Symptoms and treatment of purulent otitis. Complications. What to do if fluid is flowing from the ear, how to treat it If pus is flowing from the ear

Purulent Otitis is a serious inflammation of the ear, of a bacterial nature. Due to its high prevalence among people and the considerable risk of developing life-threatening complications, the problem of treating this disease remains very relevant today.

– a chronic or acute inflammatory process in the mucous membrane of certain parts of the ear, which is based on various infectious agents. Depending on the level of damage, it is divided into the following types: external, middle and internal. At the same time, otitis media accounts for the vast majority of calls to a specialist - an otolaryngologist.

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Spreading

According to statistics, otitis occurs in 2.5% of the population. Among diseases of the ENT organs, they make up 50%, while - up to 70%. At the same time, acute or chronic otitis media is one of the main causes of the development of sensorineural hearing loss in adults – in 25% of cases.

Origin

There are several versions of the pathogenesis of the disease. The most significant is tubular dysfunction. The reasons for its development lie either in mechanical obstruction of the auditory tube (tumors of the nasopharynx, adenoid growths) or a functional failure that disrupts the normal process of its active opening. As a result, a reduced pressure is created in the tympanic cavity, facilitating the diffusion of fluid into the structures of the middle ear. If infectious pathogens are attached to it, an acute inflammatory process may develop.

Causes

Otitis is a multi-causal disease, where the main etiological factors are bacteria, fungi and viruses.

Moreover, the leading position is given to pathogenic bacterial flora. Thus, in acute purulent otitis, the main pathogens are pneumococci and Haemophilus influenzae, and somewhat less commonly, Staphylococcus aureus. In the chronic form of the disease, Klebsiella and Pseudomonas are also found.

Some predisposing factors also play a certain role in the development of otitis media.:

• Immunodeficiency conditions: congenital or acquired (AIDS, chemotherapy);
• endocrinological pathologies (diabetes mellitus, hypothyroidism);
• systemic blood diseases (leukemia);
• dysfunction and narrowness of the eustachian tube;
• diseases of the upper respiratory tract (polyps, deviated nasal septum,);
• abnormalities in the structure of the skull bones;
• iatrogenic factors;
• frequent colds and illnesses accompanied by acute runny nose;
• sensitization of the body (allergy, ,).

Symptoms of purulent otitis media

Acute course

Acute purulent otitis is characterized by a violent inflammatory reaction, manifested by one or more clinical symptoms:

• Pain: is aching, stabbing, shooting in nature with irradiation to the temporal region;
• temperature: at first subfebrile, and then reaches febrile levels;
• hearing: decreased hearing acuity;
• discharge: purulent, with an unpleasant odor;
• symptoms of intoxication: headache, weakness, nausea.

Chronic

Typically, chronic otitis media results from an acute episode, especially in the first five years of life.

• Discharge: during an exacerbation, purulent discharge appears; perhaps over many months and even years;
• pain: feeling of fullness, pressure and congestion in the ear;
• hearing: increasing sensorineural hearing loss.

Diagnostics

• Physical examination: collecting anamnesis (complaints, identifying episodes of ARVI, influenza, rhinitis preceding the disease);
• otoscopy: pathological changes in the eardrum (swelling, redness); using optical instruments you can detect the presence of perforation;
• otomicroscopy: the use of special surgical optics for a more detailed examination;
• audiometry: determination of hearing acuity.
• tympanometry: assessment of the functioning of the Eustachian tube, determination of membrane mobility;
• CT scan of the temporal bones: especially if the diagnosis is difficult;
• laboratory test: blood test shows an increase in leukocytes, in particular neutrophils, lymphocytes.

Forms

Depending on the characteristics of the inflammatory process, there are:

• Spicy;
• chronic.

Based on localization:

• External (external auditory canal);
• internal (labyrinthitis).

Stages of the disease

1. Eustachitis: dysfunction of the auditory tube, antiseptic inflammation, release of serous secretion. There is noise and a feeling of congestion in the ears.
2. Acute catarrhal inflammation: otalgia, low-grade fever.
3. Acute purulent inflammation: increased pain, suppuration of serous contents, temperature reaches febrile levels, and increased hearing loss. Changes in the blood picture (shift of the leukocyte formula to the left).
4. Post-perforation: pain reduction, normalization of temperature and blood counts, disappearance of intoxication symptoms. Otoscopy reveals perforation of the eardrum.
5. Reparative: inflammation is eliminated, the hole is closed with scar tissue.

