Exudative otitis in children

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Exudative otitis in a child and features of its treatment

Otitis is considered one of the common diseases that is detected in children of different ages. The course of the pathology can go through several stages and depend on the state of the immune system, the structural features of the hearing aid and the presence of allergic reactions.

Table of contents:

Exudative otitis media in children is a form of otitis media, which is accompanied by the accumulation of exudate in the middle ear. With this pathology of the ear, the integrity of the eardrum is preserved and there is no pain, but hearing begins to decrease. Treatment of this form of otitis is quite difficult and this is due to the fact that most often it is possible to diagnose it already in the last stages.

The main causes of the disease

Exudative otitis is characterized by the accumulation of fluid in the middle ear cavity

Exudative otitis is characterized by the fact that exudate accumulates during inflammation of the middle ear. Such liquid is a favorable environment for the growth and reproduction of pathogenic microorganisms, and its independent removal from the organ cavity is impaired. Over time, the exudate thickens and it already contains mucus and pus.

The main cause of the development of exudative otitis media in children is considered to be a violation of the ventilation function of the auditory tube. This process is characterized by increased production of pus and mucus, as well as its prolonged course with the development of pain.

Often such a pathological process in a child’s body develops as a consequence of viral or bacterial infections.

A negative effect on the condition of the mucous membrane of the hearing organ is indicated by the incorrect and uncontrolled use of antibacterial drugs. This is explained by the fact that they create a favorable environment for those pathogens that are highly resistant to them.

Experts identify the following factors, the impact of which on a child’s body can cause the development of exudative otitis media:

  1. decrease in the body's defenses
  2. allergic rhinitis
  3. adenoids
  4. passive smoking
  5. cleft palate
  6. chronic sinusitis

Medical practice shows that most often exudative otitis media is diagnosed in children aged 2 to 5 years. This is explained by the insufficient development of the Eustachian tube at this particular age. This feature of children's physiology contributes to the fact that pathogenic microorganisms quickly penetrate from the nasopharynx into the middle ear. Often, exudative otitis media develops due to anatomical defects of the nose, that is, due to a curvature or injury to the septum. In addition, the disease can be caused by fluid getting into the ear or a sudden increase in pressure.

Symptoms and classification

Symptoms depend on the stage of otitis media

Diagnosing the exudative form of otitis is quite problematic, since the clinical picture is not so pronounced.

The following symptoms of acute exudative otitis media are distinguished:

  • gradual hearing loss
  • feeling of stuffiness in the ear
  • hearing your voice in your head
  • a change in head position is accompanied by a feeling of liquid splashing inside the hearing organ
  • nasal congestion

With this pathology, there is usually no pain or it is short-lived. In addition, there is no increase in body temperature.

In young children, the signs of exudative otitis media are not clearly expressed and the main manifestation of this disease is hearing impairment. In the absence of effective treatment, after several years, persistent grade 3 hearing loss may develop.

In its development, exudative otitis media can go through several stages:

  1. The catarrhal stage is the initial phase of exudative otitis, and the main symptom is ear congestion due to impaired functioning of the Eustachian tube. The duration of this stage can reach 4 weeks, with discomfort and autophony appearing.
  2. The secretory stage is characterized by the fact that over the next year fluid accumulates in the middle ear cavity. The reason for this pathological process lies in the fact that there is no possibility of draining the exudate naturally. At this stage, the child complains of a slight decrease in hearing and gurgling fluid in the ear.
  3. The mucous stage is accompanied by compaction of the accumulated fluid, and it becomes quite viscous. In addition, the feeling of gurgling inside the ear gradually disappears, and hearing is noticeably reduced. The mucous stage of exudative otitis media can last for 1-2 years.
  4. The fibrotic stage is the last stage of the disease and is accompanied by a gradual subsidence of symptoms. The production of viscous exudate stops and this leads to the destruction of the hearing organ, its cavity and the eardrum. Destructive and necrotic processes lead to a decrease in the quality of hearing and the development of hearing loss.

In every child, otitis media is characterized by a long course, and children do not always complain of ear congestion or hearing loss. Depending on the intensity and duration of the disease, the following are distinguished:

Depending on the location of the inflammatory process, unilateral and bilateral exudative otitis media are distinguished.

Diagnosis of the disease

An otolaryngologist can confirm the diagnosis after examination.

To make a diagnosis, the following diagnostic studies are prescribed:
  1. studying the child’s medical history during a conversation with parents
  2. examination of the hearing organ using an otoscope allows you to assess the condition of the external auditory canal and membrane
  3. tympanometry is considered the main method for diagnosing pathology, with which it is possible to determine pressure indicators in the ear cavity
  4. bone conduction testing using tuning forks
  5. computed tomography of the temporal bone is performed for severe ear disease
  6. endoscopic examination helps to assess the condition of the pharyngeal opening of the auditory tube
  7. tympanopuncture is a puncture of the membrane to obtain the contents of the cavity and its subsequent examination

Identifying exudative otitis in a small child is quite problematic, but if hearing deteriorates, characteristic symptoms and test results are present, this is not difficult.

Methods for eliminating pathology

Exudative otitis media is a serious disease that requires complex treatment.

