, there are: four forms of ESO : initial exudative, secretory, productive secretory, degenerative-secretory(with a predominance of fibrosclerotic process).
There is another classification of ESP, which is based on similar principles (physical parameters of the content tympanic cavity: viscosity, transparency, color, density and duration pathological process). It distinguishes four stages of the course of ESO: catarrhal (up to 1 month), secretory (from 1 to 12 months), mucosal (from 12 to 24 months), fibrous (more than 24 months).
Exudative otitis media in children.
Both adults and young patients suffer from exudative otitis media. But diagnosing exudative otitis in a child can be more difficult than in adults, not only due to insufficiently clear symptoms, but also due to the difficulties that arise during the collection of complaints and anamnesis (young patients do not complain). Complaints and clinical picture directly depend on the stage of the disease. The initial stage of ESO is characterized by scant complaints and clinical manifestations.
In most cases, parents seek assistance medical care the child only when they notice a decrease in his hearing, that is, the child begins to speak loudly, does not immediately respond to calls, asks to increase the volume when watching children's television programs, which already corresponds to the productive secretory form of the disease. It is the absence pain syndrome and leads to late detection of ESO. But sometimes young patients are able to describe their feelings. Adults consult a doctor with complaints of a sensation of fluid in the ear (“gurgling”), a feeling of fullness, autophony, and changes in hearing depending on the tilt of the head.
Diagnosis of exudative otitis media in children
To diagnose EOS, an audiological examination is carried out in the Federal State Budgetary Institution NKTsO FMBA of Russia in the Department of Pediatric ENT Pathology, which consists of acoustic impedance testing and tone threshold audiometry. For patients with this pathology, acoustic impedansometry is characterized by a tympanometric curve of type “B” and the absence of ipsi-reflexes, which reflects a violation of the transmission of the sound signal along the chain of auditory ossicles due to the pathological contents of the middle ear (exudate); on the audiogram - an increase in thresholds for air conduction up to 30-40 dB, mainly at low frequencies, bone conduction not changed. In case of recurrent course of exudative otitis media, specialists from the Department of Pediatric ENT Pathology in mandatory the patient is prescribed a computed tomography (CT) scan temporal bones to obtain a reliable picture of the airiness of the middle ear cavity, the state of its mucous membrane, the chain of auditory ossicles, the windows of the labyrinth and the bony part of the auditory tube, the density and localization of pathological contents.
To identify the causes contributing to the occurrence of ESO, the patient in the department of pediatric ENT pathology of the National Clinical Clinical Center of the Federal Medical and Biological Agency of Russia undergoes endoscopic examination nasal cavity and nasopharynx or X-ray examination nasopharynx (in young children when endoscopy is not possible) and paranasal sinuses.
Treatment of exudative otitis media
Treatment of patients diagnosed with ESO is aimed at eliminating the causes that led to dysfunction of the auditory tube, followed by restoration of hearing and preventing the development of morphological changes mucous membrane of the middle ear.
Treatment tactics directly depend on the stage of the disease. At the initial stages, conservative treatment methods are prescribed:
Blowing of the auditory tubes according to Politzer;
Catheterization of auditory tubes;
Physiotherapy (endoural electrophoresis with proteolytic enzymes),
Drug treatment ( antihistamines, vasoconstrictors, mucolytic drugs).
If conservative methods of therapy are ineffective, the patient is advised to undergo surgical treatment, aimed at eliminating the causes leading to blockage of the mouth of the auditory tube and disruption of its functions (adenotomy, operations on the paranasal sinuses for the rehabilitation of chronic foci of infection).
If two to three months after surgical treatment If pathological contents remain in the middle ear cavity and there is no aeration, then otosurgical intervention is performed (myringotomy, tympanotomy with the introduction of a ventilation tube).
Audiological monitoring is carried out 2-3 months after surgical intervention. When the child’s hearing is normal, the ventilation tube is removed.
In the Department of Pediatric ENT Pathology of the Federal State Budgetary Institution NCCO FMBA of Russia under the leadership of Doctor of Medical Sciences, Prof. Yunusova A.S. successfully carry out the full range of treatment for exudative otitis media both in outpatient and inpatient settings.