Differential diagnosis

Differential diagnosis is carried out with the following diseases:

• Furuncle of the external auditory canal;
• arthritis of the lower jaw joint;

The final diagnosis is made on the basis of anamnesis and instrumental research methods (otoscopy, tympanometry, etc.).

Treatment of purulent otitis in adults

Antibiotics for otitis media

For the treatment of acute purulent otitis, the drugs of choice are semi-synthetic or inhibitor-protected penicillins: Amoxicillin, Amoxicillin + clavulanate (Amoxiclav).
As alternative means use: Azithromycin, Midecamycin, Ciprofloxacin, Doxycycline, Cefuroskim, Cefaclor.

In severe cases of the disease with high febrile temperature and severe intoxication, intravenous or intramuscular administration of antibiotics is necessary.

For parenteral (injection) use:

• Fluoroquinolones: Ciprofloxacin, Levofloxacin, Ofloxacin;
• carbapenems: Imipenem, Meropenem.
• cephalosporins: Cefotaxime, Cefuroxime, Ceftriaxone.
• protected penicillins: Co-amoxiclav, Ampicillin/sulbactam.

Carbapenems and fluoroquinolones are especially indicated for severe otitis, the risk of complications, hospital infections, and high resistance of microbes to standard antibacterial therapy.

Treatment with drugs

• Desensitizing therapy (to eliminate swelling of the auditory tube): Diphenhydramine, Tavegil, Suprastin;
• non-steroidal anti-inflammatory (NSAIDs) and antianginal drugs (in the initial stage of an acute inflammatory process): Ibuprofen, Diclofenac, Ketoprofen, Metamizole sodium, Paracetamol;
• decongestants (nasal drops to narrow blood vessels): in case of association of otitis with vasomotor rhinitis, to reduce hypertrophy of the pharyngeal anastomosis and improve the sanitation of the tympanic cavity. Otrivin, Naphthyzin, Galazolin are used.

The period of their use is limited to 5–7 days in order to avoid the development of drug-induced rhinitis.

Additionally, the doctor can sanitize the mouth of the Eustachian tube with cotton swabs with decongestants or inject them into it using an auditory catheter.

Drops in the ears for purulent otitis media

Two groups of drops are used as external therapy:

• Osmotically active drops with analgesic and antiseptic effects;
• drops with the addition of antibiotics and glucocorticosteroids.

Among the first, Otipax is effective, prescribed from the very beginning of the disease, as it helps eliminate pain and relieve inflammation and infiltration of the eardrum.

In the perforated stage of the disease, drops with broad-spectrum antimicrobial agents that do not exhibit toxicity to the hearing aid are used:

• Rifampicin. Its disadvantages include the rapid development of resistant strains of microorganisms;
• norfloxacin;
• ciprofloxacin.

Combination drugs (antibacterial agent + corticosteroid)

• Anuran;
• sofradex;
• dexon.

The use of these agents is possible only if the integrity of the eardrum has been established by microscopic examination, since they have an ototoxic effect.

Among the permitted drops for the perforated stage of purulent otitis is Amoxiclav with Hydrocortisone or Dexamethasone.

Surgery

• Myringotomy: when intoxication, temperature and pain increase, the eardrum is dissected with a special needle to eliminate the purulent contents. If necessary, material can be taken for bacterial culture in order to identify the causative agent of the disease and determine its sensitivity to antibiotics;
• shunting of the tympanic cavity: ensures the outflow of exudate and allows the introduction of various drugs into the ear cavity - antibiotics, corticosteroids.

Physiotherapy

Physiotherapeutic methods are important in the complex treatment of otitis media. Among them, the most popular are UHF and laser therapy, UV irradiation, and Sollux. Their main task is to improve blood circulation in the affected area, relieve inflammation and infiltration, increase local immunity, and launch reparative processes.

Disease prevention

Disease prevention includes two main areas:

• Strengthening the immune system (hardening procedures, healthy lifestyle, good nutrition);
• elimination of predisposing factors: adenoid vegetation, hypertrophic processes of the inferior turbinates and tubal tonsil, tonsillitis, allergic conditions.

