Secretory otitis: causes, symptoms, treatment

Causes

Secretory otitis media develops for several reasons:

Formations in the nasopharynx (polyps, adenoids, etc.).
Infectious diseases of the olfactory organ.
Allergic reactions that cause swelling of the mucous tissues of the nasopharynx.
Anatomical features, for example, deviated septum.

The secretory form of otitis is a transitional phase in the complex of the inflammatory process in the middle ear. Most often occurs in early childhood (1–7 years). During this period, the child’s immunity is not yet formed or is not strong enough. Therefore, another reason for the development of otitis media is considered to be weak protective functions of the body.

What causes otitis media?

In medical practice, otitis media, as an independent disease, is characterized by three categories:

Outdoor.
Average.
Internal.

Its secretory form is considered a transitional phase in complex inflammation of the middle ear; it often appears in a child after suffering from rhinitis at the age of 1-8 years, which is explained by the fact that it is during these years that children are in intensive contact with the outside world.

Parents may inadvertently miss a runny nose or not treat it, which often results in chronic nasal congestion. Later, in addition to noticeable discomfort, obstruction is detected in the auditory tube, which connects the sinuses and middle ear. In addition, this part of the ear is involved in the discharge of mucous secretions through the nasopharynx and the normalization of sound perception in children.

The insufficiently strong organism of children is susceptible to infectious diseases, as a result, inflammation of the auditory tube becomes more typical for young patients. It is difficult to independently diagnose the disease in question, mainly due to the fact that its course is not characterized by obvious signs or deterioration in health.

When secretory otitis media transforms into a more serious form, a significant decrease in hearing becomes noticeable, and the formations contained in the middle ear become purulent discharge.

To prevent possible illness in a child who has already suffered from inflammation, regular monitoring of his condition by the attending physician allows him to protect the body from further development of otitis media.

Treatment of an already ill young patient can only be effective after a thorough examination by his pediatrician and the necessary studies have been carried out to determine the degree of hearing acuity and mobility of the eardrum.

Symptoms

The disease is characterized by mild symptoms that are easy to miss. With the development of secretory otitis, the following signs are noted:

Feeling of pressure, stuffiness in the ears.
When tilting the head, the patient notices splashes of fluid.
Noise in ears.
Hearing impairment.

Clinically, the form of otitis is manifested by a decrease in pressure in the tympanic cavity. As a result, blood actively flows to the mucous tissues, and its outflow slows down. The swelling is accompanied by secretion. At the same time, exudate accumulates. Gradually, the cavity is filled with liquid of varying degrees of viscosity.

Symptoms in adults and children

The symptoms of exudative otitis media are quite varied. Signs of the disease in adults and children often coincide. The standard manifestations of secretory otitis are:

Extraneous noise in the affected ear;
Deterioration of hearing when turning the head;
Congestion in one or both ears.

Attention! It is much more difficult to recognize secretory otitis in a child than in an adult. For example, a symptom such as autophony—the appearance of an echo of one’s own voice in the affected ear—may simply not be noticed by the baby. It is also worth saying that the disease in children can develop without symptoms at all.

Despite the fact that the patient feels well in the first stages of inflammation, pathogenic processes have already begun to develop in the ear, which cannot be determined without visiting a doctor. These include:

Deformation of the tympanic membrane and auditory ossicles.
The appearance of scars and adhesions at the site of perforations.
Calcareous plaques appearing in the tympanic cavity.

Keep in mind that only a qualified specialist can diagnose secretory otitis media after a preliminary examination and thorough examination. You cannot begin any treatment until the otolaryngologist gives appropriate recommendations.

Which doctor treats the secretory form of otitis media?

If you suspect the development of a secretory form of otitis, it is important to consult a doctor as soon as possible. Otitis is treated by an otolaryngologist (ENT).

You can also go to see a therapist or pediatrician. If the disease manifests itself initially, it does not require complex surgical treatment; such specialists are also able to draw up a scheme of procedures and monitor the healing process.

Depending on the reasons that provoke the development of otitis, you may need to consult other highly specialized doctors (allergist, immunologist, surgeon).

Secretory otitis media and its causes

Secretory otitis media falls into the category of non-purulent processes that are accompanied by deterioration in hearing levels and internal inflammation. The progression of the disease leads to its transition to the Eustachian tube, infection of the membranes and the appearance of edema. Most often, the disease occurs before the age of 8 years, but can also occur in adults. The causes of the disease include:

development of infection on the mucous membrane;
exacerbation of the patient’s existing allergies;
the presence of polyps, adenoids and other foreign processes in the nasopharynx.

