Exudative otitis media in a daughter. Exudative otitis in a child: features of the course and treatment of the disease. Prognosis of treatment and prevention

If a child has an earache, otitis media can be the cause. The disease has a large number of varieties. In order to prevent the occurrence of complications, it is important to quickly determine the appearance of the problem and begin competent treatment.

And now let's dwell on this in more detail.

What is otitis? Temperature with otitis in a child

Otitis media is an inflammation of one of the sections of the human ear. The disease can occur in a chronic or acute form. Most often, otitis media is diagnosed in children. In 80% of cases, patients under the age of 3 years have at least one episode of the disease. There are the following types of otitis media:

• external - the external passage of the human ear is inflamed;
• medium - the disease is localized in the middle ear (the most common situation);
• internal - the disease affects the inner ear.

Otitis cannot be started. If the problem is not treated, it can lead to irreversible hearing loss, inflammation of the temporal bone, and even.

All inflammatory processes are accompanied by an increase in temperature. Otitis media is no exception to the rule. The main sign of the presence of an acute form of the disease is fever. Body temperature can reach up to 39-40 degrees. The value of the indicator can remain at the same level for 7 days.

Types of otitis media

There are many types of otitis media. The disease in children is classified based on the following criteria:

• the location of the disease;
• the nature of the inflammatory process;
• features of the course of the disease;
• cause of otitis
• the rate of the pathological process.

The clinical manifestations of each type of otitis media can vary significantly.

Purulent otitis media

Purulent otitis occurs quite often. The disease is a purulent inflammation of the middle ear. All components of the department are involved in the pathological process. Most often, children suffer from the disease. In half of the cases, purulent otitis is observed in patients under the age of 18 years. 1-2% of the population has a chronic form of the disease. In 10-60% of cases, the disease leads to a decrease in hearing or its complete loss.

Otitis media

Otitis media is an infectious and inflammatory disease of the middle ear. Most often, the pathological process proceeds in an acute form. It usually only affects one ear. In rare cases, the inflammatory process can be observed in the second organ. The causative agents of otitis media are:

• streptococci;
• influenza virus;
• parainfluenza virus;
• hemophilic bacillus;
• adeno- and rhinoviruses;
• pneumococci.

In rare cases, the activity of a number of other microorganisms and fungi leads to the appearance of the disease. The causative agents of the disease enter the tympanic cavity from the nasopharynx. Because of this, the disease often occurs as a complication of an upper respiratory tract infection. In some situations, the pathogen can enter directly through the damaged eardrum and end up in the middle ear with blood flow. The latter is possible with infectious diseases. There are 3 stages of acute otitis media:

1. Preperforative - begins from the moment of inflammation and until the integrity of the tympanic membrane is violated.
2. Perforative - occurs as soon as the integrity of the eardrum is broken. The moment of completion of the stage is considered to be the cessation of purulent discharge from the external auditory canal.
3. Reparative - recovery occurs. In the event of an unfavorable development of events, the disease at this stage can become chronic.

Chronic otitis is an alternation of exacerbations and remissions.

Catarrhal otitis

With catarrhal otitis, the inflammatory process is localized in the auditory tube. Usually the problem manifests itself against the background of another infectious disease. Sometimes a sharp drop in atmospheric pressure can lead to the onset of the disease. Usually catarrhal otitis proceeds in an acute form. However, a chronic course of the disease is also possible.

From other varieties of otitis media, catarrhal differs in the possibility of occurrence or diarrhea in children, as well as a deterioration in appetite. The child tries to move less. On examination, redness of the tympanic membrane is noticeable. Fluid accumulates in the tympanic region. All this allows you to accurately diagnose.

Acute otitis media

Otitis can occur in acute or chronic form. In children, the first variant of the course of the disease is usually observed. Acute otitis can develop in all parts of the ear. Most often it appears in the middle section. Acute otitis media can lead to:

• allergy;
• water in the ear
• infectious and inflammatory diseases;
• getting into the ear of a foreign body;
• improper hygiene;
• operation;
• hypothermia;
• ear injury.

Usually in an acute form catarrhal and purulent otitis occur. They can be caused by bacteria, viruses, or fungi.

Exudative otitis media

Exudative otitis occurs without pronounced signs of inflammation. However, initially serous and then purulent exudate is formed in the cavity. The disease is a type of otitis media. During the disease, the eardrum is not damaged. However, pathology leads to a critical hearing loss in a child. If left untreated, the disease can cause grade 3 hearing loss. The temperature during the disease is usually absent.

Exudative otitis media can appear when an infection enters the cavity from nearby ENT organs. Initially, swelling of the Eustachian tube occurs, which causes a narrowing of its lumen. The outflow of exudate is disturbed. As a result of stagnation, the exudate becomes viscous. Its outflow is disturbed even more. All this leads to the development of catarrhal otitis, which subsequently turns into an exudative form. If at this stage of development the pathology is not treated, it can lead to hearing loss.

Otitis ear

The concept of "otitis media" includes all of the above varieties of the disease. Allocate external and internal otitis media. In the first case, the disease occurs due to damage to the auricle, through which the infection penetrates inside. Usually, otitis externa affects children who have impaired metabolism. Initially, the disease captures only the surface layer of the auricles. Further, the process passes to the surrounding tissues.

Internal otitis usually develops due to infection from the nasopharynx. It can become a complication of another disease. To eliminate the disease, you must first get rid of the problem that led to its appearance. Bacteria, viruses or fungi can provoke the development of the disease.

Bilateral otitis media

Bilateral otitis media is an inflammatory process of an infectious nature that affects both ears. Usually the disease develops in the middle ear. The cause of the appearance of pathology is the activity of bacteria and viruses that support inflammation and contribute to the appearance of complications. Pathology is treated with antibiotics and topical preparations.

What does otitis media look like in children with a photo

External manifestations of otitis directly depend on the form of the disease. It can proceed without any manifestations or be accompanied by purulent discharge and the ear canal. Additionally, redness of the auricle may be observed. To better understand the external manifestations of the disease, experts recommend that you familiarize yourself with the photo.

The first signs of otitis in a child

It is most difficult to determine otitis in a child under one year old. During this period, children do not yet talk and cannot tell their parents about what is bothering them. Therefore, it is necessary to carefully observe their behavior. A newborn child who has developed otitis media behaves restlessly. He sleeps badly, cries and eats. If you press on the tragus of the ear, the child will scream and twitch. Children behave calmer if they lie on a sore ear.

A child who has reached 4 months tries to reach out to a sore ear or rubs it against a pillow. If the disease is severe, it may be observed. The patient throws his head back. Additionally, diarrhea and may be present.

Older children can self-report what is bothering them. Usually a child who has otitis media complains of ear pain that radiates to the temple. Additionally, there may be a feeling of congestion and pressure in the ear. Hearing is reduced. Otitis media is sometimes accompanied by a sore throat. The disease, which occurs in an acute form, will cause an increase in temperature. The child may refuse to eat and stop sleeping. Sometimes there is confusion.

If pus has come out of the ear, this may indicate a rupture of the eardrum. After that, a decrease in temperature is observed. The pain subsides. Exacerbation of chronic otitis can be detected by the same signs.

Symptoms of otitis media

Symptoms of otitis can vary depending on the type of disease. If the child has:

1. Otitis externa, primarily swelling and redness of the ear canal. Pathological contents can stand out from it. The patient complains of pain in the ear, which intensifies when opening the mouth. With the development of the disease, there is an increase in temperature to 38 degrees. The child refuses to eat. The pain may be aggravated by sucking on the breast and pacifier. Babies can put the pacifier in their mouth and immediately spit it out. If treatment is started in a timely manner, the development of complications is extremely unlikely. Self-medication can cause inflammation from the outer ear to move to the middle one.
2. Otitis media, the child experiences unbearable shooting pain in the ear. He cries constantly. Body temperature can rise to 40 degrees and above. There is an increasing intoxication of the body. It is accompanied by diarrhea and. The child becomes weak and lethargic. Sucking movements cause severe pain, because children refuse to eat and drink. The child covers the affected ear with his hand. Older children may complain of hearing loss.
3. Internal otitis, the patient may experience hearing, coordination and balance disorders. The fact is that the inner ear is closely connected with the vestibular apparatus. Therefore, the inflammatory process affects its functions. The problem is often accompanied by dizziness, as well as nausea and.
4. Chronic otitis, purulent discharge may periodically appear from the ear canal. Outbreaks of exacerbation of the disease alternate with remissions. Hearing acuity can be significantly reduced. In some situations, complete deafness develops. On the damaged eardrum, holes are formed that do not overgrow for a long period of time.