Treatment of exudative otitis media is aimed at solving the following problems:

  • eliminating the cause that provoked the development of pathology
  • relieving swelling and restoring the lumen of the Eustachian tube
  • stopping the inflammatory process and blocking the accumulation of liquid exudate

Treatment of exudative otitis media is aimed at restoring the lumen of the Eustachian tube, and for this purpose the use of vasoconstrictor drops is prescribed. They need to be instilled into the child’s nose, and not into the hearing organ. The following drugs are most often prescribed to facilitate nasal breathing:

In addition, you can use physiological saline solution to cleanse your nose. This rinsing helps remove mucus from the nasal sinuses and create conditions for its rapid outflow through the auditory tube. Treatment of exudative otitis can be carried out with the help of antiallergic drugs that help eliminate swelling. The use of medications such as Claritin, Suprastin and Erius gives a good effect.

To thin the exudate, mucolytics can be prescribed and should be taken for 2 weeks. If the bacteriological genesis of otitis is detected, treatment is carried out using antibacterial drugs. In addition, to increase the body's defenses, vitamins are prescribed. It is possible to prevent bacterial infection with the help of immunostimulating agents, and the most famous representative of this group is Viferon. Its use helps prevent the purulent stage of inflammation and speed up the child’s recovery.

More information about pathology can be found in the video:

To quickly remove fluid from the Eustachian tubes and prevent purulent infection, the following physiological procedures are prescribed:

  • ultrasound
  • laser treatment
  • pneumomassage of membranes
  • magnetotherapy
  • electrophoresis with steroids

In some cases, surgical treatment of exudative otitis is resorted to, and the eardrum is punctured to remove excess fluid. In the chronic course of the disease, a shunt is used, through which exudate will drain during treatment and the necessary medications are administered.

Possible complications

Advanced exudative otitis media can lead to hearing loss in a child

Exudative otitis is considered a complex disease that requires mandatory treatment. If effective therapy or surgical intervention is not carried out, severe consequences may develop:

  1. purulent otitis media
  2. severe hearing loss
  3. pathological perforation of the eardrum
  4. retraction of the membrane into the ear cavity

It is important to promptly treat pathologies that can cause the formation of exudate. An important preventive measure to eliminate hearing diseases is strengthening the immune system and timely treatment of inflammation of the nasopharynx.

If a child is prone to frequent ear diseases, it may be necessary to remove the adenoids, and from time to time a preventive examination by an otolaryngologist should be performed. With timely treatment of exudative otitis media, the prognosis is positive, but if therapy is delayed, the consequences can be disastrous.

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Comments (2)

E. Glebova

24.11.2017 at 03:36 | #

The doctor recommended physiological saline solution for the child and the nose began to breathe. However, later they simply used Nazivin. I think that this form of release is much more convenient to use.

Mokina Sveta

01/11/2018 at 11:40 | #

Exudative otitis media also occurred in our child, and the doctor prescribed quite standard measures and medications for treatment. This is the well-known Nazivin with the supporting agent Suprastin. The treatment helped!

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Exudative otitis in children and adolescents (serous otitis)

Exudative otitis media is an urgent problem, since in recent years the number of patients with this diagnosis has increased significantly. Most of them are children. The symptoms of this disease often go unnoticed, which causes problems with early diagnosis and treatment, and the hearing prognosis for children with exudative otitis media is unfavorable.

What is exudative otitis media?

Exudative (serous, secretory) otitis is a disease that leads to inflammation of the mucous membrane of the middle ear and increased secretory activity of the mucous glands, as a result of which it is filled with non-purulent fluid.

The middle ear is the tympanic cavity. On one side it is covered by the eardrum, on the other by the window of the labyrinth, at the top it has access to the mastoid process, and at the bottom there is an auditory tube. A chain of auditory ossicles stretches from the eardrum to the oval window.

In the development of the disease, the main role is played by obstruction of the auditory tube, which exits from the middle ear into the nasopharynx. It is designed for ventilation, drainage and protection. Through it, the air necessary to equalize the pressure of the external environment enters the tympanic cavity and the mucous secretion is released, which is secreted in the ear. When this channel is blocked for some reason, in the tympanic cavity, firstly, the pressure drops (since the necessary air does not flow), and secondly, inflammatory effusion accumulates.

These factors lead to hearing impairment of varying intensity, and the presence of fluid creates favorable conditions for the development of bacteria, which can lead to the transition of exudative otitis to purulent otitis.

Types of exudative (serous) otitis in children

This insidious disease can develop in one ear (unilateral otitis) or in both. With bilateral exudative otitis media in children, the risk of developing hearing loss and deafness is higher. Therefore, he must be treated in a hospital setting, under the supervision of specialists. It is worth noting that bilateral exudative otitis media in children occurs in most cases.

Exudative otitis in a child can have an acute or chronic form. Recently, there has been a tendency towards the predominance of sluggish forms. This is mainly due to the uncontrolled and irrational use of antibiotics, which leads to the development of bacterial resistance to them.

Chronic inflammation lasts for many years. If tubular dysfunction is not eliminated for a long time, the exudate becomes more viscous and sticky. It sticks to the walls of the eustachian tube, the tympanic cavity and membrane, and the auditory ossicles. As a result, adhesive processes develop that cannot be cured except by surgery.

Exudative otitis: causes of occurrence in childhood

The causes of exudative otitis in a child lie in infectious and non-infectious pathologies that affect the condition of the auditory tube. For example, severely enlarged adenoids, which are very common in children. Or ENT diseases of bacterial and viral etiology: sinusitis, pharyngitis, tonsillitis, rhinitis, etc. As mentioned earlier, the mouth of the auditory tube opens into the nasopharynx, so an infection from the nose or pharynx can penetrate it and cause inflammation of the mucous membrane.

