Exudative otitis media in a 3-year-old child. Symptoms and treatment of exudative otitis media

Exudative otitis media in children is unpleasant illness, which is characterized by an inflammatory process in the ear canal. This disease is non-infectious. Most often it affects newborns, infants, as well as kids preschool age. If the disease is not treated correctly, it can provoke the development of many negative processes, so it is important to be sure when detecting suspicious signs contact a specialist for help.

General classification of pathology

Experts distinguish catarrhal and. With the first type, pronounced clinical signs often immediately begin to appear, which simplify the diagnosis of the disease.

And the exudative form of the disease is usually not diagnosed immediately, since pronounced symptoms are often absent. This pathology does not extend to the bone or muscle structures surrounding the ear canal, but accumulation of contents occurs in the ear canal.

There are acute and chronic types of pathology. For acute exudative otitis, the duration of treatment averages from 30 to 60 days. In the presence of a subacute form, the development of pathology continues for at least one and a half months. If a chronic form of the disease is diagnosed, the duration of its development is at least two months.

Unilateral and bilateral exudative otitis media in children is also diagnosed. With the development of the latter, the pathological process develops in both hearing organs at once; according to statistical data, similar processes often develop in children.

It is practically impossible to detect the presence of an exudative form of the disease on your own; this can only be done by an experienced specialist. Diagnosis of this problem is usually carried out already at the stage of development when the disease reaches a serious stage. And this is the difficulty of therapy.

Clinical manifestations

Standard clinical signs are usually not pronounced. The course of the disease is mild, there are no signs of intoxication. This pathology is poorly diagnosed even in adults, since the symptoms are not pronounced, not to mention in small children.

Usually the child is not at all able to distinguish the norm from any pathologies. Usually in young children the reaction appears only when the illness has already progressed to advanced stage, pronounced clinical signs appear.

If you suspect the presence of an exudative form of the disease, it is important to first pay attention to whether the quality of sound perception in the baby has deteriorated. It is also important to teach the child to express his feelings in words, to explain what happens if his ears are blocked, if he has difficulty hearing.

If treatment and diagnosis are not started in a timely manner, irreversible hearing loss and dysfunction in the hearing aid may develop, which subsequently leads to disturbances in the speech apparatus.

Discover this pathology it is possible only by the presence of serous contents in the ear canal or in the sink. This substance may look like a thin brown film or a large clot of viscous consistency. If you put your hand on the organ, a kind of “gluing” of the limb and the shell of the ear occurs (popularly the disease is called adhesive ear).

If therapy is started in a timely manner, relief from the disease is quick, and no consequences will develop.

Why does pathology develop?

Factors provoking the disease may be a large number of. In order to ensure the full functioning of all departments of the device, a small amount of content is regularly produced. For healthy person this is the norm.

And the substance that remains on the surface of the mucosa is usually removed during hygienic cleaning. If there is swelling of the passages, an inflammatory process develops, or the ear canal narrows, this indicates that there is an accumulation of exudative fluid in the ear canal.

The following general provoking factors for the development of pathology are identified:

• Features of the anatomical structure;
• The presence of constantly inflamed adenoids;
• Labor activity;
• Frequent acute respiratory viral diseases;
• Allergic reactions;
• Sinusitis of chronic origin;
• Weakness of the body's natural resistance to viruses and colds;
• The presence of a cleft palate in a child;
• Frequent exposure to the role of passive smoker.

To the anatomical factors that can cause the development pathological process, include insufficient patency of the ear canal, constant accumulation of excess secretion, acute or chronic pathologies in the nasopharynx.

Precursors of the disease include: runny nose, sinusitis, chronic sinusitis. The likelihood of damage to the hearing aid is especially high if the listed diseases are not treated.

A constant inflammatory process in the adenoids can provoke a pathological process. In the event that timely surgical treatment is not carried out, in the presence of permanent inflammatory reactions, which are ignored, when the nasal septum is deviated from congenital origin, the likelihood of developing the disease significantly increases.

Young children are often susceptible to the development of a pathological process when water frequently enters the ear canal during water procedures, especially in public reservoirs. And the likelihood of injury increases with frequent hypothermia.

In adults, the development of the disease may be due to the characteristics of professional activity. Thus, people of such professions as pilots and divers, whose professional activities are closely related to possible barotraumas, are more often exposed to the disease.

Also, the disease can become more active in conjunction with oncological processes in the nasal cavity and sinuses, at a time when the neoplasm becomes an obstacle in the ear canals.

With the development of exudative otitis, there is no independent outflow of fluid from the ear cavity. This content creates positive conditions in order to become more active pathogens, began to actively reproduce and provoked a pathological process.

Over time, as the disease develops, the exudate thickens, which includes not only mucus, but also impurities of pus.

One of the most common reasons The appearance of this form of otitis is dysfunction of ventilation in the ear canal. At the same time, sputum and pus are intensively produced.

With such processes sometimes appear painful sensations, prolonged development of the disease. Transferred acute respiratory diseases often capable of triggering the development of this form of otitis.

Most often, exudative otitis media develops in children from two to five years of age, this is dictated by the immature auditory system. And also frequent diseases of a viral or cold nature (since it is at this time that active formation occurs immune system children, they attend a preschool).

The most common factors that provoke the occurrence of otitis media are passive smoking. Therefore, it is necessary to ensure that the child does not encounter tobacco smoke in the room where he is constantly located.

Therapeutic measures

Diagnosis of this pathological process is most often limited to an external medical examination, as well as otoscopy. Using special instruments, the doctor examines the ear cavity and reveals the nature of the disease.

In most situations, therapy for exudative otitis media is complex and is rarely started on time. This is dictated by mild clinical manifestations.

