Bilateral exudative otitis media, how does bilateral exudative otitis media manifest itself? Exudative otitis media - how to prevent hearing loss in a child Acute bilateral exudative otitis media

Bilateral exudative otitis It is a non-infectious inflammation of the middle ear. The nature of the disease manifests itself in the accumulation of fluid in the cavity of the tympanic membrane, but is almost invisible due to the absence of perforations and pathological flora in the affected area. The development of inflammatory processes that is not prevented in time can lead to various serious complications, so if a child or an adult has symptoms, you should immediately seek help from an otolaryngologist.

Pathology with catarrhal damage in both ears is called "bilateral exudative otitis". It can also be one-sided, when only one ear is affected, but, according to statistics, this form of inflammation is established by doctors only in 10-12% of cases. The formation of a viscous secret often occurs as a result of untreated sinusitis or against the background of other chronic and acute diseases of the sinuses. It is most commonly tolerated at an early age by children, with a chance of recurrence within a year, and is much less commonly diagnosed in adults.

Exudative bilateral otitis media in a child may not cause physical discomfort and pronounced symptoms, so the appearance of the disease should be prevented in advance. In addition, the pathology does not affect the muscular and bone parts of the ear and may occur, for example, due to poor patency of the Eustachian tubes.

There are a number of anatomical features in which the risk of the disease increases:

• splitting of the sky;
• enlargement of nasal conchas;
• deviated nasal septum.

If you do not intervene in a timely manner in the development of the disease, then you can get a lot of aggravating consequences, up to its transition to diffuse otitis media and the development of conductive hearing loss.

In addition to unilateral and bilateral forms, the classification includes acute otitis media, which lasts from 7-8 weeks to 2 months, and chronic, when the duration of action exceeds 60 days.

The main stages of the development of the disease:

1. Initial. Inflammation of the Eustachian tube, in which minimal hearing impairment is felt.
2. Secretory. Due to the obstruction of the auditory tubes and the violation of the removal of fluids from the ear cavity, a mass of serous secretions accumulates, which significantly impair hearing.
3. Mucosal. Manifested hearing loss due to an increase in the viscosity of the substance.
4. Degenerate. Trophic disorders of the tissues of the tympanic membrane leading to the adhesive form of the disease.

Etiological factors

Bilateral exudative otitis media in children and adults develops for two categories of reasons - general and local. They can be very different depending on many factors. Common causes appear as:

• allergic reactions;
• eustacheitis and adenoitis;
• reduction of reactive processes of the body;
• endocrine system disorders;
• chronic sinusitis;
• wolf's mouth;
• untreated infectious diseases.

Among the local ones are hypertrophy of the pharyngeal tonsils and mechanical damage to the Eustachian tube, which leads to a violation of the ventilation and drainage functions of the middle ear. For the normal functioning of the hearing organs, a small secretion of serous fluid is required, and an excessive increase in its volume signals the need for the intervention of specialists.

Symptoms of exudative otitis media in children

Bilateral exudative otitis media in children can begin its development when water enters the ear opening, while bathing in a bath or other water procedures. This is especially dangerous at low water temperatures. Due to the incomplete process of formation of the hearing aid and the weak immune system, children from 2 to 5 years old are most often exposed to pathogens. Separately, it is important to ensure that the child is not a passive smoker: this increases the susceptibility to the disease.

In acute form, at the first manifestations of the disease, almost imperceptible pain in the ear and temperature are possible. At the subacute stage, the concentration of fluid in the ear cavity is gaining viscosity, causing a feeling of transfusion and heaviness in the affected area. Unfortunately, very often the symptoms can go unnoticed, which greatly complicates the initial diagnosis. Often, intoxication and elevated body temperature are completely absent, which is why the sick person may not seek help at all. In some cases, there may be nasal or ear congestion, but still the main symptoms remain:

1. Noise and echo in the ears when talking or moving the head.
2. Decreased hearing of one's own voice.
3. Sensation of bursting of the ear cavity and gurgling.
4. General hearing loss.