Increasingly, such ailments occur in people prone to allergies. Persistent allergic rhinitis, sinusitis, etc. lead to the development of chronic sluggish otitis.

The cause of serous otitis in children can also be catarrhal otitis. The most common pathogens are pneumococcus, Haemophilus influenzae, streptococcus and staphylococcus. Less commonly, catarrhal inflammation of the ear is caused by viruses.

The state of immunity plays an important role in the development of inflammatory diseases, and in children of the first years of life, both local protection in the mucous membrane of the ENT organs and general immunity are not strengthened.

Influenza and ARVI of the respiratory tract are a common cause of acute exudative otitis in a child.

Predisposing factors in the occurrence of exudative otitis are considered: polyps or tumors, trauma, curvature of the nasal septum, hyperplasia of the mucous membrane of the pharynx or nose, congenital abnormalities (for example, the narrowness of the lumen of the tube or nasal passages). All of them can directly or indirectly lead to blockage and inflammation of the auditory tube.

Symptoms of exudative otitis media in children

Serous inflammation of the ear is rarely accompanied by severe pain. Body temperature remains normal or rises slightly. The main sign that indicates the presence of effusion in the tympanic cavity is discomfort, congestion and tinnitus, decreased hearing acuity in one ear. Ear congestion occurs due to tubular dysfunction. Autophony may also indicate it. Exudative otitis media is mainly accompanied by a stuffy nose or runny nose.

As the ear fills with fluid, the person begins to feel fluid in the ear. This is especially noticeable when the head is tilted. Later, a feeling of pressure and fullness arises.

Even adults often do not pay attention to such signs, and children are even more unable to assess the situation and say what worries them. How to recognize the symptoms of exudative otitis media in a child? Carefully observe your child’s behavior: unreasonable changes in mood, irritability, crying, anxiety, lack of mood - these are reasons to visit a doctor. In schoolchildren, hearing problems can manifest themselves in incorrect answers in class. In general, an adult child himself will say that he has trouble hearing.

If there have already been cases of ear inflammation, then it is better to undergo periodic checks, since the absence of symptoms of serous otitis in children often leads to late diagnosis and the development of persistent hearing loss. Against the background of chronic inflammation, a gradual decrease in hearing occurs.

Diagnosis of serous otitis in children and adolescents

To identify exudative otitis media in children, the doctor first performs an otoscopy. If the eardrum appears retracted, this indicates a decrease in pressure in the eardrum. Other signs of inflammation include enlarged blood vessels, changes in the color of the membrane, and the presence of a streak (fluid level).

Next, without fail, the doctor must examine the upper respiratory tract: nasal passages, conchae and cavities, paranasal sinuses, nasopharynx and the opening of the auditory tube. This study is carried out using special mirrors in good lighting. If necessary, anemization of the mucous membrane is first performed. During the examination, pathological changes may be detected: polyps, granulations, scars, blocking of the lumen with a tubular roller, etc. The mucous membrane of the Eustachian tube looks hyperemic, edematous or atrophied.

In case of exudative otitis media in a child, it is necessary to determine the degree of patency of the auditory tube. To do this, they resort to blowing: air from a cylinder is supplied through the nostril. It must pass through the auditory tube into the middle ear. In this case, the doctor observes the movement of the eardrum through an otoscope. The degree of noise and vibration indicates whether the pipe passage is closed or not.

A more advanced method is impedance measurement. It is carried out using an ear probe, which simultaneously changes the pressure in the ear, produces sounds and registers feedback signals. Thus, it is possible to learn about the condition of not only the Eustachian tube, but also the auditory ossicles, tympanic cavity and membrane. To identify hearing problems, the child is referred to an audiologist.

Exudative otitis media in children: treatment

Treatment of unilateral and bilateral exudative otitis in a child requires an integrated approach. First, you need to identify and eliminate all causes that negatively affect the functions of the auditory tube. If necessary, acute respiratory infections and acute respiratory viral infections are treated, the nasal cavities and paranasal sinuses are sanitized, adenoids and polyps are removed, and the nasal septum is straightened. If a child is diagnosed with a viral infection, a course of antibiotics is prescribed. If allergies are present, desensitizing therapy is used.

After such events, the capacity of the eustachian tube is often restored, and effusion from the middle ear is evacuated on its own. If this does not happen (which happens in advanced cases of chronic and acute exudative otitis media in a child), treatment of auditory tube dysfunction is carried out using the following methods:

  1. Blowing. This is the same procedure that is used for diagnosis. Air pressure, which is supplied into the nose through a rubber tube connected to a balloon, helps open the Eustachian tube and remove fluid from the tympanic cavity. The pressure in the middle ear is equalized. In order to numb the nasal cavity, a cotton swab with an ephedrine solution is inserted into it. In this case, the patient must lie on the sore ear so that the solution from the cotton wool flows into the mouth of the pipe. Small children are placed on their backs and secured for blowing. Positive results are noted after the first procedure, but sometimes you have to repeat it several times.
  2. Catheterization. This method is used in those advanced cases when blowing does not produce results. Catheterization is carried out by installing a catheter through the nose, so that its beak enters the mouth of the auditory tube. Air can be supplied through it or medicinal substances can be injected. Hydrocortisone is administered to relieve swelling, and enzymes are administered to thin the mucus. For effectiveness, the procedure is repeated several times.
  3. Pneumomassage of the eardrum. This method of therapy has a positive effect on the muscles of the eardrum, especially if it is carried out in conjunction with blowing. It is carried out by changing the pressure in the ear canal using a pneumatic massager or manually.

