chronic otitis media

Introduction

Introduction to chronic otitis media Chronic middle ear infections are usually the result of untreated treatment of ear infections in childhood. This infection has never been completely ruled out, and some organisms that cause infection remain in the ear; or the infection is difficult to completely eliminate, leaving a site that is susceptible to infection. Chronic infections continue to produce pus, which eventually causes perforation in the tympanic membrane, often causing damage or damage to the small bones of the middle ear. There is another type of chronic otitis media called cholesteatoma that can cause facial paralysis and even brain infection. basic knowledge Sickness ratio: 0.1% Susceptible people: no special people Mode of infection: non-infectious Complications: facial paralysis, labyrinthitis, meningitis, epidural abscess, brain abscess, deafness

Cause

Causes of chronic otitis media

Congenital dysplasia (20%):

Mastoid dysplasia, difficult to dissipate after the lesion occurs. The mastoid is a conical protrusion on the tibia on either side of the head. The mastoid bone can be easily felt from the ear of an adult, but the child's mastoid bone is not as complete as an adult.

Infection (20%):

Such as scarlet fever, measles and pneumonia, acute necrosis of the middle ear mucosa, inflammation invading the sinusoidal mastoid, especially secondary to the more resistant Proteus and Pseudomonas aeruginosa infection, treatment is very difficult.

Nasopharyngeal lesions (10%):

The nasal and pharyngeal chronic diseases and sinusitis, tonsillitis and proliferative hypertrophy, etc., inflammatory secretions easily enter the eustachian tube, and the lesions hinder the drainage of the pharynx.

Chronic peripheral disease (10%):

Such as anemia, diabetes, tuberculosis and nephritis, the body's resistance is weakened.

Inflammatory lesions (10%):

Inflammatory lesions such as allergies can also cause otitis media, such as respiratory mucosal allergic edema, exudation, involving the eustachian tube and middle ear.

Other (20%):

Delayed treatment and improper medication in the acute phase.

Prevention

Chronic otitis media prevention

(1) Actively treat nasopharyngeal diseases to prevent bacteria from entering the middle ear and causing inflammation.

(2) Can not force the nose and casually flush the nasal cavity, can not simultaneously close the two nostrils, should cross the unilateral snot.

(3) Digging the bottom earwax should be very careful. It should be dug before digging to avoid damage to the tympanic membrane.

(4) After swimming ashore, the side of the head beats, let the water out of the ear, it is best to use a cotton swab to absorb the water.

(5) Pay attention to rest during the acute phase and keep the nasal cavity open.

(6) Those with chronic otitis media should not swim.

(7) Strengthen physical exercise, increase rest and reduce colds.

(8) Avoid spicy and spicy foods such as ginger, pepper, wine, lamb, and pepper.

(9) Do not take hot tonics, such as ginseng, cinnamon, aconite, antler, bullwhip, big cream and the like.

(10) Eat more fresh vegetables with heat and anti-inflammatory effects, such as celery, loofah, eggplant, leeks, basil, cucumber, bitter gourd, etc.

(11) The worm enters the ear canal, do not rush, hard catch, can be dripped into the oil to kill the dead insects and catch.

Complication

Chronic otitis media complications Complications facial paralysis inflammatory meningitis dural abscess brain abscess deafness

Chronic otitis media has a slow, but highly devastating infection that can cause permanent damage. Gray or yellow pus may flow out from time to time in the ear. You will lose a part of your hearing, the longer you get infected, the more your hearing loss will be. Therefore, early detection of early treatment is very important. If the infection is advanced, it may spread to the posterior mastoid bone. If the mastoid is infected, you may need to be treated with a mastoidectomy. In rare cases where treatment is ineffective, the ear bones may be damaged, causing permanent deafness.

1. Facial paralysis: The facial nerve is very close to the middle ear cavity. If it is damaged, it will cause the eye to be skewed.

2, labyrinthitis: If the inflammation invades inward, entering the inner ear will cause labyrinth, leading to dizziness and nausea, vomiting and so on.

3, intracranial complications include meningitis, extra-abdominal abscess and brain abscess. No matter what happens, it will be life-threatening. Various abscesses, such as subperiosteal abscess, subarachnoid abscess, abscess of the posterior wall of the external auditory canal, etc. After the abscess appears, the soft mass can be felt locally, redness, severe pain, and high fever.

4. If the treatment is not timely, the abscess spreads to the neck, causing pain when the neck rotates. In severe cases, it will damage the large blood vessels in the neck and cause death.

Symptom

Chronic middle ear symptoms Symptoms Hearing loss Otogenic tetanus vertigo Ear pain Middle ear and Eustachian tube cilia abnormal Deafness Ear pus constipation Achilles cold Persistent fever

Otitis media, commonly known as "rotten ears", is inflammation of the tympanic mucosa. The bacteria enter the tympanic cavity, and when the resistance is weakened or the bacterial toxin is enhanced, inflammation occurs, which is manifested as pain in the ear (acute at night), fever, aversion to cold, bitterness, red or yellow urine, constipation, and hearing loss. If the tympanic membrane is perforated, pus will flow out of the ear, the pain will be relieved, and it often coincides with chronic mastoiditis. In the acute phase, the treatment is not complete, and it will be converted into chronic otitis media. With the physical and climatic changes, the pus will flow frequently in the ear, and it will last for many years. Chinese medicine refers to this disease as "ear pus" and "ear deafness", which is believed to be caused by the prevalence of liver and gallbladder damp heat (fire). Chronic otitis media with chronic suppurative otitis media. Chronic suppurative otitis media, commonly known as "smelly ear", acute suppurative otitis media failed to cure in time, prolonged six weeks or more is chronic suppurative otitis media. There are mainly pus, tinnitus, earache, headache, dizziness and so on.