A deviated nasal septum can also disrupt the proper functioning of the ENT organs. Due to the defect, there is no possibility of mucus draining in full, so it accumulates and causes an inflammatory process.

Diagnostics

The specialist conducts a visual examination of the organs of hearing, smell, and larynx. The patient's medical history is studied and a survey is conducted to identify complaints and how long ago the first signs of otitis appeared. Already at this stage, an experienced doctor can diagnose secretory otitis media.

To determine the extent of the lesion, a hardware test is prescribed, which is performed by an audiologist. The degree of hearing loss is determined using audiometry. And the presence of fluid behind the eardrum and the recording of indicators of its mobility are established during tympanometry. Taking into account the examination and examination data, the doctor makes a diagnosis.

Secretory otitis media and its causes

Secretory otitis media refers to non-purulent processes accompanied by inflammation and hearing loss. As the disease progresses and spreads to the Eustachian tube, swelling of the mucous membrane in the area of the mouth is possible, blockage and further infection of the ear cavity itself, namely the eardrum.

Otitis is divided into internal, middle and external. Secretory otitis refers to the moderate form. It most often affects children aged 2-8 years.

The main causes of secretory otitis media are:

Adenoids, polyps and other formations in the nasopharynx;
Damage to the nasal mucosa by infections;
Allergic reactions.

It should be separately noted that the healthy functioning of the nasopharynx can also be disrupted by a deviated nasal septum. Thus, the mucus, unable to fully drain, accumulates and stagnates, leading to secretory otitis media.

Site of inflammation of otitis media

Treatment

Based on the clinical picture, medical history, age and other individual characteristics of the patient, the doctor prescribes treatment. Most often it combines a set of activities. Let's look at how to fight secretory otitis media:

Drug therapy is the mainstay of treatment. The use of drugs helps to stop the infection and normalize air exchange. The doctor may prescribe rinsing the mouth with antiseptic solutions (Miramistin, Chlorhexidine, Chlorophyllipt). Limited use of vasoconstrictor drops in the nose normalizes ventilation, relieving swelling (Otrivin, Rinorus, Nazivin). Therapy sometimes includes antihistamines (Suprastin, Claritin, Diazolin), antibiotics (Amoxicillin, Cefazolin, Augmentin) and drugs that have an anti-inflammatory effect (Miramidez, Erespal).
Physiotherapy is also very effective in the treatment of secretory otitis media. The simplest thing is to rinse the ears with hydrogen peroxide. Devices with infrared radiation have proven themselves well. After a course of procedures, pathogenic microflora is destroyed, and normal functioning of the hearing organ is restored.
Folk remedies can help in the treatment of otitis media, but they are best combined with drug therapy. Recipes include inserting a tampon soaked in propolis tincture or Kalanchoe juice into the sore ear. It is also practiced to instill tea tree oil into the ear canals (diluted in a ratio of 1:10 with sunflower oil). Calendula tincture is used for warming compresses.
Surgical treatment may be necessary if the pathology is caused by adenoids, polyps, or a deviated septum. Operations are performed under anesthesia in a hospital setting. In order to allow the fluid to come out, myringotomy and tympanopuncture are prescribed.

Secretory otitis - causes, diagnosis and treatment

Secretory (non-purulent) otitis is considered the most common disease among children than adults. It is characterized by excessive accumulation of mucous membrane secretions in the middle ear.

As a result, hearing becomes less acute, and it becomes harder than usual to recognize surrounding sounds. To avoid such consequences, it is necessary to promptly consult a doctor for help, who will name the causes and prescribe treatment for this disease, as well as introduce methods for its further prevention.

Causes of the disease

Otitis (or in other words: ear inflammation) can be of three types depending on the location of its occurrence:

outer;
average;
interior.

Secretory otitis is a disease in which excessive secretion of mucous fluid and its stagnation occur in the middle ear. The outflow of accumulated secretions must be carried out using the Eustachian tube - a canal connecting the nasal cavity and the middle ear.

It is she who is responsible for regulating the amount of secretion and for its correct and timely removal from the middle ear. If the functioning of the Eustachian tube is impaired, then the likelihood of getting secretory otitis media is quite high.

According to statistics, secretory otitis in children develops much more often and faster than in adults. It mainly affects children between the ages of two and eight years.

This phenomenon is explained by the process of active interaction with the outside world.

It is quite easy for a professional doctor to identify ear inflammation in the early stages of the disease. However, for some parents this will be a very problematic activity, since they will be faced with this problem for the first time.

Secretory otitis is a fairly common disease in young children, so it is worth familiarizing yourself with the structure of the ear and finding out why ear inflammation may occur in a child.

The middle ear is separated by a strong membrane (the eardrum) and consists of three tiny bones:

Hammer.
Anvils;
Stirrups.