Blowing, catheterization and massage are complemented by various types of physiotherapeutic procedures: electrophoresis, laser therapy, ultrasound. Electrophoresis with Lidase is widely used for otitis media. Under the influence of current, the medicine penetrates the tissue and accumulates directly at the site of the disease. Laser treatment of exudative otitis helps relieve inflammation and pain. The laser helps thin mucus and destroy bacteria. The effectiveness of climatotherapy has also been proven. For example, a holiday on the southern coast of Crimea has a beneficial effect on the condition of the respiratory tract and improves the patency of the Eustachian tube.

In addition, you can influence the auditory tube using intranasal administration of vasoconstrictor and anti-inflammatory drops, which help reduce swelling of the mucous membrane and improve nasal breathing. List of drugs that are indicated for children:

  1. Otrivin. Contains xylometazoline, which has the ability to constrict blood vessels, thereby reducing swelling of the nasal mucosa. Otrivin is indicated for children from 6 years of age.
  2. Nazivin (from birth). The active ingredient of this vasoconstrictor drug is oxymetazoline.
  3. Avamis. These are drops that contain the corticosteroid fluticasone fuorate. Avamis has a pronounced anti-inflammatory effect. Shown from 6 years old.
  4. Rinofluimucil. This is a combination of the vasoconstrictor tuaminoheptane and acetylcysteine, which has a mucolytic, anti-inflammatory and detoxifying effect. Rinofluimucil is used for children over 2 years of age.

In severe cases of exudative otitis in children, treatment with conservative methods does not help, since the fluid in the ear becomes too viscous. Then you have to eliminate the disease surgically to prevent the progression of hearing loss.

Exudative otitis: surgery in children

The simplest operation to help free the ear cavity from pathological exudate is myringotomy, followed by installation of a shunt. It is performed under general or local anesthesia. The eardrum is pierced and waited until all the fluid flows out through the hole. Then a shunt is installed. It can stand for a month or even several months until the doctor notes the cessation of hypersecretion of exudate. For bilateral otitis, myringotomy is performed on both ears. After the shunt is removed, the hole heals on its own or is sealed.

Although some complications are possible after myringotomy (eg, re-infection or persistent perforation), in cases of long-term tubular dysfunction in children with thick mucus, this procedure is the only way to prevent the development of hearing loss.

Another option for surgical treatment is tympanopuncture. First, the eardrum is anesthetized (children are usually given general anesthesia) and pierced with a needle. Then the contents from the middle ear are sucked out with a syringe. Next, it is washed with a solution of hydrocortisone and adrenaline. To break down too thick exudate, enzymes or thinning drugs (Mucodin) are administered.

If tympanopuncture was carried out successfully, with a positive effect, then it is possible to repeat the operation several times until complete cleansing. It helps prevent the development of adhesive otitis, the occurrence of cholesteatomas and scars. When adhesive processes have already begun, a sanitizing operation on the middle ear is prescribed, aimed at removing all the changed areas.

Exudative otitis: treatment at home

Parents usually cannot sit idly by when their child is sick. Therefore, at home, in between hospital visits and therapeutic procedures, you can use folk remedies.

For example, the following alcohol tinctures are recommended for ear drops for children:

Such products are sold in pharmacies, but if desired, you can prepare them yourself. The natural components of such tinctures perfectly fight inflammation, relieve pain, and speed up the healing process. Place 2 drops in each ear, 3 times a day.

Also, with otitis media, herbal decoctions help: yarrow, chamomile, St. John's wort, calendula, eucalyptus. Choose one or more herbs, you will need 1 tbsp. raw materials per glass of boiling water. Just fill the herb with water, cover with a lid and let sit for half an hour. Strain the broth, soak cotton wool in it, and then insert it into the ear canal for 20 minutes. Repeat the manipulations 3 times a day.

Before you begin to treat exudative otitis media at home, you must first consult with your doctor. Since improper treatment can harm, but not help in any way. The doctor will tell you what you can’t do and what you can do. Then focus on the child’s well-being: if he gets worse from some medications, then stop using them.

Consequences of serous otitis in childhood

The concerns of parents and doctors about this disease in children are well founded: late detection increases the risk of developing permanent hearing loss. The consequences of serous otitis in childhood negatively affect the formation of speech and general development in the future.

Complications of exudative otitis media in children in the form of adhesive adhesive processes and cholesteatoma require surgical removal. After sanitizing operations on the middle ear, plastic restoration of the excised areas will be required. Such procedures rarely allow one to return to their previous hearing acuity, and in some cases their results turn out to be completely opposite - hearing deteriorates even more.

Also, prolonged congestion in the tympanic cavity can lead to inflammation of the labyrinth, in which the auditory and vestibular analyzer is located. The development of labyrinthitis leads to deafness and the appearance of vestibular disorders, in the form of dizziness, unsteady gait, nausea and vomiting, due to which a person cannot lead a normal life.

Prevention of exudative otitis media in children

To prevent the development of otitis in children, first of all, you should pay attention to the condition of the nose and throat. This is especially true for adenoids, because they most often become the cause of the development of exudative otitis media. It is important to undergo preventive examinations that will help identify deviations before they become protracted.

