Acute otitis media ( otitis media acuta ) is a viral or bacterial infection. Here, viruses or bacteria migrate through the nasopharynx to the middle ear, where they cause inflammation.
The signs of otitis media may initially be non-specific. In case of an acute middle ear inflammation it comes first to a strong ear pain, whereby the pain is usually localized only on one side because also the middle ear inflammation is often only one sided. In some patients, there is also an increased feeling of pressure on the diseased side, as well as a knock may be heard.
Increased dizziness is also a typical first sign of middle ear infection. This is because in our ear in addition to the various auditory ossicles and the " inner ear " for auditory hearing and our balance organ, the so-called Vestibularapprat lies. If it comes to a slight constriction or a false irritation of the organ of balance due to a middle ear infection, this can lead to dizziness and possibly even one-sided fall tendency. However, most patients feel " only " a slight dizziness.
Because it is an inflammatory reaction involving viruses or bacteria, it also causes the classic symptoms of inflammation. Therefore, fever, night sweats and body aches may be the first signs of otitis media. In addition, the body with the innate immune system defends itself against the bacteria or the viruses. Therefore, in addition to pain in the middle ear, there is also redness and swelling, and there may also be heating in the area of the ear.
Due to the swelling, the auditory impression may be reduced or false ear noises ( tinnitus ) may form.
Since the middle ear is directly connected to the nose, the first sign of a middle ear infection can simply be a harmless runny nose. However, as soon as there is increased ear pain and an unpleasant feeling of pressure in the ear, the signs are clearly to be considered as middle ear inflammation.
Later, signs of otitis media change. There is a so-called Eustachian tube ( Tuba auditiva ) which connects the middle ear with the throat. Often it comes to a closure of this Eustachian tube due to the swelling in a middle ear infection. In this case, the formed mucus can no longer drain via the Eustachian tube into the pharynx, as the mucus would normally do. As a result, more and more mucus and more fluid accumulate in the middle ear. As a result, the pressure is always greater and the patient has more and more pain and, above all, an ever-increasing feeling of pressure.
These are the last signs of otitis media that should be taken very seriously. If the pressure continues to rise, the pressure may become so strong that it tears the eardrum. The eardrum usually separates the middle ear from the outer ear. If the eardrum is now defective, the accumulated fluid and the accumulated mucus may escape to the outside and the feeling of pressure and the pain diminish immediately. This leads to an outflow, which usually consists of pus, sometimes blood and above all a lot of fluid, out of the middle ear to the outside. The emergence of pus from the middle ear is the last sign of otitis media and should be avoided at best. In most cases, however, even after a tympanic rupture, the eardrum recovers and there is no delay.
It is important to note that adults are always easier to diagnose than children. In children, in addition to ear pain, there is often unspecific abdominal pain and usually excessive fever. Therefore, the diagnosis is often more difficult here and it should be noted whether, for example, the child has more often hearing problems or whether it often holds the ear.
Somewhat different from acute otitis media are the signs of chronic middle ear infection. Chronic middle ear inflammation occurs when the patient suffers from symptoms of otitis media for months. Here it comes, similar to the acute otitis media, to hearing loss and false hearing impressions.
A striking sign of chronic otitis media is the persistent, sometimes purulent discharge of secretions from the ear, which may be phased out.
Another sure sign of chronic otitis media is the enormous growth of inflammatory tissue. In this case one speaks of a cholesteatoma . In addition, the eardrum can be reddened due to the continuous load, sometimes even scarred.