Otitis media is one of the most common childhood diseases. The course of the disease can have several stages and depends on the child’s immunity, hereditary features of the structure of the hearing aid, the presence allergic reactions. Exudative otitis may give way to purulent manifestations with fever and general toxicosis. How does the disease develop and what to do if a child is diagnosed with this?
– inflammatory disease of the external, middle or inner ear. The term exudative refers to inflammation, which is accompanied by the release of exudate (liquid). This stage is inflammation without the formation of pus.
Another name for non-purulent inflammation is catarrhal or secretory otitis. Therefore, the exudative form is also called catarrhal and secretory inflammation of the middle ear. What are the features of catarrhal exudative inflammation in children?
The overwhelming majority of childhood otitis are complications of colds or viral infections. Colds and viral diseases are accompanied by swelling of the mucous membranes. The human hearing aid is designed in such a way that the ear is connected to the pharyngeal passage by a hollow tube covered with mucous tissue.
As a result of swelling of the auditory tube, its lumen narrows. When the lumen is completely narrowed, a vacuum is formed in the middle ear. Liquid from the cells of the mucous membrane sweats into the vacuum space. Thus, the middle ear cavity is filled with liquid mucus (exudate).
Swelling of the mucous membrane inside the hearing aid in children can occur due to an allergic reaction. Then the child develops allergic exudative otitis media. The cause of edema is not as important for the disease as the fact that pathogenic bacteria can settle on the resulting mucus.
If a bacterial infection settles on the exudate, the next stage of the disease forms - purulent otitis media. The purulent stage is a complication of exudative inflammation.
Catarrhal otitis media in children is almost always bilateral (with a cold, all mucous membranes swell). – can develop on one side, then it is called unilateral otitis media with bacterial infection.
Causes
Otitis media in children is formed due to two reasons: infection of the nasopharynx and narrowing of the lumen of the auditory tube. If the cause is a narrowing of the lumen of the auditory eustachian tube (its edema), then exudative (catarrhal) otitis media is formed. If a nasopharyngeal infection is present, the disease develops with a purulent complication.
Nasopharyngeal infections include frequent or chronic runny nose, . In children, enlarged adenoids are a source of toxins, compress the tube and narrow its lumen.
In some children, the structure of the auditory tube is too straight and short. With this hereditary factor Children's colds are often complicated by inflammation of the ear canals (bilateral catarrhal otitis media).
Symptoms
With the appearance of exudate, the sick child hears worse. He may feel stuffiness and noise in the ears (the first symptoms of otitis media), urgent treatment is necessary. In addition, children have impaired nasal breathing and pain (first short-term, then constant and sharp).
Severe throbbing pain occurs when purulent stage diseases. If the otitis media is catarrhal (exudative), then at the beginning of the disease, pain may occur periodically due to mechanical impact on the ear. When the diagnosis of “exudative (catarrhal) otitis” is in doubt, then tomography of the temporal bones and endoscopy of the nasopharynx are used to clarify the condition of the middle ear.
Treatment
Effective treatment of exudative inflammation should be aimed at:
- eliminating the cause of otitis ( inflammatory disease nasopharynx);
- relieving swelling and restoring the lumen of the auditory eustachian tube;
- reducing inflammation and blocking the formation of liquid exudate.
Treatment of the exudative stage does not require the use of antibiotics.
Nasal drops and rinsing
Exudative otitis media is cured when the lumen of the auditory tube is restored. For this purpose they use vasoconstrictor drops. They are buried not in the ear, but in the child’s nose. Rinsing the nose in children removes mucus from the sinuses and creates conditions for its outflow through the auditory tube. Nasal rinsing is performed with physiological saline solution.
Compresses
Treatment will be effective if you use different treatments: nasal drops, compresses externally, immunostimulants internally. Compresses are made based on alcohol tinctures medicinal plants and remedies (calendula, mint, eucalyptus, propolis).
Exudative otitis media refers to one of the forms of middle ear diseases. The symptoms of this disease are extremely difficult to notice, which makes therapy difficult. The disease can progress in both adults and children. In order to begin treatment at home, it is necessary to study the course of the disease and possible complications in more detail.
Causes
Ear affected by exudative otitis media
Exudative otitis media differs from other diseases of ear inflammation. This disease is caused by harmful bacteria and infections, which are also the causes of other pathologies. Most often, exudative otitis media is detected in children. These statistics are due to the fact that children's body more vulnerable to various harmful bacteria. that actively respond to infection. In an adult, atrophy of such tonsils occurs.