General therapy of the disease consists of integrated approach. Must be assigned conservative treatment, which consists of applying medications(anti-inflammatory, mucolytics).

Mucolytic drugs are used to quickly thin out accumulated mucus and remove it from the body. Sometimes blowing of the ear canal may be prescribed to quickly drain fluid.

Use any options alternative medicine not only impractical, but in many cases ineffective and even dangerous, since improper treatment can provoke the development dangerous consequences or complications. Methods are not allowed traditional treatment for the child, which are not agreed upon with the treating specialist.

Depending on the degree of development of the disease, the doctor prescribes antibacterial drugs, glucocorticosteroid drugs, and non-steroidal anti-inflammatory drugs to treat the ear canal.

If the function of the eardrum is not restored, secretion production does not decrease, and the quality of sound perception does not improve, the doctor considers the advisability of surgical treatment, which will effectively remove fluid from the organ cavity.

Regardless of what reason provoked the disease, and also at what stage it is, you should not deal with self-treatment using dubious options.

It is also important to strictly follow all prescribed medical recommendations; this will make it possible to restore the full functions of the hearing aid and prevent the development of dangerous complications.

Exudative otitis media in children differs from other forms of inflammation of the hearing organs in that during its development, a special sticky liquid, called exudate by doctors, collects in the middle ear. In addition to the presence of exudate, the preservation of the eardrum and the absence of pain are noted. This disease ranks first in the ranking of causes of hearing loss in children under 7 years of age (diagnosed in 60% of cases). It is also dangerous for adolescents aged 12–15 years (detected in 10% of schoolchildren). It is the absence of pain that often allows the disease to go unnoticed, quickly weakening the child’s hearing acuity. How then can we not miss the beginning of its development? And what measures should be taken for treatment and prevention?

What is exudative otitis media?

Inflammation tympanic cavity and auditory tube is observed with any otitis media. But associated symptoms allow you to highlight its specific shape.

Exudative otitis is characterized by the accumulation of fluid in the middle ear (the unnatural work of the mucous membranes is to blame for its formation, and the impossibility of removal is due to swelling against the background of developing inflammatory process).

The fluid cannot be removed on its own, since the ventilation of the middle ear cavity is impaired due to edema. As a result, the exudate becomes more and more, and they begin to multiply in it. pathogenic microorganisms, over time turning it into mucus, then into pus.

Once the liquid thickens, the risk of developing serious complications increases sharply. And this whole process is almost painless. That's why main danger exudative otitis lies in the late detection of the disease and, accordingly, a delayed visit to the doctor.

Video: otitis media in children - Dr. Komarovsky

Causes

The absence of pain characteristic of exudative otitis media does not mean that the child does not experience discomfort. But parents most often mistake them for the consequences of respiratory diseases.

Eustachian tube dysfunction usually occurs when improper treatment infections of a bacterial or viral nature.

Enormous damage is caused by interrupted treatment or replacement of medications recommended by a specialist. Incorrect use antibacterial drugs doubly dangerous for otitis media. This prepares the environment for the development of a pathogen resistant to many types of antibiotics.

Among the less common causes of the disease, otolaryngologists identify:

• passive smoking - tobacco smoke quickly destroys the ear mucosa, so a child should never inhale it;
• adenoiditis;
• chronic sinusitis;
• allergic rhinitis;
• weakened immunity.

Very often, otitis media in children develops due to the proliferation of adenoidal (lymphoid) tissue - in this case, the child’s adenoids must be removed

Features of the development of the disease in children

An underdeveloped eustachian tube in children under 5 years of age makes them especially vulnerable to this disease. Fluid from the nasopharynx has no serious obstacles to penetrate into the middle ear. A fifth of cases of exudative otitis in preschool children are caused by an infection that has penetrated to the hearing organs along with this fluid.

The development of bilateral otitis media is usually recorded. Allergic and inflammatory processes in the nasopharynx disrupt the functioning of the Eustachian tube, eliminating the possibility of natural ventilation. Under the influence of changes, special pressure is created, provoking the mucous membranes to produce exudate.

As soon as the liquid acquires the consistency of thick jelly, the auditory ossicles lose their mobility. As a result of these changes, a sharp decrease in the child’s hearing occurs.

Types and stages of the disease

Exudative otitis media is usually classified according to the duration of the disease:

1. Acute form. It is diagnosed in the first 3–5 weeks from the moment of infection.
2. Subacute or intermediate stage. After a little over a month, the disease becomes subacute course. This species is also called intermediate.
3. Chronic exudative otitis media. In the absence of treatment or its ineffectiveness, chronic otitis occurs. It is diagnosed 8 weeks after infection.

The classification also provides for the division of exudative otitis into bilateral and unilateral.

Over the entire period of its development, the disease goes through 4 main stages, differing in the intensity of the inflammatory process and the severity of the damage caused:

• catarrhal;
• secretory;
• mucosal;
• fibrous

Lack of treatment for exudative otitis media for 3 years necessarily leads to irreversible hearing loss.

Symptoms

Often young children cannot articulate what exactly is bothering them. Often the only symptom of the disease is a feeling of stuffiness in the ears. Therefore, regular preventive examination by a specialist is recommended for children under 7 years of age.

At each stage of the disease, specific symptoms of the disease are observed.

Clinical picture

On initial stage It is quite difficult to determine the disease based only on the child’s complaints. It is recommended to seek advice from a specialist if there is a slight decrease in hearing with simultaneous slight enlargement of the lymph nodes behind the ears.

At the same time, you should not expect that the inflammatory process in the middle ear will immediately reveal itself with an increase in body temperature. For more late stages The patient experiences an increase in temperature to 39°C and complains of itching in the ear and congestion.

