Otitis media

Synonym: Middle ear inflammation Otitis media is an inflammation of the middle ear. Different forms of otitis media can be distinguished, which will be discussed in more detail below.According to the course of the disease, we first distinguish between acute and chronic middle ear inflammation. Classification according to ICD-10: H65 Non-purulent otitis media H66 Purulent and unspecified otitis media H67 Otitis media in diseases classified elsewhere It is a very painful inflammation of the mucous membranes of the middle ear, which is infectious.

Causes: An acute inflammation of the middle ear occurs as part of a bacterial or viral infection and is a very common disease. Bacterial acute inflammation of the middle ear is the more common form. The bacteria enter the middle ear via the nasopharynx or the bloodstream and settle there continuously.

Viral inflammation of the middle ear usually occurs via the bloodstream and is associated with inflammation of the upper airways. A viral infection can be accompanied by a bacterial infection, or it can facilitate the outbreak of one. Pathogens can also enter the ear from the outside if a drum perforation exists, for example from the bath water during a visit to the swimming pool.

In acute serous inflammation of the middle ear, the tuba auditiva (connection between the middle ear and the nasopharynx) is closed by a swelling of the mucous membranes as part of an airway infection. Lack of ventilation of the middle ear causes a negative pressure, which ultimately leads to a tympanic cavity effusion. Those affected hear less well and complain of a feeling of pressure.

Diagnosis: The ear is examined otoscopically (with the ear funnel). First a reddened, then a de-differentiated eardrum is seen. This means that no more details can be seen on the eardrum and it is bulging.

This results in a perforation from which pus emerges. These symptoms subside after 2 to 3 weeks. Small blisters filled with blood and fluid (myringitis bullosa) may also be visible on the eardrum.

A serous secretion may leak from them. This is the case with acute serous inflammation of the middle ear. Symptoms: An inflammation of the middle ear goes through various phases.

In the first few days, the patient suffers from severe ear pain, hearing loss, fever and thumping noises in the ear. Nausea and vomiting can be accompanying symptoms. The pressure on the temple is painful.

While viral infections usually heal here, bacterial infections enter the defense phase in the next few days. Meanwhile, secretion escapes from the ear through a perforation of the eardrum and the hearing ability is reduced. A purulent secretion indicates a bacterial, a serous-blood secretion a viral infection.

Antibiotics can shorten this phase and prevent a perforation of the eardrum. The fever subsides and after another two to four weeks the middle ear infection is over. Therapy: Middle ear infections can heal without treatment.

Therefore, the first two to three days should be waited under medical supervision. As with any illness, the patient should take it easy. Nasal sprays and anti-inflammatory painkillers like ibuprofen are recommended. In case of a bacterial infection, a liquid antibiotic (e.g. amoxicillin, azithromycin and clarithromycin) is prescribed.