suppurative otitis media
Introduction
Introduction to suppurative otitis media Suppurative otitis media is a suppurative inflammation of the middle ear mucosa, which occurs in children and is a common cause of hearing loss in children. Acute suppurative otitis media is a common infectious disease in childhood, with high incidence, easy recurrence, and many complications and sequelae. Auxiliary examinations such as otoscopy and ear palpation can help diagnose suppurative otitis media. Control infection, smooth drainage, remove the disease because of its treatment principles. basic knowledge The proportion of illness: 0.002% Susceptible people: good for children Mode of infection: non-infectious Complications: intracranial hypotension headache
Cause
Causes of suppurative otitis media
Nasopharyngeal infection (25%):
After eustachian tube infection and upper respiratory tract infection, nasopharyngeal secretions can enter the tympanic cavity due to nose, swallowing and vomiting. It is also the most common way to cause otitis media, and the incidence of pediatrics is high.
External auditory canal infection (20%):
External ear canal infections are relatively rare, such as wartime firearms injuries, ear damage, boxing and diving caused by rupture of the tympanic membrane, severe otitis externa, long-term tympanic membrane erosion can also cause tympanic infection.
Blood infection (15%):
The bloodstream infection is the least common, acute severe infectious diseases and sepsis. The bacteria enter the tympanic cavity directly through the artery, and can also enter the tympanic cavity by venous thrombosis.
1, susceptible to acute infectious diseases, such as measles, scarlet fever, whooping cough and pneumonia, mainly in the upper respiratory tract inflammation.
2, children's eustachian tube is relatively short and straight compared to adults, relatively horizontal, secretions easily enter the tympanum through this pipeline.
3, children more supine breasts, especially when artificially breastfeeding, vomit and excess milk can easily flow into the tympanic cavity.
4, children with proliferative hypertrophy and perivascular lymphadenitis, easy to block the eustachian tube mouth, hinder drainage and cause inflammation.
5, children in the sprouting period, often loss of appetite, local swelling, local swelling, weakened resistance, easy to infect other diseases.
6, congenital cleft lip, cleft palate caused by pharyngeal dysfunction, easy to cause eustachian tube infection, and intratympanic submucosal embryonic tissue, anti-infective weak, proliferative, nasal polyps and other operations, due to bleeding and tamponade for too long It is also easy to cause tympanic infection.
Prevention
Suppurative otitis media prevention
If the body's resistance declines, such as nutritional disorders, cold or wet, and chronic diseases are easy to get sick, it is necessary to strengthen children's nutrition and health and enhance their resistance.
Complication
Complications of suppurative otitis media Complications intracranial hypotension headache
Chronic suppurative otitis media can cause intracranial and extracranial complications.
Symptom
Suppurative middle ear inflammation symptoms common symptoms children crying disturbed nausea diarrhea fever
Often expressed as unexplained ears, shaking his head, crying and restless. Systemic symptoms are heavier, fever, often accompanied by symptoms of digestive tract poisoning such as nausea, vomiting, diarrhea. Because the rock scales of children under 2 years old have not been closed, there is a rich vascular and lymphatic relationship between the middle ear mucosa and the dura mater. Therefore, acute suppurative inflammation of the middle ear can affect the adjacent dura mater and meningeal irritation.
Examine
Examination of suppurative otitis media
Otoscopy
In the early stage of the onset, the tympanic membrane is congested, and the radially expanding blood vessels are visible around the iliac crest and the tension. Following the diffuse hyperemia, swelling, and bulging of the tympanic membrane, the normal signs are difficult to identify, and small yellow spots are visible locally. If the inflammation cannot be controlled in time, it develops into a perforation of the tympanic membrane. Perforation generally begins to be very small, and it is difficult to see clearly. After a thorough episode of the outer ear, the perforation has a beating highlight, and pus is poured out from there. The tympanic membrane of the necrotic type rapidly dissolves and forms a large perforation.
Ear palpation
The mastoid part may have slight tenderness and the sinus area is more obvious.
Hearing test
Mostly conductive sputum, a small number of patients may have mixed convulsions or sensorineural hearing loss due to cochlear involvement.
blood test
The total number of white blood cells in the blood increased, the polymorphonuclear leukocytes increased, and the blood picture gradually became normal after the tympanic membrane was perforated.
Diagnosis
Diagnosis and differentiation of suppurative otitis media
1, need to identify several types of chronic suppurative otitis media, simple type, bone ulcer type, cholesteatoma type.
2, external auditory canal inflammation and edema in the external auditory canal and ear canal diffuse swelling, there is exudation of serous secretions, late limitation of edema and pus, secretions without mucus, deafness is not a feature, pressing the tragus pain, The lymph nodes are often swollen after the ear.
3, acute tympanitis often occurs in influenza and herpes zoster, tympanic membrane congestion forming a cannon, severe ear pain, but no perforation and pus, hearing loss is not heavy, blood leukocytes do not increase.