Forecast

With adequate and timely treatment, the prognosis is favorable: complete recovery occurs. The lack of qualified medical care creates a risk of developing serious consequences:

• Thrombosis of the sigmoid sinus of the brain;
• mastoiditis;
• intracranial abscess;
• inflammation of the meninges (encephalitis);
• sepsis;
• otogenic hydrocephalus;
• facial nerve paresis.

It is worth remembering that the effectiveness of therapy lies not only in the disappearance of clinical manifestations of the disease, but also in the complete restoration of hearing. This is confirmed by research methods such as tympanometry and audiometry.

Identification and treatment of purulent otitis is the responsibility of otolaryngologists. In case of doubt when making a diagnosis or if there is a suspicion of the occurrence of life-threatening otogenic intracranial complications, the doctor will definitely involve specialists and other specialists, primarily neurosurgeons.

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Suppuration, or otorrhea, is one of the symptoms of the development of acute purulent inflammation of the middle ear. It indicates perforation of the eardrum, since the exudate accumulated as a result of inflammation puts pressure on the eardrum, leading to its perforation. The presence of this symptom characterizes the development of the perforated stage of acute purulent otitis. In the case of a successful course of the disease and the absence of complications, the subsequent development of reparative processes is characteristic, during which the integrity of the eardrum is restored and hearing returns.

Suppuration is not a mandatory symptom. Often the accumulated pus leaves the cavity not by breaking through the eardrum, but finds its way out through the auditory tube. The appearance of otorrhea is accompanied by an additional change in the clinical picture. There is a decrease in body temperature, an improvement in general condition, and a decrease in pain.

Activities at the pre-perforation stage

However, the development of this symptom was preceded by 2-3 days, and sometimes a week of malaise, an increase in body temperature to 39 degrees, severe pain and tinnitus, that is, all symptoms characteristic of acute otitis.

To ensure that the disease does not become chronic and its severe complications do not develop, treatment should be started precisely at the pre-perforation stage.

Therapeutic measures during this period should be as follows:

• the use of ear drops, which include anesthetics, analgesics and antiseptics;
• in case of severe pain, it is possible to use non-steroidal anti-inflammatory drugs orally;
• use of warming procedures;
• the use of nasal drops with a vasoconstrictor effect;
• If there is a pronounced protrusion of the tympanic septum, the specialist may decide to perform paracentesis.

Among the ear drops most preferred during this period, Otipax is used. The drug contains a non-steroidal anti-inflammatory drug and the local anesthetic lidocaine. An analgesic effect is also achieved by prescribing a 3% alcohol solution of boric acid. All ear drops must be warmed to body temperature before instillation, and the ear canal must be closed with a cotton swab after the procedure.

Of the non-steroidal anti-inflammatory drugs that can be used in this case, the most popular are paracetamol and ibuprofen. In addition to analgesic, these drugs have antipyretic and anti-inflammatory effects, which can also help improve the condition. Vasoconstrictor nasal drops are also necessary in the treatment of this pathology, since in most cases the development of otitis is associated precisely with diseases of the nasopharynx, and is caused by the spread of purulent contents into the tympanic cavity through the auditory tube. The use of nasal drops such as sanorin, naphthyzin, galazolin prevents this process.

As for warming procedures, alcohol compresses, heating pads, and UV lamps can be used to treat purulent otitis media at home. During this period, you can warm the ear for purulent otitis media. The procedure should be immediately postponed if the pain increases sharply, which may be associated with the development of complications.

If the therapeutic measures taken do not produce an effect, the patient’s condition does not show any positive dynamics, antibiotics should be added to the treatment. The absence of suppuration indicates that topical antibiotics cannot be used, since the drug will not be able to penetrate beyond the intact eardrum and exert its therapeutic effect. The drugs of choice used in this stage of treatment of purulent otitis in adults are the antibiotic amoxicillin and its analogues, Flemoxin, Ospamox, Hiconcil, taken in tablet form.

Activities at the perforation stage

Despite the treatment, several days after the onset of the disease, the patient sometimes has pus flowing from the ear. What to do in this case? It all depends on where the patient is located and how quickly qualified assistance can be provided. In this case, consultation with an otolaryngologist is necessary to adjust treatment tactics.

Features of the use of drugs in the treatment of acute purulent otitis of the middle ear in this period are that at this stage the use of alcohol-containing drops is contraindicated, since this substance can have a toxic effect on the mucous membrane of the eardrum and lead to a worsening of the condition. Products containing anti-inflammatory components have the same effect. Otipax drops are already contraindicated during this period.