Treatment of otitis media

If a child has symptoms of otitis media, the first thing to do is seek medical attention. Self-medication is fraught with complications. The child may become deaf. Treatment is carried out on an outpatient basis. Only children under one year of age or patients who have a complication need to be hospitalized. Before a visit to the doctor, the child can be given an antipyretic.

To reduce pressure on the eardrum and improve the outflow of accumulated fluid, it is necessary to clear the nose of mucus. Then nasal vascular drops are instilled. The use of ear drops before a visit to the doctor is highly discouraged. Parents will not be able to independently determine the integrity of the eardrum. If the medicine gets into the sterile cavity of the middle ear, it can lead to damage to the auditory ossicles and nerves. The result of this will be hearing loss or even deafness.

The doctor will examine the patient and determine the type of otitis media. Then antibiotics or other drugs may be prescribed, depending on the causative agent of the disease. The task of parents is to timely supply drugs, as well as to conduct hygienic treatment of the external auditory canal. It is performed if there is an increased secretion of serous or purulent fluid. In addition, it is necessary to ensure that the child fully breathes through the nose. To do this, you need to clean the cavity from mucus and crusts. If there is a need, you can drip intranasal drops as prescribed by a doctor. In some cases, compresses may be prescribed.

Antibiotics for otitis media

Only 10-11% of patients need antibiotics. In most cases, drugs are used for purulent otitis media. The doctor may prescribe the following medicines for children:

1. . Used in acute otitis media. For children under 5 years of age, the drug is prescribed in the form of a suspension.
2. . It is used if the child is already 6 months old.
3. . It is used if urgent antibiotic therapy is required. If a child has a complicated purulent otitis media, the remedy will be prescribed in the form of injections. The drug can be used from birth. However, the dosage must be strictly observed.
4. . It is used for advanced or purulent otitis media. Medicines are prescribed for children older than 1 month.
5. Omnicef. Used in most forms of the disease. May be given to children over 6 months of age.

It is necessary to use medicines included in the category strictly according to the doctor's prescription. It should be borne in mind that viruses with fungi can also lead to the occurrence of otitis media, against which the use of antibiotics is useless.

Exudative otitis is an inflammation of the middle ear, in the cavity of which exudate is formed and remains in the cavity for a long time. The disease develops in both children and adults. According to statistics, exudative otitis in children is much more common. than in adults.

Timely treatment does not require much effort, the disease "gives in" quite easily. The main thing is to start treatment on time! If you find the first signs of otitis media in yourself, especially in children, contact your doctor immediately. A qualified ENT specialist will prescribe an effective course of treatment.

It should be noted that this disease is the second form of otitis media. belongs to the first stage.

Any form of otitis media begins with an infection in the middle ear cavity. It can get there through the nasopharynx with the development of any viral diseases, diseases of the upper respiratory tract, in particular diseases associated with swelling of the mucous membranes (sinusitis). As a result of the development of infection, swelling of the mucous membranes (nose, pharynx, Eustachian tube) occurs. This leads to a violation of the ventilation of the middle ear.

Then the infection begins to actively develop. The first stage is formed - catarrhal otitis media. If there is no proper and timely treatment, the form quickly flows into exudative otitis media, especially for children.

Why is this happening? In the cavity of the middle ear, a liquid is formed, which, with the normal, natural functionality of the auditory tube, is promptly brought out. In the event of an infection, the auditory tube narrows (swells), the exit of fluid is very difficult. Then more and more fluid begins to be produced (fluid production is a response to inflammation). The ear cavity is filled with exudate, the auditory tube continues to narrow.

Lack of timely treatment leads to the formation of a purulent form of otitis media.

In the accumulated liquid, viruses and bacteria begin to develop safely. Further, from the liquid state, the exudate turns into thick mucus, which later turns into pus. What factors influence the development of this disease:

• nose injury;
• inflammatory diseases in the mucous membranes of the nose and nasopharynx;
• lowered immunity;
• inflammatory diseases of the auditory tube;
• hypothermia;

The inflammatory process is the main cause of the development of the disease

Diagnosis of the disease

The form of ordinary and acute exudative otitis media is diagnosed as a result of a complete examination of the tympanic membrane, the nose area. Diagnosis is made using audiometry, tympanometry and endoscopy.

An important role in the diagnosis is given to the study of auditory function. Hearing loss should be moderate, with a conduction of 30-40 dB. X-ray data are also not neglected, in which it is possible to detect a deterioration in the pneumatization of the cells of the mastoid process.

Symptoms of exudative otitis media:

1. hearing loss;
2. feeling of fullness in the ears;
3. autophony - you hear yourself;
4. nasal congestion;
5. sensation of fluid transfusion in the ear cavity.

As a rule, the patient does not experience acute pain in the ears, head, and there is no temperature. These symptoms are inherent in the catarrhal form.

It is worth noting that these symptoms are not very pronounced in children. The only important and true symptom is hearing loss. If the treatment of exudative otitis in a child was started or it was completely absent, in this case, after 3-4 years, a persistent form of hearing loss may develop.

Hearing loss is one of the main symptoms of exudative otitis media.

Treatment

Treatment of exudative otitis media is prescribed depending on the condition of the hearing, the ear itself, the duration of the infection, and the cause of the disease.

In most cases, patients suffer from difficulty breathing. Therefore, procedures are being carried out to restore it - this is the treatment of diseases of the nose, troubleshooting in the nasal septum, the treatment of acute respiratory viral infections, etc.

The next stage is the restoration of the patency of the auditory tube, i.e. restoration of its drainage function. As a rule, physiotherapy is used for this - ultrasound, laser therapy, electrophoresis, magnetotherapy, etc. To remove exudate from the tympanic cavity, to tone the muscles of the auditory tube and to improve its patency, pneumomassage of the eardrums, special blowing (blowing according to Politzer) is used.

In some cases, antibiotic therapy is prescribed to treat exudative otitis media. However, the inclusion of antibiotics in mainstream treatment is still a controversial issue. Surgery is also indicated.

The goal of surgical treatment is to restore hearing function and prevent further development of the disease.

Shunting (dissection) of the eardrum and the installation of a special shunt has become widespread. Through the installed shunt, special medications are introduced that help thin the exudate.

Degenerative-secretory. The third stage is established when the adhesive exudate is converted into fibrous connective tissue. Depending on the pathological changes in the hearing organs caused by the germination of fibrous tissue, the following forms are distinguished:

• fibrous-mucoid;
• fibrocystic;
• fibrous-sclerotic (adhesive).

Causes and development factors

The development of exudative otitis in children is based on dysfunction of the auditory tube, which maintains the level of pressure on both sides of the eardrum.

Since the Eustachian tube in babies is located at a right angle to the nasopharynx, has a short and narrow shape, is lined with loose ciliated epithelium, any inflammatory processes in respiratory diseases cause its swelling and blockage.

The main reasons for the development of pathology include:

• curvature of the nasal septum, polyps in the sinuses;
• sinusitis;
• SARS, accompanied by rhinorrhea (increased mucus formation);
• allergic rhinitis;
• chronic, sluggish infectious diseases;
• inflammation of the adenoids - adenoiditis;
• "cleft palate" in children (cleft palate).

Symptoms

With exudative otitis media, there are no characteristic signs indicating an acute form of the disease, which makes it difficult to diagnose the disease early. School-age children may complain of tinnitus and hearing loss, while toddlers are unable to clearly articulate the cause of the concern.

At each stage of the disease, symptoms are observed that characterize the development of the pathological process in the middle ear:

1. The catarrhal stage in children often develops with infectious diseases of the upper respiratory tract. Inflammatory processes in the auditory tube, provoking its blockage, may be accompanied by a slight increase in temperature, which often goes unnoticed against the general background of the child's malaise. Negative pressure in the middle ear cavity results in a sensation of noise or stuffiness. Sometimes autophony occurs - a phenomenon in which the patient hears his voice in the affected ear.
2. The secretory stage is accompanied by increased secretion of effusion, which leads to a sensation of itching in the ears. With the accumulation of a large amount of serous exudate, the baby feels a transfusion of fluid when the head is tilted. Hearing acuity is reduced. In children under three years old, this can lead to impaired speech formation, incorrect pronunciation of words. As soon as the serous exudate turns into a mucosal, sticky state, the sensation of iridescent fluid in the ear stops.
3. The degenerative-secretory stage is accompanied by a significant hearing loss in a child due to sclerotization of the auditory ossicles, thinning of the tympanic membrane and violation of its functions.

