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25 Dec 2020

Acute and chronic otitis media: diagnosis and treatment

Acute and chronic otitis media: diagnosis and treatment Acute and chronic otitis media: diagnosis and treatment

ENT (ear, throat, and nose) diseases can provoke ear inflammation manifested in pain and discomfort and are fraught with life-threatening complications. Otitis media, i.e. an inflammatory disease of the inner ear, frequently occurs in preschool and school kids.

This is due to the structural features of the child's ear and weak immunity but the disease can also develop in adults. Otitis media in a child is accompanied by severe pain, anxiety, and fever.

Acute inflammation must be treated immediately as it can extend throughout the skull and provoke serious health aggravations such as brain infection. To avoid the unpleasant consequences of pathology, you need to consult an ENT doctor and undergo a complete examination.

Short information about otitis media

Specialty/treated by
Otorhinolaryngology (ENT doctor)
Symptoms Ear pain, raise of body temperature, chills, hearing impairment and loss
Types Acute otitis media, otitis media with effusion, chronic suppurative otitis media
Causes Viral, bacterial
Risk factors Smoke exposure, getting water in the ears when swimming or taking shower, age under 5 years
Complications Meningitis, brain abscess
Prevention Timely and correct treatment of ENT diseases, acute respiratory tract diseases
Medication Antipyretics (paracetamol, ibuprofen, etc.), painkiller ear drops, antibiotics
Frequency 471 million (2015)

Types of ear diseases

The human ear is made of three sections:

- Outer ear;
- Middle ear;
- Inner ear.

The inflammatory process can start in any of the mentioned parts of the human ear. Therefore, there are different types of otitis media, which differ in the place of localization and the severity of inflammation.

Otitis externa

This type of ear inflammation affects mostly swimmers or the elderly. Inflammation begins to develop as a result of mechanical trauma to the auricle or ear canal. If damaged, pathogenic microorganisms enter the outer ear and begin to multiply, and furuncle forms in their place. Redness of the ear canal is sometimes observed.

Otitis media

otitis media risks

With otitis media, the inflammation extends to the middle ear. Most often occurs in kids under 5 years of age. The inflammation can be provoked by viruses, bacteria, and fungi. In a common cold, the patency of the Eustachian tube is disrupted (connects the tympanic cavity with the pharynx). As a result, the pressure in the tympanic cavity changes, and inflammatory fluid begins to be actively produced. Ear inflammation can develop into a catarrhal or purulent form.

Catarrhal otitis media is an aggravation of acute respiratory viral infections and can reduce hearing, cause tinnitus (ringing). If left untreated, the disease will lead to an increase in body temperature and severe pain in the ear. Neglected catarrhal form develops into purulent form. The purulent form of the disease is accompanied by a breakthrough of the tympanic membrane and the release of pus from the ear canal. If the eardrum is strong, an operation is required to puncture it. This procedure is performed using local anesthesia and only by a specialist. Purulent otitis in a child may appear before the age of 5 years due to weak immunity and frequent colds.
Another form of otitis media is exudative. It is characterized by the occurrence of mucous fluid in the ear, which leads to noise and tension in the ears. The condition can lead to hearing loss if left untreated.

Acute otitis media

Inflammatory processes in the middle ear can develop in an acute form when the disease covers the tympanic cavity of the ear, the Eustachian tube, and the mastoid. Acute inflammation occurs when treatment was initially chosen incorrectly or was carried out with a delay. After 2-3 days, the eardrum ruptures, and the pus formed inside the ear flows out. After this, the patient's condition improves significantly, and the membrane heals over time without changing the quality of hearing. The danger of an acute form is that pus can spread into the cranial cavity, leading to the development of a brain abscess or meningitis.

Internal otitis media

In this case, harmful microorganisms penetrate deep into the ear and affect the vestibular apparatus. Untimely treatment can cause labyrinthitis (inner ear disorder). With internal otitis, dizziness, nausea, or even loss of balance are observed.

Chronic otitis media

In the chronic form, a hole forms in the eardrum, from which pus is released from time to time. This form of pathology occurs due to repeated inflammation of the tympanic cavity due to infections or mechanical damage to the ear. With the chronic form, patients note periodic leakage of pus from the ear, tinnitus (ringing), and occasionally dizziness.

What are the symptoms of an ear infection?

otitis media symptoms

- "Shooting" pain in the ear, radiating to the neck, teeth, or eyes;
- Increased body temperature;
- Redness of the ear canal;
- Tension in the ear;
- Ear congestion and hearing worsening;
- Noise in ears;
- Discharge of purulent masses from the ears.

The symptoms of otitis media in babies, toddlers, and kids are the same as in an adult. In addition, there is anxiety and occasional crying during the onset of pain in the ears.

The causes of ear inflammation

otitis media causes

In most cases, bilateral otitis media appears as a result of the development of pathogenic microorganisms in the ear. They enter the human body through dirty water, which contains pathogens or through mechanical damage. Another reason is the ENT diseases in the medical history of the patient. During the course of the disease, the amount of mucus increases and disrupts the ventilation of the tympanic cavity. The cells of the tympanic cavity, in turn, begin to secrete an inflammatory fluid.

Otitis externa often develops due to inappropriate ear hygiene. Sulfur acts as a protective barrier against bacteria, so washing your ears too often leads to the development of the disease, as well as failure to maintain cleanliness. In no case should you clean your ears with sharp objects, as there is a high probability of damaging the eardrum and bringing in germs in a wound.

Diagnosis and treatment of otitis media

If you observe the first signs of the ear disease in yourself or your child, go to a doctor right away. As we mentioned earlier, improper or neglected treatment leads to the development of aggravations dangerous for the human body. The specialist who treats this disease is an ENT doctor (ear, throat, and nose doctor). After examining the auricle and the auditory canal using a head reflector, an ENT doctor determines the presence of pathology. Reddened skin, a narrowed ear canal, and the presence of secretions inside indicate the presence of bacteria in the tympanic cavity.

otitis media diagnosis

Also, the doctor may prescribe additional studies if necessary:

- Audiometry - a measurement of auditory sensitivity;
- Tympanometry - a measurement of the pressure inside the ear;
- Radiography;
- CT scan.

Otitis externa in adults is treated with ear drops. Drops combine antibacterial and anti-inflammatory effects.  Otitis media requires the use of antibacterial drugs. Antibiotics are given as pills or injections. For instance, a doctor can prescribe one of the newest and comfortable to use antibiotic Azithromycin. The benefit of this medication is that it is active for the majority of gram-positive and gram-negative bacteria causing ear inflammation and is taken only three days. You can buy this and other antibiotics without a prescription at our online drugstore and find the instructions on how to use them for ear infections on the respective product page. But it is still recommended to consult your doctor on whether this drug is suitable for your case or not.

When pus accumulates in the ear cavity, general intoxication of the body occurs. And if the pus does not come out on its own, surgery is done. The operation takes place under local anesthesia, the doctor cuts the tympanic membrane in the thinnest place, and the accumulated mass flows out through the hole.

The treatment of otitis media in kids should be approached with special care. If the raised temperature lasts more than 3 days, which indicates a severe form of intoxication, the doctor prescribes an antibiotic. Anti-inflammatory and painkiller drops for 7 days or more are also indicated. Acute otitis media is advised to be treated in a hospital. Only a pediatric specialist can determine how to properly treat otitis media in a child.

Post by: Rachel Lewis, Senior Medical Advisor at Medibank, Sydney, New South Wales, Australia

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