Ear pain or a feeling of fullness rarely come without a cause. They often hide inflammation of the middle ear — the cavity concealed behind the eardrum. Let us examine the forms of the disease and their signs.
What inflammation of the middle ear is
The middle ear is the cavity between the eardrum and the inner ear, into which the Eustachian tube opens. Inflammation of this cavity is called otitis media.
A musical comparison comes to mind: the cavity works like the body of an instrument, and a blocked opening deprives it of its voice.
The main route of infection is tubal. A cold or flu damages the mucosa of the auditory tube, ventilation and drainage are impaired, the pressure in the tympanic cavity drops, and the vessels begin to leak fluid.
Flora from the nasopharynx enters this fluid: more often streptococci, staphylococci, pneumococci, and Haemophilus influenzae, less often anaerobes and gram-negative microbes.
The hematogenous route is less common, in scarlet fever, measles, and flu, as is the transtympanic route, in injury to the eardrum. Children fall ill noticeably more often than adults: three out of four children have at least one episode of otitis by their third birthday.
Acute otitis media: symptoms
Symptoms develop over several hours. There is pain inside the ear, hearing weakens partially, and the temperature rises.
- ear pain, sometimes severe;
- a feeling of pressure and fullness;
- discharge from the ear;
- hearing loss;
- elevated temperature.
In young children the picture is different: the child pulls and rubs the ear, reacts less to sounds, is fussy, loses appetite, and sometimes loses balance. Most cases of otitis resolve on their own within three days, and some symptoms persist for up to a week.
If the eardrum perforates, the pain subsides and bloody discharge appears from the ear.
Catarrhal and serous otitis
Inflammation proceeds in stages. First the serous stage: the mucosa swells, becomes infiltrated with leukocytes, and exudate forms.
Then the catarrhal stage sets in: secretion by the covering epithelium increases and the exudate thickens. A watchful approach in catarrhal otitis is possible only at the decision of an ENT doctor.
In purulent inflammation the air-filled spaces fill with edematous mucosa and pus, and the auditory ossicles lose their mobility. The accumulated contents press on the tympanic nerve plexus and the eardrum — hence the pain.
Secretory otitis and other forms of acute otitis
In otitis the cavities of the middle ear fill with fluid and mucus, sound cannot pass through this medium — hearing suffers. Secretory otitis is listed among the forms of acute otitis, along with the banal form, idiopathic hemotympanum, otitis in infectious diseases, and traumatic otitis.
Chronic otitis and other diseases of the middle ear
Acute otitis with inadequate treatment becomes chronic. The chronic form is divided into mesotympanitis, epitympanitis, and mesoepitympanitis.
Other diseases of the middle ear include cholesteatoma and perforation of the eardrum.
When to see a doctor
The doctor examines the ear with an otoscope — a device with a light and a magnifying lens. Some models deliver a puff of air into the ear: this is how blockage is checked; pneumatic otoscopy reveals signs of effusion.
Culture of the discharge, except for fluid from myringotomy, is usually not done. The diagnosis is based on the acute, within 48 hours, onset of pain and bulging of the eardrum.
A consultation is needed if the pain does not subside within three days, if otitis recurs, or if the child is under 12 months old.
Urgent medical attention: very high temperature, chills and general malaise, swelling around the ear, discharge from the ear, change in hearing, nausea and vomiting, dizziness, severe sore throat.
Separately — children under one year with pain in both ears, as well as people with diabetes, heart, lung, kidney, or nervous system diseases, and weakened immunity.
Otitis media by itself is not a reason to call an ambulance; 103/112 — if the condition has sharply worsened and signs of a life-threatening condition have appeared (for example, loss of consciousness, difficulty breathing).
This material is for reference and does not replace a doctor's consultation: the diagnosis and approach are determined by a specialist.
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This content is for reference and does not replace a doctor's consultation. Medical disclaimer