Diagnostics

The exudative form of otitis at an early stage is most often detected by chance during a general examination of the child after a viral infection.

The main manifestations of the disease at the catarrhal stage are of a short-term nature, often go unnoticed or do not cause much excitement. Therefore, parents are in no hurry to show the baby to a specialist.

To make a diagnosis and determine the stage of development of otitis media, an otolaryngologist conducts an examination using the following methods:

1. Otoscopy - Examination of the outer surface of the eardrum using an otoscope. In the catarrhal form, the tympanic membrane is retracted inward, which is explained by the vacuum in the cavity of the middle ear. Its color varies from pink to purple with a bluish tinge. The accumulation of serous exudate is manifested by the bulging of the membrane along the lower edge, sometimes in the lumen one can see the level of filling of the middle ear with fluid. During adhesion (gluing) at the last stage, the membrane is motionless, thinned, and may have adhesions.
2. Endoscopy of the Eustachian tube from the side of the pharyngeal opening. The presence of pathologies in the form of hyperplasia of the turbinates, pharyngeal adenoids, clefts of the middle part of the palate are the cause of the development of dysfunction of the auditory tube and can provoke a relapse of the disease.
3. Tympanometry is based on the ratio of pressure in the cavity behind the eardrum to atmospheric pressure. In the catarrhal form of otitis media, the pressure in the middle ear is negative, the presence of effusion equalizes it with atmospheric pressure.
4. Tonal threshold audiometry is a study whose purpose is to determine the smallest threshold of sound perceived by a child. Such diagnostics are used to identify the degree of hearing loss, if there are prerequisites in the behavior of the baby.
5. Computed tomography of the temporal bones helps to determine the condition of the mucous membrane of the middle ear, auditory ossicles, the density and amount of exudate in the ear cavity.

Methods for diagnosing exudative otitis media - photo gallery

It is possible to detect changes in the tympanic membrane only with the help of an otoscope

A study using a tympanometer shows the difference between the pressure in the inner ear in relation to atmospheric Audiometry can help detect hearing loss in children

Computed tomography of the temporal lobe provides an objective picture of structural changes in the middle ear

Endoscopy will help determine the cause of the development of exudative otitis media in a child

Differential Diagnosis

Differential diagnosis of this form of otitis media is carried out with pathologies that are accompanied by hearing loss with an intact membrane:

• otogenic liquorrhea (outflow of cerebrospinal fluid from the ear);
• cholesteatoma (tumor formation);
• otosclerosis (abnormal growth of bone tissue in the ear);
• hemorrhage in the tympanic cavity;
• congenital malformation of the auditory ossicles.

Treatment

With exudative otitis in children, complex therapy is carried out aimed at eliminating the cause of the development of the disease and restoring the drainage functions of the auditory tube. The basis of treatment is hardware procedures, the use of which improves the patency of the Eustachian tube, helps to remove accumulated exudate, and restores the elasticity of the eardrum. In addition, medication is prescribed to thin the secretions, eliminate infection, stop inflammatory processes, and reduce allergic reactions.

When choosing a treatment strategy, the following features are taken into account:

• the root cause of the dysfunction of the auditory tube is the presence of adenoids, polyps, chronic infection and congenital anomalies in the development of the nasopharynx;
• stage of the disease;
• the appearance of irreversible morphological changes in the tissues of the organ of hearing;
• child's age.

Komarovsky on the causes and methods of treating otitis media in children - video

Treatment of exudative otitis in children is outpatient, if there is no need for surgical intervention. Taking medications prescribed by a doctor is carried out under the supervision of parents, hardware procedures - when visiting a physiotherapy room in a hospital.

If the baby does not have contagious infectious diseases that caused the development of otitis, he can attend children's groups and educational institutions.

Is it possible to bathe?

The daily routine of the child does not change, the only exception is bathing - when wearing a shunt in the eardrum, water procedures are carried out with caution, preventing water from entering the auricle.

Medical therapy

Depending on the reasons for the development of the disease, the doctor chooses the main tactics of treatment. Medicines of the following groups can be prescribed:

1. Antihistamines to eliminate swelling of mucous tissues:
   • Tavegil;
   • Zodak;
   • Suprastin.
2. Mucolytics in the form of powders or syrups to thin viscous exudate (course 10-15 days):
   • Carbocysteine.
3. Vasoconstrictor drugs to reduce the swelling of the auditory tube and restore its patency (used at the initial, catarrhal stage, instilled into the nasal passages). For children under 3 years old, funds are prescribed in the form of drops based on oxymetazoline, phenylephrine. The course of application is no more than 5 days.
4. Ascorbic acid (vitamin C) to thin the mucous exudate, as well as increase the body's resistance to viral diseases.

Antibiotics for exudative otitis media are used only if a bacterial infection has entered the middle ear cavity and the disease has turned into a purulent form.

For maximum effect, systemic antibiotics of the macrolide group (Azithromycin, Clarithromycin) or penicillins (Flemoxin, Ampicillin) are used in combination with the introduction of local preparations into the tympanic cavity in the form of ear drops (Otofa, Otipax) with antibacterial, anti-inflammatory and analgesic properties.

Medicines used to treat exudative otitis media in children - photo gallery

Acetylcysteine ​​helps to reduce the viscosity of the effusion

Vitamin C reduces the density of mucous formations and prevents the development of inflammation

Vasoconstrictor drug Nazol Baby - first aid for congestion in the ear Clarithromycin is needed when a bacterial infection penetrates

Physiotherapy methods

To improve the patency of the Eustachian tube, as well as restore the tissues of the middle ear, the following hardware methods of treatment are used:

1. Phonophoresis with hyaluronidase (a proteolytic enzyme that promotes the resorption of fibrous tissue) on the mastoid process. It is carried out at stages 2–3 of the development of exudative otitis media in children to prevent the conversion of exudate into connective tissue.
2. Electrophoresis with the simultaneous use of steroid hormones.
3. Electrical stimulation of the palate. Promotes reflex opening of the Eustachian tube, which facilitates the drainage of accumulated exudate.
4. Blowing the auditory tube according to Politzer. Available only for children over 4 years old.
5. Pneumomassage of the tympanic membrane - helps to restore its elasticity.
6. Magnetotherapy improves tube patency in the early stages of otitis media.

Surgery

With the ineffectiveness of conservative methods of treatment, surgical intervention is resorted to. In surgery, there are several ways to evacuate exudate:

1. Myringotomy - a puncture of the eardrum under general anesthesia, after which its edges move apart. Further actions depend on the density and viscosity of the exudate. If the secretory fluid is mucous, but not sticky, it is removed by pushing it into the nasopharyngeal cavity through the Eustachian tube, after diluting it with the injected a-chymotrypsin. At the mucosal or fibrous stage, the secret is removed through the external auditory canal with a pump or tweezers.
2. Tympanostomy is an incision in the eardrum to facilitate access to the middle ear cavity. It is carried out in order to introduce a ventilation tube that temporarily performs the functions of the Eustachian tube. Through the shunt, the accumulated exudate is drained, as well as the sanitation of the middle ear cavity.

Folk remedies

Traditional medicine is used not so much to treat exudative otitis media, but to eliminate many of the causes that created the preconditions for impaired ventilation of the auditory tube.

So, with adenoid hypertrophy in children, the following recipes are used:

1. Solution for washing with propolis:
   • dilute 15 drops of propolis tincture in 200 ml of boiled water;
   • add 1 tsp. baking soda;
   • rinse your nose every 3-4 hours.
2. Thuja oil has anti-inflammatory and antiseptic properties. To reduce inflammation of the lymphoid tissue of the adenoids, turundas soaked in essential oil should be placed alternately, first in one, then in the second nostril. The course of treatment is 14 days, if necessary, you can repeat it after a week.

At the initial stage of eustachitis, the following methods are used:

1. Drops with aloe juice relieve inflammation and contribute to the rapid restoration of the drainage functions of the auditory tube. In order to prepare them, you should:
   • cut an aloe leaf at least 7 years old;
   • wrapped in parchment paper, put in a cold place for a day;
   • squeeze out the required amount of juice;
   • dilute in half with boiled warm water;
   • instill 3 drops daily into the nostril from which the inflammation has occurred.

To reduce the viscosity of the secretory fluid in exudative otitis media, decoctions of oregano, coltsfoot, licorice root are used, the effectiveness of which is explained by the mucolytic properties of medicinal plants.

Before using such drugs during the treatment of exudative otitis in children, you should consult with your doctor about the compatibility of the main therapy with traditional medicine recipes, as well as possible allergic reactions.

