Symptoms of exudative otitis media

One of the features of the serous form of inflammation of the middle ear is its latent course. The first signs are blurred, so it is not always possible to recognize them. In the early stages of development, the disease has the following manifestations:

• Decreased hearing acuity.
• Ear congestion and sensation of noise.
• Nasal congestion.
• A feeling of fluid flowing in the ear.

Acute pain and high temperature do not always make themselves known. Therefore, at the first signs of hearing loss, you should contact an otolaryngologist. Early diagnosis and treatment of exudative otitis can avoid many complications.

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Stages

Depending on the severity of the inflammatory process and pathomorphological changes, the following stages of exudative otitis are distinguished:

1. Catarrhal - characterized by catarrhal inflammation of the mucous membrane of the auditory tube. At this stage, there is a violation of ventilation functions, that is, the flow of air into the middle ear. The mucous membrane sucks in air, causing a vacuum to build up in the tympanic cavity and transudate to accumulate. The patient notes a slight decrease in hearing acuity. The duration of this stage is about 1 month.
2. Secretory – mucus accumulates in the eardrum, the number of secretory glands increases. There is a feeling of fullness, pressure and noise in the ear. In some cases, patients note a feeling of fluid flowing when changing the position of the head and hearing deterioration. The duration of the stage is from 1 month to a year.
3. Mucous - the contents of the tympanic cavity and other cavities of the middle ear become viscous and thick. Hearing loss increases, the thresholds of bone conduction of sounds increase. If the entire cavity is filled with viscous exudate, then when touched with cotton wool, it is pulled by a thin thread for several tens of centimeters. Because of this symptom, this stage is called "sticky ear". The eardrum thickens, its cyanosis is possible. The duration of mucous is 1-2 years.
4. Fibrous - degenerative processes prevail in the mucous membrane of the tympanic cavity. The production of mucus gradually decreases and eventually stops completely, which leads to fibrous degeneration of the mucous membrane and auditory ossicles. Mixed hearing loss progresses. Scars form in the tympanic cavity, which cause adhesive otitis media.

The conducted studies indicate that the pathological process can stop at one of the stages and recur when adhesive inflammation has formed.

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Acute exudative otitis

This disease is most often a complication of acute respiratory viral infection, affecting the mucous membranes of the oropharynx, middle ear and auditory tube. It is more common in pediatric patients due to the anatomical features of the structure of their hearing and nose organs.

Symptoms of acute sticky ear persist for 3 weeks and are manifested by the following reactions:

• Shooting pains that develop into a feeling of distension.
• Noises and ear congestion.
• Increased body temperature.
• Vestibular disorders.
• Deterioration of general well-being.

The adequacy of treatment of acute inflammation is based on accurate diagnostics, which consists of instrumental and laboratory methods. For treatment, medications, physiotherapy, and massage procedures are prescribed. If there are signs of suppuration, then surgical intervention is indicated to cleanse the tympanic cavity and restore the functions of the hearing organ.

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Chronic exudative otitis

Recurrent inflammation of the mucous membrane of the tympanic cavity with increasing hearing loss is chronic exudative otitis. Most often, the disease is bilateral and in 20% of cases occurs in patients aged 2 to 5 years, but can also be detected in adults.

The main causes of the disorder include:

• Obstruction of the orifice of the Eustachian tube.
• Violation of the air-carrying and drainage function of the auditory tube.
• Decreased pressure in the tympanic cavity.
• Diseases that impair the outflow of secretions from the paranasal sinuses.
• Diseases that cause swelling of the nasopharyngeal mucosa.
• Congenital anomalies of the facial skull.

Very often the disease manifests itself against the background of inflammatory processes in the upper respiratory tract. Patients note the appearance of transient low-intensity pain in the ears, which radiate to the temples. A decrease in hearing acuity is also observed.

The treatment tactics consist of eliminating the obstruction of the auditory tube, eliminating inflammatory changes in the tympanic cavity and restoring hearing. Particular attention is paid to the prevention of irreversible sclerotic changes in the affected tissues and structures.

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Forms

The exudative form of inflammation of the middle ear has several types, let's consider them:

1. External otitis is an infectious lesion of the external auditory canal. It manifests itself as pain, itching, swelling and the release of serous fluid from the skin of the external auditory canal. It develops due to tissue infection when they are injured, as well as when moisture gets into and accumulates in the auditory canal.
2. Middle - inflammation of the middle ear, manifested by acute pain that can radiate to other organs. Occurs due to the penetration of infectious agents into the tympanic cavity or hematogenous spread of bacteria. This form has several subtypes:
   1. Acute - often has a viral origin and occurs with infectious diseases of the upper respiratory tract. Manifests itself as ear congestion and discomfort. Requires antibacterial therapy, since without treatment it can damage the eardrum and other internal structures of the hearing organs.
   2. Exudative - develops due to blockage of the lumen of the auditory tube and a decrease in pressure in the tympanic cavity. Occurs under the action of viral and bacterial pathogens. Manifested by the accumulation of viscous exudate in the ear cavity, which leads to the development of hearing loss.
   3. Chronic purulent - due to the action of pathogenic microorganisms, a hole is formed in the eardrum, which leads to progressive hearing loss.
   4. Labyrinthitis is an internal otitis, that is, an inflammation of the inner ear. It is extremely rare. It is often a complication of the above-mentioned forms of otitis or due to a severe infectious disease or injury. The main danger of this form is irreversible damage to the brain.