These are the smallest bones in the human body. They are only a few millimeters long. The stirrup, for example, is only 4 millimeters long. This cavity connects to the nasopharynx through a narrow passage (Eustachian tube). This, in turn, allows you to equalize the pressure on the eardrum.

Features of the inflammatory process

Otolaryngologists do not classify secretory otitis as a purulent process accompanied by inflammation and decreased performance of the auditory analyzer. In case of stable spread of the disease in the ear cavity, after some time it will reach the Eustachian tube. The mucous membrane then swells, causing obstruction and infection of the ear, and the eardrum becomes inflamed.

The most common causes of ear inflammation in a child are:

introduction of any infections into the ear cavity;
manifestation of allergic reactions;
the appearance of adenoids, polyps;
weak immunity in the child;
excessive contact with cold water;
predisposing environmental environment;
frequent diseases of the nose and throat (frontal sinusitis, sinusitis, sore throat).

A deviated nasal septum may also be a predisposing factor for the appearance of secretory otitis media. If it is in the wrong position, then the outflow of fluid will be impossible and it will accumulate, leading to secretory otitis media.

Symptoms

There are unilateral and bilateral pathological processes.

As a rule, the symptom of secretory otitis in adults and children manifests itself in the same way. Signals about the course of the inflammatory process are quite varied, but there are a number of the most common signs of secretory otitis:

the appearance of extraneous noise and pressure in the ear;
severe hearing loss when tilting the head to the sides;
feeling of ear fullness;
hearing one's own voice in the ear (autophony);
sensation of fluid flowing in the ears when turning the head.

However, despite these unpleasant sensations, the general condition of the body does not change, the temperature does not rise, and there are no external pains. It is necessary to pay attention to this, since the false harmlessness of the course of the disease can dissuade a person from going to the doctor, and advanced stages of secretory otitis develop into much more complex and dangerous forms of the disease.

If you delay going to the otolaryngologist and endure discomfort in the ear for weeks, complications will soon appear in the form of severe headaches and intoxication of the ear canals.

Stages of the disease

There are several stages in the development of the disease:

Catarrhal stage. Inflammation (and therefore thickening) of the eardrum occurs, and the light effect disappears. During swallowing, the patient experiences clicking sounds, and there is an imperceptible deterioration in the audibility of sounds.
Secretory stage. In this case, the accumulation of mucus in the middle ear blocks the passage of sound waves. It is because of this that the effect of congestion appears, extraneous noise in the ear, and hearing impairment becomes noticeable.
Mucosal stage. Thick exudate accumulates in the tympanic cavity. There is no pus. The patient's pain intensifies and severe hearing loss appears.
Fibrous stage. Fluid is removed from the middle ear, and hypertrophy of the mucous membrane begins to develop. Adhesive otitis media forms. Hearing loss reaches stages 1–3.

Each stage can last several months or even years. To identify the stage of the disease, the doctor conducts a thorough examination of the ear cavity and prescribes an x-ray.

There are three stages of secretory otitis depending on the time of the disease:

Acute (about twenty-one days).
Subacute (lasts from 3 weeks to 2 months).
Chronic (more than 2 months).

In children, secretory otitis often develops as a result of viral infection of the nasopharynx. After the main illness is cured, it resolves without the use of medications.

You need to be especially careful with children, since in most cases they do not complain about the discomfort that arises. In this regard, there is a risk of detecting the disease at an advanced and untreatable stage.

To prevent such a result, it is important to pay attention to the following signs that likely indicate the development of secretory otitis media:

the child pronounces words incorrectly or does not speak at all;
often asks again;
asks to increase the volume on the TV, computer, phone;
does not answer if someone calls him loudly from the next room;
answers inappropriately during lessons at school.

The possibility cannot be ruled out that such behavior is only a manifestation of negative character traits (disobedience), but for greater confidence and peace of mind, it is advisable to consult an otolaryngologist.

Possible complications

It is advisable to identify any form of secretory otitis when it is in the initial stages. The chronic form of the disease usually leads to severe hearing loss, as a result of which degenerative changes occur.

For children, it is especially important to start treatment early. The long course of the disease prevents the child from fully developing, as he ceases to hear the sounds around him. This interference can affect psychological health. And there is not always a chance to hear missing information again.

Diagnostics

If secretory otitis is suspected in a child, a visit to an otolaryngologist is carried out. He carries out diagnostics using special measures:

otoscopy;
endoscopy of the nasopharyngeal cavity;
audiometry;
impedance measurements;
otoacoustic emissions.

A specific procedure is prescribed by a doctor after analyzing the patient’s complaints and a general examination of the ear cavity. Carrying out these measures will help to determine the condition of the internal components, the degree of hearing loss and prescribe the correct treatment.