Delayed treatment may cause the disease to progress to chronic stage, which threatens the child with hearing loss and atrophy of the eardrum.

An otolaryngologist determines exudative otitis media by the following signs:

• the efficiency of the Eustachian tube initially decreases;
• the next step is the emergence of autophony, in which a person notes that he can hear himself;
• after the patient begins to be haunted by a feeling of constant nasal congestion;
• further development of the disease leads to the appearance of tinnitus and tinnitus;
• The chain of symptoms is completed by the appearance of a feeling of transfused fluid in the ear.

Diagnostics

For an accurate diagnosis, a specialist must be based on complete and reliable data on past diseases not only of the ear, but also colds and infections. It is also important how the disease progressed, what treatment was used and how effective it was.

Only after receiving this data can the doctor prescribe special examination procedures.

This is what the eardrum may look like with exudative otitis media

First of all, a small patient undergoes an otoscopy. This procedure is aimed at examining the condition of the eardrum.

Its changes can be either minor or very serious:

• membrane opacity;
• protrusion or retraction;
• acquisition of a bluish tint by the membrane;
• thickening;
• thinning to such an extent that the liquid is visible (in this case it is even possible to see how thick the exudate is at this stage).

Assessing the mobility of the tympanic membrane is also of great importance for diagnosing otitis media. This procedure carried out using tubosonometry and a pneumatic funnel.

Pneumatic funnel for assessing eardrum mobility

The final step to make a diagnosis is to assess hearing function. Exudative otitis media is characterized by a moderate hearing loss of up to 40 dB. In particular cases, both windows of the bone labyrinth are blocked by fluid, which reduces bone conduction and results in hearing loss. For diagnosis in young children, the method of acoustic impedancemetry is used, which allows one to obtain accurate information about the operation and presence of lesions of the sound-receiving and sound-conducting apparatus.

Acoustic impedance measurement is carried out using a special sound-receiving and sound-conducting apparatus - an impedance meter.

If it is not possible to access the latest equipment, radiography data is used. With its help, it is possible to establish reduced pneumatization of cells on the mastoid process.

The development of medical technology has provided otorhinolaryngologists with the opportunity to conduct a thorough endoscopic examination of the nasopharynx. Until now, doctors had to be content with data obtained from x-ray or palpation examinations.

Fiberoscopy using endoscopes of different rigidities allows you to study in detail the condition of the auditory tubes and pharyngeal orifice. The procedure helps to determine the causes of the development of the disease, clarify its stage and nature.

Based on the data obtained, the doctor is able to prescribe conservative treatment without the slightest risk to the patient or hasten the decision on surgical intervention.

Treatment methods

Therapy for exudative otitis is always complex. Its effectiveness directly depends on the stage of development of the disease at which treatment was started.

The entire treatment course pursues three goals simultaneously:

1. Elimination of the causes that led to the development of otitis media. If adenoids, tonsils or polyps are present, they will require immediate removal.
2. Hearing restoration.
3. Return to natural state eustachian tube and eardrum.

Hardware procedures

The easiest way to restore the tone of the auditory tube and remove exudate is to use the Politzer blowing method. But in the case of young children, applying it is very problematic - blowing, like pneumomassage of the eardrum, requires active participation on the part of the child, which is almost impossible at an early age.

List of procedures:

• laser therapy;
• electrical stimulation;
• ultrasound;
• magnetic therapy to improve the patency of the auditory tubes.

Medicines

Restoring natural ventilation and normal operation Eustachian tube with the help of medications is necessarily carried out against the background of massage of the eardrum and Politzer blowing (if the child’s age allows).

Self-medication is unacceptable here, because drugs are prescribed depending on the stage of the disease, the presence of complications and the characteristics of the course of the disease.

Treatment of exudative otitis media is carried out using drugs:

• combined type containing glucocorticosteroids - they are represented by Garazon, Sofradex, Anauran.
• non-steroidal medications to combat the inflammatory process - Otipax is most often prescribed.
• antibiotics - the most popular are Otofa drops.

Table: medications used for complex therapy

Photo gallery: medications

If there is no improvement from the use of drug therapy, fluid from the middle ear cavity is removed by surgical intervention.

Surgery

Depending on the severity of the disease, one of four methods of surgical treatment is used.

Folk remedies

If you decide to use the funds traditional medicine to cure a child of otitis media, know that these medications can in no way replace hardware and drug therapy, they can only complement the treatment prescribed by the otolaryngologist.

Important! Before using any of the folk recipes, be sure to consult with your baby’s doctor to see if it can be used in this particular case.

Several proven traditional medicines for the treatment of otitis media in children:

• Bulb onions. Juice onions heated in a silver spoon. The resulting liquid is instilled 1 drop into each ear.
• Wild garlic, plantain. Tampons with heated juice of these plants are inserted into auditory canals for 20 minutes, then removed, and the ears are tightly covered with dry cotton wool.
• Basil. The antiseptic properties of basil allow it to be used as a medicine for exudative otitis media. A decoction is prepared from dried raw materials (1 tsp is poured into a glass of boiling water and heated over low heat for 15 minutes.) This decoction can be instilled into sore ear or use as lotions around it. It is important to preheat the medicinal liquid slightly until warm state.
• Eucalyptus, lavender, yarrow, dandelion, celandine. Helps treat otitis media herbal infusion. To prepare it, mix yarrow inflorescences, lavender, eucalyptus leaves, celandine and dandelion root in equal proportions, then pour a glass of boiling water and leave until cool. The infusion should be taken orally, 50 ml three times a day. You can also insert a tampon soaked in a heated mixture into your ear. After 20 minutes, the tampon is removed and the ear is wiped dry.
• Hare fat. Warmed to a warm state, hare fat is instilled into the sore ear twice a day to cure otitis media. Before the procedure, you should warm up the ear a little; after instillation, it is recommended to apply a bandage. The use of this method requires permission from the attending physician. Some forms of otitis exclude the use of heating.