Treatment prognosis and possible complications

With early diagnosis of the disease in children, the prognosis for treatment is favorable. The situation is complicated by the fact that parents do not always attach importance to the child's complaints about tinnitus or the feeling of fluid transfusion when changing body position. With the transition of the disease to the secretory-mucosal stage, these symptoms disappear altogether, however, the pathological processes in the middle ear only worsen, contributing to hearing loss.

At the secretory stage, complications are possible in the form of the attachment of pathogenic microflora and the development of purulent otitis media.

At the last, degenerative stage, the following processes can develop:

1. Violation of the function of the auditory ossicles due to the formation of connective tissue in the space of the middle ear.
2. Atelectasis - retraction of the eardrum, provoked by a long course of the inflammatory process.
3. Reduction in the volume of the tympanic membrane as a result of prolonged negative pressure in the middle ear.
4. Scarring of the fibrous tissue of the membrane, which leads to its complete immobility and hearing loss.

All forms of complications resulting from the lack of treatment lead to hearing loss or complete loss.

Prevention

Since the cause of the development of the disease in children is often inflammatory processes in the nasopharynx, you should first of all direct all your efforts to strengthening the immune system. Daily walks, proper nutrition, sports, hardening - help to increase the body's resistance to viruses.

In chronic pathologies of the upper respiratory tract, it is necessary to conduct an examination by an otolaryngologist after each relapse or exacerbation of the disease. With indications for the removal of adenoids, the best way out is to conduct a planned operation, which will prevent complications in the form of sinusitis, eustachitis and, as a result, exudative otitis media.

Also, do not ignore the baby's complaints about discomfort in the ear. The absence of fever and pain symptoms is not an indication that the organ of hearing is not subject to inflammation.

Exudative otitis in children has mild symptoms, which contributes to the course of inflammation in a latent form. Late diagnosis leads to complications in the form of hearing loss. It is possible to prevent such a development of events only if chronic inflammatory processes in the nasopharynx are eliminated and preventive examinations by an otolaryngologist.

My name is Elena. Medicine is my vocation, but it so happened that I failed to realize my desire to help people. On the other hand, I am the mother of three wonderful children, and writing articles on medical topics has become my hobby. I want to believe that my texts are understandable and useful to the reader.

- This is a disease that leads to inflammation of the mucous membrane of the middle ear and an increase in the secretory activity of the mucous glands, as a result of which it is filled with non-purulent fluid.

Inflammation of the mucous membrane of the middle ear

The middle ear is the tympanic cavity. On the one hand, it is covered by the tympanic membrane, on the other, by the labyrinth window, at the top it has access to the mastoid process, and at the bottom is the auditory tube. A chain of auditory ossicles extends from the tympanic membrane to the oval window.

In the development of the disease, the main role is played by the obstruction of the auditory tube, which exits the middle ear into the nasopharynx. It is designed for ventilation, drainage and protection. Through it, air enters the tympanic cavity, which is necessary to equalize the pressure of the external environment, and a mucous secret comes out, which is secreted in the ear. When this channel is blocked for some reason, in the tympanic cavity, firstly, the pressure drops (since the necessary air does not enter), and secondly, an inflammatory effusion accumulates.

These factors lead to hearing impairment of varying intensity, and the presence of fluid creates favorable conditions for the development of bacteria, which is why exudative otitis media can pass into.

Types of exudative (serous) otitis media in children

This insidious ailment can develop in one ear (unilateral otitis media) or both. With bilateral exudative otitis media in children, the risk of developing hearing loss and deafness is higher. Therefore, he should be treated in a hospital, under the supervision of specialists. It should be noted that bilateral exudative otitis media in children occurs in most cases.

Exudative otitis in a child can be acute or chronic. Recently, there has been a tendency towards the predominance of sluggish forms. This is mainly due to the uncontrolled and irrational use of antibiotics, which leads to the development of bacterial resistance to them.

Chronic inflammation lasts for many years. If tubal dysfunction is not eliminated for a long time, the exudate becomes more viscous, sticky. It sticks to the walls of the Eustachian tube, the tympanic cavity and the membrane, and the auditory ossicles. As a result, adhesive processes develop, which cannot be cured otherwise than by surgery.

Exudative otitis media: causes of occurrence in childhood

The causes of exudative otitis in a child lie in infectious and non-infectious pathologies that affect the condition of the auditory tube. For example, greatly enlarged adenoids, which are very common in children. Or bacterial and viral etiology: tonsillitis, rhinitis, etc. As mentioned earlier, the mouth of the auditory tube extends into the nasopharynx, so an infection from the nose or pharynx can penetrate into it and cause inflammation of the mucous membrane.

Increasingly, such ailments occur in people prone to allergies. Persistent allergic rhinitis, sinusitis, etc. lead to development.

The cause of serous otitis media in children can also be. Its most common pathogens are pneumococcus, Haemophilus influenzae, streptococcus and staphylococcus aureus. Less commonly, catarrh of the ear is caused by viruses.

An important role in the development of inflammatory diseases is played by the state of immunity, and in children of the first years of life, both local protection in the mucous membrane of the ENT organs and general immunity are not strengthened.

• calendula;
• nightshade;
• sophora japonica;
• echinacea;
• propolis.

Such funds are sold in pharmacies, but if desired, they can be prepared independently. The natural components of such tinctures perfectly fight inflammation, relieve pain, and speed up the healing process. Drip them 2 drops in each ear, 3 times a day.

Also, decoctions of herbs help with: yarrow, chamomile, St. John's wort, calendula, eucalyptus. Choose one or more herbs, you will need 1 tbsp. raw materials in a glass of boiling water. Just fill the grass with water, cover with a lid and let it brew for half an hour. Strain the decoction, and moisten cotton flagella in it, and then insert it into the ear canal for 20 minutes. Repeat manipulations 3 times a day.

Before you start treating exudative otitis media at home, you must first of all consult a doctor. Since the wrong treatment can harm, but not help. The doctor will tell you what not to do and what you can do. Then focus on the child's well-being: if he gets worse from some medications, then stop using them.

The consequences of serous otitis media in childhood

The concern of parents and doctors about this disease in children is well founded: late detection increases the risk of developing permanent hearing loss. The consequences of serous otitis in childhood negatively affect the formation of speech and general development in the future.

Complications of exudative otitis in children in the form of adhesive adhesive processes and cholesteatoma need to be removed surgically. After sanitizing operations on the middle ear, plastic restoration of the excised areas will be required. Such procedures rarely allow you to return the former acuity of hearing, and in some cases, their results are quite the opposite - hearing worsens even more.

Also, prolonged stagnation in the tympanic cavity can lead to inflammation of the labyrinth, in which the auditory and vestibular analyzer is located. Development leads to deafness and the appearance of vestibular disorders, in the form of dizziness, unsteady gait, nausea and vomiting, due to which a person cannot lead a normal life.

Prevention of exudative otitis media in children

To prevent the development of otitis in children, first of all, you should pay attention to the condition of the nose and throat. In particular, this applies to adenoids, because they most often cause the development of exudative otitis media. It is important to undergo preventive examinations that will help identify deviations before they become protracted.

Since it is very difficult to identify hearing loss in babies, periodic hearing tests will be relevant.

Parents of children prone to viral diseases need to think about raising immunity. A healthy, fortified diet, good sleep, outdoor sports exercises, hardening, visiting health resorts will help with this. During flu epidemics, you should refrain from visiting crowded places; for prevention, you can drink it. Try to ensure that in the cold season your child does not get cold.

The best prevention of exudative otitis media in children and adolescents is breastfeeding from the first days of life. It should last at least 3 months. Milk contains active substances, such as interferon, immunoglobulin, etc. They increase the level of protection of the child's body and suppress pathogenic infections.

In order to prevent milk from entering the auditory tube from the throat during feeding, you need to keep the baby reclining.

Pretty common. You can find out how to properly treat expectant mothers by clicking on the link.

Informative video

It is considered one of the most common diseases that is detected in children of different ages. The course of the pathology can go through several stages and depend on the state of the immune system, structural features of the hearing aid and the presence of allergic reactions.

Exudative otitis in children is a form of otitis media, which is accompanied by the accumulation of exudate in the middle ear. With such a pathology of the ear, the integrity of the tympanic membrane is preserved, and there are no pain sensations, but hearing begins to decline. Treatment of this form of otitis is quite difficult and this is due to the fact that most often it is possible to diagnose it already in the last stages.

Exudative otitis is characterized by the fact that exudate accumulates during inflammation of the middle ear. Such a liquid is a favorable environment for the growth and reproduction of pathogenic microorganisms, and its independent removal from the organ cavity is impaired. Over time, the exudate thickens and it already contains mucus and pus.

