Otitis in children - symptoms and treatment of the ear in a child according to Komarovsky's methods

In his television programs and articles Komarovsky E.O. more than once touched on the topic of otitis media in children. This is no coincidence, since 90% of the population faces this pathology, especially those under the age of five. The greatest prevalence of otitis in this age group is due to the structure of the child's hearing organ, as well as a number of other concomitant factors.

Inflammation of the middle ear is extremely rarely an independent disease, especially among children.

Dr. Komarovsky considers otitis in infants a secondary disease. Most often this is the result of a complication of influenza, other acute respiratory viral infections, childhood infectious diseases. Any pathology accompanied by swelling of the nasopharyngeal mucosa can lead to inflammation of the middle ear.

The short auditory tube, characteristic of a child's body, contributes to the fact that microbes and mucus from the nasal cavity easily penetrate into the middle ear, causing inflammation. The narrowing of the Eustachian tube is achieved, in addition to the production of mucus and swelling, by the presence of enlarged adenoids, squeezing it from the outside. This leads to a violation of the drainage function of the auditory tube and the development of inflammation in it, tubo-otitis.

Clinical symptoms

Doctor Komarovsky considers tubo-otitis in children to be the pathological condition that leads to the development of otitis media in a child. The Eustachian tube narrowed as a result of the pathological process interferes with the normal functioning of the middle ear, leading to the development of stagnation and inflammation in the tympanic cavity. The performed otoscopy allows you to detect the initial signs of inflammation at this stage, which corresponds to. Thus, tubo-otitis, or eustacheitis, is a catarrhal otitis media that has developed as a result of a violation of the patency of the Eustachian tube.

Komarovsky describes it as follows:

• the disease is characterized by ear congestion, which may be relieved by yawning or swallowing saliva;
• there is a decrease in hearing or autophony, that is, the resonance of one's own voice in the affected ear.

As for the pain syndrome, which is a pathognomonic sign of any otitis media, its severity can vary from slight to very intense. The general condition of the child is disturbed with catarrhal otitis slightly. Temperature indicators are within subfebrile figures.

In the event that no measures are taken to improve the drainage function of the auditory tube, stagnation in the middle ear leads to the development of inflammatory phenomena. Exudate is formed and accumulates in the tympanic cavity, and catarrhal otitis is transformed into a child. Komarovsky E.O. thinks that correct actions taken at each stage of otitis can lead to regression of clinical manifestations and recovery.

Very important for the diagnosis and treatment is the consultation of an ENT doctor and the otoscopy performed by him. This diagnostic method allows you to determine the disease itself, to find out the condition of the tympanic membrane, which, with the development of exudative otitis media, is concave, and its integrity is not broken. However, the specialist can even determine the level of exudate formed in the cavity of the middle ear, which varies depending on the position of the patient's body.

This instrumental diagnosis is important, since the choice of medicines, according to all experts, including Komarovsky E.O., depends on the condition of the eardrum.

Non-steroidal anti-inflammatory drugs, some antibiotics, ethyl alcohol are toxic to the auditory nerve when applied topically in the form of ear drops.

A perforated tympanic membrane is a contraindication to the use of such agents.

According to Komarovsky, it develops in children if the treatment was started out of time, and there is also a concomitant pathology from the ENT organs. In this case, the mucous exudate thickens in the tympanic cavity and transforms it into purulent contents.

For this course of the disease, a slightly different symptomatology is characteristic. First of all, there is a more pronounced pain syndrome. With a significant severity of the process, complaints can be noted that are characteristic not only of inflammation of the middle ear, but also of the internal one, such as nausea, vomiting, dizziness, and impaired coordination. The phenomena of intoxication in acute purulent otitis media are more pronounced. An increase in body temperature can reach 39 degrees.

The otoscopic picture is characterized by the presence of an eroded tympanic membrane protruding into the cavity of the external auditory canal. After some time, spontaneous rupture may occur, and purulent contents will appear in the lumen of the external auditory canal. In this case, they talk about the perforative stage during acute purulent otitis media.

Perforation of the tympanic membrane occurs under the influence of increasing pressure of purulent contents. According to the expert, this should be taken calmly. Within a few days, scarring of the resulting hole occurs, and hearing returns to normal within the next 2-3 months. The scar that appears on the eardrum does not interfere with the functioning of the hearing organ.

Regarding how to treat otitis in children, Komarovsky E.O. proceeds from the cause of the development of the disease. Since the leading role in the development of otitis media is played by a violation of the patency of the auditory tube due to its swelling and the formation of mucus, the primary task is the use of vasoconstrictor drops in the nose. In children, sanorin, naphthyzinum, galazolin can be used in the appropriate dosage.

In addition, the doctor Komarovsky E.O. treatment of otitis media in a child suggests combining with measures aimed at preventing thickening of the discharge from the nose. For this, the following actions are recommended:

• compliance with the temperature regime in the room at a level not higher than 20 degrees;
• regular wet cleaning of the premises;
• household dust control;
• plentiful drink.

According to the expert Komarovsky E.O., the treatment of purulent otitis media in infants at the pre-perforative and perforative stages is different.

The presence of suppuration is an indication for the abolition of drugs that have an ototoxic effect and the need for antibiotics to treat ear inflammation.

According to the sensitivity of pathogens to antibacterial agents, preference is given to drugs from the amoxicillin group. In favor of the appointment of this drug is evidenced by its presence in various dosage forms, allowing it to be used even in infants.

Since otitis media is accompanied by severe pain, paracetamol is used orally to reduce these sensations and improve the patient's condition. In addition, ear drops containing a local anesthetic or corticosteroids can be used to achieve an analgesic effect, which also helps to reduce pain.

The use of complex preparations should take place under the direct supervision of an ENT doctor, since they may contain ototoxic components.

Their use in perforated eardrum is contraindicated.

Attitude to warming procedures

Regarding the use of physiotherapeutic procedures for the treatment of otitis in children, the opinion of Komarovsky E.O. unambiguously negative. He explains this, on the one hand, by the unproven positive effect of these thermal procedures. On the other hand, the use of such measures in a child may cause a reaction opposite to what is expected. During the period of acute purulent otitis, warming procedures are contraindicated even in adult patients.

For children, the doctor advises inserting a cotton turunda into the sore ear or putting on a hat. These procedures are carried out not for the purpose of additional warming of the ear, but for its immobilization. Any touch to the affected organ causes an increase in pain.

Predictions for the development of the disease

Frequent otitis in a child Komarovsky E.O. considers related to the individual anatomical features of the patient. In the presence of a shorter and narrower auditory tube, the risk of developing otitis media after SARS, accompanied by the formation of mucus in the nasopharynx, increases. However, with age, the shape and size of the Eustachian tube may change, which will prevent infection from entering the middle ear area in this way. Since another cause of frequent otitis in a child can be enlarged adenoids that compress the passage of the auditory tube, the surgical intervention can significantly improve the situation.

Timely diagnosed otitis in a child Komarovsky E.O. considers it not too big a problem, since even without the use of antibiotics, recovery occurs in the vast majority of cases. However, the presence of purulent otitis is dangerous with the possibility of developing such serious complications as meningitis or brain abscess. In this regard, it is extremely important direct control by a specialist throughout the treatment.