Exudative otitis media in children: symptoms and treatment

What is exudative otitis media

It is necessary to distinguish between the pathology and acute otitis media, which is an inflammatory process that is triggered by an infection that has penetrated inside and occurs in the middle ear. Exudative otitis media is a disease characterized by impaired outflow of fluid in the middle ear in the absence of inflammation. The course of the pathology passes without pronounced pain, the eardrum remains unharmed, but hearing acuity begins to deteriorate. As a rule, children 3-7 years old suffer from exudative otitis media.

This form of the disease passes without pronounced symptoms, but with the formation of initially serous and then purulent exudate in the ear cavity. As the disease progresses, the patient's hearing begins to gradually decrease and, if comprehensive treatment of the pathology is not started, third-degree hearing loss may develop. Temperature during otitis may either be absent altogether or be low-grade.

Symptoms of otitis media

Identifying the exudative form of otitis is more difficult than most other ear diseases. The main sign of the development of pathology is hearing impairment. Symptoms of otitis media:

• ear congestion;
• a feeling of fluid movement in the ear cavity that occurs when turning or changing the position of the head;
• nasopharyngeal congestion (optional);
• change in the audibility of your own voice (the feeling that you are speaking with your head in a barrel).

Most often, the disease affects children under 5 years of age, but sometimes fluid accumulates in the ear cavity also in adolescents, the elderly and mature people. Acute otitis media is caused by pathogenic microbes, viruses and fungal infections. The stimulating factor for the development of ear disease is influenza or other respiratory viral pathology. The acute form lasts for 2-3 weeks.

The disease is a purulent inflammation and is localized in the mucous membrane of the tympanic cavity. As the pathology progresses, it spreads to other parts of the ear - to the cochlea, eustachian tube, etc. Inflammation of the ear leaves behind an adhesive reaction, which is accompanied by irreversible hearing loss and can become chronic, progressive.

Chronic

The development of the disease is accompanied by deterioration of hearing, a feeling of ear congestion, distortion of sound perception, a feeling of pressure on the inside of the affected organ, and tinnitus when moving the head. Chronic exudative otitis (other names - serous, non-purulent, tubotympanitis) is the next acute stage of development of middle ear pathology, which occurs due to prolonged stagnation of fluid in the tympanic cavity.

The long course of the disease allows the exudate to stagnate, which leads to irreversible changes and dysfunction of the hearing organ. The disease enters the chronic stage 2 months after the onset of the acute form. At the same time, the accumulating exudate becomes more and more viscous and forms an excellent environment for the proliferation of various pathogenic bacteria. At the same time, as the pathology progresses, hearing loss increases (small children may experience difficulties in developing speech).

Fluid in the middle ear may begin to accumulate due to infection entering the hearing organ (this happens when the nasopharynx is inflamed with characteristic swelling of the mucous membranes). Swelling of the Eustachian tube leads to disruption of ear ventilation, after which the catarrhal form of the disease develops. Without proper treatment, it transforms into an exudative form. The resulting swelling prevents the removal of secretion from the tympanic cavity, which is produced by the human body inside the ear.

The causes of otitis media are the increased activity of exudate formation at the onset of the inflammatory process. In this case, the ear cavity is filled with a thick liquid in which all kinds of bacteria, viruses and infections can multiply. Over time, the liquid acquires the consistency of thick mucus and then pus. Exudative otitis media in adults and children can be caused by the following factors:

• allergic reactions;
• anatomical defects of the nose (trauma or congenital deviated septum);
• weakened immune system;
• inflammation of the nasopharynx;
• adenoids;
• various diseases (tuberculosis, typhoid, etc.);
• water getting into the inner cavity;
• pressure drop;
• ear injury;
• purging of the hearing organ;
• inflammatory process in the auditory tube.

As a rule, bilateral exudative otitis media develops in children as a consequence of impaired ventilation of the auditory tube. The pathology is accompanied by the production of pus and mucus, and in some cases the child feels pain. Often otitis in children develops against the background of previous respiratory infections. The manifestation of the disease at an early age can be caused by improper use of antibiotics, which created favorable conditions for the proliferation of various pathogens. Factors that provoke illness in children are:

• ARVI;
• allergic rhinitis;
• decreased protective functions of the body;
• adenoids;
• passive smoking;
• chronic sinusitis;
• "cleft palate".

In children, the course of the disease may differ, and the disease is not always accompanied by symptoms: until the very end, young patients may not notice the changes occurring in their body. Fluid in a child’s ear only in rare cases causes a feeling of fullness, and hearing loss usually begins only when the disease reaches a chronic stage. If parents did not notice changes in the child’s condition and did not start treatment on time, then after 3-4 years the baby may develop a persistent form of hearing loss.

Types and symptoms of the disease

Exudative otitis media according to the nature of the disease and its duration is divided into:

• Acute stage (incubation period - 1 month after infection);
• Subacute stage (the disease enters this format 1.5 months after the first symptoms appear);
• Chronic stage (occurs when treatment was not started on time or was not carried out at all. Diagnosed 2 months after infection).

The exudative form of otitis can affect either one ear (unilateral) or both at once (bilateral otitis).