Photo gallery: traditional medicine

Caring for a sick child

In addition to the therapy prescribed by the doctor, parents need to create special conditions conducive to speedy recovery child.

Restrictions primarily apply to swimming and walking.

1. Walking is completely prohibited acute course exudative otitis media, elevated temperature body and after physiotherapy.
2. Swimming with exudative otitis media is strictly prohibited in the first two weeks. In the future, when the child comes into contact with water, you need to carefully ensure that it does not get into the ears. If treatment was started in a timely manner and it was possible to stop otitis in its acute form, then you should not bathe the child for a few more days to avoid relapse. As a replacement for a warm shower, wiping with a damp sponge is used.
3. In chronic forms of otitis, before washing the baby's hair, his ears must be carefully covered with cotton wool. Water getting into the ears will aggravate the course of the disease. It is allowed to take a warm shower indoors without drafts, after putting a thick swimming cap on the child’s head.
4. Walking is allowed with certain precautions (in the chronic form):

• The toddler's ears should be tightly covered with cotton wool before going outside;
• windy or wet weather is not suitable for walking;
• you need to protect your baby from hypothermia or overheating, dress him according to the weather;
• the headdress should fit tightly to the ears;
• During illness, it is worth reducing the child’s physical activity on the street.

Possible complications

If the disease is not detected and treated at the initial stage, it can take a chronic course with periodically alternating periods of exacerbations and remissions. This will cause the child’s hearing to worsen over time.

Lack of treatment for exudative otitis media in a child for 3–4 years leads to incurable hearing loss. It occurs due to deformation of the eardrum, the appearance of perforations on it and other irreversible changes in the sound-receiving apparatus.

Preventive measures

Children who are prone to respiratory diseases are primarily at risk. Parents of such babies should make every effort to strengthen the immune system and protective functions the body of their children.

Among the preventive measures:

• hardening;
• active games in the fresh air;
• active lifestyle;
• systematic sports;
• balanced diet rich in minerals and vitamins;
• compliance with the regime;
• personal hygiene;
• cleanliness of the home, etc.

1. It is not always possible to prevent the development of the disease, but it can always be detected in a timely manner if routine medical examinations are not neglected.
2. All respiratory diseases require immediate treatment until complete recovery, and not until the disturbing symptoms disappear.
3. A frivolous attitude towards adenoids can cause the development of inflammatory processes in the middle ear and serous fluid. The best way prevention is considered to be the timely removal of adenoids from a child.
4. Treatment with antibiotics is carried out only as prescribed by a doctor and in full accordance with the recommended dosages. The duration of the course cannot be shortened or increased independently.
5. Places where sick children may be should be avoided. If necessary, you must use personal protective equipment.
6. Among the ways to prevent the development of diseases, doctors primarily mention careful attention to the child’s diet. From the first days of life and for as long as possible, he must eat breast milk. The toddler's diet should not contain carbonated drinks, carcinogens, dyes, or preservatives.
7. The baby must firmly know and follow the rule - it is necessary to eat and drink in a strictly vertical position.
8. Parents are obliged to listen carefully to the baby’s complaints about the condition of the ears and not leave them unattended, even in the absence of pain.
9. Self-medication of exudative otitis media causes damage to the child’s health no less than the absence of treatment. The wrong selection of drugs can make the infection resistant to many of them, which will complicate further treatment and affect hearing.
10. The last stage of the disease is characterized by the cessation of fluid secretion, which most parents (who have not taken their child to see a specialist) take for self-healing or cure. In fact, this is the first signal of irreversible changes leading to hearing loss.

The fragile child's body requires careful and caring attitude from adults. No need to wait for the disease to take hold dangerous form, listen to your child. Some diseases in the initial stages may not make themselves felt at all. pain syndrome, but only minor discomfort. Such pathologies include exudative otitis media. Don’t be afraid to show your baby to the doctor once again, even if his ear is just itchy or the baby notices some extraneous noises in it. Remember, the earlier treatment is started, the easier it is to cope with the disease and prevent the development of complications.

Middle ear diseases are widespread in pediatric medicine. Exudative otitis in a child is considered quite a common occurrence. From statistical data it is known that about 60% of preschool children suffer from this problem. The trouble is that this disease is not accompanied by clearly expressed symptoms, which is fraught with its transition to a chronic form, which is characterized by serious hearing problems, and sometimes complete deafness. Therefore, it is important for every caring parent to know the causes of the disease, its subjective symptoms, which help determine the seriousness of the situation early stages illness.

Exudative otitis in children manifests itself somewhat differently when compared with other types of ear diseases. Despite the fact that the disease has an inflammatory course, acute process with increasing temperature and severe pain not visible. This often causes wasted time and late diagnosis.

There are some signs of exudative otitis media that are important to pay attention to and begin treatment in a timely manner:

• The child complains of ear congestion.
• It seems to the baby that there is liquid in the ears that gurgles and splashes when he turns his head.
• Constantly stuffy nose.
• Autophony is present.
• Hearing acuity becomes dull.

The seriousness of the problem is observed when there is an obvious deterioration in hearing for no apparent reason.

Exudative otitis media has three forms:

1. Acute form, which lasts up to 3 weeks.
2. Subacute - 3-8 weeks.
3. Chronic – more than 8 weeks.

There are 4 stages of the disease, on which its course depends.