Methods for eliminating pathology

When examining and taking an anamnesis, the otolaryngologist uses otoscopy and endoscopes of varying softness to detect damage to the eardrum, morphological changes in tissues, vesicles in the ear cavity, or deformities of the auditory ossicle. In addition, he conducts a full survey regarding recent illnesses. As additional diagnostic methods can be used:

1. Tomography of the patient's temporal lobe - to determine the condition of the ear canal and mucous membrane. Often used in relapse.
2. X-ray - to detect cell pathologies.
3. Audiometry - to detect malfunctions in hearing and susceptibility to various sound frequencies.
4. Tympanometry - if otosclerosis is suspected and to measure hearing sensitivity, membrane mobility and ventilation - by increasing pressure in the ear cavity.
5. Otomicroscopy - to determine the degree of retraction of the membrane into the middle ear.
6. Acoustic reflexes, with which you can find out the resistance of the structure of the ears to loud sounds.

After an accurate diagnosis, complex treatment is applied using mucolytic and anti-inflammatory non-steroidal and glucocorticosteroid drugs, which help to thin and remove the substance from the ear.

The most common therapy is called conservative. It includes several groups of drugs:

1. Sanorin,Nazivin. Vasoconstrictor drugs used to restore the patency of the auditory tubes.
2. Suprastin,Tavegil. Anti-inflammatory and antihistamines to reduce swelling of the nasopharynx and Eustachian tube.
3. Ambroxol,Ambrobene. Mucolytic thinners.
4. Azithromycin, Amoxiclav. Antibiotics that are taken for infections.

In addition to taking the listed substances, physiotherapy can be performed to improve the patency of the pipes:

1. Pneumomassage of eardrums.
2. Magnetotherapy.
3. Insertion of catheter tubes into the ear. (Not suitable for toddlers as it requires patient activity.)
4. Ultrasonic procedure.
5. Blowing the auditory tubes according to Politzer.
6. Laser therapy.

Alternative medicine - in most cases, the measure is unjustified and is not recommended in order to avoid additional dangerous complications, especially without the consent of the doctor. In addition, you should not engage in self-treatment or take any measures without a preliminary examination by an otolaryngologist. A poor-quality approach or lack of health measures can lead to purulent and chronic otitis media, mastoiditis, cholesteatoma, and perforation of the tympanic membrane with concomitant thinning.

Exudative otitis: surgery in children

Surgical intervention is used if the tympanic membrane does not restore its functions, the serous substance does not lose its viscosity and is not excreted, or the sound is still perceived with disturbances. Disposable removal of exudate with a pressure tube, such as a myringotomy, may be used. But most often, shunting of the middle ear and its cavity is performed - tympanopuncture. This helps with the introduction of drugs into the area of ​​damage and perfectly removes the serous substance. The shunt is inserted inside after the tympanic membrane has been cut and remains there for several months.

Prevention

To reduce the risk of exudative otitis, you should get rid of pathologies that can lead to such complications. These are rhinitis, sinusitis, polyps and adenoids. Do not forget about a healthy lifestyle, the maintenance of which can be preventive for many diseases of this nature. You need to spend a lot of time outdoors, observe personal hygiene, play sports and move a lot, periodically carry out tempering procedures for your body. In addition, it is worth avoiding hypothermia and getting water into the ear cavity. Children predisposed to respiratory diseases are in the main risk group.

More effective and reliable methods of prevention do not exist, so it is best to avoid the risk of disease and the subsequent development of pathology and monitor changes in the functioning of the hearing aid.

Exudative otitis media in children is an unpleasant disease characterized by an inflammatory process in the ear canal. This disease is non-infectious. Most often, they suffer from newborns, infants, and preschool children. If the disease is not treated correctly, this can provoke the development of many negative processes, therefore it is important to consult a specialist for help if suspicious signs are found.

General classification of pathology

Specialists distinguish catarrhal and. In the first type, pronounced clinical signs often begin to appear immediately, which simplify the diagnosis of the disease.