More often the cause exudative otitis media is inflammation of the auditory tube and nasopharynx. When the auditory tube malfunctions, it causes inflammation, which subsequently develops into exudative otitis media.
Children often get sick. This course of the disease occurs due to inflammation of the adenoids. When the tonsils become inflamed, they block the nasopharynx, which leads to a runny nose and ear infections.
Exudative otitis media can occur when:
- deviated nasal septum;
- viral and infectious disease;
- reduced immunity;
- various injuries;
- barotrauma;
- ingress of liquid (water);
- third party item.
When the first signs appear, it is necessary to begin therapy immediately, as this disease can develop into a chronic form.
Symptoms of the disease
The main symptoms of the disease include:
- decreased hearing;
- congestion in the ears;
- increasing the audibility of your voice when speaking;
- noise in ears;
- a feeling of fluid in the ears (when changing position, such fluid may flow or gurgle);
It is worth considering that nasal congestion does not always occur with exudative otitis media. Partial occurs accompanied by the presence of fluid in the middle ear. Usually, painful sensations do not arise.
Exudative otitis media can progress for several months without visible symptoms of this pathology. has symptoms in the first stages, so it is easy to identify which of the pathologies a person has fallen ill with. But if the disease is not treated in time, it can lead to irreversible consequences. The treatment of the disease itself is not difficult, but it is preferable to start therapy at the first symptoms of the disease.
Stages of the disease
There are 4 stages of exudative otitis media:
- Initial;
- Secretory;
- Mucosal;
- Fibrous.
Initial. This stage is caused by a decrease in the quality of hearing. The duration of this period is about a month. There is a deterioration in ear ventilation, which leads to an increase in the audibility of one’s own voice when speaking.
Secretory. At this stage, an increase in the amount of fluid in the ear, including sticky fluid, forms. During this period, hearing may improve for a short period of time. This stage lasts up to 1 year.
Mucosal. The accumulated liquid, at this stage, becomes more viscous, filling the entire ear cavity. The hearing does not deteriorate, it disappears. The period lasts up to 2 years.
Fibrous. At the final stage of the disease, changes occur in the hearing system. Are damaged auditory ossicles, and the shape of the eardrum is deformed. No mucus is formed at the final stage. Such changes are irreversible. The duration of the period is about 2 years.
Diagnosis of the disease
Successful diagnosis is possible thanks to knowledge about previously past illnesses ear. Otoscopy can detect changes in the eardrum that have occurred. When the membrane is worn away, the degree of exudate formed can be determined. Among other methods for diagnosing exudative or, also called, sedative otitis, we can highlight:
- (the degree of change in the patient’s hearing is determined).
- Determining the quality of the ventilation function of the ear.
- Determination of the degree of membrane mobility.
- Endoscopy.
- X-ray.
MRI is prescribed if it is difficult to make a correct diagnosis. This procedure can show changes at the cellular level.
Treatment of the disease
Only a qualified specialist can prescribe correct treatment with exudative otitis. Regardless of the patient’s age, this disease is treated simultaneously in several directions.
The initial step is to determine the cause of the dysfunction of the auditory tubes. Based on the data obtained, therapy is prescribed that can restore the patient’s hearing. At this stage treatment is carried out accompanying symptoms: runny nose, viral and colds. In rare cases, the adenoids are removed or surgery is performed to correct the nasal septum.
Medicines are prescribed to the patient based on the stage and course of the disease. Some patients take a course of non-steroidal anti-inflammatory drugs. The doctor may prescribe:
- mucolytic medications that can liquefy and remove exudate from the body;
- the most commonly prescribed drugs are those containing acetylcysteine or carbocysteine.
Drugs are prescribed for a period of up to 14 days.
Doctors do not prescribe antibiotics, since the inflammatory process most often occurs not due to ear infections, not bacteria. The prescription of such drugs occurs only if bacteria are detected in the body. Amoxicillin is one of the most common antibiotics prescribed by doctors for bacterial exudative otitis media.
Appointed antihistamines that prevent possible allergies to other drugs and stop the development of vaccine immunity. The most a common drug is "Suprastin".
