acute otitis media
Introduction
Introduction to acute otitis media Acute otitis media is frequent in infants and young children in winter and can cause deafness in severe cases. The pathogens of acute otitis media are mostly Staphylococcus aureus and hemolytic streptococcus. There are three invasive routes, through the eustachian tube, external auditory canal or middle ear. A few cases may cause perforation of the tympanic membrane. Some may turn into more chronic otitis media with secretions and cause deafness and earache. basic knowledge Sickness ratio: 0.1% Susceptible people: no special people Mode of infection: non-infectious Complications: acute mastoiditis subperiosteal abscess facial paralysis meningitis
Cause
Causes of acute otitis media
Eustachian tube infection (35%):
After the upper respiratory tract infection, the secretion of the nasopharynx can enter the tympanic cavity due to nose, swallowing and vomiting, which is also the most common way to cause otitis media. Early acute otitis media virus antibody titration is often elevated, may be adenovirus and influenza virus infection, and then bacterial invasion, children are mostly pneumococcal, hemolytic influenza, and -hemolytic streptococcus, adults are mostly hemolytic streptococcus, gold Staphylococcus aureus and Proteus. Later, the tympanic membrane was perforated and it became a mixed infection.
External auditory canal infection (30%):
Less common, such as wartime firearms, ear damage, boxing and diving caused by rupture of the tympanic membrane. Severe external auditory canal inflammation, rupture of the tympanic membrane for a long time can also cause tympanic infection.
Blood infection (20%):
At least, acute severe infectious diseases and sepsis, bacteria enter the tympanic cavity directly through the artery, and can also enter the tympanic cavity by venous thrombosis.
Prevention
Acute otitis media prevention
First of all, we should pay attention to exercise, improve physical fitness, and actively prevent and treat upper respiratory tract infections. Disable hard objects and prevent tympanic membrane damage. Swimming should be prohibited for patients with old tympanic membrane perforations or tympanic catheterization. For patients should pay attention to:
(1) When the initial heat is high, drink plenty of water.
(2) Keep the external auditory canal clean, but do not re-swipe.
(3), the ear should be on the underside when sleeping, and be careful not to be oppressed.
(4) If it is a child, in the case of breastfeeding, it is necessary to take a proper position, and it should be high and low, and it is forbidden to feed in a lying position.
(5) Take the medicine on time and change the medicine for external use. The dressing utensils should be carefully disinfected.
(6) When changing the medicine, the patient should be placed on the side of the patient or the head should be inclined to one side of the shoulder, and the auricle should be pulled. The auricle of the adult can be pulled back and forth, and the child can be moved backwards, and then the medicine is dripped or incorporated.
(7), avoid spicy food and alcohol. The lactating mother of the sick child should also avoid the above.
(8), the water used in the winter, should be warmed up, the temperature should be close to the body temperature. Convenient method: 10 minutes before the drop, the medicine is hidden in the pocket of the close-fitting clothes.
Complication
Acute otitis media complications Complications, acute mastoid inflammation, subperiosteal abscess, facial paralysis, meningitis
Acute mastoiditis, subperiosteal abscess, facial paralysis, meningitis.
Symptom
Acute middle ear symptoms Symptoms Post-ear pain, earache, fever
Sudden ear pain, often accompanied by a cold or cough. If the patient is a baby, he will cry and rub the earlobe of the ear. Fever, body temperature can be as high as 39 degrees Celsius. There may be vomiting, or the ear canal may be soft earwax or pus. The affected ear may be hearing impaired.
Examine
Examination of acute otitis media
Tympanic membrane
The slack or the full tympanic membrane is invaded, which is characterized by shortening, deforming or disappearing of the light cone. The hammer stem is displaced backwards and upwards, and the short bone of the humerus is obviously protruding, and the angle between the front and the back fold becomes smaller. When the tympanic effusion is effusion, the tympanic membrane loses its normal luster and is single yellow, orange red or amber, and the cone is deformed or displaced. In chronic cases, it may be grayish blue or milky white. The tympanic membrane has dilated microvessels in the tension zone. The short protrusion is more smeared than the sacral color, and the humeral stem is embossed. If the liquid is serous and does not fill the tympanic cavity, the liquid level can be seen through the tympanic membrane. This liquid surface is like a curved hair, called a hairline, with the concave surface facing up. When the head position changes, its relationship with the ground is unchanged. Bubbles are visible through the tympanic membrane, and the air bubbles can be increased after the eustachian tube is blown. Air otoscopy has limited tympanic membrane activity.
2. Pulling the cork
After pressing the tragus and then releasing the amps separately, the ears were tested separately, and the patient consciously had ears that sounded like a cork.
3. Hearing test
Tuning fork test and pure music listening valve test results show conductivity . Hearing loss is different, and the weight can be as high as 40dB HL. If the hearing impairment is significant, auditory brainstem response and otoacoustic emission examination should be performed to determine whether it affects the inner ear.
4.CT scan
It can be seen that the air cavity of the middle ear system has different degrees of density increase.
Diagnosis
Diagnosis and diagnosis of acute otitis media
Early examination: hyperemia of the tympanic membrane, blood vessels around the tension and the radial expansion of the hammer stem. This period is often overlooked, especially in children.
Mid-term examination: diffuse hyperemia of the tympanic membrane, accompanied by swelling, bulging outward, first seen in the posterior upper part. Afterwards, all of them are convex. The normal sign is difficult to identify. Blood: The total number of white blood cells increases, and the proportion of neutrophils increases.
Late examination: Before the perforation of the tympanic membrane, small yellow spots appear first. The beginning of the perforation is generally very small, and it is not easy to see. After thoroughly cleaning the external auditory canal, the highlight of the tympanic membrane is flashing and there is pus from the place (ear). Hearing tests are conductive.
Recovery period check: visible small perforation in the tympanic membrane, purulent secretion in the external auditory canal or dry.
