What to do in case of otitis media?

When answering the question of what to do with otitis, it should be remembered that inflammation of the ear caused by infection can affect both its outer part (the ear canal) and the inner ear, but most often the inflammatory process occurs in the middle ear, that is, in the tympanic cavity and auditory tube.

Otitis media is one of the most common ear diseases (especially in children). It is accompanied by severe pain and is fraught with very dangerous complications, so you should know what to do with otitis.

What to do if your ear hurts due to otitis? Recommendations from otolaryngologists

ENT doctors divide otitis into acute and chronic, that is, short-term or long-term, as well as catarrhal and purulent - depending on whether there is discharge from the inflamed ear and what kind. It should be borne in mind that in any case, the main cause of inflammation of the middle ear is a bacterial infection (in the form of Staphylococcus aureus, pneumococcus, Haemophilus influenzae, etc.), as well as rhinoviruses, which affect the nasopharynx and then enter the ear cavity. The main way for these infections to enter the ear is through the auditory (Eustachian) tube, which connects the inflamed nasopharynx with the ear cavity.

What to do if a child has otitis? When a child has an earache, you need to go to an otolaryngologist, and if the doctor detects inflammation of the middle ear, then the recommendations will be as follows. It is necessary to insert a turunda (a wick twisted from a sterile bandage or cotton wool), moistened with boric alcohol (3% alcohol solution of boric acid), into the ear canal and change it every three hours. Also, a 0.1% solution of furacilin in alcohol or a mixture of 70% alcohol with glycerin (1:1) can be used to moisten the turunda.

Warming the ear with a blue lamp helps, as well as warming compresses on the ear: with vodka or half-diluted medical alcohol. In this case, the auricle should not be covered with a moistened napkin: the compress is placed around it and behind the ear, compress paper or any thin film is placed on top, and everything is “warmed” with a bandage or cap. The action time of such a compress is at least two hours.

If there is a runny nose - and it occurs in almost 95% of cases of otitis in children, so that the child can breathe through the nose, you should instill 1-2 drops in each nasal passage of drops such as Sanorin, Naphthyzinum, Nazivin, etc. - at least three times a day. Such drops are not used for children under one year old!

It is necessary to put special drops in the ear (which must be warmed up to body temperature before use). Otipax and Anauran drops, in addition to relieving inflammation, quickly relieve pain (due to the painkiller contained in the drug). Otipax can be used for infants, the standard dosage is 4 drops 2-3 times a day. Anauran is used only after the child turns one year old. It is recommended to put 2-3 drops 3-4 times a day for 3-7 days.

Ear drops Otizol (contain benzocaine and phenylephrine) reduce swelling of ear tissue and relieve pain (the drug contains benzocaine and phenylephrine). The solution is administered using a pipette, the dosage is as follows: children 6-12 months - one drop three times a day, 1-6 years - 2 drops, 6-12 years - 3 drops three times a day. Adults and children over 12 years old need to drip 4 drops three times a day. Otizol is not prescribed for perforation of the eardrum, as well as for children under 6 months. Doctors recommend closing the ear canal with a cotton swab for some time after instillation.

What else should you do if your ear hurts due to otitis? The ear drops listed above help relieve pain, in addition, non-steroidal anti-inflammatory drugs (NSAIDs) are used, for example, Ibufen Junior or Ibufen D. These are drugs in the form of a suspension for use in pediatric practice. For example, the standard dose of Ibufen D is for children up to 1-3 years old - 100 mg (3 times a day), 4-6 years - 150 mg, 7-9 years - 200 mg, 10-12 years - 300 mg three times a day. NSAIDs are not recommended for more than five days in a row.

What to do if an ear hurts with otitis in adults? Yes, the same, only Otipax or Anuaran drops should be dripped 4 drops up to four times a day. During pregnancy, these drugs should be prescribed by a doctor and only in cases where the benefit to the mother greatly exceeds the possible threats to the fetus.

Adults can also use Holikaps drops (Cholina salicylate, Otinum, Brotinum) as soon as their ears start to hurt – 3-4 drops three times a day. These drops relieve pain and reduce inflammation. But they are contraindicated for purulent otitis with damage to the eardrum (read below for why).

Among the painkillers taken orally for otitis, the most commonly used are the same NSAIDs: Ibuprofen, Ibuprom, Nurofen, etc.

What to do with purulent otitis?

In almost a third of cases of otitis media, the disease is purulent in nature, when purulent exudate forms in the middle ear cavity, which begins to ooze from the ear. What to do with purulent otitis?

It is necessary to treat the ear canal with a cotton swab soaked in a solution of hydrogen peroxide (3%), furacilin or rivanol; place turundas with a solution of dioxidine (0.5%), 2% solution of silver nitrate, hydrocortisone in the ear canal.

