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Several misunderstandings of otitis media
Otitis media is a common problem in life, such as hearing loss and empyema in ear canal. In general, everyone thinks that empyema in ear canal is otitis media. In fact, we have a great misunderstanding about the symptoms, prevention and treatment of otitis media. The following small series will introduce you to the nine misunderstandings of otitis media.
Myth 1: There is no otitis media without earache and pus in the ear canal.
Clinically, otitis media can be divided into acute and chronic bacterial (suppurative) otitis media, catarrhal (secretory) otitis media and cholesteatoma otitis media. The main symptom of suppurative otitis media is acute otitis media with earache, which accords with our traditional concept of otitis media. Secretory otitis media, on the other hand, has no symptoms of pus in the ear canal and few symptoms of earache, but only symptoms of deafness and hearing loss, mainly the leakage caused by negative pressure in the middle ear and tympanum caused by eustachian tube obstruction. Because exudate is non-bacterial, it generally does not cause earache and suppuration, so it is easy to miss diagnosis and misdiagnosis, especially for children who have no chief complaint symptoms and delay treatment. For example, children with nasopharyngeal hypertrophy complicated with rhinitis and sinusitis are prone to this disease. Parents can pay attention to whether children ask you to speak too loudly or watch TV too loudly. If so, they should go to the hospital to check whether they have otitis media.
Some people check out that they have otitis media, but they still don't trust the doctor, thinking that it was misdiagnosed and they don't cooperate with the treatment. Some cholesteatoma otitis media may have intermittent symptoms of pus discharge, odor and pus discharge, but some patients may not have such symptoms, but they only have earache and headache, which are not found during examination and will always be missed and ignored.
Myth 2: Non-suppurative otitis media has a lower incidence and less harm than suppurative otitis media.
Secretory otitis media, acute otitis media with unperforated tympanic membrane and some cholesteatoma otitis media may not have pus, but the incidence is not low and the harm is not light.
Although there is no exact statistical report on the incidence of non-suppurative otitis media, it is more common than suppurative otitis media in clinic. Childhood is a high incidence period of exudative otitis media. At this age, the eustachian tube is relatively straight, the nasopharyngeal cavity is relatively small, and rhinitis and sinusitis are more common. In addition, acute upper respiratory tract infection is more likely to stimulate eustachian tube mucosal edema, and secondary eustachian tube obstruction will cause secretory otitis media. There is no significant difference in the incidence of non-suppurative otitis media among adults of all ages, and it is more closely related to colds and acute upper respiratory tract infections. The main reason is that bacterial and viral infection of nasopharyngeal mucosa involves eustachian tube mucosa, and other diseases such as nasopharyngeal carcinoma can also cause otitis media, deafness and hearing loss. In terms of harm, non-suppurative otitis media often has hearing damage or even rubber ears to varying degrees, which seriously affects hearing and even affects speech and intellectual development in infancy. Concealed cholesteatoma may even cause facial paralysis, meningitis, brain abscess and other complications, which may be life-threatening. In addition, most patients with chronic otitis media are also caused by improper treatment or delayed treatment of bacterial infection secondary to non-suppurative otitis media.
Myth 3: otitis media is caused by pus flowing out of the ear canal.
This is because we don't know much about other ear diseases. Otitis media was previously diagnosed as otitis media. Now we know that other ear diseases will also have symptoms of otitis media, such as otitis externa, and sometimes they will show symptoms of otitis externa, accompanied by bacterial infection. The main difference from otitis media is that the tympanic membrane of the former is complete and there is no perforation. Of course, suppurative otitis media is just a needle-like perforation. When it is not clearly exposed, it is sometimes difficult to distinguish it from otitis externa. There are many reasons for otitis externa, such as repeated ear digging, diabetic fungal infection, ear canal stenosis and water inflow. , especially digging ears. Furuncle and rupture caused by folliculitis of external auditory canal can also cause pus in auditory canal. Examining the ear canal can be distinguished from asking about past history. External auditory canal tumors, such as papillomas and malignant tumors, may also have pus and sometimes blood pus when infected with bacteria. Pathological examination is the main diagnostic method, and sometimes such diseases are misdiagnosed as otitis media. However, because these patients have a long history of otitis media, once the patients with otitis media find granulation growth in the external auditory canal or tympanum, they should be diagnosed as soon as possible, especially those with blood pus or earache and headache.
Due to the limitation of medical technology in the past, most patients with chronic otitis media and cholesteatoma otitis media are treated conservatively with drugs. If the operation needs to stop pus for 3 months to more than half a year, pus and tympanic membrane perforation are often easy to recur because the inflammatory lesions of middle ear mastoidosis are not completely eradicated. At present, due to the development of otology, tympanoplasty has been widely used in the treatment of otitis media. It can not only completely remove inflammation and cholesteatoma, but also repair tympanic membrane, rebuild ossicles and improve hearing, and the recurrence rate is very low. For patients with recurrent chronic otitis media, surgery can be performed at the suppurative stage, and the clinical effect can also be obtained. Patients with cholesteatoma otitis media should be operated as soon as possible, and there is no need to worry that pus will affect the surgical effect.