And the exudative form of the disease is usually not diagnosed immediately, since severe symptoms are often absent. This pathology does not extend to the bone or muscle structures surrounding the ear canal, but an accumulation of contents occurs in the ear canal.

There are acute and chronic types of pathology. In acute exudative otitis media, the duration of treatment averages from 30 to 60 days. In the presence of a subacute form, the development of pathology lasts at least one and a half months. If a chronic form of the disease is diagnosed, the duration of its development is at least two months.

Diagnose also unilateral and bilateral exudative otitis media in children. With the development of the latter, the pathological process develops immediately in both organs of hearing, according to statistics, such processes often develop in babies.

It is almost impossible to detect the presence of an exudative form of the disease on your own; only an experienced specialist can do this. Diagnosis of this problem is usually carried out already at the stage of development, when the disease passes into a serious stage. And this is the difficulty of therapy.

Clinical manifestations

Standard clinical signs are usually not pronounced. The course of the disease is mild, there are no signs of intoxication. This pathology is poorly diagnosed even in an adult, since the symptoms are not pronounced, not to mention small children.

Usually the child is generally not able to distinguish the norm from any pathologies. Usually, in young children, the reaction appears only when the disease is already moving into an advanced stage, pronounced clinical signs appear.

If you suspect the presence of an exudative form of the disease, it is important to first pay attention to whether the quality of sound perception in the baby has deteriorated. It is also important to teach the child to express his feelings in words, to explain how it happens if the ears are blocked, if he does not hear well.

With untimely treatment and diagnosis, irreversible hearing loss, dysfunction in the hearing aid may develop, which subsequently leads to a violation in the speech apparatus.

This pathology can be detected only by the presence of serous contents in the ear canal or in the sink. This substance may look like a thin brown film or a large clot of a viscous consistency. If you put your hand on the organ, a kind of “gluing” of the limb and the ear shell occurs (in the people, the disease is called sticky ear).

With timely therapy, getting rid of the disease is quick, and no consequences will develop.

Why does pathology develop?

There can be a large number of factors provoking the disease. In order to ensure the full functioning of all departments of the apparatus, a small amount of content is regularly produced. For a healthy person, this is the norm.

And the substance that remains on the surface of the mucosa is usually removed during hygienic cleaning. In the event that swelling of the passages is noted, an inflammatory process develops, or the ear canal narrows, this indicates that there is an accumulation of exudative fluid in the ear canal.

There are such common provoking factors for the development of pathology:

• Features of the anatomical structure;
• The presence of constantly inflamed adenoids;
• Labor activity;
• Frequent acute respiratory viral diseases;
• allergic reactions;
• Sinusitis of chronic origin;
• Weakening of the body's natural resistance to viruses and colds;
• The presence of a wolf's mouth in a child;
• Frequent being a passive smoker.

Anatomical factors that can cause the development of a pathological process include insufficient patency of the ear canal, the constant accumulation of excess secretions, acute or chronic pathologies in the nasopharynx.

The precursors of the disease include: runny nose, sinusitis, chronic sinusitis. The probability of damage to the hearing aid is especially high if the listed diseases are not treated.

A constant inflammatory process in the adenoids can provoke a pathological process. In the event that timely surgical treatment is not carried out, in the presence of constant inflammatory reactions that are ignored, with a curvature of the nasal septum of congenital genesis, the likelihood of developing an ailment significantly increases.

Young children are often exposed to the development of a pathological process with frequent ingress of water into the ear canal during water procedures, especially in public reservoirs. It also increases the likelihood of damage with frequent hypothermia.

In adults, the development of the disease may be due to the characteristics of professional activity. So people of such professions as pilots, divers, whose professional activity is closely related to possible barotraumas, are more often exposed to the disease.

Also, the disease can be activated in conjunction with oncological processes in the nasal cavity, nasal sinuses, at a time when the neoplasm becomes an obstacle in the auditory canals.