Treatment

The disease can be cured at any stage; it is only important to prescribe drug therapy as quickly as possible. There are two methods of prevention that help prevent the development of secretory otitis media.

Firstly, parents need to monitor the child’s complete recovery during infectious diseases occurring in the nasal sinuses (for example, sinusitis, rhinitis). Second, help the mucus leave the tympanic cavity through the Eustachian tube using an ear catheter. This procedure is performed exclusively by an otolaryngologist.

Effective treatment requires proper ventilation of the eardrum and correction of the ear canal.

They will help stabilize the pressure, drain the cavity and allow fluid to exit through the nasopharynx.

There are several methods for treating secretory otitis media:

use of ear drops;
prescribe antihistamines and vasoconstrictors (to treat the boundaries of the auditory canal);
warming, blowing and lasers in the absence of a source of infection;
antibiotics are prescribed (in the presence of microbes leading to accumulation and thickening of fluid).

If this therapy is ineffective, artificial drainage is prescribed. It involves puncturing the eardrum and rinsing the middle ear with antiseptics and antibiotics.

In quite rare situations, the otolaryngologist uses artificial bypass.

For better treatment, you can use traditional medicine. One of the proven ways to achieve a speedy recovery is to insert cotton wool soaked in a solution of propolis and Kalanchoe juice into the ear.

Another recipe involves regularly instilling tea tree oil and sunflower oil into the ear canal. For warming, use a compress of calendula tincture.

Prevention

To ensure protection of the ear cavity from the appearance of not only secretory otitis media, but also other ear diseases, the following recommendations of doctors must be followed:

visit an otolaryngologist every year;
maintain a sleep schedule, eat healthy and healthy, engage in active activities to strengthen the immune system;
in the cold season, always wear a hat and prevent the child’s body from becoming hypothermic;
try to avoid direct contact with sick people;
use special means during bathing to protect your ears from water.

If you suspect the appearance of secretory otitis media, it is important not to self-medicate, but to contact a specialist in time to conduct tests to detect the presence of the disease. Otherwise, there is a chance to cause complications, the treatment of which will have to invest much more effort and time.

Source: https://DeteyLechenie.ru/lor-zabolevaniya/sekretornyj-otit.html

Therapy in children

Methods for combating secretory otitis are not much different from therapy for adult patients. The only difference is that the drugs are selected based on the age group. It is also important to get rid of the cause of otitis media at the beginning of treatment. If this is a prolonged runny nose, then rinsing the nasal passages with solutions with the addition of sea salt (AquaMaris, Dolphin, Humer) and vasoconstrictor drops (Nazivin, Otrivin) is prescribed. If the runny nose is of allergic origin, antihistamines (Clarotadin, Fenkarol, Suprastin) are used.

If secretory otitis media is accompanied by the presence of bacterial microflora, antibiotics (Amoxiclav, Augmentin, Sumamed) may be prescribed. At the discretion of the doctor, medications are used topically (drops Anauran, Sofradex, Normax) and in a general manner. Read more about treating otitis media with antibiotics →

Physical procedures are also effective in childhood. These include gargling with Miramistin, rinsing and blowing. If all methods of treating otitis are ineffective, surgical intervention is indicated. This may be an operation to remove pathological formations in the nasopharynx or a puncture of the eardrum to ensure the outflow of fluid.

Secretory otitis: causes, symptoms, treatment, possible complications

Secretory otitis is considered a childhood disease. In adults, the disease is rare, but is severe. Otitis media is the main cause of hearing loss. Moreover, noticeable consequences do not appear immediately. Treatment of this disease should be carried out under the guidance of a doctor.

What is secretory otitis media

In the human ear there is the Eustachian tube, which performs the function of exchanging air between the outside world and the middle ear. When infection develops in it and stagnation occurs, hearing deteriorates.

Secretory otitis is a disease of the middle ear with the release of non-purulent secretion. This disease is characterized by imperceptible hearing loss and the absence of pronounced pain. This form of the disease does not deform the eardrum.

The discharge at the beginning of the disease is quite liquid and not always noticeable; as the disease progresses, it becomes viscous. If otitis media is not immediately noticed, then after six months the hearing loss becomes noticeable. If left untreated, after two years irreversible consequences occur and hearing cannot be restored.

Features of the disease

Secretory otitis media in children is a disease that children do not complain about. For this reason, parents consult a doctor when hearing loss is detected. If otitis media develops on one side, the hearing loss is almost imperceptible. Criteria that you should pay attention to in order not to miss secretory otitis media:

the child does not speak at the age of three;
there are many incorrect words in speech;
often asks again;
does not respond to low-level speech;
asks to increase the volume;
does not respond from another room;
inattentive in class.