Based on the severity of possible complications and consequences of the disease, exudative otitis media is divided into 4 stages, each of which has its own symptoms:

1. Initial (or catarrhal) stage. The development of the inflammatory process in the auditory tube begins, accompanied by swelling of the mucous membrane and deterioration of air flow into the middle ear. The duration of this period can range from several days to a month. At this time, active release and accumulation of exudate occurs in the ear.
2. Secretory phase. The secretory glands of the middle ear begin their active work. During this period, the patient notes the movement of fluid inside the ear when the position of the head changes. While sneezing or swallowing, many patients notice that they can hear better. Children may complain of unusual sensations in the ears, extraneous noises, the ear feels constantly blocked, and in some cases the child may partially or completely lose hearing. If treatment is not started, this phase will last from 6 months to a year.
3. The mucous third stage of the disease is characterized by changes in the density of the secreted fluid. The exudate becomes more viscous, so the patient no longer feels its movement through the auditory canal. There are cases when the exudate thickens so much that it becomes difficult to clean the ear even surgically.
4. The fourth fibrous stage is the death of cells and tissues in the tympanic cavity. The secretory glands no longer produce new mucus, however, the destructive effect of the secretion accumulating for a long time leads to an irreversible process - deformation of the eardrum. If no action is taken at this stage, then the little patient will face damage to the sound-conducting apparatus (including the auditory ossicles), destruction of the tympanic membrane and, as a result, complete deafness.

Diagnosis of exudative otitis media

It is usually possible to detect fluid behind the eardrum at the stage of the acute form of the disease. In this case, the otolaryngologist conducts a complete examination of the nasal ducts and ears. Diagnosis of otitis includes audiometry, endoscopy, tympanometry. A key role is played by a thorough examination of the patient’s auditory function. The decrease in hearing acuity with age is normally moderate; during examination, sound conduction should be equal to 30-40 dB. During the diagnosis, radiography may be performed, which reveals a deterioration in the pneumatization of the organ cells.

What is exudative otitis media in a child?

Pathology of the hearing organ, in which exudate (sticky mass) collects in the middle ear without an inflammatory process, is called “exudative otitis media”. It occurs at any age, but children are most often affected.

According to statistics, the disease is diagnosed in 60% of children aged 3 to 7 years and in 10% in adolescence. Moreover, 5% of children experience recurrent otitis media within a year.

As a rule, pain with this type of otitis is insignificant or completely absent. However, the child feels congestion in the ears, and hearing loss becomes noticeable.

The exudate that accumulates near the eardrum is usually liquid, which is why doctors often call the disease serous otitis. If the disease enters the chronic phase, and the fluid becomes sticky and thick, you can come across the name “secretory otitis media”, “sticky ear”, “tight tympanic catarrh”.

The frequent and asymptomatic nature of the disease leads to a delayed visit to the doctor or lack of treatment, which provokes the occurrence of various disorders in the functioning of the hearing organ. In children, pathology can cause not only a decrease in memory and attention, but also developmental delays.

What is a disease

Exudative or otitis media in children is an inflammation of the middle ear and the appearance of fluid in the eardrum. This disease often affects very young children aged 3 to 7 years, a little less often - at the age of about 15 years.

Each child has liquid (exudate) in small quantities, but it comes out through special channels. When the process of removing exudate is disrupted, the fluid is retained and becomes mucus, leading to the appearance of pus and inflammation. In children, the middle ear is structured somewhat differently than in adults, so fluid stagnation is more likely; in addition, the child’s weak immunity cannot always resist the disease.

The first symptoms of this otitis are hearing impairment and tinnitus, but often parents do not pay attention to such complaints, and the disease goes unnoticed. The general condition of the patient is usually normal, as is the body temperature, so there are no visible signs of the disease. Many very young children (under 5 years old) do not complain of discomfort or pain, and therefore the presence of exudative otitis media can only be determined during routine examinations by an otolaryngologist.

In addition to hearing loss, older children may complain of nasal congestion, difficulty breathing, a gurgling sensation in the head, and an unusual sound in their voice. You should be attentive to such complaints and visit a doctor if they arise.

Parents can notice symptoms by indirect phenomena, when the child constantly asks everything again, misunderstands, and turns the TV volume louder than usual.

This disease can occur for several reasons:

• due to poor environmental conditions;
• exposure to hazardous substances on the child’s body;
• frequent exposure to colds and infectious diseases;
• weakening of the child’s immunity after a serious illness or due to chronic diseases;
• allergy.

Almost a third of cases of exudative otitis media in children occur due to adenovirus infection. If the hearing organs are poorly ventilated, the processes of fluid removal are disrupted, the tonsils become enlarged, or an allergic reaction to something occurs, then there is a high probability of fluid accumulation, which leads to illness.

Classification of the disease

The disease is a type of otitis media, which affects the mucous membrane of the ear canal and the tympanic cavity, sparing the eardrum. However, it should not be confused with acute otitis media, when inflammation occurs in the middle ear caused by an infection.

According to the duration of the course, several phases of the disease are distinguished:

• acute - up to 3 weeks;
• subacute - from 3–8;
• chronic - more than 8.

Exudative otitis media develops gradually, in the form of stages:

• initial - primary deviations occur on the mucous membrane, when some cells are replaced by others;
• secretory - the work of goblet cells that produce secretion increases;
• mucosal - the exudate thickens and becomes viscous;
• degenerative - secretory function decreases, structures stick together. During this period, various fibrotic processes may appear: cystic, mucoid and adhesive.

• unilateral - one ear is affected;
• bilateral - both ears are affected.