In addition, the evacuation of pus from the ear canal plays an important role in the treatment of acute purulent otitis media. It would be more correct if this process is handled by a specially trained nurse from the ENT department. If treatment of purulent otitis occurs at home, the procedure should be carried out carefully, using only cotton wool twisted in the form of a spiral. The use of matches, knitting needles and factory ear sticks is strictly prohibited. The eardrum is damaged, and awkward movement can lead to additional trauma or infection of the skin of the external auditory canal. This procedure is carried out 2-3 times a day until the exudate is removed and the cotton wool becomes dry.

In cases where the secretion is very thick, with purulent otitis media, you can rinse the ear with a 3% solution of hydrogen peroxide. This will make it easier to evacuate the contents. After the procedure, the ear canal must be dried. Saline solution can be used as a means for toileting the external auditory canal.

As for the use of medications, topical medications in the form of ear drops should be added to antibiotics in tablet form. In this case, the following drops containing antibiotics are widely used:

• Otofa,
• Tsipromed,
• Normax.

It is recommended to instill drops after washing and drying the ear, warming them up to body temperature. When turning to the use of combined agents, it is necessary to pay attention to the composition of the components included in them, since the content of alcohol and non-steroidal anti-inflammatory components in case of perforation of the eardrum is unacceptable.

When treating purulent otitis in adults, many specialists suggest using the injection method to instill ear remedies. To do this, after instillation of the ear, you need to press the tragus with your finger, closing the lumen of the external auditory canal, and make movements that facilitate the penetration of the medicine into the middle ear. After some time, the patient should feel the taste of the medicine in the mouth. In this case, it is considered that the procedure was carried out correctly, and a more targeted effect of the drug is ensured.

Antibiotic therapy should continue for at least 7-10 days, even in normal condition and in the absence of clinical manifestations of the disease.

Otherwise, there is a high risk of relapse and the disease becoming chronic, which may require surgical treatment. It must be remembered that a number of antibiotics have an ototoxic effect. The use of such ear drops may cause hearing loss.

At the subsequent, reparative stage, treatment of acute suppurative otitis media consists of procedures that promote healing and restoration of elasticity of the eardrum. For this purpose, procedures such as pneumomassage and iontophoresis with lidase may be prescribed.

Outcome of suppuration

Otorrhea usually continues for several days, after which there is a persistent improvement in the condition and the return of hearing. If, in the presence of perforation of the eardrum, the patient’s condition has not improved, we can assume the development of a complication, inflammation of the mastoid process. The presence of mastoiditis may also be indicated by a worsening condition after a period of improvement.

A serious complication of the disease may be indicated by the presence of suppuration for a long time, more than 3-4 weeks. In this case, we may be talking about mastoid empyema or extradural abscess. With this development of the situation, there can be no talk of treatment at home. The patient should be hospitalized in a specialized hospital, and further treatment should be carried out under the direct supervision of an otolaryngologist.

Thus, what to do if the ear festers depends on the presence of concomitant symptoms and their dynamics. Improvement in the patient's condition with the appearance of otorrhea indicates the perforated stage of purulent otitis media. In this case, correction of the treatment and measures to evacuate the contents of the external auditory canal are required. If suppuration does not bring relief, severe pain in the ear, dizziness, and hyperthermia are still bothering you, then immediate assistance from a specialist in the ENT department is required. In this case, we may be talking about the development of complications of the disease.

For treatment purulent otitis It is best to seek help from an otolaryngologist. Even if you have reliable traditional methods of treating this disease, it is better to consult a doctor, especially since these methods are most effective as an additional remedy to classical methods of treatment.

Purulent otitis media

If there is a noticeable perforation of the eardrum due to vessel discharge, boric acid or an antibiotic powder should be injected into the cavity.

In severe conditions and with a noticeable deterioration in hearing, surgery to correct the eardrum is prescribed.

Traditional healers also take an active part in the treatment of acute otitis:

• It is recommended to mix equal parts honey and pomegranate juice and treat the ear canal with the healing mixture;
• You can instill a few drops of freshly squeezed lemon juice into the sore ear two or three times a day;
• A cotton swab is moistened and inserted into the sore ear, and it is possible to change the tampon once a day, constantly keeping it in the ear, for three weeks.

is a very common disease that affects both adults and children. Any form of it is a potential threat to human health and possibly life. After all, the whole danger lies in the close location of the affected organ to the brain.

