otitis media in children
Introduction
Introduction to pediatric otitis media Otitis media is the most common symptom of numbness or blockage in the ear, hearing loss and tinnitus. Often occurs after a cold, or unconsciously. Sometimes head position changes can improve hearing. There is self-listening enhancement. Some patients have mild earache. Children often appear to be obedient or inattentive. Otitis media, especially acute suppurative otitis media, is more common in children. Clinical manifestations are pain in the ear area, hearing loss, and systemic symptoms such as fever, headache, fatigue, loss of appetite. Once the tympanic membrane is perforated, pus can flow out of the ear. The symptoms of swelling are reduced. The structure of the ear is very special. The inside is a bone, and the outside is covered with a layer of skin. There is no other muscle tissue that can cushion the two. Therefore, once otitis media develops, it will be very painful. Although the baby can't say it, as long as the mouth is moved, whether it is sucking or swallowing, it will hurt the infected part. Therefore, the baby may be irritated, crying, or unwilling to fall asleep while eating. basic knowledge The proportion of illness: 0.003% Susceptible people: children Mode of infection: non-infectious Complications: cholesteatoma otitis media meningitis brain abscess adhesive otitis media
Cause
Causes of pediatric otitis media
Respiratory and nasopharyngeal diseases (15%):
The middle ear of normal people is connected to the nose and pharynx. When there are a lot of bacteria in the nasopharynx, these pathogens can easily enter the ear. The eustachian tube of the child is relatively short and wide, and is in a horizontal position. Once an upper respiratory tract infection occurs, the pathogen easily enters the middle ear through the eustachian tube to cause acute inflammation. Such as colds, rhinitis, pharyngitis and so on.
Swimming (15%):
When swimming, water will enter the ear from the external auditory canal, but if the tympanic membrane has no holes, water will not enter the middle ear from the outer ear. However, if there are many people in the swimming pool and the hygiene is not done well, the bacteria or disinfectant in the water will enter the body through the nose and mouth of the child, causing a cold and causing otitis media.
Lying down and drinking milk (15%):
The baby lays down on the water, drinks milk, and the water or milk will flow in the direction of the nasopharynx, posing a risk of otitis media. Therefore, when your baby drinks milk or other beverages, raise his head up and wipe him off the water or milk at any time.
Fatigue (15%):
Insufficient sleep or excessive physical exertion is the main cause of decreased immunity. Regular life, balanced diet and moderate exercise are important for staying healthy. So don't let your child play too tired, and be sure to let him get enough rest.
Smoking (10%):
Some people in the family smoke, easy to induce otitis media. Even if you rush the smoker to the balcony to smoke, his hair and clothes will be contaminated with harmful substances. When he goes to hold the baby, these harmful substances will stick to the baby's nasopharyngeal mucosa, which may cause inflammation.
Collective life (10%):
In kindergartens, the chances of a child getting exposure to a cold or a virus are greatly increased, thereby increasing the likelihood of developing otitis media.
Going out (10%):
In public transport such as closed trains or airplanes, or in public places with poor ventilation and dense population, it is easy to get infected with cold viruses, and it is easy for your baby to develop otitis media. Therefore, take the children out, try to avoid crowded places.
Treatment interruption (5%):
Usually, the symptoms of acute otitis media will be alleviated or even disappeared after a few days of taking the medicine. At this time, do not think that the baby is good according to your own judgment, stop taking medicine and treatment. Stopping treatment on the way is one of the reasons why acute otitis media has not healed or even turned chronic.
Prevention
Pediatric otitis prevention
First, pay attention to rest: to ensure sleep time and sleep quality, adhere to exercise, enhance the body's resistance.
Second, the prevention of colds: prevention of colds is the basis for the prevention of otitis media, if you accidentally catch a cold should be treated in time. During the cold, the secretions in the nasal cavity will increase. At this time, you should not pinch your nose and nose, as this will increase the pressure on the nose and throat, causing the snot and bacteria to enter the middle ear through the eustachian tube, infecting otitis media.
Third, pay attention to ear hygiene and keep your ears dry when swimming: Choose a clean swimming pool when swimming, do not swim in dirty waters. If the water is inadvertently flowed into the ear, the ear should be blown dry in time, and the outer ear should be pulled up and out to make the ear canal straight. Let the hair dryer be 5-10 cm away from the ear and blow it into the ear. Blow in warm or cold wind for 30 seconds. This eliminates the warm and humid environment in which bacteria and mold grow.
Fourth, nasal, nasopharynx diseases should be properly treated in a timely manner: the proliferation of children with hypertrophy, to be treated early. When you get an acute infectious disease such as measles, pay more attention to the cleanliness of the mouth and nose to prevent otitis media.