In addition to the above forms, diffuse otitis is distinguished - inflammation of the tissues of the external auditory canal with damage to the auricle and skin near the auricle. There is also bullous inflammation, which develops against the background of acute respiratory viral infections and manifests itself in bloody blisters (bullae) on the eardrum.

Adhesive otitis occurs with prolonged inflammation and is manifested by the formation of scars and adhesive formations on the tissues of the organ. Allergic damage to the middle ear can be a complication of acute or chronic inflammation. It is manifested by the discharge of yellow, viscous secretions, decreased hearing acuity, autophony. Each of the above types of otitis requires a comprehensive diagnostic and therapeutic approach.

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Otitis media with effusion

Sector, serous or exudative otitis media is an otolaryngological disease that occurs due to blockage of the auditory tube and decreased pressure in the tympanic cavity. It occurs when exposed to a viral or bacterial infection with subsequent transition to a purulent form.

Treatment is complex with drug therapy and physiotherapy. If inflammation is left untreated, it can lead to conductive or sensorineural hearing loss, vestibular disorders and other complications.

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Bilateral otitis media with exudation

Inflammation of the middle ear with accumulation of viscous secretion in its cavity is otitis exudative. Bilateral lesion is more common than unilateral pathological process. The danger of the disease is its complications, which can be prevented with timely diagnosis and treatment.

Signs of bilateral damage are the same in both children and adults:

• Painful sensations in the ears, radiating to the temporal region, jaw, and neck.
• Subfebrile body temperature.
• Noise, ear congestion and persistent hearing loss.
• Deterioration of general well-being.
• Vestibular disorders.
• Irritability.

In some cases, the disease causes nausea and vomiting, enlarged lymph nodes. In severe cases, purulent discharge from the ear cavity is possible.

The pathological process is directly related to the decrease in the immune system's defenses and hypothermia. Risk factors include various chronic diseases. Pathogenic microorganisms penetrate the auditory tube and the middle ear cavity.

Treatment begins with establishing the cause of the disease and pathogens. If otitis is caused by a chronic disease of the body, then therapy is aimed at eliminating it. Patients are prescribed pain-relieving ear drops with antibacterial properties, systemic antibiotics and other drugs. If conservative therapy does not bring the expected results, then surgical treatment is performed. The prognosis of bilateral inflammation depends on the correctness of the prescribed therapy and timely diagnosis.

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Right-sided exudative otitis

Exudative otitis of the right ear is an inflammatory process that affects the tissues of the eardrum, mastoid process and auditory tube. This disease affects people of any age, but most often children.

"Glue" ear develops due to the action of various microorganisms: staphylococci, streptococci, viruses, fungi. Bacteria penetrate the middle ear through the auditory tube and can cause inflammation in the nose and paranasal sinuses, nasopharynx. In rare cases, the disease develops when infected due to trauma to the eardrum or through the blood during infectious diseases of the body.

Treatment depends on the etiology of the disorder and consists of a course of drug therapy, physiotherapy and preventive measures. In particularly severe cases, surgical intervention is performed to preserve hearing acuity.

Left-sided exudative otitis

Inflammation of the middle ear occurs equally often on both the left and right sides. The peculiarity of the disease is the accumulation of viscous secretion in the ear cavity. The unpleasant condition may be asymptomatic, and the only sign of the pathology is a progressive decrease in hearing acuity.

Left-sided exudative inflammation can occur in both acute and chronic forms. In the first case, the acute course lasts about three weeks, and the chronic form is diagnosed 2-3 months after recovery.

The main causes of the disorder include:

• Reduced immunity
• Various allergic reactions and infectious diseases
• Unfavorable living conditions and poor ecology.

Local factors of the disease include mechanical or functional impairment of the ventilation properties of the auditory tube. This occurs with hypertrophy of the pharyngeal tonsil or inflammatory processes in it.

The tactics of treating left-sided lesions consists of eliminating the causes and factors that have led to disruptions in the functioning of the auditory tube. Procedures are also prescribed to restore hearing and prevent morphological processes in the middle ear. Physiotherapy is carried out for this purpose. Particular attention is paid to the medicinal component of treatment. The doctor prescribes drugs to destroy pathogenic microorganisms and strengthen local, general immunity.