All symptoms of otitis development are nonspecific, but parents should pay attention to them if they have not existed before. Consulting a specialist will help you find out the cause.

Otitis in adults

Secretory otitis in adults is quite rare. This insidious disease is dangerous because people lose their vigilance and do not get checked by an otolaryngologist even if they have symptoms. Tinnitus is attributed to pressure, discharge from the ears is ignored.

There is also no pain, fever or discomfort. The main cause of the disease in adults is considered to be a decrease in the body's defenses. Therefore, older people are more susceptible to it than everyone else.

As the disease progresses, hearing decreases, which is attributed to age-related changes. In advanced cases or bilateral otitis media, a person hears almost nothing. To prevent the disease in adults, regular medical examinations are recommended. If sounds appear that were not there before, you should consult a doctor.

Treatment with medications

The treatment method for secretory otitis is selected based on the stage of the disease, severity of symptoms, causes and general condition of the patient. Modern medicine welcomes conservative or surgical intervention.

Therapy for otitis media involves restoring the patient's hearing. With constant relapses of secretory otitis, surgical treatment is possible to artificially remove accumulated secretions.

The use of medications is the main method of treatment. If otitis is caused by a bacterial infection, then antibiotic therapy is indicated. The main form of medication is ear drops. Additionally, the doctor prescribes medications to speed up recovery:

antihistamines that relieve swelling;
drugs to restore ear secretory function;
for nasal congestion - vasoconstrictor drops to normalize the pressure in the nose and ears;
with a persistent decrease in immunity in adults, it is possible to take immunostimulants.

If necessary, blowing of the auditory tube is prescribed. In case of pronounced swelling, the following procedures are used to restore hearing and prevent additional infection:

physiotherapy with calcium gluconate;
ultrasound procedures;
infrared radiation treatment;
laser exposure.

Surgical treatment of otitis media

If conservative methods do not bring results, then surgical intervention is resorted to. As a rule, difficulties in treating otitis media arise in the presence of adenoids, polyps, or a deviated septum. In other cases, drug treatment produces a positive effect.

The operations are performed in a hospital setting under general anesthesia. During the operation, thick contents are removed and secretory function is restored.

Basic methods of surgical treatment:

Tympanotomy is used to open the eardrum. Combined with middle ear bypass. The method is used when there is a large accumulation of discharge and it is impossible to remove it in any other way. Allows you to clean the middle ear and reduce the likelihood of relapses.
Myringotomy is required to restore pressure in the eardrum. The method removes fluid from the middle ear. When treating secretory otitis in a child, it is used only in case of severe swelling or complications. This procedure can prevent rupture of the eardrum.
Tympanopuncture is a puncture of the eardrum to diagnose a pathogen or for therapeutic purposes. This method does not cause damage to the middle ear. For secretory otitis it is used rarely and for diagnostic purposes.

Folk remedies

In the fight against secretory otitis media, you can use folk remedies that provide the best effect in combination with medications. In this case, the patient should not be allergic to the drug. It is forbidden to warm up the sore ear, so as not to provoke the active development of bacteria. Before using folk remedies, you should consult a doctor.

The following recipes bring the best results in the treatment of otitis:

Squeeze aloe juice from a chilled leaf and make a lotion daily.
Grind a Kalanchoe leaf, wrap it in gauze and hold it in the ear for 30 minutes.
Mix two parts water and one part honey. Instill into the sore ear once a day.
Moisten a cotton swab with propolis tincture and stick it into the sore ear. You should lie down on the healthy side. Keep the tampon in place for at least five minutes.
Crushed fresh mint leaves are poured with half a glass of vodka and left for a week. After filtering, you can use it as a compress on the affected ear.
Place two drops of beet juice into the ear three times a day.
Crushed St. John's wort leaves are poured into 100 ml of water. A compress is applied daily. Not recommended for use in children.
A piece of garlic placed in the ear helps with large accumulations of discharge.
A decoction of celandine has antimicrobial properties and is used for all types of otitis.
Calendula tincture is used for compresses twice a day.

Complications

The insidiousness of this disease lies in the fact that it is difficult to determine at the initial stage. Treatment of bilateral secretory otitis in a child begins at the moment when the baby no longer hears well, that is, the mucous or fibrous stage of otitis begins. The accumulated liquid becomes thick and the outflow stops completely. This may reduce tinnitus.

Complications resulting from otitis media include hearing loss. The smaller the baby, the more difficult it is to diagnose the disease and the higher the risk of developing hearing loss. With advanced otitis and lack of treatment, irreversible processes begin, and hearing disappears forever.

