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Exudative ear infection – symptoms, treatment, complications

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Otitis media with effusion causes nonspecific symptoms. This does not include typical symptoms of ear inflammation, such as severe ear pain. The disease has a long course. What are the most common symptoms of otitis media with effusion? What is the reason for its development? We explain.

  • Anatomical structure of the ear
  • What is otitis media with effusion?
  • Exudative ear inflammation – causes
  • How long does an effusion ear infection last?
  • Symptoms of effusion ear inflammation
  • Otitis media with effusion – diagnosis
  • Treatment of exudative otitis media in adults and children
  • Complications after otitis media with effusion

The structure of the ear, which is the organ of hearing and balance, is divided into the outer ear, middle ear and inner ear. The hearing organ is susceptible to various diseases; he may also develop anatomical defects that cause hearing problems, such as hearing loss. Inflammation of individual ear structures manifests itself in slightly different ways. In the case of otitis media with effusion, the dominant symptom is, among other things: a feeling of fullness in the ear and decreased hearing. Children often develop effusion ear infections. The disease may be indicated, among other things, by changes in the child’s behavior and speech development disorders. It is worth learning more about the causes and treatment of otitis media with effusion, as well as nonspecific symptoms that should prompt you to see a doctor.

Anatomical structure of the ear

The outer ear consists of the pinna and the external auditory canal, which is tubular in shape and ends in the eardrum. The external auditory canal transmits sound waves from the environment to the receiving eardrum.

The eardrum closes the external auditory canal, acting as a barrier between the external environment and the middle ear, which consists of an air-filled tympanic cavity. The tympanic cavity contains three auditory ossicles – the malleus, the incus and the stapes. The function of the auditory ossicles is, among other things, to transmit sound waves. The eardrum is connected to the throat by the Eustachian tube, which equalizes the pressure inside the ear. The tympanic cavity contains muscles – the tympanic muscle and the stapedius muscle, as well as air cells and others. mastoid head cell.

The structures of the inner ear include the bony labyrinth and the membranous labyrinth. The inner ear is responsible for the sense of balance and is involved in receiving and transmitting acoustic stimuli to the brain. The organ of hearing is the organ of Corti, located in the cochlea.

What is otitis media with effusion?

Acute inflammation most often develops in the middle ear (acute otitis media), which causes very unpleasant symptoms, including: severe pain in the ears. Less characteristic symptoms are caused by chronic otitis media, which persists for a long time or persistently recurs. Otitis media with effusion differs in symptoms from acute otitis media and chronic otitis media. This inflammatory disease of the middle ear causes fluid to accumulate in the eardrum and does not cause symptoms of acute inflammation, which include, but are not limited to, ear pain and fever.

Exudative ear inflammation – causes

Otitis media with effusion develops due to dysfunction of the eustachian tube, which connects the middle ear to the pharynx. The main cause of the disease is the creation of negative pressure in the tympanic cavity, which contributes to the formation of effusion and disrupts the functioning of the mucous membrane of the tympanic cavity – the risk of developing the disease increases, for example, if the patency of the tympanic cavity is improper. Eustachian tubes. Fluid accumulating in the spaces of the middle ear irritates the mucous membrane, contributing to the development of inflammation. Remaining fluid in the tympanic cavity is an additional factor that increases the risk of infection.

Otitis media with effusion can also be caused by a bacterial or viral infection that develops outside the organ of hearing, in the nasopharyngeal cavity, and other disorders in the functioning of the body. Anatomical defects in the facial structure, such as anatomical abnormalities of the nose and cleft palate, play an important role in the development of the disease. The risk of developing the disease increases, in particular:

  • adenoid hypertrophy,

  • previous acute otitis media,

  • frequent recurrences of upper respiratory tract infections,

  • esophageal reflux,

  • chronic sinusitis,

  • inhalation allergy.

Due to risk factors for developing otitis media with effusion, this disease is common in children. It’s worth knowing untreated otitis media with effusion can lead to serious problems in the development of the child. Changes in the child’s behavior, such as a lack of response to sounds, impaired speech development, or frequent raising of the voice, may be associated with effusion of the ear.

