Acute otitis

Acute otitis is the most common reason of ear pains among children. This disease is often triggered by coryza. The nasopharynx mucous membrane gets swollen, its vessels expand, it turns red, profuse suppuration is discharged. Auditory tubes opening into the nasopharynx get narrow due to the swelling, and it means that the tube can’t perform their main function – to balance outside pressure and middle ear pressure. The air can’t get to the eardrum and is gradually sucked through the mucous membrane. The middle ear pressure goes to negative related to the atmosphere one. Otitis media manifests as ear pain, ear congestion, “echo” symptom when patient’s words resound like an echo in the mountains. This condition is called acute tubootitis or eustachitis. Vasoconstrictor nasal drops, which reduce the swelling of mucous membrane and normalize the pressure, are applied to treat tubootitis.

If the disease is not treated on this stage, then it goes to the next one –  transudation stage. Blood fluid starts to go from vessels into the middle ear cavity due to negative pressure sucking force. As the fluid accumulates, the pressure goes positive, the eardrum looks bulging and tense. A patient suffers from another problem – a feeling of fluid flowing in the ear when changing a head position.

In a day or two bacteria start to breed in the accumulated fluid, and suppuration is produced. A patient suffers from fever, ear aches get worse, hearing is impaired. At this stage doctors prescribe antibiotics orally, vasoconstrictor and antiseptic drops locally into the nose and ear. When there is too much suppuration in the middle ear cavity, it ruptures the eardrum and comes out of the external ear canal. To avoid an eardrum perforation, besides timely treatment an otolaryngology surgeon performs paracentesis or auripuncture to remove the suppuration from the ear with a small syringe. It prevents the eardrum rupture and speeds up the healing process. But if the rupture happens, then ear drops with spirit are prohibited to use.

Mastoiditis as a complication

Sometimes acute otitis has such complication as mastoiditis – suppurative inflammation of the mastoid processus. This processus of the temporal bone is situated behind the ear. It consists of bone sockets covered with mucous membrane and normally contains air. Its walls are contiguous with the eardrum cavity walls, that’s why the infection gets in the sockets when eardrum cavity walls are melt down by suppuration. Then an abscess is created. The symptoms are pain when pressing on the mastoid processus, ear ache gets worse and distributes further, the ear sticks out, the skin behind it gets red and swollen. A doctor sees overhanging upper-back wall of the external auditory tube at the examination. Mastoid processus X-ray is used to confirm mastoiditis diagnosis. Mastoiditis is a dangerous disease as it can cause intracranial life-threatening complications such as meningitis, encephalitis, brain abscess, venous sinuses thrombosis.

Treatment of otitis media

Otitis media can go chronic. A maltreatment that has led to the eardrum rupture is one of its causes. Cronic otitis media often requires surgical treatment – a plastic surgery of the eardrum, removal of damaged bone structures (carious-changed fragments of the temporal cone, cholesteatomas).

Treatment of otitis for children is almost the same as for adults. It might be hard to diagnose otitis for infants as they can’t express their complaints clearly. In this case the only way is to run otoscopy – an examination of the external auditory tube and eardrum by an otolaryngologist. The treatment plan is as follows: Vasoconstrictor nasal drops are prescribed at the first stage of acute otitis media (tubootitis stage). One must keep in mind that it’s undesirable to apply nasal sprays for infant children, as a strong flush can hurt the nose structures and lead to loss of smelling. Antifebrile medicine is prescribed if required; its dose is calculated based on the body weight. Hot spirit compresses can be applied on the ear; physiotherapeutic procedures are also recommended.

Antibiotics are prescribed if a patient complaints on a feeling of “water in the ear” and fluid running in the ear when changing a head position, severe ear aches, fever and inflammation blood processes. Room temperature antiseptic ear drops – aminosalicylic acid solutions or boric spirit – are applied to the ear canal. Water in the ears must be avoided when taking a shower or bathing a child, so cotton balls, preferably glycerin or vaseline-wetted, are inserted in the ear canals. One must be supervised by an otolaryngologist to control the eardrum condition and possible complications.

In general, otitis treatment (without complications) for children usually takes a week and a half – two weeks. To prevent otitis, one must avoid getting cold (wear a hat in cold and windy weather) and timely treat a runny nose. Adenoids must be monitored and removed, if required, for children.

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