In most cases, specialists diagnose bilateral exudative otitis; unilateral inflammation occurs only in 10–12% of cases.

Exudative form of otitis in adults and children

Exudative otitis media is an acute or chronic non-infectious disease that affects the mucous membrane of the ear. In most cases the process is one-way. Both ears are rarely affected. This pathology can occur in children and adults. The disease most often occurs in a chronic form. Otherwise it is called tubotympanitis or non-purulent otitis media.

The human hearing organ is complex. It has 3 sections. Inflammation most often affects the middle one. It is located behind the eardrum. In 20% of cases, this pathology is detected in children under 5 years of age. Otitis media is called chronic if symptoms persist for 2 months. If the disease lasts less than 3 weeks, then such inflammation is acute.

Exudative otitis media occurs in several stages. The following periods are distinguished:

• catarrhal;
• secretory;
• mucosal;
• degenerative.

Stage 1 lasts for more than 30 days. The mucous membrane of the auditory tube is damaged. Ventilation is disrupted. At stage 2, mucus is formed. It accumulates in the tympanic cavity. A sick person develops hearing loss. Over time, the mucus becomes thicker. This stage lasts up to 2 years. Then fibrosis develops, dysfunction of the auditory ossicles. Irreversible changes occur.

Main etiological factors

Otitis media in children and adults develops for several reasons. The following factors are of greatest importance:

• sinusitis;
• adenoids;
• allergic rhinitis;
• synechia;
• tumors of the nasal cavity;
• deviated nasal septum;
• swelling due to influenza and ARVI;
• barotrauma;
• congenital developmental anomalies;
• inflammation of the auditory tube (eustachitis);
• allergy;
• dysfunction of the autonomic nervous system.

The development of exudative otitis media is more often observed in people with a hereditary predisposition. Old age is a risk factor. Exudative otitis media often develops after tracheal intubation. Reasons include packing for nosebleeds. The development of the disease is based on obstruction of the auditory tube. This causes a drop in pressure in the tympanic cavity, which leads to hyperfunction of the glands. Predisposing factors are smoking, inhalation of smoke and aerosols.

Manifestations of exudative otitis media

Exudative otitis occurs with periods of exacerbation and remission. The most common symptoms are:

• hearing loss (hearing loss);
• feeling of stuffiness;
• short-term pain;
• feeling of fluid transfusion;
• nasal breathing disorder.

A common symptom is autophony. Such patients feel their own voice in their heads. Other symptoms of the disease include noise in the ear on one or both sides, and a cracking sound when blowing the nose. When bending, the patient's hearing may improve. Acute exudative otitis often manifests itself as pain.

Young children often have no complaints. Symptoms are mild. Parents of the baby may notice a decrease in hearing acuity. Bilateral otitis is most severe in children and adults. Chronic or acute exudative otitis media in children and adults is dangerous due to its possible complications. These include:

• suppuration due to infection;
• perforation of the eardrum;
• formation of adhesions;
• retraction of the tympanic membrane;
• development of progressive hearing loss;
• lesion of the mastoid process of the temporal bone.

If the signs of the disease are left unattended, cholesteatoma may form. This is a cavity with a capsule in which dead cells are located in combination with other substances. Bypass surgery may be required. The presence of chronic otitis media in children is fraught with mental retardation and impaired speech function.

Causes

The main cause of serous otitis is the presence of an infection that comes from the nasopharynx. As a result, the Eustachian tube becomes blocked, oxygen circulation is disrupted, and a vacuum is created in the ear canal.

The provoking factors for the occurrence of the disease are:

• decreased immunity after illness;
• poor environmental conditions;
• frequent colds or infectious diseases;
• water getting into the outer ear;
• inflammatory processes in the nasopharynx;
• severe swelling due to prolonged rhinitis, sinusitis;
• structural abnormalities of the ear and nasopharynx;
• adenoids.

In children, pathology often develops due to the proliferation of adenoid tissue. In this case, it is better to remove the adenoids.

Symptoms and signs

The signs of serous otitis are mild, which is the main reason for the late detection of the disease. Body temperature and general condition are usually within normal limits. Children do not show any complaints at all, so exudative otitis media is detected only during examination by an otolaryngologist.

Main signs of the disease:

• hearing loss;
• sensation of fullness or gurgling in the ear canal;
• crackling in the ear, impaired hearing of your voice;
• ringing in the ears when turning or tilting the head.

At the initial stage (acute period), ear pain and a slight increase in temperature are possible. At this time, exudation is not yet observed; only air circulation in the ear canal is disrupted.

In the subacute period, fluid concentrates in the tympanic cavity and transforms into a viscous substance. The patient is concerned about decreased hearing, a feeling of water transfusion, and heaviness in the ear.

If the disease is started, it gradually becomes chronic. The clinical picture is characterized by the development of persistent hearing loss and destructive processes in the tympanic cavity, up to the appearance of a tumor in the middle ear.

Infants or newborns cannot yet talk about their well-being, so parents should pay attention to the baby’s behavior.

If a child has otitis media, he tries to sleep on the side where the sore ear is located to reduce discomfort. Infants are capricious and refuse to feed, as sucking increases discomfort. The baby can take only one breast to keep the sore side warm. If intoxication is present, the child sleeps poorly and his appetite decreases. In some cases, a decrease in motor activity, lethargy, and drowsiness may be observed.

