What is Suppurative Otitis Media?

Infants and young children are not afraid of complaining about their illness, often manifesting as ears, shaking their heads, and crying for unknown reasons. Systemic symptoms are severe and fever is often accompanied by symptoms of gastrointestinal poisoning such as nausea, vomiting, and diarrhea. Because the scales of children under 2 years of age have not been closed, there is a rich vascular and lymphatic connection between the middle ear mucosa and the dura mater. Therefore, acute purulent inflammation of the middle ear can affect the adjacent dura mater and cause meningeal irritation.

Luo Renzhong

(Chief physician)

Department of Otorhinolaryngology, Guangzhou Women and Children's Medical Center

Suppurative otitis media is a purulent inflammation of the middle ear mucosa that occurs in children and is a common cause of hearing loss in children. Acute suppurative otitis media is a common infectious disease in childhood, with a high incidence, easy recurrence, and many complications and sequelae. Auxiliary tests such as otoscopy and ear palpation can help confirm the diagnosis of suppurative otitis media. Control infection, smooth drainage, remove disease due to its treatment principles.

Western Medicine Name

Pyogenic otitis media

Affiliated Department

Faculty-

Disease site

Ear

The main symptoms

Unexplained ears, shaking his head, fever, gastrointestinal poisoning symptoms

Contagious

Non-contagious

Clinical manifestations of suppurative otitis media

Infants and young children are not afraid of complaining about their illness, often manifesting as ears, shaking their heads, and crying for unknown reasons. Systemic symptoms are severe and fever is often accompanied by symptoms of gastrointestinal poisoning such as nausea, vomiting, and diarrhea. Because the scales of children under 2 years of age have not been closed, there is a rich vascular and lymphatic connection between the middle ear mucosa and the dura mater. Therefore, acute purulent inflammation of the middle ear can affect the adjacent dura mater and cause meningeal irritation.

Diagnosis of suppurative otitis media

Otoscopy for suppurative otitis media

In the early stage of onset, the tympanic membrane was congested, and the sacrum stem and the peripheral part of the tension part showed radial dilated blood vessels. Following that, the tympanic membrane was diffusely congested, swollen, and bulged outward. The normal signs were difficult to identify, and small yellow spots were seen locally. If inflammation cannot be controlled in time, it develops into a tympanic membrane perforation. The perforation usually starts very small and is not easy to see. After thoroughly plotting the external ear, it is seen that there are pulsating highlights at the perforation, and pus is actually flowing from there. Necrotic tympanic membranes quickly dissolve, forming large perforations.

Suppurative otitis media ear palpation

The mastoid area may have slight tenderness, and the tympanic sinus area is more obvious;

Hearing test for suppurative otitis media

Most of them are conductive deaf, and a few patients may have mixed deafness or sensorineural deafness due to cochlear involvement.

Pyogenic otitis media blood test

The total number of white blood cells in the blood image increased, polymorphonuclear leukocytes increased, and the blood image became normal after the tympanic membrane was perforated.

Purulent otitis media treatment

Control infection, smooth drainage, remove disease due to its treatment principles. Systemic treatment early enough to use antibiotics or other antibacterial drugs to control the infection, in order to completely cure. Generally available drugs such as penicillins, cephalosporins. If early treatment is timely and appropriate, it can prevent perforation of the eardrum. After large-scale perforation, pus was taken for bacterial culture and drug sensitivity test. Refer to the results and use sensitive antibiotics instead. Antibiotics need to be used for about 10 days, pay attention to rest, and clear the stool. Those with severe systemic symptoms are given supportive therapy such as fluid replacement. In children, the tympanic membrane is thick and difficult to perforate. In order to prevent the infection from spreading into the skull, tympanostomy can be considered when necessary, and the drainage is shortened to shorten the course and prevent complications. If the mastoid airspace melts and pus is present, mastoidectomy should be performed in time.

Acute suppurative otitis media lasts more than 6 to 8 weeks, and the disease invades the middle ear mucosa, periosteum, or deep bone and causes irreversible damage, which is called chronic suppurative otitis media. Chronic suppurative otitis media in childhood often requires surgical treatment after the child's eustachian tube function improves. ^[1]