With the development of exudative otitis media, there is no independent outflow of fluid from the ear cavity. This content creates positive conditions for pathogenic microorganisms to become active, begin their active reproduction, and provoke a pathological process.

After a while, as the disease develops, the exudate thickens, which includes not only mucus, but also impurities of pus.

One of the most common causes of this form of otitis media is ventilation dysfunction in the ear canal. At the same time, sputum and pus are intensively produced.

With such processes, sometimes there are painful sensations, a protracted development of the disease. Transferred acute respiratory diseases are often able to provoke the development of this form of otitis media.

Most often, exudative otitis media develops in children from two to five years of age, this is dictated by an immature hearing aid system. As well as frequent diseases of a viral or catarrhal nature (since it is at this time that the active formation of the immune system of children takes place, they attend a preschool institution).

The most common factor that provokes the occurrence of otitis media is passive smoking. Therefore, it is necessary to ensure that the child does not encounter tobacco smoke in the room where he is constantly located.

Therapeutic activities

Diagnosis of this pathological process is most often limited to an external medical examination, as well as otoscopy. With the help of special tools, the doctor examines the ear cavity, reveals the nature of the course of the disease.

In the predominant number of situations, the treatment of exudative otitis is difficult, rarely started on time. This is dictated by mild clinical manifestations.

The general therapy of the disease consists in an integrated approach. Be sure to prescribe conservative treatment, which consists of the use of medications (anti-inflammatory, mucolytics).

Mucolytic drugs are used to quickly thin the accumulated mucus and bring it out. Sometimes blowing the ear canal may be prescribed to quickly drain the fluid.

It is not only inappropriate to use any alternative medicine options, but in many cases it is ineffective, and even dangerous, since improperly performed treatment can provoke the development of dangerous consequences or complications. It is not allowed to use alternative treatment methods for a child that are not agreed with the treating specialist.

Depending on the degree of development of the disease, the doctor prescribes antibacterial drugs, glucocorticosteroid drugs, non-steroidal anti-inflammatory drugs to treat the ear canal.

If there is no restoration of the function of the eardrum, secretion production does not decrease, there is no improvement in the quality of sound perception, the doctor considers the advisability of using surgical treatment, which will effectively get rid of the fluid in the organ cavity.

Regardless of what reason provoked the disease, and also at what stage it is, you should not engage in self-treatment using dubious options.

It is also important to clearly follow all the prescribed medical recommendations, this will make it possible to restore the full functions of the hearing aid, to prevent the development of dangerous complications.

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Otitis media affects 60% of children and 20% of adults at least once in their lives. The most common type of this disease is otitis media, or inflammation of the middle ear, which is accompanied by acute pain. Less common is exudative otitis, that is, associated with the release of fluid, in which there are no painful symptoms.

Accompanying this disease, hearing impairment, stuffiness and gurgling sounds in the ears for a long time, especially in children, may go unnoticed. As a result, the exudative process can turn into chronic purulent inflammation or lead to significant hearing loss.

From the above study shows that the disease was considered a non-bacterial process, because the cultures were usually negative, showed that relapses are due to the presence of a biofilm containing one or more microorganisms. The fact that the bio-membrane is a natural barrier helps explain the ineffectiveness of antibiotics and host defense mechanisms against infection. Without suggesting ways to change therapies to date, methods need to be developed to prevent the formation or destruction of biofilms.

Causes and symptoms of exudative otitis media

In adults, these tonsils atrophy, and therefore do not cause as many problems as in childhood.

The main cause of exudative, aka sedative, otitis media is swelling of the mucous membrane of the nasopharynx and auditory tube. performs an important function - ventilates and provides its drainage. In case of violation of the removal of fluid from the ear, its excess occurs, which becomes the first prerequisite for the development of exudative otitis media.

Italian Research Group on Acute Medicine of Otitis. A delayed prescription may reduce the use of antibiotics for acute otitis media: a prospective observational study in primary health care. Adenoidectomy and tympanostomy tubes in the treatment of otitis media.