Since it is very difficult to detect hearing loss in children, periodic hearing tests will be relevant.

Parents of children prone to viral diseases need to think about boosting their immunity. A healthy, fortified diet, good sleep, outdoor sports exercises, hardening, and visits to health resorts will help with this. During flu epidemics, you should refrain from visiting crowded places; for prevention, you can take antiviral drugs. Try to ensure that your child does not become hypothermic during the cold season.

The best prevention of exudative otitis media in children and adolescents is breastfeeding from the first days of life. It should last at least 3 months. Milk contains active substances such as interferon, immunoglobulin, etc. They increase the level of protection of the child’s body and suppress pathogenic infections.

To prevent milk from flowing from the throat into the auditory tube during feeding, you need to keep the baby reclining.

Otitis media in pregnant women is quite common. You can find out how to properly treat it for expectant mothers by clicking on the link.

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Exudative otitis in children: what is the danger of the disease, ENT recommendations

The disease discussed in this article occurs in different age categories of people. Exudative otitis is characterized as a process of inflammation of the middle ear cavity, in which there is an accumulation of fluid in the ear. The presence of fluid in the ear is not a warning sign. Anatomically, a person is provided with a certain amount of fluid, but its amount is small. Fluid from the ear is removed in the standard way through the sink and this does not bother the person. If the fluid is unable to escape, it begins to accumulate inside and the inflammatory process begins.

Exudative otitis is characterized by the presence of inflammatory fluid in the middle ear

Causes of exudative otitis media in children

Exudative otitis in children appears mainly between the ages of 2.5 and 7 years, but you should not relax. Exudative otitis media can affect a person at different ages. The disease is treated by otolaryngologists. They distinguish the following causes of otitis media in children:

  • weak immunity of the body due to a recent illness or the presence of a chronic disease;
  • a disease accompanied by exudative inflammation: infection, sinusitis, rhinitis and others;
  • allergic inflammation as a reaction to an irritant;
  • anomaly of the tonsils, resulting in poor patency in the ears;
  • abnormal structure of the nasal cavity, nasal septum;
  • anomaly of the oral cavity in the form of cleft palate;
  • excessively enlarged nasal concha;
  • the presence of formations or tumors in the nose or cavity;
  • development of the inflammatory process of the almond arches;
  • excessive cooling of the body;
  • environmental influences;
  • unfavorable living conditions.

Features of development

Exudative otitis media in children comes down to fluid appearing in the ear. The causes of fluid in the ear are explained as follows:

  1. As a result of the inflammation process in the nasal cavity, the normal functioning of the “Eustachian tube” stops.
  2. Due to impaired functionality, air gradually ceases to enter the middle ear.
  3. This condition increases the pressure in the ear, which leads to the formation of excess fluid in the child's ears.
  4. Subsequently, the fluid accumulates, thickens, acquires a sticky consistency, filling the entire space of the middle ear.

If treatment is not started on time, the accumulation of fluid leads to a decrease in the quality of hearing.

It is worth distinguishing between several forms of otitis media in a child. There is acute exudative otitis media, a subacute form, and also a form that has become chronic.

Stages of the disease

Revealing the specifics and stages of a disease such as otitis media in children, it is necessary to understand what kind of disease it is. It appears gradually, there are no special obvious signs. To see the development of the disease, carefully study the characteristic features of each stage of development.

There is inflammation of the outer, inner and middle ear

If you notice signs of at least one of the stages, consult a doctor immediately. A negligent attitude towards the disease will lead to complications in children, and later to a chronic form, which is not so easy to treat.

So, there are four stages of disease development:

  1. Catarrhal otitis. At this stage, the process of inflammation and malfunction of the “Eustachian tube” begins. The mucous membrane becomes inflamed, and air gradually stops flowing into the middle ear area. The duration of the stage is about a month.
  2. Secretory otitis. At this stage, the cavity is filled with excess fluid. It is at this stage that the baby begins to feel pressure in the ear, audibility decreases, and noise interference appears. When you turn your head or change position, you hear a sound similar to the splashing of liquid. This stage lasts up to a year.
  3. Mucosal otitis. This stage is characterized by the process of liquid thickening. It becomes sticky, and the sounds of splashing water are not heard because the liquid stops moving through the ear cavity. When cleaning the ear, the stickiness of the discharge is so great that the cotton wool sticks to the ear. This stage lasts from one to two years.
  4. Fibrous otitis. If the disease has developed to this stage, practically no fluid is released, and an irreversible process of deformation of the hearing ossicles begins.

The duration of the four stages of the disease is an individual feature of each person. In one child it develops within a year, while in another it progresses over three years. There are cases when parents did not notice any changes in the functioning of the baby’s hearing system, and the baby did not feel any particular unpleasant symptoms. The discovery of otitis media occurred by chance. For example, during a routine examination upon admission to kindergarten. The worrying fact is that if treatment for exudative otitis media is not started at the initial stages of development, this will lead to hearing loss in the child.

Diagnosis of the disease

Diagnosis of the disease is complicated by the fact that there are no clear symptoms. The main symptom of otitis in a child is hearing loss. But besides this, there are other signs by which an attentive parent will determine that there is a problem:

  • a state of congestion in the ear and nose, with no discharge present;
  • presence of noise in the ear cavity;
  • a feeling of “echo” from one’s own voice;
  • immobility of the tympanic septum;
  • Upon examination, a thickening and yellow color of the septum are detected.