• Initial, which is characterized by inflammation in the Eustachian tube, with a violation of its ventilation and, accordingly, air circulation. This process lasts about a month. All this time, the child has experienced a slight deterioration in hearing. In addition, he hears his own voice in his head.
• Secretory is accompanied by the collection of fluid in the tympanic cavity and an increase in pressure.
• During the mucosal stage, the exudate is converted into a viscous substance. The hearing deteriorates even more, but the feeling of splashing water in the ears disappears. This process lasts from 1 to 2 years.
• The fibrotic stage is characterized by the cessation of mucus production. Destructive processes occur in the tympanic cavity. This lasts up to 2 years.

Basically, the occurrence of childhood otitis is a complication of viral and cold infections, a characteristic feature of which is swelling of the mucous membranes. It is known about the structure of the hearing aid that the ear is connected to the pharyngeal passage by a hollow tube, which is covered with mucous tissue. When the auditory tubes swell, their lumens become narrowed. Complete narrowing of the lumen in the middle ear leads to the formation of a vacuum there. A liquid consisting of mucous tissue cells flows into the vacuum, as a result of which the entire space of the middle ear becomes filled with exudate. This leads to hearing loss due to dysfunction of the auditory tube.

The mucous membrane inside the hearing aid in a child may swell due to allergies. In such cases, allergic exudative otitis is diagnosed. Serious problems occur when pathogenic microorganisms settle on the mucus.

The presence of bacteria in the exudate leads to the next phase of the disease - purulent otitis media, which is considered a serious complication that requires emergency medical care.

Most often, as a result of a cold, swelling of all mucous membranes occurs, which is fraught with bilateral exudative otitis media in children.

There are many reasons for the appearance of this disease. It is worth highlighting those that occur most often:

• Inflammatory processes in the nasopharynx, maxillary sinuses, nose, which cause changes in the condition of the mucous membrane of the hearing aid.
• Adenoid growths that close the lumen in the auditory tube.
• Malignant and benign neoplasms.
• Vasomotor rhinitis and chronic rhinosinusitis.

Most often, the reason why exudative otitis appears is considered to be untimely and unqualified treatment of acute otitis in a child. This happens if parents do not consult a doctor, but try to solve the problem on their own.

Exudative otitis media in children treatment

Serous otitis in children is dangerous disease with long and difficult treatment. The main task of doctors is to eliminate the main cause, as a result of which the function of the auditory tube is disrupted. If everything is done on time and correctly prescribed therapy is used, hearing is subsequently restored and the development of changes in the mucous membrane in the middle ear is prevented.

The treatment regimen is prescribed depending on the stage of the disease and the general condition of the child. At the initial stage, conservative therapy is prescribed:

• the auditory tubes are blown according to Politzer;
• catheterization of the auditory tubes is performed;
• endoural electrophoresis with proteolytic enzymes is used;
• medications are prescribed in the form of antihistamines, vasoconstrictors and mucolytics.

If the effectiveness of all of the above methods of treating bilateral otitis is not observed, surgical treatment is prescribed. With its help, the causes of the disease are eliminated, due to which the mouth of the auditory tube is blocked and its function is disrupted. Usually this procedure is sufficient. But it happens when this method of treatment turns out to be ineffective. In this case, otosurgical intervention is performed, which consists of myringotomy, tympathonia with the introduction of a ventilation tube.

The goal of the next stage of treatment for bilateral otitis exudative in children is to restore hearing function and minimize the risk of irreversible problems with the middle ear.

If during audiological monitoring, which is carried out 2-3 months after the surgical intervention, the child’s hearing is normalized, the ventilation tube is removed.

For parents who are interested in the question of how to treat exudative otitis media, it is important to understand that any independently made decision in this matter can lead to the most serious and irreversible processes.

Drug treatment

Treatment of exudative otitis in children includes the following drugs:

• Drops with a vasoconstrictor effect to make breathing easier - Nazivin, Xylometazoline, Sanorin. You should not take these medications for more than 5 days.
• Anti-allergy medications that relieve swelling - Erius, Claritin, Suprastin.
• Mucolytics that help thin the exudate. The course of taking these medications lasts up to 2 weeks.
• When observing the bacterial genesis of the disease, antibacterial agents, which help relieve inflammation, suppress exudation and normalize capillary permeability. It's about about Garazon. The use of this medicine is permitted from the age of 6 years. There is a drug called Otofa, which is approved for children from birth. Thanks to it, the growth of bacteria stops.
• Complex of vitamins.

The effectiveness of therapy becomes much higher if it starts in a timely manner.

Folk remedies

In the treatment of exudative otitis media, the use of traditional medicine has a good auxiliary effect. There are many recipes for it. It is worth noting the most effective of them:

Kalanchoe tincture

To prepare it, you need to grind the leaves of the plant and pour boiled sunflower or olive oil over them. The mixture is infused for 3 weeks. This healing agent The turunda is soaked and inserted into the ear canal.

Hare fat

The fat is warmed to room temperature, and 2-3 drops are instilled into each ear. After which a dry bandage is applied. Before the procedure, the affected ear is slightly warmed with a bag of warm salt.

Onion

The core is cut out of the onion, into which crushed cumin seeds are poured. The onion filled with cumin is placed in the oven and simmers there until it becomes soft. After which the onion is rubbed through a sieve or squeezed through a bandage. The juice is instilled into the sore ear.

Basil oil

You can purchase the oil at the pharmacy or make it yourself. For self-cooking you need to take 25 basil leaves and pour ½ cup of olive oil over them. This miracle remedy is infused for 7 days. Before instillation of the ear, the oil is warmed to room temperature.