Adults should be attentive to the condition and behavior of the baby in order to notice the first signs of illness in time and consult a doctor.

If a child has suffered from an upper respiratory tract disease, the likelihood of developing serous otitis increases.

Features of otitis media in children - video

Symptoms and stages

There are two forms of recurrent otitis:

• hyperergic;
• hypoergic.

The first form is characterized by the following clinical signs:

• acute onset;
• severe symptoms of intoxication;
• increase in body temperature to 39°C and above;
• serious condition of the patient;
• A large amount of mucus and pus is released from the ear canal.

The second form lasts longer, but is easier. Symptoms:

• low-grade fever;
• loss of appetite;
• poor sleep;
• weakness;
• slight discharge from the ear.

There are also catarrhal and purulent forms of otitis. Signs of catarrhal form:

• high excitability of the patient;
• low-grade fever;
• slight pain in the ear, often felt at night.

Purulent form:

• hyperthermia;
• problems with appetite;
• perforation of the eardrum;
• purulent discharge from the ear.

Also, the symptoms of the disease depend on the pathogen. In particular, recurrent otitis caused by staphylococcus is characterized by:

• temperature increase;
• anxiety;
• dyspeptic disorders;
• manifestations of anemia;
• enlargement of the eardrum.

In some cases, recurrent otitis occurs in a more severe form, which manifests itself:

• sleep disorders;
• vomiting;
• general weakness
• nausea;
• hyperthermia;
• convulsions;
• apathy.

If the first signs of recurrent otitis occur, you should immediately consult a doctor to avoid negative consequences.

Hyperthermia.

Diagnosis of serous otitis media

Only an otolaryngologist diagnoses exudative otitis media. To do this, a survey is carried out about previous diseases, as well as an examination of the middle ear using special instruments (otoscopy). During the examination, the doctor can identify any modifications to the eardrum, the presence of exudate and bubbles in the ear cavity, and deformation of the auditory bone.

Additional instrumental diagnostic methods are:

1. Tympanometry. Measuring the degree of mobility of the eardrum and the ventilation function of the auditory tube by creating pressure in the ear canal. In combination with other diagnostic methods, tympanometry is used to judge hearing sensitivity.
2. Audiometry. Study of the level of hearing and perception of sounds of different heights. The method makes it possible to detect damage to the hearing aid even in the youngest patients.
3. Radiography. Helps identify cellular pathology.
4. Computed tomography of the temporal bones. Performed in case of relapse of the disease or difficulty in making a diagnosis. In this way, the condition of the mucous membrane, ear canal, and middle ear cavities is determined.

Using soft and hard endoscopes (devices for examining the ear), the pharyngeal part of the Eustachian tube and auditory tubes are examined to determine ventilation functions, the nature of the lesion and clarify the diagnosis.

In case of damage to the auditory ossicles, dysfunction of the eustachian tube, decreased auditory perception, or suspected otosclerosis (abnormal growth of bone tissue), differential diagnosis is carried out using multifrequency tympanometry.

In some cases, it is necessary to distinguish between serous otitis media with a rupture of the auditory ossicular chain and a tumor in the tympanic cavity. To do this, an x-ray and tympanogram are performed.

Treatment is prescribed only after a complete examination and correct diagnosis. Therapy boils down to eliminating the cause of the disease and restoring the patient’s hearing. If adenoids or polyps are detected, they must be removed followed by treatment of the paranasal sinuses.

Conservative therapy

Treatment in most cases is carried out in a hospital, since the patient is prescribed an extensive list of activities.

Therapy includes taking such groups of medications as:

• antibacterial (in the presence of infection): Azithromycin, Amoxiclav;
• mucolytics for thinning sputum: Ambroxol, Ambrobene;
• anti-inflammatory and antihistamine (to relieve swelling of the nasopharynx and Eustachian tube): Suprastin, Tavegil;
• vitamin complexes;
• vasoconstrictors (to restore aeration of the auditory tube and improve the outflow of exudate): Sanorin, Nazivin.

To improve the patency of the Eustachian tube, it is recommended to carry out physical procedures:

• laser therapy (at the initial stage of the disease);
• blowing the auditory tubes according to Politzer - introducing air into the middle ear using special devices;

Procedures such as catheterization, the introduction of medications into the ear canal using a special catheter, require the active participation of the patient in the process, and therefore are not suitable for children. Young patients are usually prescribed drug therapy in the form of vasoconstrictor nasal drops, anti-inflammatory and antibacterial drugs.

Treatment is prescribed only by an otolaryngologist, depending on the stage of the disease and the age of the child. Self-administration of medications is unacceptable, as it can lead to complications and an unpredictable course of the disease.

The course of therapy depends on the severity of the pathology and can last up to 14 days. The results are assessed after 1 month by repeating diagnostic measures. If conservative treatment is ineffective or in the later stages of the disease, surgery is recommended.

Surgical intervention

Surgical treatment methods include:

• myringotomy - used for a one-time removal of fluid using a special tube under pressure;
• tympanopuncture - installation of permanent drainage and administration of medications into the ear cavity using a plastic tube (shunt) until the patient’s condition improves.

Folk remedies

Alternative medicine offers its own methods of treating exudative otitis media. It must be remembered that folk recipes are an addition to the main treatment, and not a replacement for it. Before using them, you should definitely consult your doctor.