Suspicion of otitis in a child requires a doctor to be called to the house

By consulting a doctor, you guarantee a high-quality solution to ear problems, if such problems exist. What does a doctor do before starting treatment for exudative otitis media in children? He carries out certain activities to diagnose the disease, the complexity of the disease and the stage of development:

  • makes a survey of parents about what diseases the child has suffered in life and recently;
  • studies the specifics of the illnesses suffered, their complexity, and the medications used to treat the child;
  • performs an otoscopy to determine the condition of the tympanic septum;
  • conducts an examination to determine how movable the septum in the ear is;
  • performs a hearing test to check the degree of decrease;
  • analyzes the condition of the child’s entire hearing system, including the auditory tubes;
  • If necessary, prescribe tomography and x-rays.

Treatment of the disease

In order for the treatment of exudative otitis to be correct, the treatment must be carried out by a professional. Do not start self-medication. Treatment of otitis media in children without medical supervision will lead to disastrous results. Only an experienced otolaryngologist will correctly diagnose and prescribe treatment that is suitable for the baby. Treatment of otitis in a child is not much different, but differs from the treatment of an adult. Three treatment options are used, which complement each other and together lead the patient to recovery.

  1. Treatment with medications. It is permissible to treat a child’s ear with medications only after visiting a doctor. The choice of medication depends on the specifics of the disease and diagnostic results. Drugs are prescribed that relieve inflammation, soften fluid, and constrict blood vessels. If there is an infection in the body, antibiotics may be taken. In case of an allergic cause of otitis, antihistamines are prescribed.
  2. Procedural activities. Also, otitis media in children is treated by prescribing a course of procedures. Ultrasound, laser therapy, electrophoresis, magnet therapy, and blowing are used. The procedures help remove excess fluid from the ear cavity and improve the muscle condition of the tissues. It is worth noting that the procedures are used to treat otitis media in children 3 years of age and older.
  3. Surgical treatment. Surgery is also allowed to treat ears in children. The principle of the operation is to insert a catheter, or shunt, into the ear through an incision in the membrane. Through a shunt, medications are injected directly into the middle ear. If necessary, the patient is kept in this state for up to 4 months. At the end of treatment, the shunt is removed.

When asked by parents how long it takes to treat otitis media, we will answer as follows: the duration of treatment directly depends on when you saw the problem and sought help from a doctor. To speed up treatment, the use of folk remedies is allowed, but do this only after consultation with your doctor. Remember, the child’s health is in the hands of the parents.

Source: http://nasmorkoff.ru/ear/ekssudativnyj-otit-u-detej-v-chem-opasnost-zabolevaniya-rekomendacii-lora/

Exudative otitis in a child

Otitis media is one of the most common childhood diseases. The course of the disease can have several stages and depends on the child’s immunity, hereditary structural features of the hearing aid, and the presence of allergic reactions. Exudative otitis may give way to purulent manifestations with fever and general toxicosis. How does the disease develop and what to do if a child is diagnosed with exudative otitis media?

Peculiarities

Otitis is an inflammatory disease of the outer, middle or inner ear. The term exudative refers to inflammation, which is accompanied by the release of exudate (liquid). The exudative stage is inflammation without the formation of pus.

Another name for non-purulent inflammation is catarrhal or secretory otitis (catarrh and secretion are two more names for fluid that exudes from cells). Therefore, exudative otitis is also called catarrhal and secretory inflammation of the middle ear. What are the features of catarrhal exudative inflammation in children?

The overwhelming majority of childhood otitis media are complications of colds or viral infections. Colds and viral diseases are accompanied by swelling of the mucous membranes. The human hearing aid is designed in such a way that the ear is connected to the pharyngeal passage by a hollow tube covered with mucous tissue.

As a result of swelling of the auditory tube, its lumen narrows. When the lumen is completely narrowed, a vacuum is formed in the middle ear. Liquid from the cells of the mucous membrane sweats into the vacuum space. Thus, the middle ear cavity is filled with liquid mucus (exudate).

Swelling of the mucous membrane inside the hearing aid in children can occur due to an allergic reaction. Then the child develops allergic exudative otitis media. The cause of the edema is not so important for the disease; another thing is important: pathogenic bacteria can settle on the resulting mucus.

If a bacterial infection settles on the exudate, the next stage of the disease forms - purulent otitis media. The purulent stage is a complication of exudative inflammation.

Catarrhal otitis media in children is almost always bilateral (all mucous membranes swell with a cold). Purulent otitis media can develop on one side - then it is called unilateral otitis media with bacterial infection.

Causes

Otitis media in children is formed due to two reasons: infection of the nasopharynx and narrowing of the lumen of the auditory tube. If the cause of otitis is a narrowing of the lumen of the auditory eutachian tube (its edema), then exudative (catarrhal) otitis media is formed. If a nasopharyngeal infection is present, the disease develops with a purulent complication.

Infections of the nasopharynx include frequent or chronic runny nose and adenoids. In children, enlarged adenoids are a source of toxins, compress the Eustachian tube and narrow its lumen.

In some children, the structure of the auditory tube is too straight and short. With this hereditary factor, childhood colds are often complicated by inflammation of the ear canals (bilateral catarrhal otitis media or purulent complications).