Migirov L. Duvdevani S. Cronenberg J. Otogenic intracranial complications: a review of 28 cases. Abscess of the posterior cerebral fossa, description of 4 cases. Evidence of allergic inflammation in the middle ear and nasopharynx in atopic children with otitis media with effusion.

Children often have a bilateral type of exudative otitis media. It is provoked by inflamed adenoids. When they grow, they block the nasopharynx and squeeze the Eustachian canal. As a result, symptoms such as a stuffy nose and ears, a runny nose, and a parted mouth in a child occur.

National Institute of Clinical Excellence. Otitis media and sinusitis-like diseases. Pathogenic shifts and change in the rate of cure for otitis media and tonsillopharyngitis. The role of laser tympanostomy in the treatment of allergic children with chronic serous otitis media.

Antimicrobial use in acute infections of the upper respiratory tract in family medicine. Mannose-binding lectin and upper respiratory infections in children and adolescents: a review. Comparative evaluation of video telescoping for the diagnosis of pediatric otitis media with effusion.

IT'S IMPORTANT TO KNOW!

In addition, the following factors can provoke otitis media in the middle ear:

Scottish Intercollegiate Recommendation Network. Immune status and Eustachian tube function in recurrent otitis media with effusion. Acute otitis media in children less than three months of age: clinical presentation, etiology and comorbidities. Placebo effect of rupatadine on allergen-induced symptoms in patients exposed to aeroallergens at the Vienna Trial Chamber. The role of antibiotics in the treatment of uncomplicated acute otitis media. Genetic relationship between populations of pneumococci originating from the nasopharynx, adenoid and tympanic cavity of children with otitis media.

• curvature of the nasal septum;
• infectious and viral diseases;
• weakened immunity;
• eustachitis;
• injury;
• allergic rhinitis;
• barotrauma;
• water ingress;
• sulfur plug;
• foreign object.

As soon as suspicious symptoms appear, it is necessary to start treating the patient immediately, as the problem can become chronic.

Otitis and its consequences: behind the ears. Pneumococcal conjugate vaccination in children with recurrent acute otitis media: a therapeutic alternative? Biofilms in ear, nose and throat infections: how important are they? Medical treatment of diseases of the middle ear in children under 2 years of age with sensorineural hearing loss.

During the last decades, the incidence of allergic rhinitis has grown to epidemic proportions. Correct and timely diagnosis is the basis for access point management and is based on a thorough history and thorough medical examination. The origin of allergic rhinitis was documented by allergic tests.

Symptoms and manifestation

Otitis exudative media does not manifest itself in the same way as other types of ear diseases. This is also inflammation of the ear, but there is no acute process, and therefore symptoms such as fever or severe pain are not observed. This complicates timely diagnosis.

Exudative otitis media gives the following symptoms:

• ear congestion;
• , gurgling and splashing when turning the head;
• nasal congestion;
• autophony;
• deterioration in hearing acuity.

Basically, the problem is noticed when hearing loss becomes apparent for no apparent reason.

Depending on the intensity of the course and duration of the disease, there are:

• acute - about 3 weeks;
• subacute - about 3-8 weeks;
• chronic exudative otitis media - 8 weeks or longer.

There are also types of exudative otitis according to the localization of inflammation: unilateral and bilateral.

It is worth knowing the difference between exudative otitis media and acute otitis media, which occurs as a result of a dangerous infection that has fallen deep into the ear. Chronic exudative otitis media is one of the varieties of otitis media. The characteristic features of the disease is the accumulation of exudate (viscous fluid) in the depths of the ear, without an inflammatory process preceding the onset of the disease. The disease is difficult to identify in a timely manner, since there are no characteristic symptoms, including acute pain, present in ordinary otitis media. The presence of the disease can be determined solely by hearing loss, as well as incomprehensible discharge from the ear. Exudative otitis media affects, as a rule, children aged 4 to 8 years, and also partially in adolescence. In adults, the disease manifests itself quite rarely, in a slightly aggressive form.

