The disease is mostly transformed from acute non-suppurative otitis media, so the treatment of acute non-suppurative otitis media is the key to preventing this disease. Chronic non-suppurative otitis media often affects hearing, and deafness is difficult to recover, especially for children, and should be treated as soon as possible. For patients with unilateral tinnitus and deafness, the nasopharynx should be checked to exclude nasopharyngeal cancer.
1. Syndrome of Yin deficiency and phlegm and blood stasis
A feeling of occlusion in the ear, prolonged unhealed, hearing loss, accompanied by tinnitus, dry throat, restless sleep at night. The examination showed that the eardrum was obviously invaginated, cloudy, and thickened, and a little sticky secretion remained after the tympanic membrane was punctured or cut. The quality is reddish, with little moss and thin pulse. Nourishes yin, removes phlegm, removes blood stasis and clears ears.
2. Qi stagnation and blood stasis syndrome
The feeling of fullness and occlusion in the ear, which has not healed over the years, the hearing loss gradually increases, and is accompanied by tinnitus. The eardrum was obviously invaginated, cloudy, thickened, calcium plaques deposited, or adhesions. The Eustachian tube is blocked or under-patched. Tongue or petechiae, slow pulse. Regulate Qi, remove blood stasis and clear ears.
3. Syndrome of Qi deficiency and phlegm and blood stasis
A feeling of blockage in the ear, prolonged unhealed, hearing loss, accompanied by tinnitus, mild to severe symptoms, easy to catch a cold, and nasal congestion, sometimes with snot. Examination showed invagination, opacity, and thickening of the eardrum. Tympanic membrane puncture or incision with a little sticky secretion accumulation. The complexion is not gorgeous, the tongue is pale, and the pulse is thin and slow. Invigorating Qi and promoting blood circulation, removing phlegm and clearing ears.
4. Mutual formation of phlegm and blood stasis
A feeling of occlusion in the ear, prolonged unhealed, hearing loss, accompanied by tinnitus. Invagination, opacity, thickening of the eardrum, puncture or incision of the eardrum, there is a little sticky substance remaining in the ear orifice. The tongue is fat, the fur is slightly greasy, and the pulse is slightly slippery. Dispel phlegm, remove blood stasis and clear ears.
1. Early removal of nasal and pharyngeal lesions can achieve certain results.
2. Line tympanic membrane massage or repeated Eustachian tube insufflation, help to improve hearing.
3. For early cases, corticosteroids and enzyme preparations can be used to improve hearing. The method is: prednisone 5mg, orally, 3 times a day, γ-chymotrypsin injection 5mg, intramuscular injection, once a day, 7d as a course of treatment.
4. Surgical treatment. Incision of the tympanic membrane, placement of a ventilation tube, or middle ear surgery can improve hearing.
5. People with severe hearing loss can wear hearing aids.
clinical manifestations
1. Deafness is often caused by repeated acute attacks, with good and bad hearing, and gradually aggravated. It can be conductive at first, then mixed, and there can also be a phenomenon of "self-acoustic enhancement" in the early stage.
2. Tinnitus Tinnitus often makes patients very distressed. It can be low-pitched at the beginning and high-pitched (such as cicadas) in the late stage, but there is no certain pattern.
On examination, the tympanic membrane may be seen as cloudy, hypertrophic, thinned, or with calcined plaques. The posterior and upward displacement of the malleus showed a "pseudo-short" phenomenon, the short protrusion was prominent, and the light cone was deformed, scattered or disappeared. Use tympanic otoscope to check the activity of the tympanic membrane, and it can be seen that the tympanic membrane is poorly or unable to move.
Cause
Chronic non-suppurative otitis media can be caused by repeated acute flare-ups of inflammation due to the lack of timely and proper treatment of acute inflammation, or the presence of lesions in the nose and nasopharynx . Often due to intratympanic effusion, the tympanic membrane and the tympanic wall are adhered, or the ossicular chain joint is rigid, which is called middle ear adhesion.
Differential diagnosis
1. Ear distention: effusion in the middle ear of ear distention disease, the course of the disease can exceed 3 months or even 1 year, the light yellow clear liquid is obtained after repeated punctures, or the exudation continues after the tympanic membrane is cut, the tympanic membrane can be seen congested, and the eardrum is mostly Orange-yellow, air bubbles in the tympanic cavity can be seen after the Eustachian tube is inflated.
2. Long-term deafness: the course of disease exceeds 3 months, and the hearing loss is sensorineural deafness; or although it is mixed deafness, the tympanic membrane and Eustachian tube function normally.
treatment method
Cause
Chronic non-suppurative otitis media can be caused by repeated acute flare-ups of inflammation due to the lack of timely and proper treatment of acute inflammation, or the presence of lesions in the nose and nasopharynx . Often due to intratympanic effusion, the tympanic membrane and the tympanic wall are adhered, or the ossicular chain joint is rigid, which is called middle ear adhesion.
Symptoms
1. Deafness is often caused by repeated acute attacks, with good and bad hearing, and gradually aggravated. It can be conductive at first, then mixed, and there can also be a phenomenon of "self-acoustic enhancement" in the early stage.
2. Tinnitus Tinnitus often makes patients very distressed. It can be low-pitched at the beginning and high-pitched (such as cicadas) in the late stage, but there is no certain pattern.
On examination, the tympanic membrane may be seen as cloudy, hypertrophic, thinned, or with calcined plaques. The posterior and upward displacement of the malleus showed a "pseudo-short" phenomenon, the short protrusion was prominent, and the light cone was deformed, scattered or disappeared. Use tympanic otoscope to check the activity of the tympanic membrane, and it can be seen that the tympanic membrane is poorly or unable to move.