1. Wash the basil and squeeze the juice out of it. Place 5 drops into the ear canals for one week.
2. Pour 1 cup of boiling water over mint leaves (2 tablespoons) and leave to steep for an hour. Strain and rinse your ears with the resulting liquid.
3. Combine elderberry, yarrow and chamomile flowers in equal proportions and brew with boiling water for 15 minutes. Strain the infusion, moisten a cotton swab in it and insert it into the diseased ear canal for 30 minutes. Repeat for 14 days.
4. Bake the onions in the oven, cut off the top and pour 1 tsp into the cavity. cumin. Cover with the cut part of the onion and place in the oven for another half hour. Cool the onion. Place the resulting juice in the ear canal at night, 3 drops each, for 10 days.

Traditional medicine in the photo

General recommendations

In addition to the prescribed treatment, it is necessary to comply with certain conditions that contribute to a speedy recovery:

• In the first two weeks, swimming is strictly prohibited. If the treatment was carried out in a timely manner and the disease was stopped in its acute form, in order to avoid a relapse, you should not bathe the baby for several days. In the future, you need to make sure that water does not get into your ears;
• after physiotherapy and in the acute phase of the disease it is not recommended to walk;
• in the chronic form of the disease, before washing your hair, it is necessary to cover your ears with cotton swabs, since water entering the ear canal will aggravate the disease;
• During a walk, you should avoid hypothermia and reduce physical activity. Before going outside, you should tightly cover your ears with cotton swabs.

Recurrent otitis media in children: causes and treatment

30.09.2011

“Mom, my ear hurts!” - the parents of 80% of children in Russia hear this complaint at least once in their lives. An ENT doctor diagnosed my son with “inflammation of the middle ear” three times in six months. “So, you have recurrent otitis media,” the doctor announced solemnly. “It is dangerous due to persistent hearing loss and, as a consequence, a delay in speech formation and general intellectual development.” “Are you going to faint or fall?” – I thought in sadness. No, it's stupid and useless. You need to thoroughly study the repeat offender enemy and throw all your strength into fighting him.

Why do my ears hurt?

Fortunately, information about otitis media is not a military secret. We open the medical encyclopedia and read: “Otitis media is an inflammation of the ear. The cause of acute otitis media is a violation of the immune defense of the mucous membrane of the upper respiratory tract and middle ear, resulting from cold, acute respiratory and other infectious diseases, and injuries to the middle ear.” It is clear that otitis media occurs most often against the background of ARVI. Our otolaryngologist explained to me that children under two years of age are at risk. In babies, the Eustachian tubes are still short and narrow, but they are responsible for the outflow of fluid from the middle ear to the nasopharynx. A cold is otitis media’s best friend; it “narrows” these tubes even more, creating an environment for the proliferation of harmful bacteria in the ears. So if a child often “snots”, there is no reason to be surprised by constant ear inflammation.

When teething in the back, babies often fiddle with their ears and cry. But these may also be symptoms of incipient otitis media. Just in case, it is better to show the baby to an ENT doctor.

Well, what if there are no traces of colds, but otitis media goes away and immediately returns again? It turns out that allergies are also associated with ear inflammation. It is useless to treat such otitis with drops; you need to recognize the allergen and cut off its access to the baby’s body. And sometimes fungal infections become allies of otitis media. The main symptoms of otomycosis (fungal infection of the ear) are itching in the ear canal and headache.

What is the cause is the cure

If the cause of recurrent otitis media has been identified, you can breathe a sigh of relief - full recovery is just around the corner. My child’s case turned out to be trivial: constant colds caused otitis media. Each time I simply “undertreated” my son. We only went through the first stage of treatment - “elimination of the current exacerbation”, in the language of doctors. That is, they used prescribed drops and antibiotics, and as soon as the pain and inflammation went away, they happily ran outside without a hat. But in order to get rid of otitis once and for all, you need to go through the second stage - “relapse prevention”. First of all, you need to bathe your baby carefully after otitis media, covering the ears with cotton wool. When walking, they should be closed, you can’t get too cold, you need to protect yourself from colds. These rules are common to everyone. The otolaryngologist will advise additional measures. You may need to blow out the auditory tubes, vibrating the eardrum, or even a simple operation - inner ear bypass. It all depends on the individual characteristics of the child.

Allergic otitis media is treated differently. It is important to identify and eliminate the allergen. Sometimes it is enough for a nursing mother to change her diet to relieve her baby of ear pain. To treat otitis caused by a fungal infection, antifungal drugs (for example, Travogen, Levaril, or Nizoral) are used. The key to ear health in this case is keeping them clean. Don't forget to wipe your ear - the external auditory canal, not the internal one - 2-3 times a week! There is nothing for you to do there - it is easy to damage, and it cleans itself with the help of thin hairs that push the sulfur out.

From the forum nanya.ru

Opinion on the topic: You can check whether your ear hurts by pressing your finger on the tragus or behind the ear. A child with a sore ear will move away or react to the pain.

Prevention of otitis

When a child's ears hurt, it is very difficult and sad. The baby loses appetite, peace and sleep. I would like to wish children never to get otitis media, and adults to remember about prevention. Remember that babies born prematurely or with low birth weight are more susceptible to ear inflammation - they need to be especially carefully protected from colds. Children of smoking parents are also in the “risk zone” - what’s not a reason to get rid of a bad habit? Breastfeeding has been proven to reduce the risk of ear infections.