To make nasal breathing easier, a specialist may prescribe vasoconstrictors for up to 5 days. Such drugs include Otrivin.
| A drug | Photo | Price |
|---|---|---|
| From 62 rub. | ||
| From 132 rub. | ||
| From 152 rub. |
Other therapies
In almost all cases of exudative otitis, drug treatment is not enough. This is explained by the fact that there is a violation of the auditory tubes, and one of the main tasks is to restore this system. For this purpose, Politzer blowing is additionally prescribed.
Thanks to this procedure, a certain massage of the eardrum occurs. The procedure can restore muscle tone and improve the patency of the Eustachian tube. When blowing is prescribed, exudate leaves the ear more quickly, which speeds up recovery.
In some cases, ultrasound or magnetic therapy may be prescribed. In-ear electrophoresis – quite effective method treatment of exudative otitis. It is worth noting that electrophoresis uses hormonal agents.
Surgical intervention
If drug treatment combination with physiotherapy turned out to be ineffective, then surgical intervention is prescribed. More often, surgery is prescribed if the disease occurs at the last stage. Most often carried out:
- tympanocentesis;
- myringotomy.
Such methods are considered the most effective in the treatment of exudative otitis media.
A myringotomy involves making a small cut in the eardrum, allowing all the fluid to drain out. To do this, a tube is inserted into the hole in the eardrum. This method is carried out once.
Tympanopuncture involves installing drainage for a long period of time. Through this drainage, medications are injected into the ear. The duration of this surgical intervention can only be determined by a doctor. More often than not, this period does not exceed 1 month. Through such a tube, agents are introduced into the ear that dilute the fluid and drugs that help reduce the inflammatory process.
Possible complications
At an advanced stage of exudative otitis media, pus may form in the middle ear. The membrane may be retracted deeper into the ear cavity. If treatment is not carried out on time, this will lead to hearing loss and irreversible changes in the eardrum. Cells and tissue may die, which can be fatal.
Folk remedies for the treatment of exudative otitis are effective only on initial stage. It is necessary to consult a specialist to make a correct diagnosis and prescribe appropriate therapy.
Disease prevention
IN modern world Prevention of exudative otitis media is not carried out. Experts recommend that when the first symptoms of the disease or other inflammatory processes that occur in the body appear, undergo the recommended treatment.
Any cold or bacterial disease It is worth treating immediately after the first symptoms appear, this will protect against the occurrence of exudative otitis media. This disease is extremely dangerous, and treatment in the early stages is more effective. On late stages In most cases, surgical intervention is performed.
Exudative otitis media is quite difficult to detect in the first stages, since there are practically no symptoms. When the first symptoms appear, you need to urgently undergo therapy. Severe symptoms indicate the transition of the disease to subsequent stages. The earlier the patient will undergo treatment, the fewer imprints the disease will leave on his health.
Video: Exudative otitis media
Exudative otitis is an inflammation of the middle ear, in the cavity of which exudate forms and remains in the cavity long time. The disease develops in both children and adults. According to statistics, exudative otitis in children is much more common. than in adults.
Timely treatment does not require much effort; the disease “gives in” quite easily. The main thing is to start treatment on time! If you notice the first signs of otitis media, especially for children, consult a doctor immediately. A qualified ENT specialist will prescribe effective course treatment.
It should be noted that this disease is the second form of otitis media. The first stage includes.
Any form of otitis media begins with an infection entering the middle ear cavity. It can get there through the nasopharynx if any viral diseases, diseases of the ENT organs, in particular diseases associated with swelling of the mucous membranes (sinusitis). As a result of the development of infection, swelling of the mucous membranes (nose, pharynx, eustachian tube) occurs. This leads to impaired ventilation of the middle ear.
Then the infection begins to actively develop. The first stage is formed - catarrhal otitis media. If there is no due and timely treatment, the form quite quickly develops into exudative otitis media, especially for children.
Why is this happening? Fluid is formed in the cavity of the middle ear, which, with normal, natural functionality of the auditory tube, is promptly removed to the outside. If an infection develops, the auditory tube narrows (swells), making the exit of fluid very difficult. Then more and more fluid begins to be produced (fluid production is a response to inflammation). The ear cavity fills with exudate, the auditory tube continues to narrow.
