Symptoms of exudative otitis media

One of the features of the serous form of the inflammation of the middle ear is a latent flow. The first signs are smeared, so it is not always possible to recognize them. At the first stages of development the disease has such manifestations:

• Decreased acuity of hearing.
• Ejaculation and sensation of noise.
• Nasal congestion.
• Sensation of pouring fluid in the ear.

Acute pain and fever do not always make themselves felt. Therefore, at the first signs of hearing loss, you should consult an otolaryngologist. Early diagnosis and treatment of exudative otitis avoid many complications.

[1]

Stages

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

1. Catarrhal - characterized by catarrhal inflammation of the mucosa of the auditory tube. At this stage there is a violation of ventilation functions, that is, air intake in the middle ear. The mucous membrane absorbs air, because of which a vacuum builds up in the tympanic cavity and the transudate is collected. The patient notes a slight decrease in hearing acuity. The duration of this stage is about 1 month.
2. Secretory - in the tympanic membrane, mucus accumulates, the number of secretory glands increases. There is fullness, pressure and noise in the ear. In some cases, patients experience a feeling of fluid transfusion when the head position changes and the hearing deteriorates. The duration of the stage is from 1 month to a year.
3. Mucous - the contents of the tympanum and other cavities of the middle ear become viscous and dense. The hearing loss increases, the thresholds of bone conduction of sounds are raised. If the entire cavity is filled with a viscous exudate, then when it is touched with cotton wool, it is pulled back by a thin thread several dozen centimeters. Because of this symptom, this stage is called "sticky ear". The eardrum thickens, its cyanosis is possible. Duration of mucosis is 1-2 years.
4. Fibrous - degenerative processes predominate in the mucosa of the tympanic cavity. Gradually decreases, and through time and completely stops production of mucus, which leads to fibrous degeneration of the mucous membrane and auditory ossicles. Mixed hearing loss progresses. In the tympanic cavity, scars form which cause the adhesive middle otitis.

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

[2], [3], [4], [5], [6],

Acute exudative otitis media

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

Symptoms of acute "sticky" ear persist for 3 weeks and are manifested by such reactions:

• Shooting pains that turn into a feeling of bursting.
• Noises and stuffiness of the ear.
• Increased body temperature.
• Vestibular disorders.
• Deterioration of general well-being.

Adequacy of treatment of acute inflammation is based on accurate diagnosis, which consists of instrumental and laboratory methods. For treatment appoint medication, physiotherapy, massage procedures. If there are signs of suppuration, then surgery is shown to cleanse the tympanum and restore the functions of the hearing organ.

[7], [8], [9]

Chronic exudative otitis media

Recurrent inflammation of the mucosa of the tympanic cavity with increasing deterioration of hearing is a chronic exudative otitis media. Most often the disease is bilateral, and in 20% of cases it occurs in patients from 2 to 5 years, but can be detected in adults.

The main causes of the disorder include:

• Obstruction of the mouth of the Eustachian tube.
• Disturbance of airway and drainage function of the auditory tube.
• Decrease in pressure in the tympanum.
• Diseases that violate the outflow of secretions from the paranasal sinuses.
• Diseases that cause swelling of the nasopharyngeal mucosa.
• Congenital malformations of the facial skull.

Very often the disease manifests itself against the background of inflammatory processes in the upper respiratory tract. Patients report the occurrence of transient low-intensity pain in the ears, which are given to the whiskey. There is also a decrease in hearing acuity.

Therapeutic tactics consists in eliminating disturbances in the patency of the auditory tube, eliminating inflammatory changes in the tympanum and restoring hearing. Particular attention is paid to the prevention of irreversible sclerotic changes in affected tissues and structures.

