Treatment methods for otitis media with effusion

Written by Deng Bang Yu
Otolaryngology
Updated on September 01, 2024
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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.

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Can otitis media heal itself?

Some cases of otitis media can recover on their own, mainly depending on the degree of inflammation and the patient's own resistance. If the inflammatory response is mild and the patient’s own resistance is strong, there is a chance for gradual recovery through resistance. However, this situation requires dynamic observation of the changes in the condition. Without treatment, some patients may gradually worsen, and in such cases, timely consideration of medication is necessary. If the inflammatory response is already significant, or if the patient's own resistance is poor, it is generally recommended to promptly perform an otoscopy and cooperate with antibiotics to fight the infection. Generally, the treatment period is about one week.

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How to medicate for secretory otitis media?

Secretory otitis media refers to a type of sterile otitis media caused by the negative pressure in the middle ear cavity due to blockage of the Eustachian tube, leading to the exudation and accumulation of fluid in the middle ear cavity. The treatment of secretory otitis media includes both pharmacological and surgical interventions. Pharmacologically, corticosteroids such as dexamethasone and prednisone are mainly used. Some antibiotics, like cephalosporin antibiotics, may also be used. Nasal treatments, such as mometasone furoate nasal spray, are also necessary. Additionally, medications that facilitate the drainage of secretions from the middle ear, such as Mucosolvan, can be used. (Medication should be used under the guidance of a doctor.)

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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.

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Does otitis media require intravenous therapy?

Otitis media refers to acute or chronic inflammation of the tympanic membrane, tympanic cavity, or mastoid cavity. Whether otitis media requires intravenous (IV) therapy mainly concerns acute suppurative otitis media. Generally, if the symptoms of otitis media are mild, such as ear pain without ear discharge, fever, headache, etc., IV therapy is usually not necessary. If the patient's symptoms are severe, such as intense ear pain, discharge from the ear, or even fever and other systemic symptoms, then IV anti-infection treatment should be considered. It is also common to perform a complete blood count to check the number of white blood cells; a high white blood cell count further supports the need for IV anti-infection treatment.

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What are the symptoms of otitis media?

Otitis media comes in several types, with most cases of acute otitis media involving ear pain, typically throbbing or stabbing pain, followed by decreased hearing, or tinnitus. There may also be ear discharge or pus; using a cotton swab, one might notice an unusual smell from the ear secretions. Systemic symptoms such as fever and chills are less common, with the primary symptoms being localized, mainly consisting of ear pain, reduced hearing, and discharge.