The main cause of exudative otitis in a child is the transition from a primary disease to a more complex form. Most experts are inclined to believe that this disease is a complication of a common ailment. There are a number of reasons that can become provoking for the occurrence of exudative otitis media:

• inflammatory processes in the nasopharynx;
• severe damage to the nose due to trauma and complex fractures:
• complex infectious diseases;
• weak body resistance;
• allergic reactions;
• The most common cause is water getting into the ear while taking a bath or shower.

It is worth noting that in 50% of cases it initially develops, and after - bilateral exudative otitis media.

Symptoms

The difficulty in diagnosing the disease is that uh ksudative otitis has hidden symptoms that interfere with treatment. In medical practice, cases have been noted when the disease smoothly flowed into a chronic form, while the symptoms did not manifest themselves.

Consider the main symptoms of exudative otitis media:

• hearing impairment, up to its short-term loss;
• it feels like it is in the ear;
• with sharp turns of the head;
• possible inflammatory processes in the nasopharynx;
• your own voice echoes in your ears.

Pain may be absent or short-lived. Unlike otitis media, body temperature remains normal.

Stages and forms of otitis media

Exudative otitis media in children and adults has several types, as well as stages of development. It is worth considering each variety separately in order to diagnose in time which form of exudative otitis media develops in a person.

Outer

This variety develops under the influence of an acute infection, and is also characterized by strong inflammatory processes that spread even to the inner layer of the ear (the lobe and outer shell are affected). The provocative elements of this form are:

• overdose of pharmacological agents;
• lack or a sharp decline in immunity;
• bites of poisonous insects;
• listening to music with headphones.

As complications, there is hearing loss, lack of sensitivity of the outer ear, as well as an increase in lymph nodes.

Chronic

This is a transitional stage of ordinary otitis media, which is formed as a result of the lack of timely treatment or not fully implemented therapeutic measures.

The inflammation is non-purulent, but large-scale, as it affects almost the entire ear. It feels as if the auditory organ is bursting from the inside or there is a constant presence of a plug. With sudden movements of the head, an unusual noise appears.

Chronic exudative purulent otitis occurs if the disease has not been cured within the first two months. Unfortunately, some of the effects of the disease are irreversible, including complete hearing loss.

Spicy

Acute exudative otitis media is a complication resulting from purulent inflammation inside the auricle. Fluid accumulates in the ear, which is pus-like microorganisms that can affect a sensitive and weakened membrane. Among the characteristic features of this form, it is worth noting that hearing loss cannot be stopped, and the further rehabilitation process takes a lot of time and money.

middle ear

The final stage of development of exudative otitis. A secret is formed in the ear, which forms high pressure in it. As a result, as in all previous stages, there is a decrease in auditory activity.

When the amount of secretion exceeds the allowable rate, it begins to seep into the nasopharynx in the form of colorless mucus. After, an empty space is formed, the pressure of which violates the sensitivity of the eardrum.

Reference. Bilateral exudative non-purulent otitis media is easy to treat and does not have irreversible consequences, unlike the chronic or acute form. Timely treatment will help to avoid all unpleasant consequences.

Chronic exudative otitis media

Like the acute form of the disease, chronic exudative otitis media develops in adolescents, as well as in children of a younger age group. This form of the disease develops if the duration of exudative otitis media exceeds two months.

As experts in the field of otolaryngology note, the presence of this disease indicates that the eardrum is under enormous pressure, as a result of which its deformation may occur. The consequences of this are hearing loss, as well as tympanosclerosis.

Diagnostics

For successful diagnosis, it is necessary to have records of all previous diseases of the patient, transferred to the ear. Among the diagnostic measures, the following mandatory procedures can be distinguished:

• otoscopy. The presence of deformation in the auricle is determined;
• audiometry. Current hearing level measurements;
• among the mandatory procedures there is a Valsalva test and endoscopy;
• to clarify the diagnosis, as well as confirm the presence of exudative otitis media, an x-ray is performed, as well as computed tomography (as an additional measure).