Although effusion of the ear is a common childhood disease, sometimes it is diagnosed too late – in many cases, the child consults a doctor when hearing problems occur. Otitis media with effusion is rarely diagnosed in adults, but some hearing loss may be associated with the development of this condition in childhood.

In some cases, otitis with effusion goes away on its own, but more often it has a recurrent or chronic course, which increases the risk of developing severe complications.

How long does an effusion ear infection last?

Depending on the duration of the disease, acute, subacute and chronic forms of otitis media with effusion are distinguished. The acute form of otitis media with effusion lasts up to 10 days. The subacute form of the disease lasts up to 3 months, the chronic form – more than 3 months.

Symptoms of effusion ear inflammation

Symptoms of effusion of the ear, which often appear during the course of the disease, include:

  • feeling of fullness in the ear,

  • sensation of fluid in the ear,

  • flows into the ear

  • tinnitus,

  • mild to moderate ear pain

  • recurrent ear infection

  • change in the child’s behavior – the child does not respond to commands and may be hyperactive,

  • violations of sound orientation.

During the course of otitis media with effusion, symptoms from the upper respiratory tract appear, including: recurrent infections with symptoms of rhinitis, symptoms of gastropharyngeal reflux and bad breath.

Otitis media with effusion – diagnosis

Diagnosis of otitis media with effusion includes laryngological and hearing tests, such as the whisper test and otoscopic examination. The scope of tests is selected according to the age of the child. Other methods for diagnosing otitis media with effusion include: audiometry and additional studies that reveal, for example, defects in the anatomical structure of the nasopharyngeal cavity and the organ of hearing. In some cases, magnetic resonance imaging or computed tomography is necessary.

Treatment of exudative otitis media in adults and children

Treatment of otitis with effusion includes three methods: observation of the patient, conservative treatment and surgical treatment. Pharmacological treatment is used one-time – anti-inflammatory and painkillers, as well as antibiotics if an infection occurs in the middle ear. Appropriate treatment of recurrent airway inflammation and monitoring of hearing status is necessary.

Surgical treatment of otitis media with effusion is used for the chronic form of the disease if conservative treatment has not brought improvement. Indications for surgical treatment are:

  • hearing loss 30 dB or more,

  • recurrent ear infections

  • chronic insufficiency of the eustachian tube,

  • developmental disorders associated with the disease, such as speech disorders,

  • anatomical defects associated with an abnormal structure of the head.

Surgical treatment includes drainage of the ear, thanks to which it is possible to remove residual fluid from the tympanic cavity, as well as eliminate the causes, including: blockage of the pharyngeal openings of the eustachian tubes of the pharyngeal tonsil. Ear drainage involves cutting the eardrum, removing any remaining fluid, and installing a ventilation tube.

Complications after otitis media with effusion

The minimally symptomatic course of otitis media with effusion facilitates the identification of the disease when it leads to serious disturbances in the functioning of the hearing organ. Otitis media with effusion can lead to, among other things: perforation of the eardrum and permanent hearing loss. Due to complications of otitis media with effusion, the risk of developing cholesteatoma, an inflammatory tumor of normal cells (not associated with a cancer process), increases. A growing cholesteatoma can begin to put pressure on the bones, labyrinth or auditory nerve, causing additional complications.

Sources:

  • J. Kuczkowski, Modern problems of diagnosis and treatment of acute and effusion otitis media, Forum Medycyny Rodzinnej, 3, 2011.

  • B. Zelnik-Jurkiewicz, O. Olszewska-Sosińska, M. Rakowska, Long-term results of ventilation and drainage treatment of chronic otitis media with effusion in children, Otolaryngology Polska, 60, 2006.

  • J. Bozedar Latkowski, Otorhinolaryngology for medical and dental students, Wydawnictwo Lekarskie PZWL, Warsaw, 2004.

  • Childhood diseases
  • ENT diseases
  • Symptoms
  • Pregnancy and baby

Source: Wprost

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