The main reason for the development of otitis media in children is a violation of the ventilation function of the auditory tube. This process is characterized by increased production of pus and mucus, as well as its long course with the development of pain.

Often such a pathological process in a child's body develops as a consequence of a viral or bacterial infection.

The negative impact on the condition of the mucous membrane of the organ of hearing indicates the incorrect and uncontrolled use of antibacterial drugs. This is due to the fact that they create a favorable environment for those pathogens that are highly resistant to them.

Experts identify the following factors, the impact of which on the child's body can cause the development of exudative otitis media:

1. decrease in the body's defenses
2. allergic rhinitis
3. second hand smoke
4. cleft palate
5. chronic sinusitis

Medical practice shows that exudative otitis media is most often diagnosed in children from 2 to 5 years old. This is due to the insufficient development of the Eustachian tube at this particular age. This feature of child physiology contributes to the fact that pathogenic microorganisms quickly penetrate from the nasopharynx into the middle ear. Often, exudative otitis media develops with anatomical defects of the nose, that is, with a curvature or injury of the septum. In addition, fluid in the ear or a sharp jump in pressure can cause the disease.

Symptoms and classification

It is rather problematic to diagnose the exudative form of otitis media, since the clinical picture is not so pronounced.

The following symptoms of acute exudative otitis media are distinguished:

• gradual hearing loss
• feeling
• hearing your voice in your head
• a change in the position of the head is accompanied by a feeling of a splash of fluid inside the organ of hearing
• nasal congestion

With such a pathology, there are usually no pain sensations, or they are short-term. In addition, there is no increase in body temperature.

In young children, the signs of exudative otitis media are not pronounced and the main manifestation of such a disease is hearing loss. In the absence of effective treatment, a persistent grade 3 may develop after a few years.

In its development, exudative otitis media can go through several stages:

1. The catarrhal stage is the initial phase of exudative otitis, and the main symptom is ear congestion due to a malfunction of the Eustachian tube. The duration of this stage can reach 4 weeks, while discomfort and autophony appear.
2. The secretory stage is characterized by the fact that over the next year, fluid accumulates in the middle ear cavity. The reason for this pathological process lies in the fact that there is no possibility of exudate discharge in a natural way. At this stage, the child complains of a slight hearing loss and gurgling fluid in the ear.
3. The mucosal stage is accompanied by compaction of the accumulated fluid, and it becomes quite viscous. In addition, the sensation of gurgling inside the ear gradually disappears, and hearing is noticeably reduced. Mucosal stage of exudative otitis can last for 1-2 years.
4. The fibrous stage is the last stage of the disease and is accompanied by a gradual subsidence of symptoms. The production of viscous exudate stops and this leads to the fact that the destruction of the hearing organ, its cavity, etc., begins. Destructive and necrotic processes lead to a drop in the quality of hearing and the development of hearing loss.

In each child, otitis is characterized by its long course, and children do not always complain of stuffy ears or hearing loss. Depending on the intensity of the course and the duration of the disease, there are:

• spicy
• subacute
• chronic exudative otitis media

Depending on the localization of the inflammatory process, unilateral and bilateral exudative otitis is isolated.

Diagnosis of the disease

To make a diagnosis, the following diagnostic studies are prescribed:

1. studying the child's history when talking with parents
2. examination of the organ of hearing using an otoscope allows you to assess the condition of the external auditory canal and membrane
3. tympanometry is considered the main method for diagnosing pathology, with the help of which it is possible to determine pressure indicators in the ear cavity
4. bone conduction study using tuning forks
5. computed tomography of the temporal bone is performed in severe ear disease
6. endoscopic examination helps to assess the condition of the pharyngeal mouth of the auditory tube
7. tympanopuncture is a puncture of the membrane to obtain the contents of the cavity and its subsequent examination

It is rather problematic to identify exudative otitis media in a small child, but with hearing impairment, the presence of characteristic symptoms and research results, this is not difficult to do.

Methods for eliminating pathology

Treatment of exudative otitis media is aimed at solving the following problems:

• elimination of the cause that provoked the development of pathology
• removal of puffiness and restoration of the lumen of the Eustachian tube
• relief of the inflammatory process and blocking the accumulation of liquid exudate

Treatment of otitis media is aimed at restoring the lumen of the Eustachian tube, and for this purpose, the use of vasoconstrictor drops is prescribed. They must be instilled into the nose of the child, and not into the organ of hearing. The most commonly prescribed drugs to ease nasal breathing are:

• Sanorin
• Xylometazoline

In addition, physiological saline solution can be used to cleanse the nose. Such washing helps to remove mucus from the sinuses and create conditions for its speedy outflow through the auditory tube. Treatment of exudative otitis can be carried out with the help of antiallergic drugs that help eliminate swelling. A good effect is the use of such medicines as Claritin, Suprastin and Erius.

To thin the exudate, mucolytics may be prescribed, which should be taken within 2 weeks. In the event that a bacteriological genesis of otitis media is detected, then treatment is carried out using antibacterial drugs. In addition, vitamins are prescribed to increase the body's defenses. It is possible to prevent bacterial infection with the help of immunostimulating agents, and the most famous representative of this group is Viferon. Its use helps to prevent the purulent stage of inflammation and speed up the recovery of the child.

More information about the pathology can be found in the video:

For the speedy removal of fluid from the Eustachian tubes and the prevention of purulent infection, the following physiological procedures are prescribed:

• ultrasound
• laser treatment
• pneumomassage of the membranes
• magnetotherapy
• electrophoresis with steroids

In some cases, surgical treatment of exudative otitis media is resorted to, and a puncture of the eardrum is made to remove excess fluid. In the chronic course of the disease, a shunt is used through which exudate will drain during treatment and the necessary medications will be administered.

Possible Complications

Exudative otitis is considered a complex disease that requires mandatory treatment. If effective therapy or surgical intervention is not carried out, serious consequences may develop:

1. severe hearing loss
2. pathological perforation of the tympanic membrane
3. retraction of the membrane into the ear cavity

Timely treatment of pathologies that can cause the formation of exudate is important. An important preventive measure to eliminate diseases of the hearing organs is to strengthen the immune system and timely treatment of inflammation of the nasopharynx.

If the child is prone to frequent ear diseases, it may be necessary to remove the adenoids, and from time to time, a preventive examination should be performed. With timely treatment of exudative otitis media, the prognosis is positive, and if therapy is delayed, the consequences can be disastrous.

- This is an inflammatory process of the middle ear cavity, non-infectious. This disease is especially common in young children.

During an uncured disease, it entails a lot of unpleasant consequences and complications, and therefore, at the first obvious symptoms of the appearance of a pathology, an urgent consultation of a specialist and adequate effective treatment are needed.

Otitis media is divided by specialists into catarrhal and exudative, and if the first one almost immediately entails symptoms such as severe pain, then the second one proceeds sluggishly, without obvious symptoms. The disease does not affect the bone and muscle tissues inside, but pathogenic mucus begins to accumulate in the ear cavity.

Diagnostics

You can also diagnose exudative otitis media in children at home - after carefully examining the auricle, you can find signs of serous fluid. It happens in the form of a thin brownish plaque formed, and may be a large clot of viscous exudate.

The hand attached to the ear, as it were, sticks together with the auricle, therefore, in folk medicine, the disease was called "sticky ear".

In children

Otitis media, according to the statistics of the Ministry of Health of Russia, is detected in young children 2-3 times more often than in the adult population. This is due to the physiological characteristics of a small organism - the size and proximity to the auricle of the tympanic cavity. At preschool age (from 2 to 5 years), 80% of all children suffer from this disease. The disease is not difficult to cure, it is only necessary to start treatment in a timely manner, correctly establishing the diagnosis. If the baby is not treated, then over time, exudative otitis media will lead to unpleasant consequences associated with hearing loss, and then complete hearing loss.

Reasons for development

There are many factors that influence the development of otitis media. As you know, a small amount of fluid is regularly produced in the middle ear cavity for proper functioning. This is the normal state of a healthy body. What we clean out of the auricles through morning hygiene procedures is the remnants of this fluid. If the ear canals are swollen, inflamed, or have an abnormally small opening, exudative fluid begins to collect in the cavity.

Anatomical

Often, poor patency and accumulation of excess secretions occur against the background of acute and chronic diseases of the nasopharynx. Frequent untreated rhinitis, sinusitis and sinusitis are harbingers of exudative otitis media. Another reason is catarrhal otitis, which has passed into an acute stage of development.