It is important to consult your doctor before using any of these recipes. In addition, it should be remembered that with the help of these remedies alone it is impossible to completely cure otitis media. But as aid they are indispensable helpers.

Physiotherapy

Physiotherapeutic procedures are prescribed in order to speed up recovery drainage function auditory tubes, remove fluid from the middle ear cavity and prevent purulent infection. The following methods are used for this:

• electrophoresis;
• ultrasound;
• Magnetic and laser therapy.

One of the most common physiotherapeutic methods is considered to be blowing the auditory tubes according to Politzer. A qualified doctor is required to perform it. The tip of a rubber balloon must be inserted into one of the child’s nostrils. At this time, the second nostril should be closed. The doctor tells the baby certain words that he must repeat. At this time, after the doctor compresses the balloon, air enters the Eustachian tube from the nasal cavity, and then into the middle ear cavity.

Surgical intervention

May happen serious complications, if all the methods listed above did not bring positive results. In such cases it is impossible to do without surgical methods cleansing the tympanic cavity from exudate.

The doctor chooses the method individually. It depends on the severity and course of the disease, its clinical picture.

TO effective methods in the fight against exudative otitis media include:

• Tympanopuncture, which is characterized by suction of exudate from diseased ears using a small puncture in the eardrum.
• Tympanotomy involves making a small cut in the eardrum to improve the drainage of fluid from the middle ear.
• Bypass surgery is considered a rather unpleasant and painful, but at the same time effective procedure, so local anesthesia is used to perform it. The essence of this method is that a special tube is inserted into a small incision in the eardrum, through which agents are introduced that liquefy the pathological contents of the ears and the liquid is pumped out. A child under 3 years of age is allowed to undergo this procedure under general anesthesia.

What is the danger of the disease?

Timely seeking help from the hospital and providing qualified assistance promotes rapid recovery. Delay in treatment can cause serious complications. As a result of the prolonged presence of exudate in the tympanic cavity, changes occur in anatomical structure middle ear. The mucous membrane of the auditory tube also undergoes changes. As a result, there is a risk of:

• membrane perforation;
• damage to the walls of the tympanic cavity;
• inflammatory processes in the auditory ossicles, as a result of which they become deformed;
• hearing loss and dementia, which are the most dangerous consequences.

The famous doctor Komarovsky urges parents not to let the disease develop in their children. From this it becomes chronic, which after 3 years turns into irreversible hearing loss. Due to the fact that this disease often has no symptoms, Komarovsky strongly recommends preventive examinations of the baby at least once every six months. A child prone to colds It is better to show the lore at least once every three months.

In addition, under no circumstances should you treat a child yourself. Such a frivolous attitude can threaten the child with serious hearing problems.

Prevention of exudative otitis media in children

Preventive measures are conditionally divided into 2 parts:

• It is necessary to ensure that the child suffers less from diseases that may result in otitis media. When they appear, you cannot treat the child yourself. Therapy must be selected by a doctor, and treatment must be completed.
• It is important to increase the protective properties of the baby’s body.

1. The child should undergo piercing procedures from an early age, and try to walk with him in the fresh air often and for a long time.
2. It is important to teach your child from an early age the basic rules of personal hygiene.
3. The love of sports instilled in childhood will save him from physical inactivity.
4. The child must be able to blow his nose correctly.

Any complaint from the baby or suspicious change in his behavior should be a reason to consult a doctor. This is the only way to warn serious illness and possible, sometimes irreversible consequences.

It is worth knowing the difference between exudative otitis media and acute otitis media, which occurs as a result dangerous infection, getting deep into the ear. Chronic exudative otitis media is one of the types of otitis. The characteristic features of the disease are the accumulation of exudate (viscous fluid) deep in the ear, without an inflammatory process preceding the onset of the disease. The disease is difficult to detect in a timely manner, since there are no characteristic symptoms, including sharp pains, present in ordinary otitis media. The presence of the disease can be determined solely by hearing loss, as well as strange discharge from the ear. As a rule, children aged 4 to 8 years are susceptible to exudative otitis media, and also partly in adolescence. In adults, the disease manifests itself quite rarely, in a slightly aggressive form.

The main cause of exudative otitis in a child is considered to be the transition from a primary disease to a more complex form. Most experts are inclined to believe that this disease is a complication of a common illness. There are a number of reasons that can provoke the occurrence of exudative otitis media:

• inflammatory processes in the nasopharynx;
• severe damage to the nose due to trauma and complex fractures:
• complex infectious diseases;
• weak body resistance;
• allergic reactions;
• The most common cause is water getting into the ear while taking a bath or shower.

It is worth noting that in 50% of cases, it initially develops and then develops bilateral exudative otitis media.

Symptoms

The difficulty in identifying the disease is that uh Xudative otitis media has hidden symptoms that interfere with treatment. IN medical practice There have been cases where the disease smoothly turned into a chronic form, while the symptoms did not manifest themselves.

Let's look at the main symptoms of exudative otitis media:

• hearing impairment, up to short-term loss;
• it feels like there is something in the ear;
• with sudden turns of the head;
• possible inflammatory processes in the nasopharynx;
• your own voice echoes in your ears.

Pain may be absent or short-lived. Unlike otitis media, body temperature remains normal.

Stages and forms of otitis

Exudative otitis media in children and adults has several types, as well as stages of development. It is worth considering each type separately in order to diagnose in time which form of exudative otitis media develops in a person.

Outer

This variety develops under the influence acute infection, and is also characterized by severe inflammatory processes that extend even to the inner layer of the ear (the lobe and outer concha are affected). The provoking elements of this form are:

• overdose of pharmacological agents;
• absence or sharp decline of immunity;
• poisonous insect bites;
• listening to music on headphones.