By the way, a recent sociological study in the USA showed that children from wealthy backgrounds are more likely to suffer from recurrent otitis media. I hope this rule does not work in Russia.

www.nanya.ru

Prognosis and possible complications

Untimely consultation with a doctor and thoughtless infatuation with traditional medicine recipes can lead to:

• purulent or chronic otitis media;
• cholesteatoma (enlargement of the tissues of the tympanic cavity);
• chronic mastoiditis (inflammation of the process of the temporal bone);
• thinning and perforation of the eardrum.

If you do not pay attention to the symptoms and do not treat the disease for 2–3 years, this leads to persistent hearing loss, which occurs as a result of irreversible processes.

Early diagnosis and properly selected therapy lead to complete recovery. It should be taken into account that in 30% of cases a relapse of serous otitis is registered. As a rule, this is due to the presence of adenoids and chronic throat diseases in the child.

Preventive measures

To prevent exudative otitis media, diseases that contribute to the appearance of exudate and the development of pathology should be treated in a timely manner:

The risk group includes children who are predisposed to respiratory diseases.

Preventive measures include:

• hardening procedures;
• walks in the open air;
• compliance with personal hygiene rules;
• active lifestyle and sports.

In addition, it is important to ensure that the child avoids hypothermia and does not walk without a hat, and when swimming, water does not get into the ears.

How to treat exudative otitis in children

Exudative otitis in children is a common disease, although it is less common than the main types of otitis. And although 60% of 3-7-year-old patients suffering from otitis suffer from the disease at least once, most often doctors still manage to prevent such a turn of events in the form of otitis media: more often in children, the development of this form of the disease can be prevented, but in some circumstances the development of this form of otitis is inevitable.

Fortunately, treatment of exudative otitis in children is successful in most cases: undesirable consequences, as well as the transition of the disease to a chronic condition, are practically excluded with adequate drug treatment.

The mechanism of development of exudative otitis media

Behind the eardrum is the space of the middle ear, which contains a group of bones that amplify and transmit sounds to the internal parts of the hearing organ. The middle ear communicates with the nasopharynx through the auditory (Eustachian) tube, which performs drainage, protective and ventilation functions.

When ventilation is disrupted, a vacuum increases in the tympanic cavity, which promotes the release of transudate from the epithelium - edematous fluid. Subsequently, flat epithelial cells degenerate into secretory and goblet cells, which leads to the formation of mucous discharge, which, having no outlet, becomes viscous and sticky.

Otitis media is sometimes called "glue ear."

In the future, this leads to the formation of fibrous tissue, which reduces the conductivity of the auditory ossicles, and the development of hearing loss in children. Discharges of this nature in medicine are called exudate, or serous effusion, and the pathology that occurs when it accumulates is exudative (serous) otitis media of the middle ear, or turbootitis.

In the exudative form of otitis, the cavity behind the eardrum is gradually filled with serous effusion, which thickens over time and interferes with the normal functioning of the auditory ossicles

This form of the disease is not characterized by the involvement of bone and epithelial tissues of the ear cavity in inflammatory processes, which means there are no symptoms of severe pain. For this reason, otitis media in children is often diagnosed in the later stages, when the disease becomes degenerative or causes hearing loss.

Manifestation of illness in a child

The “catch” of the disease in children, as in adults, is the almost complete absence of obvious symptoms of otitis media. The child does not suffer from acute pain in the ear, so very often children with this disease go for an initial examination to an otolaryngologist when the disease has already reached one of the complicated stages. There are 4 such stages in total:

1. initial - gradual deterioration of hearing due to impaired air circulation in the entire ear, a feeling of stuffiness in the ears, increased audibility of one’s own voice;
2. secretory - filling of the middle ear with fluid (pathological secretion), proliferation of bacteria. The patient may feel the sounds of a “splash” of water when he changes the position of his head;
3. mucosal - is the completion of the process of filling the ear with fluid. The secretion becomes extremely viscous and sticky. At this stage, the child continues to feel increased hearing loss, the “water” in the ears stops “splashing”;
4. fibrous - in the cavity of the middle ear, as a result of scarring and pressure provided by the fluid, often irreversible changes occur: the auditory ossicles are damaged, degenerative changes in the eardrum are observed.

Exudative otitis media in a child whose treatment was not started on time does not give the proper signals for the need to visit an otolaryngologist. The only thing a child can complain about with this form of the disease is poor hearing, an “echo” of his own voice. Only an otolaryngologist can recognize the disease, its stage and complications that have already arisen: even a doctor cannot always accurately describe the condition of a sick child with exudative inflammation of the middle ear, so sometimes even tomography is used for diagnosis.

The only sure sign for a trip to the ENT in the case of children is deterioration in hearing, as well as a slowdown in the development of speech abilities - children sometimes have bilateral exudative otitis media, which is characterized by such signs.

Causes of recurrent disease

The causative agents of infections are streptococci and staphylococci. Also, bacteriological studies of the contents of the middle ear revealed diplococci, Proteus, and Pseudomonas aeruginosa.

There is evidence that viral infections of the upper respiratory tract provoke inflammation of the middle ear. They usually cause recurrent inflammation.