Adenoids

In children, pathology may appear against the background of adenoids, if the operation was not performed on time or the inflammatory process was not eliminated, congenital curvature of the nasal septum. Babies are prone to developing otitis media with uncontrolled swimming in pools and ponds in summer, and hypothermia in winter.

Professional activity

Complications in adults include professional activities. Exudative otitis media is a disease characteristic of pilots, submariners, divers, whose work is specifically related to various kinds of barotrauma. In addition, the disease can develop against the background of oncological problems in the nasopharynx and sinuses, when the tumor blocks the auditory canals.

Classification

A consultation with an experienced otolaryngologist with suspected otitis media will provide some general insight into the disease in general. As a rule, the doctor making the diagnosis will definitely introduce you to the various forms of otitis media and tell you how they are classified. Today there is a single medical scheme that determines the form and stage of the disease:

Spicy

Exudative acute otitis media. The disease lasts from 1 to 2 months. If a subacute form is diagnosed, the process reaches 7-8 weeks.

Chronic

Medium - the disease lasts more than two months.

Bilateral

Otitis media bilateral - the development of the disease affects both ears. According to statistics, this form of otitis media is more common in children.

It is almost impossible to diagnose exudative otitis media on your own. Standard symptoms are not expressed, the disease proceeds sluggishly, intoxication is completely absent. Even an adult is not immediately able to pay attention to those minor changes that occur in the body. Young children generally do not tend to notice deviations from the norm. Firstly, because in principle they still do not understand that something is going wrong, and secondly, a small child begins to react only when he is in severe pain.

Therefore, if you suspect the development of exudative otitis media in a child, first of all, pay attention to whether his hearing has decreased. Move to the far end of the room and call the baby softly. If the child is older, ask him to tell you if he feels stuffy or tinnitus, first explaining how it happens. Inappropriately noticed and cured pathology in children leads to the development of hearing loss and dysfunctions associated with the correct development of speech.

Treatment

The disease is diagnosed visually by a specialist. Upon examination, the doctor, using the otoscopy method, and having studied the cavity of the tympanic membrane, will immediately notice changes, determine their nature, and prescribe treatment.

To restore the full clinical picture, the otolaryngologist will definitely conduct additional studies. They are designed to identify the cause of the development of pathology, and in cases with young patients, to determine whether otitis media affected hearing acuity.

Treatment depends on the diagnosis. Basically, the disease is eliminated with the help of complex drug therapy, including the use of anti-inflammatory non-steroidal drugs and mucolytic drugs. The latter are designed to quickly liquefy and remove exudate.

The use of traditional medicine is possible only as an auxiliary and supportive method of treatment. Even seemingly harmless washing of the ear cavity with herbs should be agreed with the attending physician.

Exudative otitis media is an inflammatory disease of the middle ear, which has a non-infectious nature of occurrence. The disease is characterized by the formation of exudate (liquid of a sticky consistency) in the ear cavity, its rapid accumulation, leading to a decrease and complete loss of hearing. Otitis exudative is insidious in that it is possible to diagnose it at a late stage due to the absence of severe symptoms.

Reasons for the development of the disease

In 90% of cases, exudative otitis media occurs in children. The largest number of patients are aged 3 to 6 years, the second category - aged 6 to 15 years. This is explained by the vulnerability of the auditory analyzer and weak immunity.

The disease got its name from the pathological formation of exudate - serous fluid. Normally, it is excreted by the body at the physiological level, but when an infection enters and inflammation of the Eustachian tube, mucosal edema occurs, which prevents this process. The accumulated exudate provides an ideal environment for the development of bacteria, which occurs during the acute stage of the disease.

Acute exudative otitis media occurs for several reasons:

• decreased immunity in chronic diseases;
• allergic reactions;
• acute diseases of viral etiology;
• living in adverse conditions and / or in areas with poor ecology.

Exudative otitis in a child is explained by frequent respiratory diseases, passive smoking, congenital pathologies of the ears, mouth and nasopharynx.

Existing forms of the disease

Doctors distinguish three forms of pathology:

1. Acute. The initial stage of the disease, lasting up to 8 weeks.
2. Chronic. Chronic exudative otitis media occurs if left untreated within 8 weeks of onset.

It is subdivided by type:

1. Unilateral exudative otitis.
2. Bilateral exudative otitis.

The second type of pathology is more common. It covers both ears, greatly reducing hearing acuity.

Bilateral exudative otitis media in children is one of the types of diseases that lead to hearing loss.

Clinical manifestations of the disease

The danger of the disease lies in the latent symptoms. It is difficult to identify it on your own, the acute stage passes without clear clinical manifestations. The main symptoms include:

• progressive hearing loss
• congestion in the ear or both ears;
• in the blocked ear, the audibility of one's own voice;
• the sound of splashing or pouring water in the ears;
• congestion of the nasal passages.

Exudative otitis media in children is more difficult to diagnose. If an adult notices unusual changes and discomfort in the ears, then the child may not pay attention to them if they do not bring pain and discomfort.

You can identify the disease by nasal congestion, hearing loss.

If the patient has chronic exudative otitis, then the symptoms persist. And the longer there is no treatment, the worse the hearing becomes.

The course of the disease, stages

Symptoms and treatment of the disease depend on the stage of otitis media. Doctors distinguish 4 forms of pathology.

1. Initial. It is characterized by an inflammatory process and a decrease in ventilation in the Eustachian tube. The duration of the initial stage is about 4 weeks. Symptoms are practically absent, there is a slight deterioration in hearing, the audibility of one's voice in the head.
2. Secretory. The second stage is characterized by the formation of fluid in the ear cavity. Of the symptoms, there is a sensation of splashing water, heaviness and pressure. The secretory stage can last about a year.
3. Mucosal. The exudate becomes viscous, hearing loss occurs. The sensation of transfusion of water disappears, noise appears. The duration of the stage is about 2 years.
4. Fibrous. Mucus is produced in small amounts and disappears completely. Hearing loss is noted. Lasts over 2 years.

Danger and complications

The chronic form of the disease passes into the next stage - adhesive otitis media. With it, adhesions are formed in the auditory canals that close the cavity. Other complications are possible:

• recurrence of acute otitis media;
• recurrence of chronic suppurative otitis media;
• perforation of the eardrum;
• mastoiditis.

Chronic bilateral exudative otitis in children leads to a delay in mental and mental development, impaired speech function and deafness.

Pathology treatment methods

The therapy is aimed at eliminating the cause that caused the stagnation of the viscous substance and removing inflammation to restore the functions of the hearing aid.

Medical therapy

An ENT doctor can determine how to treat exudative acute otitis media after diagnosis. Medications are prescribed depending on the age of the patient, the stage of the pathology and the changes that have occurred in the ear cavity. To eliminate the inflammatory process and normalize the production of exudate, drugs are used:

1. Nonsteroidal medicines - these include ear drops and antipyretics.
2. Mucolytics, thinning and facilitating the release of fluid.
3. Antihistamines. They are prescribed for allergies in children.
4. Nasal drops to relieve nasal congestion.
5. Calming drugs and herbs that have a sedative effect.

Treatment of exudative otitis in children and adults can be carried out using antibiotics if a secondary infection caused by bacteria has joined. In other cases, antibiotic therapy is not required.

Physiotherapy

To increase the patency of the Eustachian tube, physiotherapy procedures are prescribed. They enhance the effect of drug therapy, help relieve inflammation and prevent complications. To cure acute bilateral exudative otitis media, procedures are prescribed:

• electrophoresis with drugs of their steroid group;
• ultrasound;
• magnetotherapy;
• pneumomassage;
• laser therapy.

Certain types of physiotherapy are not prescribed for young children.

Surgical intervention

Exudative otitis media leads to obstruction of the Eustachian tube. And to eliminate the cause of this process, sometimes surgery is required, which involves:

• alignment of the nasal septum;
• removal of the tonsils;
• removal of viscous fluid from the ear cavity (performed once);
• shunting of the tympanic cavity with exudative otitis media, necessary to create artificial ventilation of the ear cavity and the introduction of drugs.

ethnoscience

Treatment at home with traditional medicine is possible after coordinating the methods with the doctor. The use of recipes based on herbs and other natural ingredients is possible in combination with traditional therapy.

• Grind the leaves of Kalanchoe and pour vegetable oil, let it brew for 3-4 weeks. Lubricate the cavity of the auricle with the resulting mixture.
• Slightly warm the sore ear and lubricate the inside with hare fat.
• Squeeze the juice from the onion, heat to a boil on a teaspoon and instill in the ear after cooling.
• Prepare a decoction of herbs: yarrow, celandine, eucalyptus, lavender, dandelion. Leave for tincture in a thermos for 8 hours. Take orally and put in the ear a cotton swab dipped in a decoction.