Lack of timely treatment leads to the formation purulent form otitis
Viruses and bacteria begin to develop safely in the accumulated liquid. Next, the exudate turns from a liquid state into thick mucus, which later turns into pus. What factors influence the development of this disease:
- nasal injuries;
- inflammatory diseases in the mucous membranes of the nose and nasopharynx;
- decreased immunity;
- inflammatory diseases of the auditory tube;
- hypothermia;
The inflammatory process is the main cause of the development of the disease
Diagnosis of the disease
The form of ordinary and acute exudative otitis media is diagnosed as a result of a complete examination of the eardrum and nasal area. Diagnosis is carried out using audiometry, tympanometry and endoscopy.
An important role in diagnosis is played by the study of auditory function. Hearing loss should be moderate, with sound conduction of 30-40 dB. X-ray data are also not neglected, which can reveal a deterioration in the pneumatization of mastoid cells.
Symptoms of exudative otitis media:
- hearing loss;
- feeling of stuffiness in the ears;
- autophony - you hear yourself;
- nasal congestion;
- sensation of fluid transfusion in the ear cavity.
As a rule, the patient does not have acute pain There is no temperature in the ears, head. These symptoms are inherent in the catarrhal form.
It is worth noting that in children these symptoms are less pronounced. The only important and true symptom is hearing loss. If treatment for exudative otitis media in a child was started or was completely absent, then after 3-4 years it may develop permanent form hearing loss.
Hearing loss is one of the main symptoms of exudative otitis media
Treatment
Treatment of exudative otitis media is prescribed depending on the condition of the hearing, the ear itself, the duration of the infection, and the cause of the disease.
In most cases, patients suffer from difficulty breathing. Therefore, procedures are carried out to restore it - this is the treatment of nasal diseases, troubleshooting problems in the nasal septum, treatment of acute respiratory viral infections, etc.
The next stage is to restore the patency of the auditory tube, i.e. restoration of its drainage function. As a rule, physical procedures are used for this - ultrasound, laser therapy, electrophoresis, magnetic therapy, etc. To remove exudate from the tympanic cavity, to tone the muscles of the auditory tube and for better patency, pneumomassage of the eardrums and special blowing (Politzer blowing) are used.
In some cases, antibiotic therapy is prescribed to treat exudative otitis media. However, the inclusion of antibiotics in primary treatment still remains controversial issue. Surgery is also prescribed.
The goal of surgical treatment is to restore hearing function and prevent further development diseases.
Bypassing (cutting) the eardrum and installing a special shunt has become widespread. Through the installed shunt, special medications are administered that help dilute the exudate.
Parents often have to deal with ear diseases in their children. This is due to the developing immune system and structural features of the hearing aid. In the article we will dwell in more detail on exudative (serous) otitis media, consider the causes of its occurrence, symptoms, methods of treatment and prevention.
From this article you will learn
Causes
To understand the mechanism of the appearance of exudative otitis media, let’s consider the structure of the ENT organs. The ear and nasopharynx are connected by the auditory (Eustachian) tube. She performs a protective drainage function, promotes ventilation and regulates pressure.
If its operation is disrupted, exudate accumulates in the ear cavity. As a result, exudative otitis media occurs. It can be unilateral or bilateral.
The disease occurs more often in children, since their Eustachian tube has a smaller angle of inclination. This leads to a decrease in its conductivity. In adults, this problem occurs much less frequently, due to the more advanced structure of the ear and developed immunity.
The main causes of middle ear exudative:
- abnormal structure of the nasal septum;
- penetration of infection directly into ear canal;
- ENT infections;
- complications after acute respiratory viral infections;
- adenoiditis, inflammation of the adenoids - the most common reason otitis (statistically, 30%);
- allergy;
- weak immunity of the baby;
- unfavorable environmental conditions.
Regardless of the cause, the disease must be treated immediately. Ignoring the problem can lead to purulent processes and hearing impairment.
Symptoms
Identify the disease early stages difficult due to the lack of pronounced symptoms. Absent in serous otitis acute period, severe pain and heat. The main symptoms of the disease are as follows:
- constant feeling of ear fullness;
- the nose is stuffy, but there is no mucous discharge, as with a runny nose;
- hearing deteriorates;
- there is a feeling of the presence and movement of fluid in the ear cavity;
- you can hear your own voice as if from within.