Fifth, the diet should be light, easy to digest, and rich in nutrients: eat more fresh vegetables and fruits, do not eat spicy and stimulating foods, such as wine, onions, garlic, etc., to prevent heat and internal attack. In normal times, you should also eat more foods that are poisonous and poisonous, such as honeysuckle and mung bean soup.
6. When bathing your child and washing your hair, try to avoid sewage flowing into your ears.
7. Avoid feeding too much when feeding your child or the hole in the nipple is too big. The baby can't swallow and cause cough, so that the milk can cause the middle ear infection through the eustachian tube.
8. When you dig your child's ears, the movement should be gentle, avoiding damage to the skin and mucous membranes in the ear and causing infection.
9. When a child catches a cold, pay special attention to whether his ear is abnormal, especially for children who have had otitis media.
Complication
Pediatric otitis media complications Complications cholesteatoma otitis media meningitis brain abscess adhesive otitis media
1. Repeated otitis media will increase the perforation of the tympanic membrane and harden the adhesion of the middle ear, which will further reduce the hearing. If the drug is not used properly, it can cause a decline in the function of the inner ear nerves, which makes it more difficult to treat.
2. Repeated inflammation of the middle ear can lead to otitis media with cerebral ulcer or cholesteatoma. When the bone is eroded, it may cause intracranial and extracranial complications such as facial nerve spasm, meningitis, brain abscess, and even life-threatening.
3, if the otitis media is not treated in time, the fluid in the ear is not absorbed, it will lead to tympanic sclerosing, adhesive otitis media, cholesterol granuloma and other secondary diseases, resulting in permanent hearing loss, treatment is very difficult. Infant and childhood is a good time to learn language. If the language learning disorder is caused by hearing difficulties, it is like closing a window in which the child knows and perceives the world, which seriously affects the child's mental development. Experts pointed out that some parents have misunderstandings about secretory otitis media. Some believe that as long as the ears have not been exposed to unclean water, they will not get otitis media; some think that only the ear pus is secretory otitis media, which is delayed. The timing of treatment. There are many types of otitis media, which is one of the more common ear diseases in winter and spring. Parents must detect the child's behavior early and find that the child is taken to the ENT hospital early.
Symptom
Symptoms of middle ear inflammation in children Common symptoms Hearing loss Ear canal flow after pus ear pain Ear root pain Ear pain Ear lymph nodes enlarge Appetite decline fever ear discharge
First, there is a fever without cold symptoms
If the child has a fever without a cold, parents should be alert to whether he has otitis media.
Second, refuse to eat, cry, do not want to fall asleep
The structure of the ear is very special. The inside is a bone, and the outside is covered with a layer of skin. There is no other muscle tissue that can cushion the two. Therefore, once otitis media develops, it will be very painful. Although the baby can't say it, as long as the mouth is moved, whether it is sucking or swallowing, it will hurt the infected part. Therefore, the baby may be irritated, crying, or unwilling to fall asleep while eating.
Third, slow response
Secretory otitis media does not pus, but a large amount of fluid remains in the middle ear, which may cause temporary hearing impairment in the baby, and symptoms of slow response.
4. Yellow, white or blood-containing liquid flowing out of the ear
If your child's ear is yellow, white, or contains blood, then your baby must have otitis media. The pus out indicates that the liquid that was originally left in the middle ear has broken the eardrum.
Examine
Pediatric otitis media examination
Otoscopy
In children with otitis media, there is liquid in the middle ear cavity, which can be as thin as water, and the color is usually a little yellowish. If it takes a long time, it may be very sticky. Like glue, it has a very typical character. Most doctors can get a diagnosis by asking a doctor's history and combining various examinations.
Otoscopy is the main diagnostic method for otitis media in children. Otoscope can detect tympanic membrane congestion, invagination or external protrusion, and signs such as effusion can be diagnosed, and then acoustic impedance examination can confirm the diagnosis.
Diagnosis
Diagnosis and diagnosis of otitis media in children
First, suffering from severe pain in the head near the ear, refused to eat, cry, do not want to fall asleep. Luo Renzhong said that the structure of the ear is very special. The inside is a bone, and the outside is covered with a layer of skin. There is no other muscle tissue that can cushion the two.
Second, fever, otitis media is often accompanied by a sudden fever, body temperature can rise to 37.8 ° C to 40 ° C.
Third, see if there is suppuration, if the mouth is out of yellow, white or blood-containing liquid, then your baby may have otitis media. The pus flowing out indicates that the liquid originally left in the middle ear has broken the eardrum.