Complications

If secretory otitis is not diagnosed in a timely manner and, accordingly, not treated, the disease gradually progresses. Considering the form of pathology, it transforms into the mucosal stage. In this case, the accumulated liquid thickens. The squelching sensation goes away when you tilt your head, but your hearing decreases. After some time, degenerative changes begin.

According to statistics, a long course of otitis media in early childhood is especially dangerous. A child is unable to develop normally without hearing the sounds around him. Against this background, the baby may lag behind in psychological development. Not in all cases, lost information can be compensated for after recovery.

Features of otitis media in children

The main problem with the disease in children is the almost imperceptible manifestation of symptoms. This often leads to the diagnosis of otitis already at an advanced stage. Hearing loss in children may go unnoticed if there are no complaints from the child.

In order to detect the disease in a timely manner, it is necessary to pay attention if the child often asks again, mispronounces many words or is silent for a long time. These signs may appear due to the individual characteristics of the child, but if they are present, it is better to consult a specialist for diagnosis.

Prevention

Doctors have developed a set of rules and measures to reduce the likelihood of developing secretory otitis media:

Planned systematic examinations of children in kindergartens and schools are provided. Adults are also regularly examined by specialists during a medical examination.
Doctors recommend strengthening the immune system by hardening, proper nutrition, and exercise.
People diagnosed with Eustachian tube dysfunction are not recommended to take a job that involves changes in atmospheric pressure.
During the cold season, you should wear a hat and avoid hypothermia.
It is necessary to minimize contact with infected people (flu, ARVI).
When swimming in open water, you should use means to protect your ears from water.

Although the disease does not cause acute pain or fever, you should not try to treat it yourself. It is unprofessional actions that most often lead to the transition of the acute stage to the chronic form and the development of complications.

Author: Tatyana Grosova, nurse, especially for lechim-gorlo.ru

Secretory otitis media

Common ear diseases at the age of 2-8 years include secretory otitis media.
The cold period of the year is a popular time for the development of pathology: viral infections, low temperature and low immunity give impetus to the occurrence of the disease.

Since without adequate treatment, secretory otitis media leads to irreversible hearing loss, timely diagnosis and treatment avoid complications and secondary infection.

What is secretory otitis media

Based on location, otitis is divided into 3 forms: internal, middle and external. The middle ear includes secretory otitis - a pathology associated with excessive formation and stagnation of exudate in the middle ear.

During normal functioning of the organ of hearing, fluid is produced by the epithelial layer and is excreted through the eustachian tube through the nose.

But if the patency of the auditory tube is reduced due to adenoid vegetations, polypous growths or cancerous formations, the exudate does not come out, but stagnates in the middle ear cavity, causing inflammation and excessive secretion. This is how secretory otitis media develops in a child.

The discharge at the beginning of the disease is liquid, thickening as the pathology develops. Ventilation in the auditory tube is disrupted, negative pressure is formed in the tympanic area: the membrane and auditory ossicles gradually lose functionality.

After six months, the patient experiences hearing loss that progresses over time.

If you do not contact an otolaryngologist during this period, the inflammation decreases, but irreversible changes in the hearing organ provoke hearing loss that is not subject to conservative therapy.

Secretory otitis in a child is difficult to diagnose at first. Parents do not notice the manifestations of the disease, since it is truly asymptomatic, and fever and complaints of ear pain in the baby are rare.

For this reason, 80% of cases of pathology detection occur in an advanced stage. Compared to the clinical picture in adults, secretory otitis media in children in 8 out of 10 cases develops unnoticed.

Therefore, diagnostic measures that can establish secretory otitis media in children come to the forefront before surgical intervention is required for cure.

Let us consider in detail the reasons for the appearance of pathology.

What is secretory otitis media?

Why does the disease develop?

Most often, children 2-8 years old are susceptible to pathology due to incompletely formed components of the hearing aid:

The Eustachian tube in babies is not long and narrow, which makes it difficult to move exudate;
a child’s immunity is weaker than an adult’s, as a result of which infection occurs faster;
up to 14 years of age, children’s tonsils are subject to frequent inflammation (adenoiditis), which leads to a narrowing of the lumen of the Eustachian tube;

In addition to the above prerequisites, secretory otitis in adults and children is caused by the following features:

allergic manifestations that produce hyperemia of the epithelium of the middle ear and accelerate the production of exudate;
inflammation of the nasal and oropharynx (sinusitis, pharyngitis, rhinitis, tonsillitis);
formations on the epithelial tissue of the nasal passages (polyps, scars, tumors);
chronic diseases of the auditory tube, leading to a decrease in its patency;
congenital deformities of the Eustachian tube;
curvature of the nasal septum (due to injury or surgery);
pathology “cleft palate”;
forced stay in a lying position, leading to mild infection of the middle ear;
frequent contact with water, which allows water to enter the ear canals and leads to the development of bilateral secretory otitis media;
reduced resistance and unfavorable environmental conditions (weak ecology).