Prevention methods for adults and children

Otitis media can be prevented by timely treatment of ear diseases, immune support, and exclusion of bad habits. Children from an early age need to instill a love of sports, proper nutrition.

Exudative otitis media in adults is less common than in children. The disease can be asymptomatic for a long time, which complicates the diagnosis. Therefore, it is extremely important to identify the pathology in a timely manner in order to receive qualified medical care and prevent complications.

Home " Weeks » Bilateral exudative otitis media in children treatment. Features of the course of exudative otitis media in children

exudative otitis media (ESO ) is called the chronic form of otitis media, in which an accumulation of pathological fluid (exudate) occurs in the middle ear as a result of damage to its mucous membrane. With ESO, the integrity of the tympanic membrane is not broken and in the absence of an inflammatory process in the nasal cavity, nasopharynx and oropharynx, infection of the middle ear does not occur, despite the fact that the formed exudate is a favorable environment for the development of viruses and bacteria, since it is a protein environment.

It is precisely because the exudate contains a large amount of protein that over time it changes its physical properties (thickens, becomes viscous), which leads to a long and severe course of the disease.

Pain is one of the signs of inflammation. The absence of inflammatory changes in the middle ear explains why ESO is painless. This is precisely the insidiousness of this pathology.

In the medical literature, you can find other names for this common disease, namely: exudative otitis media», « secretory», « mucosal otitis media», « effusion otitis media”, “gleu ear” - “sticky ear”.

Causes of exudative otitis media in children

The main reasons contributing to the development of ESO are:

Changes in the mucous membrane of the auditory tube against the background of acute and chronic inflammatory diseases of the nose, paranasal sinuses and nasopharynx as a result of a decrease in immunity,

Dysfunction of the auditory tube, due to dysfunction of the muscles that open it,

Obturation of the mouth of the auditory tube with adenoid vegetations (growths), hyperplastic (enlarged) tubal tonsil, cicatricial changes, benign and malignant neoplasms of the nasopharynx,

Ineffective therapy for acute otitis media,

Anatomical and physiological features of the development of the auditory tube in childhood.

It should be noted that one of the predisposing factors to the occurrence of ESO is a visit to a day care institution. At the age of 2 to 7 years, the development of this pathology may be preceded by an acute viral infection, chronic adenoiditis, acute catarrhal otitis media. In children from 8 to 15 years old, the development of exudative otitis media occurs against the background of vasomotor rhinitis or chronic rhinosinusitis.

Types of exudative otitis media in children

According to their duration, ESP is divided into three forms currents: acute (up to 3 weeks), subacute (3 to 8 weeks) and chronic (more than 8 weeks).

According to the nature of the changes occurring in the mucous membrane of the middle ear, they distinguish four forms of ESO : initial exudative, secretory, productively secretory, degenerative-secretory(with a predominance of fibro-sclerotic process).

There is another classification of ESO, which is based on similar principles (physical parameters of the contents of the tympanic cavity: viscosity, transparency, color, density and duration of the pathological process). It distinguishes four stages of the course of EOM: catarrhal (up to 1 month), secretory (from 1 to 12 months), mucosal (from 12 to 24 months), fibrous (more than 24 months).

Exudative otitis media in children.

Exudative otitis media affects both adults and small patients. But it can be more difficult to diagnose exudative otitis media in a child than in adults, not only due to insufficiently vivid symptoms, but also due to the difficulties that arise during the collection of complaints and anamnesis (small patients do not complain). Complaints and the clinical picture directly depend on the stage of the disease. The initial stage of EOM is characterized by poor complaints and clinical manifestations.

In most cases, parents seek medical care for a child only when they notice a hearing loss, that is, the child begins to speak loudly, does not immediately respond to the call, asks to turn up the volume when watching children's TV shows, which already corresponds to the productive secretory form of the disease. It is the absence of pain that leads to the late detection of EOM. But sometimes little patients are able to describe their feelings. Adults go to the doctor with complaints of a sensation of fluid in the ear (“gurgling”), a feeling of fullness, autophony, a change in hearing depending on the inclination of the head.

Diagnosis of exudative otitis media in children

For the diagnosis of ESO, an audiological examination is carried out in the Department of Pediatric ENT Pathology in the Department of Pediatric ENT Pathology, which consists of acoustic impedancemetry and tone threshold audiometry. For patients with this pathology, acoustic impedancemetry is characterized by a tympanometric curve of type "B" and the absence of ipsi-reflexes, which reflects a violation of the transmission of a sound signal along the auditory ossicles chain due to the pathological content of the middle ear (exudate), on the audiogram - an increase in air conduction thresholds to 30-40 dB, mainly at low frequencies, bone conduction is not changed. In case of recurrent course of exudative otitis media, specialists of the Department of Pediatric ENT Pathology without fail prescribe computed tomography (CT) of the temporal bones to the patient to obtain a reliable picture of the airiness of the middle ear cavity, the condition of its mucous membrane, the ossicular chain, labyrinth windows and the bone section of the auditory tube, density and localization of pathological contents.

To identify the causes contributing to the occurrence of ESO, a patient in the Department of Pediatric ENT Pathology of the NCCO FMBA of Russia undergoes an endoscopic examination of the nasal cavity and nasopharynx or an X-ray examination of the nasopharynx (in young children if endoscopy is not possible) and paranasal sinuses.

Treatment of exudative otitis media

Treatment of patients diagnosed with POE is aimed at eliminating the causes that led to the dysfunction of the auditory tube, followed by restoration of hearing and prevention of the development of morphological changes in the mucous membrane of the middle ear.

The tactics of treatment directly depends on the stage of the disease. In the initial stages, conservative methods of treatment are prescribed:

Blowing the auditory tubes according to Polizer;

catheterization of the auditory tubes;

Physiotherapy (endoural electrophoresis with proteolytic enzymes),

Drug treatment (antihistamines, vasoconstrictors, mucolytic drugs).

If conservative methods of therapy are ineffective, the patient is shown surgical treatment aimed at eliminating the causes leading to the block of the mouth of the auditory tube and the violation of its functions (adenotomy, operations on the paranasal sinuses to sanitize chronic foci of infection).

If, two to three months after surgical treatment, pathological contents remain in the middle ear cavity and there is no aeration, then otosurgical intervention is performed (myringotomy, tympanotomy with the introduction of a ventilation tube).

Audiological control is carried out 2-3 months after surgery. When the child's hearing is normalized, the ventilation tube is removed.

In the Department of Pediatric ENT Pathology of the Federal State Budgetary Institution NCCO FMBA of Russia under the guidance of MD, prof. Yunusova A.S. successfully carry out the whole range of treatment of exudative otitis media both in outpatient and inpatient settings.

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Middle ear diseases are widespread in pediatric medicine. Exudative otitis in a child is considered a fairly common occurrence. From statistical data it is known that about 60% of preschool children suffer from such a problem. The trouble is that this disease is not accompanied by pronounced symptoms, which is fraught with its transition to a chronic form, which is characterized by serious hearing problems, and sometimes complete deafness. Therefore, it is important for every caring parent to know the causes of the disease, its subjective symptoms, which help determine the severity of the situation in the early stages of the disease.

Exudative otitis in children manifests itself somewhat differently when compared with other types of ear diseases. Despite the fact that the disease has an inflammatory course, an acute process with fever and severe pain is not observed. This often causes lost time and untimely diagnosis.

There are some signs of exudative otitis media that are important to pay attention to and start treatment in a timely manner:

• The child complains of ear congestion.
• It seems to the baby that there is a liquid in the ears that gurgles and splashes while turning the head.
• The nose is constantly stuffed up.
• There is autophony.
• Hearing sharpness is dulled.

The severity of the problem is observed when there is an obvious deterioration in hearing for no apparent reason.

Exudative otitis has three forms:

1. Acute form that lasts up to 3 weeks.
2. Subacute - 3-8 weeks.
3. Chronic - more than 8 weeks.

There are 4 stages of the disease, on which its course depends.

• Initial, which is characterized by inflammation in the Eustachian tube, with a violation of ventilation in it, and, accordingly, air circulation. This process takes about a month. All this time, the child has a slight hearing loss. In addition, he hears his own voice in his head.
• Secretory is accompanied by a collection of fluid in the tympanic cavity and an increase in pressure.
• At the mucosal stage, the exudate is converted into a substance of a viscous composition. Hearing worsens even more, but the sensation of splashing water in the ears disappears. This process takes 1 to 2 years.
• The fibrous stage is characterized by the cessation of mucus production. Destructive processes take place in the tympanic cavity. This lasts up to 2 years.

