Treatment of otitis media

synonym

" Otitis media treatment "

Generally

A middle ear infection is usually associated with a number of unpleasant symptoms.

Between the eardrum ( Latin: membrana tympania ) and the inner ear, is the middle ear. To him count the tympanic cavity ( lat .: Cavitas tympanica ) with the ossicles hammer, anvil and stapes, as well as the Eustachian tube ( lat .: tuba auditiva ) and the eardrum. In middle ear inflammation, the inside mucous membranes are inflamed.

Those affected may complain of earache, hearing loss, ear noise, ear bumps, general malaise, headache and fever.

The most common cause is a spread of infections in the area of ​​the pharynx or nose. For between the middle ear and nose and throat room is the Eustachian tube, also called tube. When swallowing, yawning or speaking certain sounds, it opens and creates a pressure equalization. This ensures that the pressure in the middle ear corresponds to the pressure in the nasopharynx or the outside air. However, pathogens can " ascend " into the middle ear and cause inflammation.

In rare cases, an injury in the eardrum can be an entry point for germs in the middle ear. A special form is the scarlet and measles-induced middle ear infections.

Chronic middle ear infections cause severe hearing loss, as inflammation-related fluid retention restricts the mobility of the ossicles.

In this context, a distinction is made between a chronic mucosal suppuration, as well as a chronic bone suppuration. Both variants of the chronic otitis media cause little pain, but a chronic Ohrausfluss.

The most dreaded complications of middle ear inflammation include the passage of the pathogens into the inner ear, the damage to the mimic facial nerve ( facial nerve ), the spread of inflammatory processes to the meninges and / or brain and the formation of a blood clot in the skull.

treatment

Chronic inflammation of the middle ear is particularly unpleasant and often requires surgical treatment.

1) pain therapy

Earache is almost always in the foreground in the case of otitis media and should be treated. In principle, many painkillers ( analgesics ) are suitable for this, but in practice mostly tablets with the active ingredient paracetamol or ibuprofen are used.

Ear drops usually do not reach the place of pain. Only in the case of a " perforating middle ear infection ", ie if there is a tear in the eardrum, the drops reach the middle ear.
Often, however, effluent secretion prevents sufficient efficacy. Therefore, ear drops are very critical in the treatment of pain.

2) nose drops

Many doctors recommend the use of mucous decongestant nasal spray or drops. They cause a swelling of the nasal, - and the tubal mucosa and thereby improve the ventilation of the middle ear. However, the application is not suitable for a longer period, since the active ingredients contained dry out the nose and even " dependent ".
In addition, children may only use special products developed for this age group.

3) antibiotics

Experts have been discussing the real benefits of antibiotic treatment for middle ear infections in recent years. For many years, it was largely the therapy of choice. But in the age of increasing resistant germs (" problem germs"), the application is questioned.

Basically, it must be decided in each case whether an antibiotic is necessary. However, studies have shown that in about 85% of cases spontaneous improvement of symptoms occurs within the first two to three days.

In practice, therefore, patients are often asked to undergo a second check-up about 2 days after the onset of the complaint. Of course, if symptoms worsen during this period, you should consult a doctor sooner.

Nonetheless, in certain cases of otitis media, an antibiotic must be used immediately. These include:

  • Children <6 months of life

  • Children> 2 years, with bilateral otitis media, even with only mild pain and fever <39 degrees

  • Strong pain and fever> 39 degrees

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  • Persistent, purulent discharge

  • Risk factors ( eg immunodeficiency, mastoiditis, Down syndrome )

In general, the doctor initially chooses amoxycillin as the antibiotic of choice. In most cases, an application is sufficient for about five to seven days to eliminate the symptoms. If the treatment does not work, alternative drugs can be chosen.

4) Surgical Therapy

If there is no improvement in the symptoms despite antibiotic treatment, a so-called " pathogen detection " must be carried out. For this purpose, the eardrum is opened with a small cut ( paracentesis ), and the underlying, usually purulent, liquid sucked off. Subsequently, bacteria can be detected from the liquid and a suitable antibiotic can be selected. The procedure is not painful. In adults it is done under local anesthesia, in children under general anesthesia.

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If the secretion is too thick to be aspirated, the doctor must place a small plastic tube ( tympanic tube ) in the cut of the eardrum. Thus, the secretion can proceed on its own and dreaded complications, such as an obstruction or abscesses are avoided. After a few months, the eardrum grows and the tubes are repelled.

5) home remedies

Some home remedies can relieve the symptoms of middle ear infection. Basically, sufferers should drink a lot and protect themselves. However, if symptoms persist for longer, be sure to call a doctor. The following home remedies are recommended:

  • Red light heat: Special red light bulbs cause a soothing warming of the inflamed middle ear. Make sure you are far enough away from the light source and protect your eyes from the infrared radiation.
  • Onion bag: For the preparation, 1-2 raw, fresh onions are chopped and beaten in a small cotton cloth or kitchen paper. Then warm it up to body temperature and place the bag on the diseased ear. To fix it better, you can easily use a cap or a headband. After about 20 minutes the onion bag is removed.

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