Otolaryngologists have not reached a consensus on whether secretory otitis media is provoked by an infectious agent. On the one hand, bacteriological culture of ear discharge did not reveal infectious provocateurs and the non-purulent form of the disease indicates their absence. On the other hand, it has been proven that the activity of adeno- and rhinoviruses, as well as streptococci, can give rise to pathology.

Sinusitis is one of the causes of the disease.

How to recognize the disease

Manifestations of the disease are similar for adults and children and are manifested by the following symptoms:

often manifested ear congestion that occurs when the angle of the head changes; pressure and feeling of “beating” in the ears;
hearing loss when turning the head or lying down;
feeling of fluid moving inside the ear when turning the head;
tinnitus that occurs spontaneously;
hearing one's own voice “inside” the ear (autophony).

These symptoms seem harmless, especially in the absence of fever, pain, and external manifestations in the form of profuse suppuration. In this case, both one ear (unilateral secretory otitis) and both at once (bilateral process) appear in the affected area.

Symptoms of secretory otitis in a child are lost against the background of a progressive viral or bacterial disease - tonsillitis, pharyngitis, ARVI, parainfluenza. The clinical signs of these diseases disappear as the patient recovers, creating a misleading picture of complete healing. But there are several characteristic manifestations of childhood pathology that serve as a reason to contact an otolaryngologist:

the baby does not respond to calls, words are pronounced incorrectly in conversation;
the child regularly asks to repeat what was said;
Requests to increase the volume when listening to audio or playing on educational computers are becoming more frequent;
does not hear requests if the baby and parents are in different rooms;
In school and preschool institutions, complaints about “inappropriate” answers are becoming more frequent.

Of course, the above symptoms do not always indicate pathology and in some cases characterize the individual characteristics of the child’s behavior.

Therefore, it is important for parents to make sure that the signs do not confirm a decrease in auditory interaction with the environment.

This requires a medical diagnosis, since some of the symptoms are difficult to establish independently (for example, the baby is unlikely to explain even obvious autophony to his parents).

Noise in ears.

Stages of the disease

In the development of the disease, otolaryngologists describe 4 stages:

catarrhal (up to 30 days): manifested by hyperemia of the epithelial tissue of the Eustachian tube, the anatomical features of which in a child contribute to the narrowing of the patency of the mouth and stagnation of the discharge inside; the inflammatory process affects the eardrum; patients experience some hearing loss and internal clicking sounds when swallowing;
secretory (10-12 months): swollen mucosa produces liquid exudate that covers the auditory ossicles and interferes with the conduction of sound waves; under fluid pressure, the eardrum bulges and stretches, causing noise and a feeling of pressure in the ears; in children, stage 2 with bilateral otitis media causes an increase in temperature to the febrile level, irritability and nervousness, in adults - a noticeable deterioration in hearing;
mucosal (1-2 years): the anatomy of the auditory (Eustachian) tube does not allow the removal of a large amount of exudate, causing it to break through the eardrum; the patient in the 3rd stage feels relief - the headache goes away, the noise in the ears disappears, excessive pressure disappears, and an erroneous judgment appears that the disease is receding; but suddenly there is severe pain in the ears, auditory perception deteriorates;
fibrous (more than 2 years): the final stage, characterized by the discharge of discharge from the middle ear, the formation of ties between the auditory ossicles, scarring of the rupture of the eardrum; The patient has stage 2-3 hearing loss.

When contacting an otolaryngologist, he identifies additional signs of illness in a child that are not available for self-diagnosis:

the eardrum is thinned and stretched so that it is almost invisible (stage 2-3);
adhesions and scars on the membrane, indicating a previous rupture (stage 4);
discharge of non-purulent origin;

Having made sure that the symptoms indicate secretory otitis in the baby, the otolaryngologist prescribes treatment based on the diagnostic results and an assessment of the child’s medical history.

Treatment of secretory otitis in children

Treatment of the disease involves the use of:

drug treatment;
physical procedures;
surgical intervention;
folk remedies.