[10], [11], [12], [13],

Forms

Exudative form of inflammation of the middle ear has several types, consider them:

1. External otitis - an infectious lesion of the external auditory canal. It manifests with pain, itching, swelling and discharge of serous fluid from the skin of the external auditory canal. It develops due to the infection of tissues during their traumatization, as well as the ingression and accumulation of moisture in the ear canal.
2. Middle - inflammation of the middle ear, manifests acute pain, which can give to other organs. Occurs because of the infiltration of infectious agents into the tympanum or in the hematogenous spread of bacteria. This form has several subspecies:
   1. Acute - often has a viral origin and occurs with infectious diseases of the upper respiratory tract. It is manifested by ear congestion and discomfort. It requires antibacterial therapy, since without treatment it can damage the eardrum and other internal structures of the hearing organs.
   2. Exudative - develops due to occlusion of the lumen of the auditory tube and pressure decrease in the tympanic cavity. Occurs when viral and bacterial pathogens are active. It is manifested by the accumulation of viscous exudate in the ear canal, which leads to the development of hearing loss.
   3. Chronic purulent - due to the action of pathogenic microorganisms in the tympanic membrane, an aperture is formed due to which progressive hearing impairment develops.
   4. Labyrinthitis is an internal otitis, that is an inflammation of the inner ear. It is extremely rare. Often acts as a complication of the above forms of otitis or because of severe infectious disease, trauma. The main danger of this form is irreversible brain damage.

In addition to the above forms, diffuse otitis media - inflammation of the tissues of the external auditory canal with damage to the auricle and skin near the auricle. Also there is bullous inflammation, which develops against the background of acute respiratory viral infection and manifests bloody vesicles (bullae) on the tympanic membrane.

Adhesive otitis occurs with prolonged inflammation and is manifested by the formation of scars and cohesive 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 removal of yellow, viscous secretions, decreased acuity of hearing, autophony. Each of the above types of otitis requires a comprehensive diagnostic and treatment approach.

[14], [15], [16], [17], [18], [19], [20]

Exudative otitis media

Sectoral, serous or exudative otitis media is an otolaryngic disease caused by occlusion of the auditory tube and a decrease in pressure in the tympanum. Occurs when exposed to a viral or bacterial infection with a further transition into a purulent form.

Treatment is complex with pharmacotherapy and physiotherapy. If you leave the inflammation without treatment, it can lead to a conductive or neurosensory type of hearing loss, vestibular disorders and other complications.

[21], [22], [23]

Bilateral exudative otitis media

Inflammation of the middle ear with congestion in its cavity of a viscous secret is an otitis exudative form. Bilateral lesion occurs more often than a unilateral pathological process. The danger of the disease is its complications, which can be prevented with timely diagnosis and treatment.

Signs of bilateral lesions are equally manifested in both children and adults:

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

In some cases, the disease causes attacks of nausea and vomiting, an increase in lymph nodes. In severe course, purulent discharge from the ear can be possible.

The pathological process is directly related to the decrease in the protective forces of the immune system and the supercooling of the body. The risk factors include various chronic diseases. Disease-causing microorganisms penetrate into the auditory tube and the middle ear cavity.

Treatment begins with the establishment of the cause of the disease and pathogens. If otitis is caused by a chronic disease of the body, then the therapy is directed at its elimination. Patients are prescribed anesthetic ear drops with antibacterial properties, systemic antibiotics and other medications. 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.

[24], [25], [26], [27]

Right-sided exudative otitis media

Exudative otitis of the right ear is an inflammatory process that affects the tissues of the tympanic membrane, the mastoid process and the auditory tube. This disease is sick at any age, but more often children.

The "sticky" ear develops due to the action of various microorganisms: staphylococci, streptococci, viruses, fungi. Bacteria penetrate into the middle ear through the auditory tube and can cause inflammation in the nose and paranasal sinuses, the nasopharynx. In rare cases, the disease develops when infected due to injuries of the tympanic membrane or through the blood in 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 aimed at maintaining the severity of hearing is performed.

Left-sided exudative otitis media

Inflammation of the middle ear with the same frequency occurs both on the left and on the right side. The peculiarity of the disease is the accumulation in the ear cavity of a viscous secretion. An unpleasant condition can be asymptomatic, and the only sign of a pathology is a progressive decrease in hearing acuity.

Left-sided exudative inflammation can take place in both acute and chronic form. 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:

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

Local factors of the disease include mechanical or functional disturbance of the ventilation properties of the auditory tube. Similar occurs at a hypertrophy of a pharyngeal tonsil or inflammatory processes in her.

The tactics of treating left-sided lesions consists of eliminating the causes and factors that caused disturbance of the auditory tube. Also, procedures are prescribed to restore the hearing and prevent morphological processes in the middle ear. To do this, physiotherapy is performed. Particular attention is paid to the drug component of treatment. The doctor prescribes drugs for the destruction of pathogens and the strengthening of local, general immunity.