Otitis stages and symptoms

Early symptoms of otitis include ear congestion, lightning ear pain, autophony (when said words are echoed in the head). Rhinitis symptoms, such as runny nose, fever, headache, often precede or co-exist with otitis. Otitis can often develop in children suffering from adenoids. During an external ear canal examination an otolaryngologist can notice eardrum retraction, and during a nasopharynx examination – swelling of auditory tube swabs and their arctation. It’s typical for acute tubootitis or auditory tube inflammation. This is the first stage of acute otitis media. Tubootitis treatment aims to restore auditory tube patency and treat rhinitis. In this case vasoconstrictor nasal drops or sprays (for older children and adults) are prescribed. These drugs help to reduce swollen mucosa to improve auditory tube functions and nasal breathing, as well as fight with rhinitis symptoms. One can make camphor oil applications on the ear area if a child stands them well. Such physiotherapeutic procedures as laser, magnet, quartz are also recommended. Antifebrile and antihistamine medicine is prescribed if needed.

If otitis is not treated at this stage, then in 2-3 days some fluid starts to build up in the ear providing conditions for bacteria to grow. So leucocytes come out of the vessels to fight them and otitis media with effusion starts. Ear pain gets more severe, hearing gets worse, a feeling of fluid running in the ear when changing a head position appear. High body temperature and inflammatory changes in the blood analysis are noted. During an ear examination, a doctor can see an evagination and redness of the eardrum, often a transparent fluid level too. At this stage otitis must be treated with antibiotics (usually with aminopenicillins covered with clavulanic acid), apply aminosalicylic acid solutions or boric spirit to the ear canal, use nasal vasoconstrictor drops.


When there is too much fluid in the middle ear, it breaks the eardrum and suppuration flows out through the external ear canal. A ruptured eardrum doesn’t usually heal itself and stays for the rest of the life making it easier for infections to get into the eardrum. It leads to recurring otitis and hearing impairment. In the face of a rupture, otolaryngologists perform paracentesis or auripuncture to remove the suppuration in order to avoid eardrum rupture and speed up a recovery process. A created hole heals soon.

Otitis complications

In bad cases of untreated otitis, suppuration can not only rupture the eardrum but melt down bone walls of the middle ear as well. Thus an infection gets into the inner ear and mastoid causing labyrinthitis and mastoiditis correspondingly. Labyrinthitis has such symptoms as hearing impairment, loss of balance, dizziness, nystagmus. Painfulness of mastoids (situated behind the ear), redness and swelling of the skin over them, protruding ears and smooth postaural fold are typical for mastoiditis. While performing an otoscopy, a doctor can notice overhanging of the upper-back wall of the ear pathway. A diagnosis is proved by an X-ray. Mastoiditis is treated in a surgical way, a puncture of a mastoid cavity with suppuration suction can be performed on children. Mastoiditis is a dangerous disease as it can cause intracranial life-threatening complications such as meningitis, encephalitis, brain abscess, venous sinuses thrombosis.

Chronic otitis media

In case of chronic otitis media, the ear becomes a source of infection for bones and brain tunics. Eardrum bone walls get melt down creating a cholesteatoma that needs a surgical treatment. A ruptured eardrum along with ear bones adhesion lead to hearing impairment. Patients also suffer from constant ear congestion, heavy head, tympanophony. Otitis treatment include recovery of Eustachian tube patency performed by air douche or injection of antiedemic medicine into their openings, resolving procedures, prevention of exacerbation. In non-acute condition of the disease myringoplasty – closure of the eardrum rupture – is performed. Patients with chronic otitis must avoid water in the ear, so cotton balls with Vaseline are stuck into the ear ways. These patients must take care of runny nose and treat it timely in order to prevent otitis exacerbation.

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