All other measures necessary for the successful diagnosis of the disease are prescribed by a qualified otolaryngologist.

Treatment

The therapeutic course consists of a number of procedures, including drug treatment, physiotherapy, etc. Initially, the provoking cause of the disease must be eliminated.

Throughout the entire therapeutic course, the child must be under the supervision of a doctor, as well as take all prescribed drugs in a timely manner. The child's body reacts to the medications used differently than an adult, therefore, in case of incompatibility with the drug or too strong a therapeutic effect, it is urgent to change the drug to another drug. Also, in case of complications, the baby needs to urgently provide first aid. Therefore, to avoid dangerous precedents, doctors strongly recommend that the child stay within the hospital.

Medical treatment

Consider the drugs used to eliminate this disease.

The rest of the drugs are selected and prescribed on an individual basis.

Surgical intervention

In case of a serious complication, the ENT can use two procedures that are designed for only one thing - the patency of drugs to the center of inflammation.

The first method is myringotomy. This manipulation involves the cleansing of the passage of the auricle. It is worth noting that the day before the procedure, the ear is carefully sterilized. In general, the operation is performed under general anesthesia, during which the excess secretion in the auricle is eliminated.

The second procedure is tympanopuncture. Quick and easy manipulation that does not require special training. A puncture is made in the eardrum, through which the drugs will enter the inflammation site. As a rule, the second procedure is used if exudative otitis media develops in adults.

Physiotherapy

Physiotherapy is used as an additional treatment for the disease. It includes the following procedures:

• Ultrasound. Allows you to destroy the blockade of the secret, as well as bring it out;
• laser intervention. It is intended to stabilize the patency of medicines inside the ear;
• Electrophoresis is an analogue of ultrasound therapy, with the only difference: instead of low-frequency waves, small current discharges are used.

Other procedures are also used, but most often they are intended for adults.

The main difference from acute otitis media is the absence of pain and infectious inflammation. Exudative otitis in most cases is a complication of inadequately or untimely treated catarrhal form of the disease. In turn, the exudative form becomes purulent if the treatment is absent or carried out incorrectly.

Children of different ages are more at risk of developing the disease, this is due to the increased vulnerability of the children's auditory analyzer. According to statistics, this widespread disease is the main cause of childhood hearing loss, the occurrence of this pathology occurs in almost 80% of cases. In adults, the disease is much less common and practically does not lead to permanent hearing loss.

Causes of the development of the disease and its types

Normally, a certain amount of exudate is synthesized in the middle ear cavity, which is removed from it in a physiological way. If the outflow of serous fluid is disturbed, symptoms of exudative otitis media develop. All the causes that cause the appearance of this disease can be divided into general and local (local).

Common reasons for the development of pathology include:

• decreased activity of the immune system due to various chronic diseases;
• development of allergic reactions;
• acute and long-term diseases of an infectious nature - adenovirus infection, sinusitis, catarrhal otitis;
• living in an ecologically unfavorable area;
• low living conditions.

Local causes are a violation of the patency of the Eustachian tubes, which can be caused by:

• mechanical blockage of the ear canals with a foreign object - does not occur in adults (this is mainly the cause of impaired patency in children under 3 years old);
• congenital or acquired anomalies of the anatomical structure - splitting of the upper palate, curvature of the nasal septum, increased size of the turbinates, in this case, surgical treatment of the pathology is required;
• trauma of the middle ear, including barotrauma in pilots and scuba divers;
• proliferation of tissues of the pharyngeal tonsils, which occurs mainly due to the current sluggish inflammatory process in it.

Types of exudative otitis media

Experts distinguish three forms of the disease:

1. Acute - a disease whose duration does not exceed three weeks is called acute otitis media.
2. Subacute - from 3 to 8 weeks, an intermediate form, in most cases not found in clinical practice.
3. Chronic - if 8 weeks or more have passed since the onset of the disease, they speak of chronic otitis media.

