What is chronic suppurative otitis media?

First, the pathological reasons of chronic suppurative otitis media

1, acute respiratory infections often occur in people with poor constitution, and are also prone to nasal, sinusitis, tonsillitis and other nasal, sinus and pharyngeal diseases. When suffering from acute respiratory infections, it is easy to affect the acute eustachian tube. Suppurative otitis media.

2, when suffering from acute respiratory infections, is often caused by forced snoring, flying, swimming, diving, nasal irrigation or eustachian tube blowing.

3, suffering from scarlet fever, measles and other acute infectious diseases often associated with acute suppurative chronic suppurative otitis media atlas.

4, improper feeding posture or too much milk, too urgent, the baby can not swallow, causing cough, easy to squeeze the milk into the Eustachian tube.

5, some factors can cause narrowing of the lumen of the eustachian drum, affecting its normal function, and most likely to cause acute suppurative otitis media, such as: adenoid hypertrophy, nasopharynx swelling, nasopharyngeal adhesions, soft palsy, behind the nose Hole polyps, the posterior hypertrophy of the inferior turbinate, and atrophic rhinitis form suede.

6, swimming in unclean water and diving.

7, doctors in the treatment of nasal nasopharynx hemorrhage, the use of nasopharyngeal stuffing emboli must be replaced in time, otherwise it will cause eustachian tube dysfunction, there is a cause is not noticed by everyone, some people have ear dug Bad habits, ear dents are likely to cause tympanic membrane trauma, when washing hair or bathing, sewage can enter the middle ear from the tympanic membrane trauma, causing infection.

Second, the common cause of chronic suppurative otitis media

The main causes of chronic suppurative otitis media are:

1. Acute inflammation prolonged unhealed

Acute suppurative otitis media has not been thoroughly treated, or the bacterial virulence is strong, the patient’s resistance is low, and the lesion is delayed to chronic, which is a common cause;

2. Eustachian tube function is abnormal

Abnormal function of the eustachian tube leads to poor gasification of the mastoid, which may be related to the occurrence of this disease. Among patients with chronic suppurative otitis media, the majority of patients with poor mastoid gasification, but the exact relationship is not clear;

3. Severe lesions, deep bones

Acute necrotizing otitis media, the lesions reach the periosteum and bone, and the tissue damage is serious;

4. adjacent organ lesions

Chronic lesions of the nose or pharynx, such as adenoid hypertrophy, chronic tonsillitis, chronic sinusitis and other recurrent episodes of middle ear inflammation;

5. The body’s resistance is reduced and immunity is low.

Acute infectious diseases, combined with chronic diseases, or malnutrition and anemia, such as scarlet fever, measles, tuberculosis, etc., especially infants and young children, resulting in decreased body resistance, low immunity, making acute otitis media easy to evolve into chronic.

Third, the clinical manifestations of chronic suppurative otitis media

(1) Simple type: the most common, mostly due to recurrent upper respiratory tract infection, the pathogenic bacteria invade the tympanic cavity through the eustachian tube, also known as the eustachian tube type. The inflammatory disease is mainly located in the tympanic mucosa. The tympanic mucosa is hyperemia, thickening, round cell infiltration, and active secretion of goblet cells and glands. The clinical features are: ear pus, mostly intermittent, mucinous or mucopurulent, generally not odorous. The amount varies, and the amount of pus increases when the upper respiratory tract is infected. The perforation of the tympanic membrane is mostly central to the tension, and the size is different, but there are residual tympanic membranes around the perforation. The tympanic mucosa is pink or pale and can be slightly thickened. Deafness is conductive and generally not heavy. Mastoid X-rays are often hardened without bone defects.

(B) type of bone ulcer: also known as necrotic or granulation type, mostly from acute necrotic otitis media. The tissue destruction is extensive, the lesions are deep into the bone, and the tissue around the osseous and sinus can be necrotic. After the mucosal epithelium is destroyed, local granulation tissue or polyps are formed. This type of characteristics: the ear flow pus is mostly persistent, there is bloodshot between the purulent, often smelly. Large perforations in the tympanic membrane may involve drum rings or marginal perforations. There are granulation or polyps in the tympanic cavity and can be pierced into the external auditory canal. Conductive enthalpy is heavier. The mastoid X-ray is a sclerotic or stenosis type with bone defect destruction.

(C) cholesteatoma type: cholesteatoma is a non-true tumor, but a cystic structure located in the middle ear, mastoid cavity. The inner wall of the capsule is a stratified squamous epithelium filled with exfoliated epithelium, keratinized material and cholesterol crystals. The outer layer of the capsule is closely connected with its adjacent bone wall or tissue by a layer of fibrous tissue of different thickness. Because the capsule contains cholesterol crystals, it is called cholesteatoma.

complication

Chronic suppurative otitis media has many complications. Lighter may cause abscesses, and severe cases may even cause meningitis. According to experts from Nanjing Zhengda ENT Hospital, the main complications are as follows:

1, various abscesses, such as subperiosteal abscess, subarachnoid abscess, abscess of the posterior wall of the external auditory canal, etc. After the abscess appears, the soft mass can be felt locally, redness, severe pain, and high fever. If the treatment is not timely, the abscess spreads to the neck, causing pain when the neck rotates. In severe cases, it will damage the large blood vessels in the neck and cause death.

2, facial paralysis, facial nerve is very close to the middle ear cavity, if it is damaged, it will cause the eye to be skewed.

Symptoms of chronic suppurative otitis media

3, labyrinthitis, if inflammation invades inward, entering the inner ear can cause labyrinth, leading to dizziness and nausea, vomiting

4, causing meningitis, extra-abdominal abscesses and brain abscesses.

Fourth, chronic suppurative otitis media preventive measures

(1) actively participate in sports activities, work and rest to enhance physical fitness;

(2) treatment of nasal, sinus and pharyngeal diseases;

(3) When you have a respiratory infection, do not rub your nose, do not fly, do not swim, stop nasal irrigation and eustachian tube blowing treatment; (4) actively carry out prevention of various acute infectious diseases;

(5) promotes the correct breast posture. When breastfeeding, the baby should be picked up and the head should be vertical. If the milk is too much, the speed should be controlled. The size of the nipple used for artificial feeding should be appropriate;

(6) eradicates various factors that cause eustachian tube stenosis;

(7) Choose a place with a clean water source when swimming;

(8) doctors should promptly replace the tamponade of the nasopharynx;

(9) Do not dig your ears. Patients with acute suppurative otitis media should be thoroughly perforated. Patients with tympanic membrane should not swim. When washing hair or taking a bath, avoid sewage into the ear. Actively carry out the screening work for chronic suppurative otitis media. Take practical precautions in different situations. Thereby reducing the incidence of chronic otitis media.

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