What is chronic suppurative otitis media?

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I. pathological causes of chronic suppurative otitis media

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1. Acute respiratory infection often occurs in people with poor physique, and also in people with nasosinusitis, sinusitis, tonsillitis and other diseases of the nose, sinuses and pharynx. When suffering from acute respiratory infection, it is easy to affect the eustachian tube and cause acute suppurative otitis media.

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2. When suffering from acute respiratory tract infection, it is often caused by blowing nose forcefully, flying by plane, swimming, diving, nasal washing or eustachian tube blowing.

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3. In case of scarlet fever, measles and other acute infectious diseases, acute suppurative otitis media and chronic suppurative otitis media are often combined.

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4. The feeding posture is improper or the milk quantity is too much or too urgent. The baby has no time to swallow, causing choking and coughing, which is easy to squeeze the milk into the eustachian tube.

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5. Some factors may cause stenosis of the pharynx and other lumens, affect its normal function, and also cause acute suppurative otitis media, such as adenoid hypertrophy, swelling and pain of the nasopharynx, adhesion of the nasopharynx, paralysis of the soft palate, polyps of the posterior nostril, hypertrophy of the posterior end of the inferior turbinate, callus formation of atrophic rhinitis, etc.

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6. Swim and dive in unclean water.

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7. When doctors treat the bleeding in the nasal cavity and nasopharynx, the stuffing plug used in the nasopharynx must be replaced in time, otherwise it will also cause the dysfunction of eustachian tube. There is another cause that is not noticed by everyone. Some people have the bad habit of digging their ears, which is likely to cause tympanic membrane injury. When washing their heads or bathing, the sewage can enter the middle ear from the tympanic membrane injury and cause infection.

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2. Common causes of chronic suppurative otitis media

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The common causes of chronic suppurative otitis media are as follows:

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1. Acute inflammation can not be cured

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Acute suppurative otitis media has not been completely treated, or the bacterial virulence is strong, the patient’s resistance is low, and the disease is prolonged to chronic, which is the common reason;

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2. Eustachian tube function abnormality

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The abnormal function of eustachian tube may lead to the poor gasification of mastoid, which may be related to the occurrence of the disease. In chronic suppurative otitis media, the majority of patients with poor mastoid gasification, but the exact relationship is not clear;

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3. The lesion is serious and deep to bone

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Acute necrotizing otitis media, the pathological changes reach to periosteum and bone, the tissue damage is serious;

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4. Adjacent organ diseases

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Chronic diseases of the nose or pharynx, such as adenoid hypertrophy, chronic tonsillitis, chronic sinusitis and so on, lead to recurrent inflammation of the middle ear;

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5. The body’s resistance and immunity are decreased

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Acute infectious diseases, combined with chronic diseases, or malnutrition and anemia, such as scarlet fever, measles, tuberculosis, etc., especially in infants and young children, result in the decline of the body’s resistance and immune ability, so that acute otitis media can easily evolve into chronic.

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3. Clinical manifestations of chronic suppurative otitis media

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(1) simple type: the most common type is caused by repeated upper respiratory tract infection when pathogenic bacteria invade tympanum through eustachian tube, also known as eustachian tube chamber type. Inflammatory diseases are mainly located in the mucosa layer of tympanum, which is congested and thickened, infiltrated by round cells, and secreted by goblet cells and glands. The clinical features are: ear purulent, mostly intermittent, mucopurulent or mucopurulent, generally odorless. The amount of pus increases with upper respiratory tract infection. The perforation of tympanic membrane is mostly central and of different sizes, but there are residual tympanic membrane around the perforation. Tympanum mucous membrane is pink or pale, but slightly thickened. Deafness is conductive and generally not serious. The mammography of mastoid is usually sclerotic without bone defect.

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(2) bone ulcer type: also known as necrosis type or granulation type, most of which are caused by acute necrotizing otitis media. Tissue damage is extensive, and the lesion is deep to bone. Necrosis can occur in the surrounding tissues of auditory ossicles and tympanic sinuses. Granulation tissue or polyp can be formed in the local area after the destruction of mucous epithelium. This type of characteristic: ear purulence is persistent, purulent sex has bloodshot between, often have stink. The large perforation of tympanic tension may involve the tympanic ring or marginal perforation. There are granulations or polyps in the tympanum, and they can protrude into the external auditory canal through perforation. Conductive deafness is more severe. The mammography of mastoid is sclerotic or diploic type with bone defect.

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(3) cholesteatoma type: cholesteatoma is not a real tumor, but a cystic structure in the middle ear and mastoid cavity. The inner wall of the capsule is a stratified squamous epithelium, filled with exfoliated epithelium, keratinized substances and cholesterol crystals. The outer side of the capsule is closely connected with the adjacent bone wall or tissue by a layer of different thickness of fibrous tissue. Cholesteatoma is called cholesteatoma because of cholesterol crystal in the capsule.

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Complications

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There are many complications of chronic suppurative otitis media, which may cause abscess in the light and even meningitis in the severe. According to experts from Nanjing Zhengda otolaryngology hospital, the complications mainly include the following aspects:

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1. All kinds of abscesses, such as subperiosteal abscess, infratemporal abscess, and posterior wall abscess of external auditory canal, can be felt in the local area after abscess, with red swelling, severe pain and high fever. If the treatment is not timely, the abscess will spread to the neck, causing pain when the neck rotates. In serious cases, it will damage the large blood vessels in the neck, leading to death.

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2. Facial paralysis, the facial nerve is very close to the middle ear cavity, if it is damaged, it will cause mouth and eye deviation.

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Symptoms of chronic suppurative otitis media

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3. Labyrinthitis. If the inflammation invades inward, entering the inner ear will cause labyrinthitis, resulting in vertigo, nausea and vomiting

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4. Causing meningitis, extrameningeal abscess and brain abscess.

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IV. preventive measures for chronic suppurative otitis media

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(1) take an active part in sports activities and combine work with rest to strengthen the body;

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(2) to treat diseases of nasal cavity, sinuses and pharynx;

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(3) do not blow your nose, fly or swim when suffering from upper respiratory tract infection, and stop nasal washing and eustachian tube blowing treatment; (4) actively carry out the prevention of various acute infectious diseases;

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(5) propagandize the correct breast posture, lift the baby several times to make the head vertical, control the speed if there is too much milk, and the size of the nipple used for artificial feeding should be appropriate;

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(6) eliminate all kinds of factors that cause eustachian tube stenosis;

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

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(8) the doctor should replace the plug in the nasopharynx in time;

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(9) don’t dig ears. When suffering from acute suppurative otitis media, the treatment should be thoroughly perforated. Patients who need tympanic membrane should not swim. When washing their hair or bathing, they should also avoid sewage from entering the ears. Actively carry out the general survey of chronic suppurative otitis media and take practical preventive measures according to different situations. So as to reduce the incidence of chronic otitis media.

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