Methods for treating otitis media

Patient's question:

Left or right cold-induced

Doctor's answer:

Otitis media is most commonly characterized by a feeling of fullness or blockage in the ear, hearing loss, and tinnitus. It often occurs after a cold or develops unnoticed. Sometimes, a change in head position can temporarily improve hearing. There may be a sensation of self-hearing amplification, and some patients may experience mild ear pain. In children, it is often in understanding or difficulty concentrating.
1. Hearing Loss: Hearing impairment, with self-hearing amplification. When the head is tilted forward or the healthy side, the fluid may leave the cochlea, temporarily improving hearing (positional hearing improvement). If the fluid is viscous, hearing may not change with head position. Children often show delayed responses to sounds, poor concentration, and declining academic performance, leading parents to seek medical attention. If only one ear is affected and the other is normal, it may go unnoticed for a long time and only be discovered during a check-up.
2. Ear Pain: Acute cases may have dull ear pain, often the first symptom, which can be persistent or intermittent. Chronic cases may have less noticeable ear pain. This condition is often accompanied by a feeling of ear blockage or fullness, which may temporarily ease when the tragus is pressed.
3. Tinnitus: It is usually low-pitched and intermittent, resembling sounds like "popping," buzzing, or flowing water. During head movement, yawning, or nose blowing, a gurgling sound may occur in the ear.
Guidelines:
1. Active Treatment of Upper Respiratory Tract Lesions: Such as chronic sinusitis or chronic tonsillitis.
2. Medication: For simple cases, local treatment is primarily used. Antibiotic solutions or mixed solutions of antibiotics and corticosteroids can be used, such as 0.25% chloramphenicol solution, chloramphenicol hydrocortisone solution, or ofloxacin ear drops.
3. Precautions for Local Medication:
- Before applying medication, clean the external auditory canal and the middle ear cavity of pus. Use 3% hydrogen peroxide or boric acid solution to rinse, then dry with cotton swabs or use a suction device to remove the pus before applying the medication.
- For excessive pus, use liquid; for less pus, use boric acid alcohol.
4. Ear Drop Method: The patient should sit or lie down with the affected ear upward. Gently pull the auricle backward and upward, then drop 3–4 drops of medication into the external auditory canal. Lightly press the tragus several times to help the medication pass through the eardrum into the middle ear. Do not change position for several minutes. Note that ear drops should be as close to body temperature as possible to avoid dizziness.
5. Large Tympanic Membrane Perforation Affecting Hearing: After the ear has dried, a tympanic membrane repair or tympanoplasty can be performed about 2 months later.
6. Osteoma-type Otitis Media: If drainage is unobstructed, local medication is the primary treatment, but regular follow-ups are necessary. For unobstructed drainage or suspected complications, or for cholesteatoma-type otitis media, early modified radical mastoidectomy or radical mastoidectomy should be performed to completely remove the lesion and prevent complications.