Complications include hearing loss, lack of sensitivity in the outer ear, and enlarged lymph nodes.

Chronic

This is a transitional stage of ordinary otitis, which occurs as a result of lack of timely treatment or incompletely implemented therapeutic measures.

The inflammation is not purulent, but large-scale, as it affects almost the entire ear. It feels as if the auditory organ is bursting from the inside or there is a constant presence of a plug. When you move your head suddenly, an unusual noise appears.

Chronic exudative purulent otitis media occurs if the disease was not cured within the first two months. Unfortunately, some consequences of the disease are irreversible, including complete loss hearing

Spicy

Acute exudative otitis media is a complication resulting from purulent inflammation inside auricle. Fluid accumulates in the ear, which are pus-like microorganisms that can affect the sensitive and weakened membrane. Among characteristic features of this form, it is worth noting that hearing loss cannot be stopped, and the further rehabilitation process takes a lot of time and money.

Middle ear

The final stage of development of exudative otitis media. A secretion forms in the ear, which forms in it high pressure. As a result, as in all previous stages, there is a decrease in auditory activity.

When the amount of secretion exceeds permissible norm, it begins to seep into the nasopharynx in the form of colorless mucus. Afterwards, an empty space is formed, the pressure of which disrupts the sensitivity of the eardrum.

Reference. Bilateral exudative non-purulent otitis is easy to treat and does not have irreversible consequences, unlike the chronic or acute form. Timely treatment will help avoid all unpleasant consequences.

Chronic exudative otitis media

Like acute form diseases, chronic exudative otitis media develops in adolescents, as well as in younger children age group. This form of the disease develops if the duration of exudative otitis exceeds two months.

As experts in the field of otolaryngology note, the presence of this disease indicates that the eardrum is under enormous pressure, as a result of which its deformation can occur. The consequences of this are hearing loss, as well as tympanosclerosis.

Diagnostics

For successful diagnosis, it is necessary to have records of all previous diseases the patient suffered on the ear. Among diagnostic measures The following mandatory procedures can be identified:

• otoscopy. The presence of deformation in the auricle is determined;
• audiometry. Current hearing level measurements;
• Mandatory procedures include the Valsalva maneuver and endoscopy;
• To clarify the diagnosis, as well as confirm the presence of exudative otitis media, an x-ray is taken, as well as CT scan(as an additional measure).

All other measures necessary for successful diagnosis of the disease are prescribed by a qualified otolaryngologist.

Treatment

The therapeutic course consists of a number of procedures, including drug treatment, physiotherapy, etc. Initially, the provoking cause of the disease must be eliminated.

Throughout the entire therapeutic course, the child must be under the supervision of a doctor, and also take all prescribed medications in a timely manner. A child’s body reacts to medications used differently than an adult, therefore, in case of incompatibility with the drug or too strong therapeutic effect It is urgent to change the drug to another drug. Also, in case of complications, the baby must urgently receive first aid. medical care. Therefore, to avoid dangerous precedents, doctors strongly recommend that the child remain within the hospital.

Drug treatment

Let's look at the drugs used to eliminate this disease.

Other medications are selected and prescribed on an individual basis.

Surgical intervention

In case of a serious complication, the ENT may use two procedures that are intended for only one thing - patency medicines to the center of inflammation.

The first method is myringotomy. This manipulation involves cleansing the passage of the auricle. It is worth noting that the day before the procedure, the ear is thoroughly sterilized. In general, the operation is performed under general anesthesia, during which excess secretion in the auricle is removed.

The second procedure is tympanopuncture. Quick and easy manipulation that does not require special preparation. A puncture is made in the eardrum, through which medications will be delivered to the site of inflammation. As a rule, the second procedure is used if otitis media develops in adults.

Physiotherapy

Physiotherapy is used as an additional treatment for the disease. It includes the following procedures:

• Ultrasound. Allows you to destroy the blockade of the secretion, as well as bring it out;
• Laser intervention. Intended to stabilize the passage of drugs into the ear;
• Electrophoresis is an analogue of ultrasound therapy, with the only difference: instead of low-frequency waves, small current discharges are used.

Other procedures are also used, but most often they are intended for adults.

It is considered one of the most common diseases detected in children. of various ages. The course of the pathology can go through several stages and depend on the state of the immune system, the structural features of the hearing aid and the presence of allergic reactions.

Exudative otitis media in children is a form of otitis media, which is accompanied by the accumulation of exudate in the middle ear. With this pathology of the ear, the integrity of the eardrum is preserved, and there are no painful sensations, but hearing begins to decline. Treatment of this form of otitis is quite difficult and this is due to the fact that most often it is possible to diagnose it already in the last stages.

Exudative otitis is characterized by the fact that exudate accumulates during inflammation of the middle ear. Such liquid is a favorable environment for the growth and reproduction of pathogenic microorganisms, and its independent removal from the organ cavity is impaired. Over time, the exudate thickens and it already contains mucus and pus.

The main cause of the development of exudative otitis media in children is considered to be a violation of the ventilation function of the auditory tube. This process is characterized by increased production of pus and mucus, as well as its prolonged course with the development of pain.

Often such a pathological process in children's body develops as a consequence of previous viral or bacterial infections.

A negative effect on the condition of the mucous membrane of the hearing organ is indicated by the incorrect and uncontrolled use of antibacterial drugs. This is explained by the fact that they create a favorable environment for those pathogens that are highly resistant to them.

