Treating otitis media
'Otitis media treatment'
Between the eardrum (Latin: Membrana tympania) and the inner ear, is the middle ear. The tympanic cavity (Latin: Cavitas tympanica) with the ossicles hammer, anvil and stapes, as well as the ear trumpet (Latin: Tuba auditiva) and the eardrum. With an otitis media, the inner mucous membranes are inflamed.
Those affected may complain of earache, hearing loss, ringing in the ears, knocking in the ear, general feeling of illness, headache and fever.
The most common cause is the spread of infections in the throat or nose. Because between the middle ear and the nasopharynx is the ear trumpet, also known as the tube. When swallowing, yawning or speaking certain sounds, it opens and creates a pressure balance. This ensures that the pressure in the middle ear corresponds to the pressure in the nasopharynx or the outside air. However, pathogens can enter the middle ear in this way "rising up“And cause inflammation.
In rare cases, an injury in the eardrum can be a gateway for germs to enter the middle ear. A special form is the otitis media caused by scarlet fever and measles.
Chronic otitis media cause severe hearing loss, as inflammation-related fluid accumulation restricts the mobility of the ossicles.
In this context, a distinction is made between chronic mucosal suppuration and chronic bone suppuration. Both variants of chronic otitis media cause hardly any pain, but they do cause chronic ear discharge.
One of the most feared complications of otitis media are the pathogens entering the inner ear Damage to the facial nerve (Facial nerve), the spread of inflammatory processes Meninges and or brain and the creation of a Blood clot in the area of the skull.
1) pain management
Earache is almost always the main focus of otitis media and should be treated. In principle, many painkillers are suitable for this (Analgesics), but in practice mostly tablets with the active ingredient paracetamol or ibuprofen are used.
As a rule, ear drops do not get to the place where the pain develops. Only with a "perforating otitis media“So if there is a tear in the eardrum, the drops enter the middle ear.
Frequently, however, draining secretion prevents sufficient effectiveness. Therefore, ear drops are to be assessed very critically in pain treatment.
2) nose drops
Many doctors recommend the use of nasal spray or drops to decongest the mucous membrane. They cause the nasal and tube mucosa to swell and thereby improve the ventilation of the middle ear. However, the application is not suitable for a longer period of time, as the active ingredients contained in it dry out the nose and even "dependent" do.
In addition, only special products developed for this age group may be used with children.
Experts have had a lot of discussion in recent years about the real benefits of antibiotic treatment for otitis media. For many years it has been the therapy of choice for the most part. But in the age of increasing resistant germs ("Problem germs“) The application is called into question.
Basically, it must be decided in each individual case whether an antibiotic is necessary. Studies have shown, however, that in about 85% of cases a spontaneous improvement in symptoms occurs within the first two to three days.
In practice, those affected are therefore often asked for a second check-up about 2 days after the symptoms began. Of course, if symptoms worsen during this period, you should consult a doctor earlier.
Nevertheless, in certain cases of otitis media, an antibiotic must be used immediately. These include:
Children <6 months of age
Children> 2 years, with bilateral otitis media, even with only slight pain and fever <39 degrees
Severe pain and fever> 39 degrees
Persistent, purulent discharge from the ear
Risk factors (e.g. Immunodeficiency, mastoiditis, Down syndrome)
Generally, the doctor first chooses amoxicillin as the antibiotic of choice. Usually one application for about five to seven days is enough to eliminate the symptoms. If the treatment does not work, alternative agents can be chosen.
4) Surgical Therapy
If there is no improvement in the symptoms despite antibiotic treatment, a so-called "Pathogen detection" respectively. To do this, the eardrum is opened with a small incision (Paracentesis), and the mostly purulent liquid behind it is sucked off. Bacteria can then 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.
If the secretion is too thick to be suctioned off, the doctor will need a small plastic tube (Ventilation tubes) in the cut of the eardrum. In this way, the secretion can run off on its own and dreaded complications, such as dilated bone or abscesses, are avoided. After a few months, the eardrum grows back and the tubes are rejected.
5) home remedies
Read more on the topic: Home remedies for earache
Some home remedies can relieve the symptoms of otitis media. Basically, those affected should drink a lot and take it easy.However, if symptoms persist, it is imperative to see a doctor. The following home remedies are recommended:
- Red light heat: Special red light lamps cause a beneficial warming of the inflamed middle ear. Make sure you keep a sufficient distance from the light source and protect your eyes from infrared radiation.
- Onion sachets: For the production, 1-2 raw, fresh onions are chopped and wrapped in a small cotton cloth or kitchen paper. Then warm it up to body temperature and place the sachet on the diseased ear. To fix it better, you can loosely use a hat or headband. After about 20 minutes the onion bag is removed again.