An adult may not pay attention to these symptoms while they are mild. In the case of children, this is even more difficult to do, especially if the infant is sick. It is difficult for kids to clearly formulate their feelings, even if he pays attention to them.
For early diagnosis parents need to be vigilant. If the child does not respond immediately, needs to speak louder or repeat information, there is reason to suspect hearing impairment. And this, in turn, is a reason to visit an otolaryngologist.
Stages of disease development
In medicine, there are four main stages of serous otitis:
- The initial catarrhal stage of the disease has a blurred clinical picture. The pathology is just beginning to develop; due to inflammation, the auditory tube swells, its functionality gradually decreases until ventilation stops completely. The production of serous fluid increases, and there is a slight deterioration in hearing. This continues for 14–30 days. Very rarely, at the first stage, the disease can go away on its own and not progress to the next stages.
- The second stage is secretory. Signs of the disease become brighter, wax secretion increases, fluid accumulates in the ear cavity. It does not flow due to disruption of the Eustachian canal. The hearing continues to deteriorate, and a pronounced sensation of fluid appears, especially when tilting the head. The duration of the secretory period can range from several months to a year.
- At the third, mucosal, stage of the disease, the accumulated fluid is transformed into a viscous substance, and purulent processes can begin in the cavity of the diseased ear. The feeling of iridescent liquid goes away, while the symptoms of autophony are felt much brighter and become noticeable even to others. The appearance of pus can cause acute consequences. The mucous stage lasts up to several years.
- The final stage is fibrous. If treatment of the disease has not been started earlier, at this stage there is pathological change tissues and deformation of bone septa. These changes are irreversible and can cause loss of basic hearing functions. Developing chronic hearing loss or even complete deafness. cure conservative methods Exudative otitis media is impossible at this stage; doctors’ actions will be aimed at reducing the consequences.
The stages described are conditional; this is a kind of systematization of the disease. The course of the disease may differ slightly from that described, as it depends on individual characteristics body. In any case, the earlier the disease is diagnosed, the more effective therapy exudative otitis media in children.
Diagnostics
It is difficult to overestimate how important it is to detect the disease in a timely manner. In the case of exudative otitis, the lack of diagnosis against the background of a practically asymptomatic course can lead to hearing loss. Therefore, at the first doubt, you should contact an otolaryngologist. He is the one who can carry out specific diagnostics organ of hearing and make a correct diagnosis.
To make a diagnosis of “exudative otitis media” the following can be carried out: diagnostic measures and research:
- Interviewing the patient to identify the nature of the complaints, the time of their occurrence, and possible causes of the disease.
- An initial examination of the ear with an otoscope allows the specialist to visualize changes in the eardrum, bone tissue, swelling of the mucous membrane, accumulation of fluid, the presence of purulent processes. Experienced doctor after an examination, a diagnosis can be made, but sometimes it requires additional clarification in order to understand what stage the disease is at, what causes it, and give recommendations for treatment.
- Audiometry. It can be speech, tone and computer. During this procedure, the speech therapist moves away from the patient at a distance of 6 meters and calls certain words in a whisper, followed by an increase in volume, and the patient must repeat them. In pure-tone audiometry, a sound of a certain frequency is turned on, and the patient presses a button when he begins to hear it. Computer research is the most accurate; in this case, sensors are installed that record specific reactions person to the sound.
- Impedancemetry is instrumental method examination includes tympanometry and examination of reflexes to a sound stimulus. During tympanometry, a rubber probe is inserted into the ear canal, through which air is supplied at different pressures. A special microphone records the reaction of the eardrum to assess its mobility. To measure reflexes, sound is directed directly into the ear and the resistance of the eardrum, ear ossicles and auditory tube in response to the stimulus is recorded.
- Endoscopic examination of the nose and nasopharynx reveals possible reasons serous otitis.
- An X-ray examination is performed if endoscopy is not possible.
- If the disease recurs or the diagnosis needs to be clarified, computed tomography temporal part of the head.
The diagnostic methods used will allow you to accurately establish the diagnosis, determine the extent and causes of the disease. Based on the results of the examinations, a decision is made on how to treat exudative otitis media in a child.
