Pus in the ear

Introduction Chronic suppurative otitis media is characterized by repeated pus in the ear, perforation of the tympanic membrane, and hearing loss. Anyone who is treated improperly for acute suppurative otitis media, has excessive bacterial toxicity, has weak body resistance or has mastoiditis, and is persistently pus for 1 to 2 months, and is called chronic suppurative otitis media. The incidence of this disease is relatively high. In recent years, there have been more than a thousand primary school students in the census, the incidence has changed from 0.5% to 4.3%, and the incidence rate of farmers surveyed in Shandong, Henan and Guizhou provinces is 1.6%. The incidence of primary school students in the UK is 0.9%. Most of the patients are young and middle-aged, and rarely occur after the age of 40.

Cause

1. Delayed treatment and improper medication in the acute phase.

2. The mastoid dysplasia is difficult to dissipate after the lesion occurs.

3. Secondary to acute infectious diseases such as scarlet fever, measles and pneumonia, acute necrosis of the middle ear mucosa, inflammation invading the tympanic papilla, especially secondary to the more resistant Proteus and Pseudomonas aeruginosa infection, treatment very difficult.

4. Nasal and pharyngeal chronic diseases and sinusitis, tonsillitis and proliferative hypertrophy, etc., inflammatory secretions easily enter the eustachian tube, and the lesions hinder the drainage of the pharynx.

5. Chronic body diseases such as anemia, diabetes, tuberculosis and nephritis, the body's resistance is weakened.

6. suffering from allergic diseases, such as respiratory tract mucosal allergic edema, exudation, involving the eustachian tube and middle ear.

7. The upper tympanic cavity is cholesteatoma, osteonecrosis of the ear or destruction of the lateral wall of the drum.

an examination

Related inspection

Ear, nose, throat swab bacterial culture Otolaryngology CT examination

1. Audiological examination: manifested as varying degrees of conduction, mixed or sensorineural hearing loss.

2. Imaging examination: High-resolution CT of the tibia is an effective tool for evaluating the nature and extent of chronic suppurative lesions. Through imaging examination, we can understand the degree of gasification of the mastoid, the state of the small bone, the various parts of the middle ear and the extent of the lesion.

Differential diagnosis

Need to identify several types of chronic suppurative otitis media, simple type, bone ulcer type, cholesteatoma type.

According to the pathology and clinical manifestations are divided into three types:

(A) simple type: the most common, mostly due to recurrent upper respiratory tract infection, the pathogenic bacteria invade the tympanic cavity through the eustachian tube. The clinical features are: ear pus, mostly intermittent, mucinous or mucopurulent, generally not odorous. The amount varies, and the amount of pus increases when the upper respiratory tract is infected. The perforation of the tympanic membrane is mostly central to the tension, and the size is different, but there are residual tympanic membranes around the perforation. The tympanic mucosa is pink or pale and can be slightly thickened. Deafness is conductive and generally not heavy.

(B) type of bone ulcer: also known as necrotic or granulation type, mostly from acute necrotic otitis media. This type of characteristics: the ear flow pus is mostly persistent, there is bloodshot between the purulent, often smelly. Large perforations in the tympanic membrane may involve drum rings or marginal perforations. There are granulation or polyps in the tympanic cavity and can be pierced into the external auditory canal. Conductive enthalpy is heavier.

(C) cholesteatoma type: cholesteatoma is a non-true tumor, but a cystic structure located in the middle ear, mastoid cavity. Because the capsule contains cholesterol crystals, it is called cholesteatoma.

The ear continues to pus for a long period of time, with a special malodor, and there is marginal perforation in the tympanic membrane or in the upper part of the tension. From the perforation, there is a gray-white scaly or bean-like substance in the drum, which is strangely smelly. Generally, there are heavier conductive sputum, such as lesions and cochlea, and deafness is mixed.

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