Experts identify the following factors, the impact of which on a child’s body can cause the development of exudative otitis media:

1. decrease in the body's defenses
2. allergic rhinitis
3. passive smoking
4. cleft palate
5. chronic sinusitis

Medical practice shows that most often exudative otitis media is diagnosed in children aged 2 to 5 years. This is explained by the insufficient development of the Eustachian tube at this particular age. This feature of children's physiology contributes to the fact that pathogenic microorganisms quickly penetrate from the nasopharynx into the middle ear. Often, exudative otitis media develops due to anatomical defects of the nose, that is, due to a curvature or injury to the septum. In addition, the disease can be caused by fluid getting into the ear or a sudden increase in pressure.

Symptoms and classification

Diagnose exudative form Otitis is quite problematic, since the clinical picture is not so pronounced.

The following symptoms of acute exudative otitis media are distinguished:

• gradual hearing loss
• feeling
• hearing your voice in your head
• a change in head position is accompanied by a feeling of liquid splashing inside the hearing organ
• nasal congestion

With this pathology, there is usually no pain or it is short-lived. In addition, there is no increase in body temperature.

In young children, the signs of exudative otitis media are not clearly expressed and the main manifestation of this disease is hearing impairment. In the absence of effective treatment, persistent grade 3 may develop after several years.

In its development, exudative otitis media can go through several stages:

1. The catarrhal stage is the initial phase of exudative otitis, and the main symptom is ear congestion due to impaired functioning of the Eustachian tube. The duration of this stage can reach 4 weeks, with discomfort and autophony appearing.
2. The secretory stage is characterized by the fact that over the next year fluid accumulates in the middle ear cavity. The reason for this pathological process lies in the fact that there is no possibility of draining exudate naturally. At this stage, the child complains of a slight decrease in hearing and gurgling fluid in the ear.
3. The mucous stage is accompanied by compaction of the accumulated fluid, and it becomes quite viscous. In addition, the feeling of gurgling inside the ear gradually disappears, and hearing is noticeably reduced. The mucous stage of exudative otitis media can last for 1-2 years.
4. The fibrous stage is the last stage disease and is accompanied by a gradual subsidence of symptoms. The production of viscous exudate stops and this leads to the destruction of the hearing organ, its cavity, etc. Destructive and necrotic processes lead to a decrease in the quality of hearing and the development of hearing loss.

In every child, otitis media is characterized by a long course, and children do not always complain of ear congestion or hearing loss. Depending on the intensity and duration of the disease, the following are distinguished:

• spicy
• subacute
• chronic exudative otitis media

Depending on the location of the inflammatory process, unilateral and bilateral exudative otitis media are distinguished.

Diagnosis of the disease

To make a diagnosis, the following diagnostic studies are prescribed:

1. studying the child’s medical history during a conversation with parents
2. examination of the hearing organ using an otoscope allows you to assess the condition of the external auditory canal and membrane
3. tympanometry is considered the main method for diagnosing pathology, with which it is possible to determine pressure indicators in the ear cavity
4. bone conduction testing using tuning forks
5. CT scan temporal bone performed for severe ear disease
6. endoscopic examination helps to assess the condition of the pharyngeal opening of the auditory tube
7. tympanopuncture is a puncture of the membrane to obtain the contents of the cavity and its subsequent examination

It is quite problematic to identify exudative otitis in a small child, but with deterioration of hearing, the presence characteristic symptoms and the results of the study, this is not difficult to do.

Methods for eliminating pathology

Treatment of exudative otitis media is aimed at solving the following problems:

• eliminating the cause that provoked the development of pathology
• relieving swelling and restoring the lumen of the Eustachian tube
• stopping the inflammatory process and blocking the accumulation of liquid exudate

Treatment of exudative otitis media is aimed at restoring the lumen of the Eustachian tube, and for this purpose the use of vasoconstrictor drops is prescribed. They need to be instilled into the child’s nose, and not into the hearing organ. The following drugs are most often prescribed to facilitate nasal breathing:

• Sanorin
• Xylometazoline

In addition, you can use physiological saline solution to cleanse the nose. This rinsing helps remove mucus from the nasal sinuses and create conditions for its rapid outflow through the auditory tube. Treatment of exudative otitis can be carried out with the help of antiallergic drugs that help eliminate swelling. The use of medications such as Claritin, Suprastin and Erius gives a good effect.

To thin the exudate, mucolytics can be prescribed and should be taken for 2 weeks. If the bacteriological genesis of otitis is detected, treatment is carried out using antibacterial drugs. In addition, to increase the body's defenses, vitamins are prescribed. It is possible to prevent bacterial infection with the help of immunostimulating agents, and the most famous representative of this group is Viferon. Its use helps prevent the purulent stage of inflammation and speed up the child’s recovery.

More information about pathology can be found in the video:

To quickly remove fluid from the Eustachian tubes and prevent purulent infection, the following physiological procedures are prescribed:

• ultrasound
• laser treatment
• pneumomassage of membranes
• magnetotherapy
• electrophoresis with steroids

In some cases they resort to surgical treatment exudative otitis, and the eardrum is punctured to remove excess fluid. At chronic course In case of illness, a shunt is used through which exudate will drain during treatment and the necessary medications are administered.

Possible complications

Exudative otitis is considered a complex disease that requires mandatory treatment. If not carried out effective therapy or surgical intervention, severe consequences may develop:

1. severe hearing loss
2. pathological perforation of the eardrum
3. retraction of the membrane into the ear cavity

It is important to promptly treat pathologies that can cause the formation of exudate. Important preventive measure to eliminate diseases of the hearing organs is to strengthen the immune system and timely treatment of inflammation of the nasopharynx.

If a child has a tendency to frequent illnesses ears may require adenoid removal, and from time to time you should undergo a preventive examination. With timely treatment of exudative otitis media, the prognosis is positive, but if therapy is delayed, the consequences can be disastrous.