The most dangerous viruses in the context of recurrent otitis are influenza A2, B1, and parainfluenza viruses. Scientists have been able to establish that in many cases children with recurrent otitis media have antibodies to the parainfluenza virus in their blood. This theory is also confirmed by statistical data that the disease is more often activated during periods of surges in the incidence of ARVI.

Relapses are provoked by bacteria; the trigger for them is viral infections.

The occurrence of disease outbreaks also depends on the state of the local immune system and the presence of chronic diseases in nearby organs. Among the “leaders” of prerequisites are adenoids, chronic tonsillitis, rhinitis, and sinusitis.

It is noted that the frequency of otitis media decreases in children after removal of the tonsils in the pharyngeal ring. This is due to the elimination of congestion in the venous plexuses of the oropharynx. The function of the muscles of the pharynx, trophism in the tissues, and the act of opening the auditory tube are restored.

Otitis media in children may be caused by systemic diseases, congenital abnormalities of the immune system, disruption of the upper respiratory tract, or the presence of hereditary structural features of the ear cavity.

Exudative otitis media in children: treatment

In adults and children, the methods of treating the disease in the described manifestation are practically the same: the otorhinolaryngologist first of all deals with eliminating the causes of inflammation in the ear, and then, through medications and physical therapy, eliminates the otitis media itself.

However, in the case of young children, treatment is complicated because most physical therapy procedures require the patient to actively participate in the process. With older children, this problem is usually no longer relevant.

Drug treatment

Treatment of exudative otitis in children always occurs in a complex manner. Regardless of what form the disease has acquired, the doctor prescribes the following groups of drugs to the young patient:

• antibiotics _ If the disease is caused by bacteria and infections, then successful treatment without antibiotics is not considered for young children. Depending on the age of the patient, the ENT specialist may prescribe, for example, “Otofa” (for children from birth) or “Garazon” (for children from 6 years old), but there are other drugs that the doctor may consider more suitable - such serious drugs are always are selected individually;
• mucolytics . Special medications that will help thin the fluid accumulated in the middle ear also have age restrictions: the doctor may prescribe, for example, “ACC” or “Carbocysteine”;
• antihistamines . To “unload” the liver and other organs during active drug therapy, antihistamine drugs are prescribed. In particular, the doctor may prescribe Zodak, Suprastin, Celfax or Ketotifen, depending on the age of the patient;
• vasoconstrictor drops . To facilitate the work of the middle ear, nasal drops such as Naphthyzin, Nazivin, Sanorin, Polidex, Xylometazoline or Tizin (different age restrictions) can also be prescribed;
• preparations of combined action for local use. Combination medications that are applied topically also help fight intra-ear infections. For example, children are often prescribed Otipax (from birth) or Sofradex (from 1 year).

Important! All of the above drugs are contraindicated to be “prescribed” to a child on your own, since they all have a number of contraindications. Only a qualified ENT specialist can select the optimal treatment regimen for exudative otitis in a child, based on the symptoms, stage and cause of the disease.

Physiotherapy

It is often almost impossible for young children to undergo physiotherapeutic procedures for such diseases. The fact is that the child often has to help the doctor implement this or that procedure. However, depending on the age of the patient, the doctor may prescribe:

1. magnetic therapy - usually the positive south pole is used, which helps reduce the rate of bacterial growth, improve the elasticity of blood vessels in the ears, eliminate pain and help reduce inflammation;
2. ultrasound - for such a disease, low-frequency ultrasound is preferable, which is used to irrigate the sore ear through special medications. One session of such therapy lasts about 25-30 seconds, thanks to the procedure the patient simultaneously receives hydromassage of the affected tissues and antibacterial procedures;
3. laser - this therapy is aimed at improving patency in the Eustachian (auditory) tube; thanks to laser therapy in the initial stages of the disease, swelling can be effectively relieved;
4. electrophoresis - the procedure is similar to ultrasound therapy, only it replaces ultrasound with direct current. The procedure is not painful, the patient only feels a slight tingling sensation. The purpose of the procedure is to eliminate inflammation in the nasopharynx, nasal cavity and tympanic cavity of the ear.

There are other physiotherapeutic procedures, but they are most often relevant for adult patients.

Causes of otitis in children: how to avoid relapse

The causes of otitis in children often lie in the characteristics of a fragile organism and anatomical differences. It is at an early age that a person is more susceptible to various types of ear diseases. At the same time, there are effective ways to protect your child from such diseases. In order to understand this issue, it is necessary to consider in more detail the mechanism of development of otitis media depending on the causes of its occurrence.

Features of the child’s body and ear structure

The main reason that a child experiences frequent otitis media is the young body’s tendency to undergo inflammatory processes. This is mainly due to an underdeveloped immune system. In the first years of life, children develop the body's defense mechanisms. While immunity is in its infancy, the baby is susceptible to infection, as well as the development of complications after illness.

In addition, it is necessary to note the anatomical features of the hearing organs. Otitis has an additional possibility of development due to almost completely open access to the hearing organs to bacteria. The situation is aggravated by insufficient production of sulfur secretion. Until the immune system is fully formed and the organs are rebuilt in an adult way, recurrence of ear diseases will not be uncommon.

The main difference between the hearing organs of children is their specific structure, due to the underdevelopment of some elements at an early age. This is a completely natural phenomenon, so if there are no other abnormalities, there is nothing to worry about.