Drug treatment

It is performed under the supervision of an otolaryngologist after the diagnosis has been established. Main goals of treatment:

identify the cause that provoked secretory otitis media and eliminate it as soon as possible;
restore hearing functions by reducing secretion and reducing intra-ear pressure;
removing discharge from the ear cavities;

Medication prescriptions are effective in the case of early diagnosis of the disease in children, when it has not become chronic. In this case, the following is effectively used:

nasal decongestants (drugs that promote vasoconstriction and relieve hyperemia of the auditory tube) - 0.05% solution of xylometazoline, Phenylephrine, Ximelin, Dlynos, Naphthyzin, Galagozin;
ear drops that relieve pain and act as antiseptics - Otinum, Sofradex, Otipax, Anauran;
mucolytics that thin out exudate - Acetylcysteine, Acetal, Asibrox;
antibacterial therapy in case of purulent discharge - Amoxicillin, Fenspiride, Biseptol, Otofa;
immunomodulators - Derinat, Anaferon, Dibazol.
antiviral drugs - Influvac, Imudon.

The therapeutic protocol must be strictly followed even with positive dynamics: canceling prescriptions, replacing medications, or using them independently is prohibited.

Drug treatment.

Physiotherapy

Shows good results when combined with medication prescriptions. Among the methods used, those that are effective for secretory otitis in children are the following:

electro- and phonophoresis;
laser therapy for the damaged ear;
infrared radiation;
electric massage at the mouth of the auditory tube;
blowing of the Eustachian tube using the Politzer method;
rinsing the ear canals with a warm solution of hydrogen peroxide;

Surgical intervention. Recommended in the absence of positive dynamics from conservative treatment or when stage 4 secretory otitis is established (overgrowth of fibrous tissue). To do this, a saline solution under pressure is injected into the cavity of the tube through a thin probe, which helps wash out the mucous exudate.

If necessary, medicinal drugs are administered into the tympanic cavity using a similar technique (Dioxidin, Trypsin, Lidaza). As a last resort, the otolaryngologist artificially pierces the eardrum, installing a temporary drainage that allows the free flow of secretions.

The vacated cavity is treated with antiseptics and antibiotics.

If the disease is identified in an advanced form with persistent hearing loss, surgical intervention is performed to remove adhesions on the eardrum. If the functioning of the auditory ossicles is impaired, they are excised and replaced with artificial ones. Removal of atypical growths of lymphoid tissue and foreign formations of the mucous membrane helps to improve the child’s condition.

Folk remedies. They are characterized by supportive and preventive functions and do not act as independent treatment methods. Popular manipulations include:

washing the ear canals with hydrogen peroxide: the procedure is carried out both in a hospital setting and at home, the principle of action is based on the properties of peroxide to dissolve ear discharge; to obtain the effect, 2 ml of peroxide is injected into each ear, waiting for the reaction to complete (the solution in the ear stops hissing and foaming);
in the absence of purulent exudate, lotions with warm vodka are used: the effect of temperature dilutes the secretion and promotes its waste;
Applications of decoctions of medicinal herbs have a similar effect: gauze moistened with a warm decoction is applied to the sore ear until it cools;
instillation of aloe juice, Kalanchoe, water-honey solution, propolis into the ears (the latter remedies are acceptable in the absence of allergies to bee products);

Before using traditional methods, consultation with an otolaryngologist is necessary: temperature exposure is unacceptable if a purulent form of otitis is suspected. In addition, an increase in temperature locally during secretory otitis promotes increased mucus production and increased hyperemia of the mucous membranes.

Based on the above, depending on the stage of the disease, the ENT specialist develops an individual treatment protocol. In the absence of positive dynamics, repeated diagnostics are performed to identify the etiology of the pathogen.

Laser therapy on the damaged ear.

Forecast

With timely detection of pathology and adequate therapy, improvement in condition is observed after 5-8 days. Full recovery is expected in 2-4 weeks: hearing is restored and the discharge of exudate stops.

Complications

Common complications of secretory otitis are caused by improper treatment or lack thereof. These include:

transition of the disease into a chronic form with long periods of remission;
with the addition of a bacterial infection, the development of purulent otitis;
rupture of the eardrum;
mastoiditis and meningitis;
brain abscess;
destruction of the auditory ossicles and irreversible hearing loss;

Mastoiditis.

Preventive actions

The basic rules for preventing pathology include:

prevention of upper respiratory tract diseases;
maintaining ear canal hygiene;
increasing the resistance of the child’s body by taking vitamin and mineral complexes, developing hardening skills, and maintaining an active lifestyle;
Due to the difficulty of identifying secretory otitis in children, regular preventive examinations by an otolaryngologist are recommended, especially if the child frequently complains of ear congestion.

Remember: the disease is curable at any stage, but the earlier therapy is started, the more effective the treatment will be. And preventing pathology using preventive methods is much easier than curing it.

What is secretory otitis media? The answer to this question can be found in the video.

Source

Source: https://neosensys.com/lor/sekretornyy-otit/