Clinical manifestations of pathology

Due to the blurred clinical picture, the absence of vivid manifestations (fever, pain, symptoms of intoxication), the disease is usually detected by chance during an examination or treatment for another pathology.

There are symptoms, when they appear, you need to see a doctor to exclude the development of this disease.

Such manifestations include:

• sounds resembling splashing or pouring of water appear in the ears;
• autophony - a person hears an echo of his own voice;
• the audibility of one's voice decreases during a conversation;
• hearing loss, persistent stuffy ears;
• nasal breathing disorder.

It is easier to diagnose and start treatment of the disease in adults, because children rarely bring their parents' attention to abnormalities unless they cause pain or severe discomfort. Mom should be wary if the child has a chronically stuffy nose or it is more convenient for him to breathe through his mouth; the child becomes silent and begins to listen while he speaks; hearing impairment is noted, these symptoms may indicate the development of exudative otitis media.

Acute otitis has the same symptoms as chronic, only the duration of the process differs. If otitis media is treated while it is acute, the patient is more likely to recover without damage to the hearing aid.

Features of the diagnosis and treatment of the disease

If the symptoms of the disease indicate the development of exudative otitis media, in order to prescribe the correct treatment, it is necessary to confirm the diagnosis, for which it is carried out:

• assessment of the ventilation functions of the Eustachian tube;
• examination by acoustic turbosonometry;
• determination of the mobility of the tympanic membrane;
• endoscopic examination;
• radiography.

The main directions of treatment of pathology

The treatment of otitis should first of all be aimed at eliminating the causes that led to the stagnation of serous exudate in the middle ear cavity. Then, the further development of inflammation is prevented and, if possible, the functioning of the auditory analyzer is restored in full.

Medical therapy

Drug treatment is selected based on the severity of the clinical signs of the disease, the stage of its course and the individual characteristics of the patient's body.

Most often, drugs of the following groups are prescribed to stop the inflammatory process:

1. Non-steroidal anti-inflammatory drugs - ear drops (otipax or otinum), with an increase in temperature as a result of the addition of a secondary infection, you can take paracetamol, efferalgan or mefenamic acid.
2. Drugs that thin the exudate and facilitate its release (mucolytics) are the most effective ACC and carbocysteine, the course of administration is at least 14 days.
3. It is necessary to supplement the treatment with hypoallergenic agents, which will significantly reduce the likelihood of developing an allergic reaction to the drugs taken (this is especially true in children).
4. To eliminate the common cold, otrivin nasal drops are treated for 5-7 days.
5. Antibiotic therapy for exudative otitis media is prescribed only in case of secondary bacterial infection, most often amoxicillin is used, as well as drops in the ears (tsipromed, normax or otofa).

Physiotherapy procedures

Treatment with physiotherapeutic methods helps to restore the patency of the auditory tube in the presence of a sluggish inflammatory process and enhances the effect of drug therapy.

With exudative otitis, the following methods are used:

• ultrasound;
• electrophoresis with lidase preparations;
• laser therapy;
• pneumomassage;
• treatment with diadynamic currents;
• magnetotherapy.

Surgical methods

Treatment of exudative otitis media is impossible without eliminating the causes of obstruction of the Eustachian tubes, sometimes this requires the use of surgical methods, which include:

• if necessary, surgical alignment of the nasal septum or removal of the tonsils - tosillectomy;
• a single removal of exudate from the ear cavity can be performed using myringotomy or tympanopuncture;
• tympanotomy serves for a long-term removal of serous fluid, the eardrum is dissected and a polyethylene tube is installed in the hole for 2-4 weeks;
• shunting - after dissection of the eardrum, a shunt is installed, for 3-4 months it is used to aerate the ear cavity and administer drugs.

There are no effective methods to prevent the development of otitis media in childhood or adulthood. In order to reduce the risk of pathology, doctors recommend timely treatment of all inflammatory diseases of the nasal cavity, throat and ears.

Useful video about otitis media