First of all, the shape and size of the Eustachian tube differs significantly in the child. In adults, it is narrower and has curves that prevent germs from passing into the middle ear. In children, it is short and straight, and also wider. Because of this, the risk of otitis media increases even with a common cold.

Through the Eustachian tube, germs and infections can enter the ear, which can cause other diseases of the ear-nose-throat system. Also, the structural features of the pipe can provoke a relapse due to the accumulation of pathogenic microflora.

Another aspect of the differences in hearing organs in children is the type of epithelial tissue lining the hearing organs. Relapse may be due to the retention of microorganisms by loose epithelium. In adults, it is represented by the mucous membrane, which helps eliminate the threat, along with other secretions.

Congenital problems

Also, the causes of otitis in children may be associated with a hereditary predisposition to this disease and other congenital problems. Several groups of such factors can be distinguished:

• Complications of pregnancy and childbirth. Diseases suffered by the mother during pregnancy, pathologies of childbirth, prematurity of the child, birth injuries and other complications can affect the development of the immune system, hearing organs and the entire body as a whole.
• Deviations of physiological development. Pathologies such as cleft palate in children, deviated nasal septum and other disorders increase the susceptibility to such diseases.
• Weakened immunity. A decrease in the body's defenses, especially if it is congenital, provokes a relapse of many diseases, including otitis media, which is associated with the inability to effectively resist infection.
• Presence of congenital diseases. Relapse can also be caused by disorders of other systems, in particular those of a chronic nature. The ears are affected by the vascular system, pathologies of metabolic processes, endocrine, etc.

If persistent otitis media in a child is associated with these factors, the only thing left to do is to strengthen the immune system by all means and monitor the baby’s health. Some pathologies can be corrected through long-term treatment and surgery.

Hygiene issues

Maintaining good hygiene for a child is not an easy task. Most of the responsibility falls on the shoulders of the parents. At the same time, the baby’s activity is not always controlled, and this, in turn, can lead to otitis media relapse.

Kids learn about the world tactilely; in order to get acquainted with a new object, they need not only to see it, but preferably smell it, touch it and, of course, lick it. And an even more inquisitive child will try to put some interesting stick in his mouth, nose or ear. The problem is that this way the baby can get an infection in the ear or injure the external organs of hearing, which can also lead to infection.

To prevent relapse of otitis, parents must monitor not only what and how their child plays with, but also correctly carry out hygienic cleaning procedures. It is important to teach your child how to properly care for themselves at an older age. Ear hygiene is the first step towards health. The entry of water into the ear canal should be limited. It is equally important to prevent exposure to loud noises and pressure changes.

Another point is proper nose blowing. In some children, inflammation may develop due to the inability to properly clean the nose. The nostrils need to be cleaned one at a time. In addition, it is important to tilt your head to the side so that mucus or flushing fluid does not enter the Eustachian tube.

Disease provocateurs

Most often, otitis media occurs due to complications of another disease. The main triggers are colds and viral diseases, but some cases are associated with allergic reactions.

Diseases that cause otitis media or its recurrence may be:

• ARVI;
• flu;
• parainfluenza;
• allergic rhinitis;
• angina;
• bronchitis;
• sinusitis;
• polypous rhinosinusitis;
• frontal sinusitis;
• tonsillitis;
• laryngitis;
• tuberculosis;
• scarlet fever;
• typhus;
• sinusitis;
• measles, etc.

If a child experiences repeated otitis media after about a week, this most likely indicates that the inflammation has not been completely cured. There is also a possibility of re-infection due to weakened immunity.

In children, the risk of developing otitis media due to an infectious disease is especially high. This is due to the fact that it is much easier for pathogens to enter the middle ear due to the simple structure of the Eustachian tube. The wide, short, straight tube becomes an easy path for bacteria.

In addition, due to the protracted course of a cold or other viral disease, even after complete elimination of otitis media, a relapse may occur. This situation is quite common in the presence of chronic ear inflammation. Any irritant can restart pathological processes, especially when the body is weakened by another disease.

Prevention measures

If a child has frequent otitis media, you need to know what to do to reduce the risk of recurrence of the disease and eliminate its negative consequences. The main preventive measures are aimed at proper treatment of colds and general strengthening of the immune system. This is especially true for children with congenital diseases and anatomical abnormalities.

To increase the body's resistance, it is necessary to adjust the menu and increase the amount of vegetables and fruits consumed. In winter, it is recommended to take synthetic vitamin complexes due to the shortage of available natural sources of nutrients.

To prevent relapse after inflammation, make sure there is no infection and the consequences of its influence. It is important to cure the primary disease and in the future, if it occurs again, to prevent the infection from progressing. In some cases, medical intervention and even surgery may be necessary. Predominantly surgical approaches are associated with a deviated nasal septum, adenoids, eustachian tube dysfunction, or the presence of pockets in the auditory cavity that retain pus and infection in chronic otitis media.

Taking care of the health and strength of the immune system, as well as proper ear care, reduce the risk of otitis media in a child. At the same time, it is important not only to independently monitor his condition, but also to teach him to carry out preventive measures from early childhood.

Please note: this article is for informational purposes only and is not a guide to action. Only a doctor can diagnose the cause of the disease and prescribe the correct treatment. Therefore, at the first signs of the disease, we strongly recommend that you consult a specialist. Treatment should be carried out in a timely manner to avoid complications. Do not self-medicate, be sure to consult your doctor.

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