Otitis media


How is otitis media caused?
Otitis media primarily refers to the inflammation of the tympanic membrane, tympanic cavity, and mastoid in the middle ear. Clinically, the main causes of otitis media include the following: firstly, infectious factors, which are mainly bacterial infections. Bacteria can infect the middle ear through the external auditory canal, through the Eustachian tube from the nasopharynx to the tympanic cavity of the middle ear, or via the bloodstream to the tympanic cavity, tympanic membrane, and mastoid, leading to symptoms of otitis media. These are our pathways of infection. So, what causes these infections? Or what factors might influence the occurrence of these infections, that is, the occurrence of otitis media? Key factors include decreased immunity in children, increased virulence of bacterial infections, which involves highly infectious bacteria, and our anatomical structure, namely, the imperfection or incompleteness of the middle ear structure and the anatomical connections between the ears.


Is otitis media easy to treat?
Clinically, otitis media is a common and frequently occurring disease, primarily referring to acute and chronic inflammation of the eardrum, tympanic cavity, and mastoid antrum. Its clinical treatment mainly involves two aspects: surgical treatment and medication. Generally, during the acute phase of the disease, medication is the main treatment, primarily using antibiotics to control the infection. Surgical treatment is mainly aimed at chronic otitis media, secretory otitis media, or cholesteatoma otitis media, involving the removal of lesions and repair of structures. Overall, the treatment for otitis media is generally effective and yields good results. The key is to detect and treat it early without delay.


How to treat otitis media with effusion?
Otorrhea in otitis media suggests that it may be acute purulent otitis media. This fluid could be mucopurulent or purulent secretion, primarily considered to be caused by bacterial infection. Clinically, we mainly focus on anti-infection treatment. Locally, antibiotic ear drops like ofloxacin ear drops can be used. Systemically, oral antibiotics such as cephalosporins are utilized among others. Additionally, in cases of otorrhea, we need to rule out cerebrospinal fluid leakage caused by otitis media, which results in drainage through the external auditory canal. This requires a CT scan for verification.


How to drain fluid from otitis media
Otitis media with effusion refers to the fluid in the tympanic cavity of secretory otitis media. Clinically, the methods for draining or reducing the effusion mainly include the following: First is pharmacological treatment, which primarily involves antibiotics, steroids, and medications that promote the secretion of fluids. This is the pharmaceutical approach to treatment. There is also invasive treatment, which includes procedures such as tympanocentesis, tympanostomy tube placement, and eustachian tube balloon dilation, with the aim of draining or extracting these fluids. Clinically, treatment generally begins with pharmacological approaches, followed by invasive procedures.


How is acute otitis media treated?
Acute otitis media is caused by bacterial infection. It is an infectious inflammation of the middle ear chamber, eardrum, or mastoid cavity. Since it is a bacterial infection, the primary treatment choice is anti-infection therapy, specifically the use of antibiotics. Currently, in clinical practice under the guidance of a doctor, cephalosporin antibiotics are mainly used. At the same time, certain antibiotic ear drops should not be used, such as ofloxacin ear drops and lomefloxacin ear drops, especially in cases of acute otitis media with severe symptoms like fever and headache. Based on the condition, we also consider anti-infection treatment through infusion. Infusion refers to the intravenous use of cephalosporin antibiotics, among others. Additionally, some corticosteroids can be used to enhance the anti-infection effects.


How to relieve pain from acute otitis media?
Acute otitis media commonly leads to pain, and it can also cause feelings of ear blockage, decreased hearing, and secretions in the ear canal. If the pain is significant, it is primarily considered to be caused by acute infection and inflammation. Initial treatment involves timely anti-infection therapy, predominantly with antibiotics, taken orally. If the inflammation is severe, infusion therapy may be necessary, and ear drops can also be considered. If, after anti-infection treatment, the pain still hasn't significantly relieved, painkillers can be considered. Generally, the treatment period is about a week, and regular follow-up checks with an otoscope and maintaining dryness in the outer ear canal are necessary. (Medications should be used under the guidance of a doctor based on specific conditions.)


How to treat granulation in otitis media?
Granulation tissue proliferation in otitis media indicates an active phase of inflammation. In clinical treatment, the first approach is medication, mainly using antibiotics and hormones, with both local and systemic applications of these drugs concurrently. Treatment usually lasts about two weeks. Generally, most granulations in otitis media are relatively small and can gradually shrink or even completely disappear with such medication. For granulations that fill the middle ear and tympanic cavity, if they cannot be reduced or controlled effectively through medication, then surgical intervention is necessary to remove the granulations in the middle ear cavity and thus treat the otitis media.


What should I do if otitis media is causing pus discharge?
Otitis media refers to various inflammations of the middle ear cavity, primarily bacterial inflammation. These bacteria are mainly Staphylococcus aureus and Streptococcus pneumoniae. Otorrhea in otitis media indicates relatively severe inflammation and the occurrence of a tympanic membrane perforation, allowing the purulent discharge to be expelled from the ear. In addition to indicating severe inflammation of otitis media, it is necessary to use antibiotics to control the infection. This can include topical antibiotic ear drops like compound polymyxin B ear drops and oral cephalosporin antibiotics, as well as intravenous infusion of cephalosporins to treat the infection.


Treatment methods for otitis media with effusion
Otitis media with effusion mainly refers to a type of secretory otitis media, where there is negative pressure in the middle ear cavity and fluid accumulation occurs. Treatment usually begins with medications, lasting either one to three months or three to six months. Antibiotics, steroids, and medications that facilitate the drainage of the effusion, such as Mucosolvan, may be used. Additionally, medications that constrict the mucosal blood vessels in the nasal cavity can also be used to facilitate the function of the Eustachian tube. If medication does not relieve or cure the condition, invasive treatment methods such as tympanic membrane puncture, tympanotomy, tympanostomy tube insertion, and Eustachian tube balloon dilation can be employed.


Can you swim with otitis media?
Patients with otitis media should not swim, whether it is acute or chronic otitis media. This is because water can enter the ear during swimming. Once dirty water enters the ear, especially in cases of chronic otitis media, it can lead to an acute episode of chronic otitis media. Many patients with chronic otitis media have a perforated eardrum. Without the protection of the eardrum, dirty water can directly enter the middle ear, causing an acute episode of otitis media. This can result in suppuration, ear discharge, and further deep infections, such as infections reaching the deep bone tissue of the mastoid, which requires a long time to treat and might even necessitate surgical intervention. If it is the acute phase of otitis media, the entry of water can irritate the eardrum or cause the pus in the middle ear to worsen, further hindering recovery and exacerbating the condition.