Symptoms

With the appearance of exudate, the sick child hears worse. He may feel stuffiness and tinnitus, the first symptoms of otitis media, urgent treatment is necessary. In addition, children have impaired nasal breathing and pain (first short-term, then constant and sharp).

Severe throbbing pain occurs during the purulent stage of the disease. If the otitis media is catarrhal (exudative), then at the beginning of the disease, pain may occur periodically due to mechanical impact on the ear. When the diagnosis of “exudative (catarrhal) otitis media” is in doubt, to clarify the condition of the middle ear, tomography of the temporal bones and endoscopy of the nasopharynx (examination of the eustachian tube using a probe) are used.

Treatment

Effective treatment of exudative inflammation should be aimed at:

  • elimination of the cause of otitis (inflammatory disease of the nasopharynx);
  • relieving swelling and restoring the lumen of the auditory eustachian tube;
  • reducing inflammation and blocking the formation of liquid exudate.

Treatment of the exudative stage does not require the use of antibiotics.

Nasal drops and rinsing

Exudative otitis media is cured when the lumen of the auditory tube is restored. For this purpose, vasoconstrictor drops are used. They are buried not in the ear, but in the child’s nose. Rinsing the nose in children removes mucus from the sinuses and creates conditions for its outflow through the auditory tube. Nasal rinsing is performed with physiological saline solution.

Compresses

Treatment will be effective if you use different treatments: nasal drops, compresses externally, immunostimulants internally. Compresses are made based on alcoholic tinctures of medicinal plants and remedies (calendula, mint, eucalyptus, propolis).

With otitis media, the child feels very painful. Therefore, during otitis media, the child’s ears should be kept closed at all times by placing cotton wool on them and securing them with a cloth bandage or cap.

Immunostimulants

In order to prevent bacterial infection, treatment of otitis media uses immunostimulating drugs. The most famous representative of this group is Viferon. The use of Viferon allows you to prevent the purulent stage of inflammation and speed up recovery.

Physiotherapy

Physiotherapeutic methods can speed up the removal of fluid from the Eustachian tubes and prevent purulent infection. The following procedures are used:

  • pneumomassage of the eardrums;
  • blowing of the Eustachian tubes;
  • laser irradiation of the mouth of the Eustachian tube (entrance into it from the nasopharynx).

Catarrhal otitis is dangerous due to possible complications. Therefore, its treatment must be quick and effective.

Complications

Purulent otitis media in a child is a complication of exudative (catarrhal) inflammation. Mucous exudate is a favorable environment for the proliferation of pathogenic bacteria. If they enter the child’s body and settle on the exudate inside the ears, purulent otitis media forms.

The purulent formation matures, increases in volume, puts pressure on the eardrum and breaks through it. After rupture (perforation), pus flows out, the pain ceases to be throbbing and weakens. The temperature is decreasing.

If spontaneous breakthrough does not occur, the eardrum is opened surgically. If the pressure is too strong, pus can break into the cavity of the inner ear and cause a severe complication - meningitis. Therefore, purulent otitis media requires monitoring and observation. To prevent the formation of a purulent stage, proper treatment is necessary: ​​relieve swelling in time and use immunostimulants.

Source: http://lecheniedetej.ru/uxo-gorlo-nos/ekssudativnyj-otit.html

How to treat exudative otitis media in a child?

The insidiousness of the disease lies in the high risk of complications to which children are susceptible.

Hearing damage can be irreversible, which is why medical supervision is so important.

And only a doctor can make an accurate diagnosis of “exudative otitis media in a child.”

Read about the symptoms and treatment of catarrhal otitis in children here.

Concept and characteristics

The disease is characterized by the outflow of fluid in the middle ear, but there is no inflammation.

The infection penetrates inside and is localized in the middle ear, but in the first stages there are no symptoms that would indicate pathology. The eardrum is intact, there is no significant pain, but hearing acuity is slowly decreasing.

Children aged 3-7 years are more susceptible to exudative otitis media. The pathology occurs without noticeable signs, although first a serous exudate forms in the ear cavity, and then a purulent one.

As the disease progresses, the child’s hearing decreases, therefore, if therapy is not carried out in a timely manner, the development of third-degree hearing loss is possible.

Causes

The disease gets its name from the word exudate, which is the name given to the fluid that collects in the middle ear. It is also considered a convenient environment for the life of pathoorganisms. Gradually the liquid thickens and consists mainly of mucus and pus.

The cause of the disease is impaired ventilation of the auditory tube.

And this, in turn, can happen due to a previous respiratory infection, for example, bacterial or viral.

Also, the adverse effects of incorrectly taken antibiotics can also provoke this dangerous disease.

Other possible preconditions for the disease include:

Insufficient development of the eustachian tube is another provoking factor. Simply put, it is not difficult for disease to travel from the nasal passage to the middle ear, since microbes and other pathogenic organisms do not have to travel a long way.

Otolaryngologists also note that tobacco smoke is one of the most common provocateurs of the disease, therefore you should not smoke in the house where the child lives, and on the street, walking with the child, in the car, etc.

Types and forms

According to the time course of the disease, it is customary to distinguish several phases of the disease - acute otitis (lasts up to three weeks), subacute (3-8 weeks), and chronic, if the pathology has lasted for more than 8 weeks.