Next, let's talk about treating purulent otitis media at home. More specifically, let’s find out whether this can be done, and in what cases? And most importantly, we will determine the correctness of such actions in order to maximally protect the body from negative effects.

Treatment of purulent otitis at home

Let's start with the fact that there is no way to treat otitis at home cannot be an alternative to qualified medical therapy. Ear inflammation can cause very serious complications and become chronic if treated improperly or not.

If improvement in well-being does not occur within 5 days, or deterioration is observed, then you should immediately seek help from a specialist. After all, you cannot know for sure whether perforation of the eardrum will occur. What if not, due to anatomical features. What then? The pus will look for a way out!

Attention! The patient must be aware of the seriousness of the disease and be aware of his own actions. “Playing doctor” at home with purulent otitis media can end very badly.

The proximity of the hearing organ to the bones of the skull and face, as well as to the brain, characterizes this pathology as quite unpredictable in terms of possible consequences.

Purulent otitis is a form of the disease that does not tolerate self-medication

Thus, among the most serious and life-threatening consequences, the following can be identified:

• meningitis;
• inflammation of the temporal bone;
• brain abscess.

Such diseases may well cause disability or death of the patient.

It is worth noting one more point - the success of treatment of this type of otitis is related to the time within which the patient seeks qualified help.

Treatment of purulent otitis in adults at home

Treatment of purulent otitis at home involves mandatory bed rest

Practice shows that it is usually treated on an outpatient basis, that is, at home .

However, if there is a suspicion of damage to the mastoid process, then immediate hospitalization is performed.

Treatment of purulent otitis in adults at home can be carried out, but only after visiting a doctor, who, after examination and diagnosis, will prescribe effective complex therapy.

At home, the patient must comply with bed rest and all doctor’s instructions, consisting of taking the following medications:

1. - for otitis media, this form is required to be prescribed. They have a detrimental effect on the life of pathogenic microorganisms.
2. Nonsteroidal anti-inflammatory drugs– eliminate inflammation and pain.
3. Antipyretic drugs– reduce body temperature, improving the patient’s condition.
4. – for this case, drugs with anti-inflammatory and analgesic effects are selected.
5. Nasal vasoconstrictor drops- to eliminate swelling of the Eustachian tube and normalize its functioning.
6. Antihistamines– eliminate swelling and prevent the occurrence of allergic reactions.
7. Vitamin complexes– supply the body with the necessary substances and microelements, helping to speed up recovery.

Besides, the patient must rinse the affected ear at home, which will help remove purulent masses. Such ear hygiene will help prevent the proliferation of various pathogenic organisms in the affected area.

If the course of the disease is favorable and timely contact with an ENT specialist, treatment can take from 10 to 14 days.

During the recovery period of the disease, the patient is prescribed various physiotherapeutic procedures. Mainly:

• UHF submandibular zone;
• inhalation;
• electrophoresis with various types of applications for the submandibular, parotid and temporal regions.

Important! With this form of otitis, the use of warming agents is strictly prohibited; this can cause increased suppuration.

Due to the specific nature of the disease, self-medication in this case is clearly harmful to health. Therefore, we treat this pathology at home, but only under the watchful guidance of a doctor.

Treatment of purulent otitis in children at home

If symptoms of purulent otitis are detected, the child must be immediately shown to a specialist

Treatment of purulent otitis in a child at home is completely excluded.

There is no question of any experimentation at home, since the disease can develop, not to mention all the same complications.

In childhood, purulent otitis media develops at lightning speed, therefore, parents should carefully look at their child and observe his behavior.

At the slightest suspicion, you should immediately consult a doctor, because the prognosis for treatment will depend on the timeliness of visiting a specialist.

The doctor prescribes comprehensive treatment based on the stage of the disease. If the pus has not yet spread widely, then therapy is carried out at home.

If a child is diagnosed with an advanced form of pathology, he is immediately hospitalized, where in stationary conditions an incision is made into the eardrum, then the ear cavity is cleansed of purulent masses.

