Symptoms of chronic otitis media with pus

The article is professionally consulted by Master, Doctor Nguyen Nam Phong - Pediatrician - Department of Pediatrics - Neonatology, Vinmec Phu Quoc International General Hospital

Mucus otitis media is one of two forms of chronic otitis media. This is a discharge of pus from the ear that lasts for more than 3 months. The cause of chronic otitis media with purulent pus is due to prolonged inflammation in the nasopharynx such as sinusitis, especially due to tonsillitis. Chronic purulent otitis media includes the following clinical forms:
otitis media with closed tympanic membrane tympanic fibrosis: no discharge from the ear, no perforation of the tympanic membrane, prolonged and recurrent chronic nasopharyngitis. The valsava test was negative. In addition, atrial fibrillation also has the following characteristics: Concave tympanic membrane Protruding short piece of hammer bone The shaft of the malleus is horizontal The bright triangle is narrowed. Chronic purulent otitis media lasts many years and develops in episodes of acute otitis media. Chronic purulent otitis media will not go away if the patient still has an inflammatory condition in the nasopharyngeal area. Furthermore, chronic purulent otitis media can easily become purulent otitis media, progressing to diseases such as atrial fibrosis, otitis externa, otitis externa,...

2.1 Characteristics of lesions Localized lesions in the mucosa of Eustachian tube, tympanic cavity, corpus callosum and striatum.
In the Eustachian tube the mucosa is chronically inflamed with secretions. The tympanic cavity: the mucosa is infiltrated with leukocytes, edematous, thickened, especially the upper atrium. The tympanic membrane has an anterior lower quadrant perforation. Perforation smooth border, not close to bone. In the striatum and the mastoid cells, the mucosa may also be inflamed, causing the mastoid cell growth to stop, and the mastoid to narrow. 2.2 Functional symptoms The patient has purulent discharge from the ear and the discharge increases with each episode of inflammation of the nose and throat. The characteristic of ear pus is that it is clear, or yellow stretched into fibers without rotten smell, insoluble in water. Hearing is not affected. 2.3 Physical symptoms Presence of a pea-shaped or circular perforation in the stretch membrane. The perforation is characterized by smooth edges, not close to the skeleton. Use a hook with a blunt end to not get caught in the bone. Tympanic cavity: pink, sometimes polyps can be seen through the perforation. Use a non-cholesteatome boneless perforation probe. 2.4 Test results Audiogram : conductive deafness. X-ray: taking the schuller position, the image is poor and there is no bone inflammation.

Treatment of chronic purulent otitis media should first be treated from nasopharyngeal diseases such as tonsillectomy, treatment of nasopharyngeal fibroids, surgery to open the epiglottis. Then carry out local treatment including:
Wipe clean the pus Instillation of mucosal astringent Drop in the ear suspension: chloramphenicol + hydrocortisone Closed tympanic cavity: inject 0.5 ml of Alpha-Chymotrypsin or Hydrocortisone In summary, Chronic purulent otitis media is often caused by prolonged nasopharyngitis, which progresses from acute to chronic otitis media. Patients often have purulent, sticky, non-rotten ear symptoms, and hearing is not affected much. To treat chronic purulent otitis media, the patient needs to be completely treated for nasopharyngitis.