Treatment method
The type of treatment is selected by an otolaryngologist based on the results obtained during the examination. Since otitis is a consequence, first of all it is necessary to eliminate the cause of the disease, and then try to restore the lost functions. There are conservative and surgical methods. Let's take a closer look at the specifics of their application.
Conservative treatment
Conservative methods are used in the early stages of the disease, most often used in combination. These include the following treatments:
- Medication – involves treatment with drugs necessary to reduce swelling of the mucous membrane, liquefy and remove fluid from the ear cavity. These can be mucolytics, antiallergic, vasoconstrictor drugs. If available bacterial infection antibiotics are used.
- Physiotherapy can give good results in the treatment of exudative. Most often, endaural and endonasal electrophoresis is used using enzyme preparations. The essence of the method is the effect of current on the diseased organ with the simultaneous administration of the drug. The current promotes better penetration of the drug, enhancing its effectiveness. Magnetic therapy and laser therapy can be used.
- Blowing with a Politzer balloon can help restore the function of the auditory tubes. To do this, the tip of the device is inserted into the nose, it is first cleaned and a vasoconstrictor drug is dripped. An otoscope is inserted into the ventilated ear, the second end of which is applied to the ear of the otolaryngologist. The patient says the words: “steamboat, one, two, three”; at the vowel sound, the doctor presses the canister, and air enters the Eustachian tube under pressure. Characteristic sounds are heard through the otoscope, from which one can judge the patency of the pipe. This method is not suitable for small children and cannot be done at home.
- Catheterization is highly effective eustachian tubes. During this procedure, a catheter is inserted into the nasal passage and brought into the cavity of the auditory tube. A catheter is used to diagnose, ventilate or administer drugs. Today this method is rarely used, as it is traumatic, it is contraindicated in children under 5 years of age and in acute inflammatory process. Use is justified if other methods have been ineffective. The procedure is performed by an experienced otorhinolaryngologist under sterile conditions. treatment room or in a hospital.
Surgical intervention
In later stages of the disease conservative treatment is often ineffective. In such cases, a decision is made to perform surgery. First of all, such treatment is aimed at eliminating the cause of the disease. This could be adenoid removal, surgery on the nasal sinuses, correction of septums and structural anomalies.
If the cause cannot be eliminated, otosurgical operations are performed: myringotomy, tympanotomy.
Myringotomy is an incision into the eardrum to remove exudate. The choice of removal method depends on its density. It can be carried out through the ear or nasal passage.
Tympanotomy is also an incision of the eardrum, but with shunting. Through the inserted tube, accumulated fluid is removed and medicines. In essence, it temporarily takes over the functions of the auditory tube.
After the tube and ear cavity are restored to normal condition, the shunt is removed. To assess the effectiveness of treatment, audiological examinations are carried out regularly.
Folk remedies
Traditional medicine does not remain aloof from the problem of exudative otitis media and offers its own treatment methods. Mainly we are talking about the use medicinal herbs. The main ones:
- basil juice - drop into ears;
- mint tincture - you can rinse your ears;
- tinctures of elderberry, yarrow and chamomile flowers - you can do tamponing;
- aloe juice – relieves inflammation.
Remember, application alternative medicine It is possible only in combination with the main treatment and only with the permission of the doctor. You should not resort to these methods as monotherapy and self-medicate such a complex disease.
Prevention and prognosis
As Dr. Komarovsky says in his video on exudative otitis media, preventive examinations ENT specialist is a guarantee of timely identification of the problem and effective treatment without surgical intervention.
In addition, it is necessary to pay attention to the child’s immunity. It must be strengthened with the help of hardening, walking, playing sports, proper nutrition and mode. This will reduce the number of acute respiratory infections, and accordingly, the likelihood of complications will be lower.
All diseases must be treated in a timely manner and the course must be completed. It is neglected and untreated diseases that give complications in the form. Be vigilant and observe your child’s behavior in order to notice changes in time.
The prognosis for serous otitis depends on the stage of the disease. At the initial stages, the prognosis is favorable, treatment gives good results, the disease goes away completely, leaving no traces. On late stages Irreversible changes in the hearing aid may occur. In this case, the prognosis is less optimistic; it is possible to improve the patient’s condition, but achieve complete cure hard.
IMPORTANT! *when copying article materials, be sure to indicate an active link to the original