For the treatment of childhood purulent otitis at home, the doctor usually prescribes such drugs:

1. Ear drops, characterized by disinfecting and analgesic effects.
2. Painkillers, the dosage of which is determined by the ENT specialist in accordance with the age and weight of the child.
3. Nasal drops, which are necessary to eliminate swelling of the auditory tube and more effective release of pus.

Reference! The use of antibiotics for purulent otitis in children is a necessary measure for the treatment of this pathology.. Children up to 2 years– this is a mandatory condition for prescribing antibacterial drugs for this form of the disease.

In addition to drug treatment, parents should follow regular procedures to clean the affected ear from purulent discharge, for which you need to stock up on antiseptic preparations and cotton swabs. The pus must be removed very carefully, and then the ear cavity must be rinsed with special solutions.

In order to ensure an overall stable condition, The child must be provided with plenty of warm drinks, but not hot! This will also contribute to a speedy recovery.

Purulent otitis - treatment with folk remedies

Since purulent otitis media can provoke the spread of inflammation to bone tissue and the brain, the use of traditional medicine methods at the acute stage of the disease is strictly prohibited.

Alternative medicine can only be used as an addition to primary therapy and only after discussion with the treating doctor.

There are a huge number of traditional medicine recipes, but not all of them bring the desired result, and many are simply downright harmful to health. I would also like to mention various such methods, such as “dropping celandine juice into the ears or placing a slice of onion with a piece of butter in the ear canal” - this is just absurd.

With this “treatment” you can simply burn off all the mucous membrane in the ear or provide microbes with a comfortable environment for active reproduction.

Traditional medicine is not a panacea for all diseases, but a measure of additional treatment

But you shouldn’t completely reject traditional therapy either. You just need to use it skillfully, because nature is rich in a variety of medicinal herbs. For example, for purulent otitis, you can use the following recipes:

• chamomile decoction– for washing the ear cavity. This plant has long been known for its antibacterial and antiseptic properties. To prepare the decoction, you need 1 tablespoon of chamomile flowers (can be purchased at any pharmacy), pour 500 ml of water, bring to a boil and leave for 45 minutes. Use the resulting warm decoction to syringe the affected ear;
• After cleaning and rinsing the ear from pus, cotton swabs soaked in
• laying, soaked mummy solution;
• wild garlic juice (bear onion)– has bactericidal and antimicrobial effects. The turunda is impregnated with this substance and placed in the ear canal.

In addition, the patient can take medicinal drink, which can be prepared from rose hips, currants, raspberries. This is not only healthy, but also a tasty drink, enriched with vitamins and essential substances for a weakened body.

Purulent otitis is perhaps the most serious and dangerous form of inflammation of the ear cavity. Postponing its treatment “until better times” or trying to get rid of the disease at home on your own can have a negative impact on the patient’s overall health.

Therefore, even if you are an ardent fan of home treatment, this time you should still abandon your principles, otherwise they can cost you very dearly.

Acute purulent otitis media (otitis media purulenta acuta) is an acute purulent inflammation of the mucous membrane of the tympanic cavity, in which all parts of the middle ear are involved to one degree or another in catarrhal inflammation.

This disease has some symptoms similar to the common cold. So, otitis media is also characterized by fever and headache.

In addition, otitis often occurs simultaneously with colds. But there are other symptoms characteristic of otitis media that indicate the development of an inflammatory process in the ear.

You can “survive a cold” without resorting to the help of doctors, but if signs of otitis media appear, you should seek help from an otolaryngologist. Because if you do not start timely treatment of purulent otitis media in adults, this disease can lead to a noticeable decrease in hearing and even cause the development of meningitis.

Causes

The cause of the disease is a combination of factors such as a decrease in local and general resistance and infection in the tympanic cavity. Purulent otitis media occurs as a result of inflammation of the auricle, affecting the middle ear cavity, mucous membrane and eardrum.

Causes of purulent otitis media:

• entry of bacteria, viruses, fungi into the auricle;
• complications of diseases of the nose, sinuses, nasopharynx;
• severe ear bruise;
• consequences , ;
• hypothermia.

The most common route of infection is tubogenic - through the auditory tube. Less commonly, the infection enters the middle ear through a damaged eardrum due to injury or through a wound to the mastoid process. In this case, they talk about traumatic otitis media.

Symptoms of purulent otitis media

There are several signs that help determine that you have acute purulent otitis media and not another ear disease. But the main symptoms of various diseases in the field of otolaryngology usually coincide.