1, ear pus: is the main common symptoms of this disease. May be mucus, pus, or pure purulent. Non-hazardous pus is thin and odorless. Although there are not many dangerous pus, it is thicker, mostly purulent, and has a bad smell.

2, deafness: light and heavy, because most of the disease is single ear, easy to be ignored. Such deafness is more proportional to the progress of the disease, that is, the lesion is heavier and the deafness is also aggravated. It is generally conductive.

3, in addition to the above symptoms, such as dizziness, vomiting, facial paralysis, severe headache, chills, high fever and other symptoms, to prove that complications have occurred, should go to the hospital immediately.

Examine

Chronic otitis media examination

1. Hearing examination: There are only conductive hearing impairment in early or several cases. In severe or long-term cases, there are mild to severe mixed hearing impairments, and more serious may be full.

2, X-ray examination: Because most chronic otitis media is a sequela of repeated otitis media in children, most of the mastoid gasification is poor. A small number of mastoid gasification is good, mostly tympanic membrane long-term cavernous otitis media, or chronic otitis media caused by trauma and talent.

3, otoscopy: simple chronic otitis media can be seen on the tympanic membrane perforation. Most of them are central perforations, that is, there are residual tympanic membranes around them. Very few are edge-type perforations, that is, there is no residual tympanic membrane on one side. In addition to observing the perforation on the tympanic membrane, it is important to note that there are other otitis media sequelae.

Diagnosis

Diagnosis and diagnosis of chronic otitis media

According to the pathology and clinical manifestations are divided into three types:

(1) simple type: the most common, mostly due to recurrent upper respiratory tract infection, the pathogenic bacteria invade the tympanic cavity through the eustachian tube. The clinical features are: ear pus, mostly intermittent, mucinous or mucopurulent, generally not stinky. The amount varies, and the amount of pus increases when the upper respiratory tract is infected. The perforation of the tympanic membrane is mostly central to the tension, and the size is different, but there are residual tympanic membranes around the perforation. The tympanic mucosa is pink or pale and can be slightly thickened. Deafness is conductive and generally not heavy.

(2) Osteopathic type: also known as necrotic or granulation type, mostly caused by acute necrotic otitis media. This type of characteristics: the ear flow pus is mostly persistent, there is bloodshot between the purulent, often smelly. Large perforations in the tympanic membrane may involve drum rings or marginal perforations. There are granulation or polyps in the tympanic cavity and can be pierced into the external auditory canal. Conductive enthalpy is heavier.

(3) cholesteatoma type: a non-true tumor of cholesteatoma, and a cystic structure located in the middle ear and mastoid cavity. Because the capsule contains cholesterol crystals, it is called cholesteatoma.

The ear continues to pus for a long period of time, with a special malodor, and there is marginal perforation in the tympanic membrane or in the upper part of the tension. From the perforation, there is a gray-white scaly or bean-like substance in the drum, which is strangely smelly. Generally, there are heavier conductive sputum, such as lesions and cochlea, and deafness is mixed.

According to the severity of the lesion and the degree of risk, it is divided into three types:

(1) Simple type: also known as the eustachian tube tympanic type, the most common, the lesion is mainly confined to the tympanic room. The normal eustachian tube and the front tympanic cavity are covered by ciliated columnar epithelium, containing glands, posterior tympanic cavity, sinus sinus and mastoids are cuboidal epithelium, and the tympanic bone, muscle, ligament and nerve are surrounded by mucous membranes, forming many wrinkles. Folded and shallow bags, the general mucosal infection is inflamed. If the treatment is timely, the tympanic membrane is perforated, the circulation is smooth, and the inflammation can be cured quickly. Otherwise, the shallow bag lesions expand, the mucosal lesions become irreversible, although there are not many pus, but the long-term pus is not only, or after the self-healing, repeated pus. The mastoids are well vaporized and flawless.

(2) necrotic type: also known as bone type. Mucosal tissue is extensively damaged, and hemorrhage and necrosis can occur in the auditory bone, drum ring, sinus sinus and mastoid small chamber. In particular, there are many perforations above the slack and the posterior tympanic cavity. There are not many pus and odor, and the perforation can often See gravy and polyps blocked drainage, severe hearing loss, sometimes headaches and dizziness, mastoids are mostly interstitial or sclerotic.

(3) cholesteatoma type: also known as dangerous type. A hyperplasia epithelial mass forms in the tympanic or sinus sinus, which is surrounded by fibrous tissue containing necrotic upper keratin, keratin and cholesterol crystals. Because it can compress and destroy bone and has malignant tumor properties, it has been mistakenly called cholesteatoma in the past, and it is not a tumor. Although there are not many ear pus, but the smell is strange, there are white pieces and tofu spleen-like cholesteat epithelium. It can cause headache, dizziness, extensive bone destruction, and complicated intracranial and extracranial complications. It is called dangerous otitis media, and the mastoid is mostly hardened.

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