Basically, the occurrence of childhood otitis media is a complication of viral and catarrhal infections, a characteristic feature of which is swelling of the mucous membranes. It is known about the structure of the hearing aid that the ear is connected to the pharyngeal passage by a hollow tube, which is covered with mucous tissue. With swelling of the auditory tubes, their gaps become narrowed. The complete narrowing of the lumen in the middle ear leads to the fact that a vacuum is formed there. A fluid consisting of cells of the mucous tissue flows into the vacuum, as a result of which the entire space of the middle ear becomes filled with exudate. This leads to hearing loss due to dysfunction of the auditory tube.

The mucous membrane inside the hearing aid in a child may swell due to allergies. In such cases, allergic exudative otitis is diagnosed. Serious problems arise in the case of a settlement on the mucus of pathogens.

The presence of bacteria in the exudate leads to the next phase of the disease - purulent otitis media, which is considered a serious complication that requires emergency medical care.

Most often, as a result of a cold, swelling of all mucous membranes occurs, which is fraught with bilateral exudative otitis media in children.

There are many reasons for the appearance of this disease. It is worth highlighting the most common of them:

• Inflammatory processes in the nasopharynx, maxillary sinuses, nose, which cause changes in the state of the mucous membrane of the hearing aid.
• Adenoid growths covering the lumen in the auditory tube.
• Malignant and benign neoplasms.
• Vasomotor rhinitis and chronic rhinosinusitis.

Most often, the cause of exudative otitis media is untimely and unqualified treatment of acute otitis media for a child. This happens if parents do not go to the doctor, but try to solve the problem on their own.

Exudative otitis media in children treatment

Serous otitis in children is a dangerous disease with a long and difficult treatment. The main task of doctors in this case is to eliminate the main cause, as a result of which the function of the auditory tube is impaired. If everything is done on time and correctly prescribed therapy is used, hearing is subsequently restored and the development of changes in the mucous membrane in the middle ear is prevented.

The treatment regimen is prescribed depending on the stage of the disease and the general condition of the child. At the initial stage, conservative therapy is prescribed:

• the auditory tubes are blown through the Polizer;
• caterization of the auditory tubes is performed;
• endural electrophoresis with proteolytic enzymes is used;
• drugs are prescribed in the form of antihistamines, vasoconstrictors and mucolytics.

If the effectiveness of all of the above methods of treating bilateral otitis media is not observed, surgical treatment is prescribed. With its help, the causes of the disease are eliminated, due to which the mouths of the auditory tube are blocked and its function is impaired. Usually this procedure is sufficient. But sometimes this method of treatment is ineffective. In this case, an otosurgical intervention is performed, which consists of myringotomy, tympatonia with the introduction of a ventilation tube.

The task of the next stage of treatment in children with bilateral exudative otitis is to restore hearing function and minimize the risk of irreversible problems with the middle ear.

If during the audiological control, which is carried out 2-3 months after the intervention of the surgeons, the child's hearing returns to normal, the ventilation tube is removed.

For parents who are interested in the question - how to treat exudative otitis media, it is important to understand that any self-made decision in this matter can lead to the most serious and irreversible processes.

Medical treatment

Treatment of exudative otitis in children includes the following drugs:

• Drops with a vasoconstrictor effect in order to facilitate breathing - Nazivin, Xylometazoline, Sanorin. Do not take these medicines for more than 5 days.
• Anti-allergic drugs that relieve swelling - Erius, Claritin, Suprastin.
• Mucolytics that help thin the exudate. The course of taking these medications lasts up to 2 weeks.
• When observing the bacterial genesis of the disease, antibacterial agents are prescribed that help relieve inflammation, suppress exudation and normalize capillary permeability. It's about Garazon. The use of this medicine is allowed from the age of 6 years old baby. There is a drug Otofa, which is approved for children from birth. It stops the growth of bacteria.
• Complex of vitamins.

The effectiveness of therapy becomes much higher if it is started in a timely manner.

Folk remedies

In the treatment of exudative otitis media, a good auxiliary effect is the use of traditional medicine. There are many of her recipes. It is worth noting the most effective of them:

Kalanchoe tincture

To prepare it, it is necessary to grind the leaves of the plant and pour them with boiled sunflower or olive oil. The mixture is infused for 3 weeks. Turunda is impregnated with this healing agent and inserted into the ear canal.

hare fat

The fat is heated to room temperature, and 2-3 drops are instilled into each ear. Then a dry dressing is applied. Before the procedure, the sore ear is slightly warmed up with a bag of warm salt.

Onion

A core is cut out in the bulb, into which cumin seeds are poured in crushed form. The onion filled with cumin is placed in the oven and languishes there until it becomes soft. After that, the bulb is rubbed through a sieve or squeezed through a bandage. Juice is buried in a sore ear.

Basil oil

Oil can be purchased at a pharmacy or make it yourself. For self-preparation, you need to take 25 basil leaves and pour them with ½ cup of olive oil. This miracle remedy is infused for 7 days. Before instillation of the ear, the oil is heated to room temperature.

It is important to consult your doctor before using any of these prescriptions. In addition, it should be remembered that with the help of these funds alone it is impossible to completely cure exudative otitis media. But as an aid, they are indispensable helpers.

Physiotherapy

Physiotherapeutic procedures are prescribed in order to quickly restore the drainage function of the auditory tubes, remove fluid from the middle ear cavity and prevent purulent infection. For this, the following methods are assigned:

• electrophoresis;
• ultrasound;
• magnetic and laser therapy.

One of the most common physiotherapeutic methods is the blowing of the auditory tubes according to Politzer. It requires a qualified doctor to perform. Insert the tip of a rubber balloon into one nostril of the child. At this time, the second nostril should be closed. The doctor calls the baby certain words that he must repeat. At this time, after the balloon is compressed by the doctor, air enters the Eustachian tube from the nasal cavity, after which it enters the middle ear cavity.

Surgical intervention

Serious complications can occur if all the methods listed above fail. In such cases, it is impossible to do without surgical methods for cleaning the tympanic cavity from exudate.

The doctor individually chooses the method. It depends on the severity and course of the disease, its clinical picture.

Effective methods in the fight against exudative otitis media include:

• Tympanopuncture, which is characterized by suction of exudate from diseased ears with the help of a small puncture in the eardrum.
• Tympanotomy consists of a small incision in the eardrum in order to improve the outflow of fluid from the middle ear.
• Bypass surgery is considered a rather unpleasant and painful, but at the same time effective procedure, so local anesthesia is used for it. The essence of this method lies in the fact that a special tube is inserted into a small incision in the eardrum, through which agents are introduced that dilute the pathological contents of the ears and the liquid is pumped out. A child under 3 years of age is allowed to do this procedure under general anesthesia.

What is the danger of the disease?

Timely appeal for help to the hospital and the provision of qualified assistance contributes to a quick recovery. Delay in treatment can lead to serious complications. As a result of the long-term presence of exudate in the tympanic cavity, changes occur in the anatomical structure of the middle ear. The mucous membrane of the auditory tube also undergoes changes. As a result, there is a risk of:

• membrane perforation;
• damage to the walls of the tympanic cavity;
• inflammatory processes in the auditory ossicles, as a result of which they are deformed;
• hearing loss and dementia, which are the most dangerous consequences.

The famous doctor Komarovsky urges parents not to start the disease in babies. From this, it becomes chronic, which after 3 years turns into irreversible hearing loss. Due to the fact that this disease often has no symptoms, Komarovsky strongly recommends that preventive examinations of the baby be performed at least once every six months. It is better to show Laura at least once every three months for a child prone to colds.

In addition, in no case should you treat the child yourself. Such a frivolous attitude can threaten the child with great hearing problems.

Prevention of exudative otitis media in children

Preventive measures are conditionally divided into 2 parts:

• Care must be taken to ensure that the child is less ill with diseases that may result in otitis media. When they appear, you can not treat the child yourself. Therapy must be selected by a doctor, the treatment is brought to an end.
• It is important to increase the protective properties of the baby's body.

1. It is necessary to carry out stabbing procedures for a child from an early age, often and for a long time try to walk with him in the fresh air.
2. It is important to teach your baby from an early age to the elementary rules of personal hygiene.
3. The love for sports instilled since childhood will save him from hypodynamia.
4. The child must be able to blow his nose properly.

Any complaint of the baby or a suspicious change in his behavior should be the reason for going to the doctor. This is the only way to prevent a serious disease and possible, sometimes irreversible consequences.

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