Traditional symptoms of otitis media:

• throbbing pain in the ear area;
• pain behind the ear;
• heat;
• chills;
• extraneous noise in the ear;
• decreased audibility.

These signs are characteristic of the initial stage of the disease, when inflammation causes extensive suppuration. Typically this process lasts 2-3 days. Next, acute purulent otitis of the middle ear passes into the phase of perforated damage to the eardrum, as a result of which pus flows out of the ear cavity through the formed hole in the eardrum, and the patient experiences significant relief and pain is reduced.

The third stage is the final stage, the body fights the infection, inflammation gradually decreases, pus ceases to be released, and the eardrum restores its integrity.

Signs of otitis media in a child

Each stage of the disease is characterized by certain symptoms.

Symptoms of purulent otitis in a child of the 1st stage:

• earache;
• heat;
• hearing loss.

Stage 2 symptoms:

• the temperature drops;
• the pain subsides;
• hearing loss continues;
• Purulent discharge begins to come out of the ear.

Stage 3 symptoms:

• the temperature drops;
• the pain disappears;
• hearing is restored;
• the discharge stops;
• the perforation of the eardrum heals.

This disease requires early diagnosis and antibiotic therapy.

Chronic purulent otitis media

This is an inflammation of the middle ear, which is characterized by recurrent flow of pus from the ear cavity, persistent perforation of the eardrum and progressive hearing loss (hearing loss can reach 10-50%).

This otitis is manifested by the following clinical picture:

1. Constant purulent discharge from the ear with a putrid odor;
2. Noise in the affected ear;
3. Hearing impairment.

It develops when acute otitis is treated untimely or inadequately. It can be a complication, etc., or a consequence of a traumatic rupture of the eardrum. Chronic otitis affects 0.8-1% of the population. In more than 50% of cases, the disease begins to develop in childhood.

Chronic purulent otitis media without bone destruction and complications can be treated with medications under the outpatient supervision of an otolaryngologist.

Complications

Lack of suitable treatment leads to irreparable damage to health. The consequences of otitis media in adults are the result of a structural transition of further inflammation into the temporal bone or inside the skull.

Complications may include:

• violation of the integrity of the eardrum;
• mastoiditis – inflammation of cells in the bone;
• facial nerve paralysis.
• meningitis - inflammation of the lining of the brain;
• encephalitis - inflammation of the brain;
• hydrocephalus - accumulation of fluid in the cerebral cortex.

To avoid these unpleasant diseases, you need to know how to treat purulent otitis media in adults.

Treatment regimen for acute purulent otitis media

In adults, treatment of purulent otitis media includes the following procedures and medications:

• antibiotics;
• , antipyretic drugs;
• vasoconstrictor ear drops;
• heat compresses (until pus appears);
• physiotherapy (UHF, electrophoresis);
• antihistamines;
• surgical cleaning of the ear canal from pus.

It should be noted that after the appearance of purulent discharge, warming procedures should under no circumstances be performed. If the disease is chronic, puncture or dissection of the eardrum may be required.

How to treat purulent otitis media in adults

Diagnosis is usually not difficult. The diagnosis is made based on complaints and the results of otoscopy (visual examination of the ear cavity using a special instrument). If a destructive process in bone tissue is suspected, an x-ray of the temporal bone is performed.

Purulent otitis in adults requires outpatient treatment; at high temperatures in combination with fever, it is recommended to remain in bed. Hospitalization is required if a mastoid lesion is suspected.

To reduce pain in the initial stages of the disease, use:

• paracetamol (one tablet 4 times a day);
• Otipax ear drops (twice a day, 4 drops);
• tampon according to Tsitovich (a gauze swab soaked in a solution of boric acid and glycerin is inserted into the ear canal for three hours).

To relieve swelling in the tissues of the auditory tube, the following is prescribed:

• Nazivin;
• tizin;
• Santorini;
• naphthyzin.

Antibiotics used for purulent otitis media:

• amoxicillin;
• augmentin;
• cefuroxime

If after several days of treatment there is no improvement or the symptoms worsen, surgical treatment is performed; it is urgently indicated when signs of irritation of the inner ear or meninges appear. After paracentesis or self-perforation, it is necessary to ensure the outflow of pus from the middle ear: drain the ear canal with sterile gauze swabs 2-3 times a day or wash the ear with a warm solution of boric acid.