Otitis externa is an acute bacterial suppurative inflammation of the skin of the external auditory canal caused by bacterial infection, which usually occurs in the soft tissue of the external auditory canal. It is generally divided into acute and chronic types, mostly in summer and autumn. The main causes of acute otitis externa include ear removal, foreign body injury and drug stimulation. After suffering from acute otitis externa, it can turn into chronic otitis externa if it is not treated in time or incompletely. If chronic otitis externa develops further, inflammation may infect the middle ear, leading to otitis media and hearing loss.
Children are the high incidence group of otitis media. Acute otitis media is caused by bacterial infection, and a few are viral infection. If acute otitis media is not treated in time, once it turns into chronic otitis media, it will cause endless complications, which may induce exudative otitis media and even suppurative otitis media, causing long-term otitis media with pus in the ear and perforation of tympanic membrane, and even cholesteatoma otitis media. Severe cases can cause intracranial and extracranial complications, such as facial paralysis, meningitis and brain abscess. If not treated in time, it may be life-threatening.
Ear drops:
Phenol glycerol cannot be used after perforation.
The purpose of using ear drops is to make high-concentration drugs directly act on the focus, and play the role of anti-inflammatory sterilization or softening earwax. In the specific application, drugs should be selected according to the condition. Professor Feng Yu, vice president of Guangzhou Twelfth People's Hospital, introduced that the commonly used ear drops mainly include the following categories:
1. Antibiotic anti-inflammatory ear drops. Ofloxacin ear drops can be used for otitis media, otitis externa, suppurative otitis media and otitis media caused by sensitive bacteria. Chloramphenicol ear drops can be used for acute and chronic suppurative otitis media.
2. Hormone ear drops. The effect is to eliminate edema, but it needs to be combined with antibiotic anti-inflammatory ear drops to prevent the spread of inflammation.
3. Phenol glycerin ear drops. Used for sterilization and pain relief of external auditory canal inflammation. However, it should be noted that it is only used for those whose eardrums are not perforated, but not for those who are perforated. On the one hand, phenol glycerin ear drops contain carbonic acid, which will lead to larger perforation. On the other hand, phenol glycerin ear drops contain ototoxicity, which can stimulate the inner ear, and may cause deafness after tympanic membrane perforation. In addition, phenol glycerin ear drops usually take only 3~5 days, and long-term use will lead to eardrum thickening and hearing loss.
4.4% boric acid alcohol. It has the function of cleaning the external auditory canal, has a good curative effect on itching of the external auditory canal, and can also be used for otitis externa and acute non-suppurative otitis media.
5. Hydrogen peroxide. Has antibacterial, purulent, and antipruritic effects, and can be used for treating acute suppurative otitis media with excessive pus. Wash the pus of external auditory canal with hydrogen peroxide before dropping the medicine, and then drop other ear medicines.
6. Earwax softening ear drops. Sodium bicarbonate ear drops (also known as cerumen water) is an alkaline solution, which can soften cerumen and be used for cerumen embolism of external auditory canal for easy removal. However, due to the time and conditions of its softening process, if it is not mastered well, the swelling of cerumen in the ear canal will cause pain and discomfort, so it is best to go to the hospital for treatment.
7. Powder medicine. Mainly earthwork folk prescription, try not to use it, which not only blocks the external auditory canal, but also hinders the doctor from checking the condition.
8. Otototoxic drugs. Aminoglycoside ear drops, such as gentamicin, can cause deafness.
Take medicine:
Acute otitis media should be treated with antibiotics.
Feng Yu said that if you have acute otitis externa or acute suppurative otitis media, you should take antibiotics at the same time as ear drops to enhance the curative effect. General routine treatment needs 10 days. But it is not acute otitis, such as fungal otitis externa, and antibiotics are generally not recommended.
In addition, Feng Yu mentioned that once the eardrum is perforated, it will regrow after 1 month of general treatment. If the eardrum does not grow well for 3 months, it is necessary to consider surgical repair.
"Once traumatic tympanic membrane perforation occurs, you can't use any ear drops. Because traumatic perforation has the possibility of self-healing, ear drops may cause perforation to heal. " Feng Yu said that in daily life, examples of breaking the eardrum of the ear have occurred from time to time. For example, some people hit the eardrum with their ears; Someone was slapped and the eardrum was broken; Someone went to the massage shop for massage, and the technician covered his ears with his palm to do the action of boosting and decompressing, damaging the eardrum; In his 30-year career as a doctor, the most extreme example Feng Yu has ever seen is that when a couple are making out, this man sucks out his girlfriend's eardrum.
Nursing:
Don't pick your ears+prevent colds.
Feng Yu reminded that the care of otitis externa is very important, and we should pay attention to:
1. Try not to pick your ears. Don't dig your ears with unclean sharp objects to avoid infection and inflammation. Professor Wang Xijun from the Department of Otolaryngology, Armed Police Hospital said: "About 50% of outpatients with otitis externa are caused by ear digging, which will cause inflammation." Feng Yu said that the distance from the mouth of the adult external auditory canal to the eardrum is only 3.5 cm. When cleaning the earwax with a cotton swab, the part extending into the external auditory canal should be between 2.5 cm and 3 cm to avoid stabbing the eardrum. In addition, if you don't go to massage shops and beauty salons to pick out your ears, first, there is no guarantee for disinfection of appliances, and second, non-professionals may hurt the eardrum.
2. Prevent colds. Summer is the high incidence season of colds, otitis media is often caused by colds, and eustachian tube ventilation can cause infiltrating otitis media.
3. Try not to let water enter the external auditory canal. When swimming or washing your hair and taking a bath, if water enters your ears, you should immediately wipe the water with a cotton swab to keep the external auditory canal clean and dry.
In addition, keeping the same posture for a long time, such as working, studying or playing games, is easy to oppress the delicate blood vessels and nerves in the ear. This is the reason why many patients with tinnitus can't find the cause. If you sit for more than 1 hour, you should do exercise and relax your neck properly.