A 2% solution of carbolic alcohol mixed with glycerin should be instilled into the ear cleaned in this way (2-3 drops three times a day), as well as antibacterial ear drops Tsipromed, Otofa and Normax, which do not have an ototoxic effect. Tsipromed (0.3% ear drops containing ciprofloxacin) can only be used after 15 years - five drops three times a day; the drug is contraindicated for pregnant and lactating women.

Otofa drops contain the antibiotic rifamycin; adults are recommended to instill 5 drops in the ear (3 times a day), children - 3 drops twice a day. Normax drops contain the fluoroquinolone antibiotic norfloxacin; the drug is prescribed 2-3 drops in the ear 4-6 times a day, in severe cases, instill the inflamed ear every three hours until the intensity of pus discharge decreases. These drops cannot be used to treat purulent otitis in children under 12 years of age and women during pregnancy.

A few words about what an ototoxic effect is and why it is contraindicated to use ear drops such as Otinum, Otizol, Garazon, Sofradex, and Polydexa for purulent otitis with perforation of the eardrum. The side effects of these drugs include their ability to damage the hair cells of the cochlea, ampullar and otolith receptors, and auditory nerve fibers, resulting in sensorineural hearing loss up to irreversible hearing loss. Such effects are caused by the active ingredients of these drugs - bactericidal antibiotics of the aminoglycoside group (Streptomycin, Neomycin, Gramicidin, Gentamicin, Amikacin), as well as salicylic acid and its salts. The latter include Otinum and Otizol drops; aminoglycosites include Garazon (gentamicin), Sofradex (gramicidin), and Polydexa (neomycin) drops.

What to do with purulent otitis for systemic infection control? In clinical otolaryngology, it is customary to prescribe antibacterial drugs for 6-7 days when treating acute inflammation of the middle ear in children of the first two years of life, as well as in adult patients with reduced immunity. For children over two years old and adults, antibiotics are prescribed only with a significant increase in temperature (+38 ° C and above), headaches and other signs of infectious intoxication - two days after the onset of typical symptoms of acute otitis.

In acute purulent otitis, the most effective antibiotics, according to most doctors in this specialization, are Amoxicillin and Clarithromycin. Amoxicillin (Amin, Amoxillat, Ospamox, Flemoxin Solutab, etc.) is given to children 2-5 years old at 0.125 g three times a day, to children 5-10 years old - 0.25 g three times a day (after meals). The dosage for adults is 0.5 g three times a day. The dosage of Clarithromycin recommended by doctors for adults and children over 12 years old is 0.25 g twice a day, the duration of administration is 5 days.

What to do if your ears are blocked due to otitis?

The inflammatory process in otitis media extends to the tympanic cavity and eardrum. The mucous membrane of the cavity thickens, the resulting serous exudate accumulates in the auditory tube, covering the eardrum. Because of this, the air supply to the middle ear cavity is significantly reduced or stops completely, the pressure in the cavity drops, and the eardrum is drawn in. This is expressed in such a symptom as ear congestion.

What to do if your ears are blocked due to otitis? Treat otitis. If otitis is catarrhal and the integrity of the eardrum has not been compromised, then the treatment (described above) leads to the elimination of inflammation, restoration of air flow through the auditory tube and the return of the eardrum to its normal state. The ears "put aside" and the person hears everything well again.

When otitis is purulent, pus accumulates in the tympanic cavity and blocks the flow of air, which leads to ear congestion. The volume of purulent discharge increases, its outflow is difficult, and as a result, the pressure on the inflamed eardrum increases. As a result, this leads to its perforation.

Adequate therapy eliminates the infection, relieves the symptoms of otitis, and the eardrum heals. But, as ENT doctors note, the diseased ear may remain blocked for some time (up to half a month). No additional measures are provided in this case, since in most cases hearing returns to normal.

If the ear is blocked for too long, the doctor you contact with this problem will conduct an otoscopy and find out the cause. Most likely, this is due to too large scars on the eardrum, and these scars prevent it from moving, and therefore from transmitting sound vibrations. To solve this problem, such physiotherapy procedures as UHF, electrophoresis and tubus quartz of the ear cavity are prescribed.

What should not be done with otitis?

Please note what you should not do if you have otitis:

• Do not put boric alcohol in the ears of small children (under two years of age);
• do not blow your nose through both nostrils at the same time: only one at a time, closing one nostril at a time;
• if there is purulent discharge from the ear, the sore ear should not be warmed in any way;
• in case of perforation of the eardrum due to purulent otitis, you cannot use ear drops such as Otinum, Otizol, Garazon, Sofradex, Polydexa (for reasons, see the section What to do with purulent otitis?).

Considering that inflammation of the middle ear can be complicated by otitis of the inner ear (labyrinthitis), inflammation of the tissues of the mastoid process (mastoiditis), meningitis and brain abscess, treatment of this disease should be carried out only under the supervision of a doctor, but knowing what to do with otitis and what medications to use is certainly useful.