Exudative otitis media can be described in stages:

  1. Initial - this stage is characterized by primary deviations at the mucosal level, some cells are simply replaced by others.
  2. Secretory - the volume of work of goblet cells increases, which produces secretion.
  3. Mucosal - the exudate gradually thickens and becomes viscous.
  4. Degenerative - the level of secretion drops, structures stick together, fibrotic processes develop.

Also, otitis media can be unilateral, affecting one ear, and, accordingly, bilateral, affecting two ears at once.

In the vast majority of cases, children suffer from bilateral otitis media.

Symptoms and signs

Since the symptoms are mild, the diagnosis is made late, and treatment promises to be protracted.

The baby's body temperature is either normal or low-grade.

The general condition of the child is also normal. Children may not complain about anything at all, so it can be discovered literally by chance at a routine appointment with an otolaryngologist.

Signs of the disease will be as follows:

  • decreased hearing acuity;
  • a feeling of pressure or some gurgling in the ear canal;
  • crackling in the ear;
  • the patient does not fully hear his voice;
  • noise in the ears when you turn your head.

In the acute period, pain in the ear is possible, but not severe. There is no exudate at that time, only the air circulation in the ear canal is disrupted.

In the subacute period, the fluid itself becomes viscous, the patient may complain of hearing problems, he is tormented by a feeling of fluid transfusion, as well as heaviness in the ear.

Complications

If the disease is neglected, it will soon become chronic. Without proper treatment, the disease will become irreversible hearing loss within three years.

Self-medication is also dangerous: you can damage the auditory tube, eardrum, the child’s hearing will be impaired, and it will be impossible to fully restore it.

Diagnostics

Only an otolaryngologist can diagnose the disease.

The doctor will ask what illnesses the child has suffered, examine the middle ear with special instruments and perform an otoscopy.

Additional research methods:

  1. Tympanometry - pressure is created in a special way in the ear canal itself.
  2. Audiometry - examines the level of hearing, as well as the perception of sounds of different heights.
  3. X-ray – reveals cellular disorders.
  4. CT scan of the temporal bones is done for new development of the disease or if it is difficult to prepare a diagnosis.

The doctor determines which diagnostic methods to use in each specific case.

Treatment methods

How to treat a baby? Therapy is prescribed only after a complete examination of the child and an accurate diagnosis. All treatment comes down to removing the very cause of the disease, and then the baby’s hearing is restored.

If polyps or adenoids are found, it is recommended to remove them.

Blowing of the auditory tubes according to Politzer

This procedure is necessary in order to improve the patency of the Eustachian tube.

So, air is introduced into the middle ear using special devices.

At the onset of the disease, laser therapy is also possible.

Catheterization

Catheterization means inserting a special thin tube into the middle ear. But this method is not suitable for children, since inserting the catheter requires some participation from the patient himself. Therefore, alternative methods are selected for children.

Physiotherapy

Electrophoresis is quite often used. This treatment option involves administering medications through the skin. The technique is often chosen because it uses a reduced volume of medications.

But the effectiveness of therapeutic methods is high - with the help of electric current, the solutions administered by the patient’s body are absorbed twice as quickly (when compared with injections).

This method does not cause any inconvenience, so it can also be used to treat small children.

Medicines

Vasoconstrictor drugs may be prescribed - Nazivin, Sanorin.

They are necessary to restore aeration of the ear canal, as well as improve the outflow of fluid. To thin the sputum, mucolytics are prescribed - Ambrobene or Ambroxol.

If an infection is detected, antibiotics are prescribed - Azithromycin or Amoxiclav. Also, according to the doctor's decision, anti-inflammatory drugs and antihistamines can be prescribed. An obligatory part of treatment is taking vitamin complexes.

Surgical intervention

If necessary, surgical treatment is also prescribed. This could be a myringotomy - it is needed to remove fluid once, using a special tube to create pressure.

Tympanopuncture can be performed - a special drainage is installed, medications are injected into the ear cavity using a shunt until the little patient’s condition improves.

Komarovsky's advice

The famous pediatrician Komarovsky notes that exudative otitis media is a serious disease. If necessary, the child may be hospitalized.

Considering the fact that the disease remains asymptomatic for some time, Komarovsky reminds how important it is to undergo preventive examinations.

This should happen at least once every six months, and in children it can be examined more often, once every three months.

If the child is prone to frequent acute respiratory viral infections and rhinitis, then you need to go to the ENT specialist more often.

Prevention

All preventive work can be divided into two parts. The first is to try to exclude diseases that can lead to otitis media. These are frequent ARVI, rhinitis, sinusitis, sinusitis, adenoids.

If it was not possible to avoid diseases, then it is within the power of parents to treat them competently and efficiently, and most importantly, to provide further treatment.

The second part of all preventive procedures is to increase the body's defenses.

This means basic hardening procedures, frequent and long walks in the fresh air, teaching the child the rules of personal hygiene, and finally, sports and physical education. There should be no place for physical inactivity in a child's life.

Treatment of exudative otitis is a long-term work that must be completed. The disease is controlled by the doctor; no traditional methods will be effective and can only worsen the baby’s condition.

Teach your child to blow his nose correctly, teach him to indicate his complaints, teach simple hygiene rules - wash his hands with soap after each visit to the street.

Take your child for routine preventive examinations; not a single doctor will blame you if the mother “frequently” visits doctors for preventive purposes.

You can learn about the first signs of serous meningitis in children from our article.

About the diagnosis of exudative otitis media in children in this video:

Source: http://pediatrio.ru/o/otit/ekssudativnyj-u-rebenka.html