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secretory otitis media treatment, secretory otitis media how to do, secretory otitis media medication

secretory otitis media treatment, secretory otitis media how to do, secretory otitis media medication

Diagnosis and treatment knowledge of secretory otitis media

Visiting department: otolaryngology treatment cost: about (10,000-50,000 yuan) in the top three hospitals in the city. Cure rate: treatment cycle: treatment methods: drugs and surgical treatmentGeneral treatment of secretory otitis media

Clearing middle ear effusion, improving middle ear ventilation and drainage and etiological treatment are the treatment principles of this disease.

1. Remove middle ear effusion and improve middle ear ventilation and drainage

(1) Tympanic membrane puncture and drainage: local anesthesia for adults. The No. 7 needle with a shorter inclined plane of the needle tip was penetrated into the tympanum from the front and lower part of the tympanic membrane under aseptic operation to pump effusion. If necessary, puncture can be repeated, and glucocorticoid drugs can also be injected after pumping.

(2) Myringotomy: The liquid is viscous and the tympanic membrane puncture cannot be sucked out; When children are uncooperative and cannot make tympanic membrane puncture under local anesthesia, tympanic membrane incision should be made. The operation can be performed under local anesthesia (children must be under general anesthesia). With tympanotomy. Make radial or arc incision in the anterior and inferior quadrant of tympanic membrane with tympanic membrane incision knife, pay attention not to hurt the inner wall mucosa of tympanic membrane, and suck all the liquid in tympanic membrane after tympanic membrane incision.

(3) Tympanic catheterization: the disease is prolonged or recurring; Rubber ear; If it is estimated that the function of Eustachian tube is difficult to return to normal in a short time after head radiotherapy, the initiator should make tympanic catheterization to improve ventilation and drainage and promote the recovery of Eustachian tube function. The indwelling time of snorkel is generally 6-8 weeks, and the longest time can reach half a year to one year. After the function of Eustachian tube is restored, the snorkel is taken out, and some patients can discharge the snorkel into the external auditory canal by themselves.

(4) Keep nasal cavity and eustachian tube unobstructed: 1% ephedrine solution or alternately drop (spray) nose with beclomethasone dipropionate aerosol, 3-4 times a day.

(5) Eustachian tube blowing: nose pinching and blowing method, Boehner ball method or catheter method can be used. Prednisolone can still be blown into the pharyngeal orifice of Eustachian tube through catheter, once every other day, 1ml on each side each time, for 3-6 times in total.

2. Actively treat nasopharyngeal or nasal diseases such as adenoidectomy, nasal septum correction, inferior turbinate surgery, nasal polypectomy, etc. Tonsil special hypertrophy, and with secretory otitis media relapse, should make tonsillectomy.

3. Antibiotics or other synthetic antibiotics can be used in acute stage, such as cefradine 0.5 g, 4 times/d; Ofloxacin 0.1-0.2 g, 3-4 times/d. Ampicillin 50-150mg/kg/d can be given to children, or amoxicillin 0.15 g, 3 times/d, cefmetaxil 0.25 g-0. 5g/time, 2 times/d, and children 10mg/kg, 2 times/d. It has strong antibacterial effect on pathogenic bacteria such as Haemophilus influenzae and Streptococcus pneumoniae, and can be used for people who are insensitive to other antibacterial drugs.

4. Glucocorticoid drugs such as dexamethasone or prednisone are taken orally for short-term treatment.

Treatment of secretory otitis media based on syndrome differentiation

1. Traditional Chinese medicine therapy:

Traditional Chinese medicine believes that secretory otitis media belongs to the categories of "wind deafness", "ear distension and ear closure", "ear distension and pain" and "ear arthralgia". Its pathogenesis is mostly wind evil invasion, meridian qi fullness, or phlegm-dampness turbid evil, upper ear orifice or pathogenic toxin retention, and qi and blood stasis. The main points of syndrome differentiation and treatment are:

1) Stagnation of orifices due to wind evil: After catching a cold, I feel stuffy or slightly painful in my ears, tinnitus and hearing loss, self-sound enhancement, invagination of tympanic membrane, red swelling or liquid plane. Accompanied by fever, evil wind, nasal congestion and runny nose. It is advisable to dispel wind and evil, promote qi circulation and promote fullness.

Yinqiao Powder and Ventilation Powder: Honeysuckle 20g, Forsythia suspensa 12g, Platycodon grandiflorum 10g, Mint 10g, Lophatherum gracile 10g, Schizonepeta tenuifolia 10g, Arctium lappa 15g, Reed rhizome 10g, Ligusticum Chuanxiong 15g, Bupleurum chinense 20g and Cyperus rotundii 10g. For severe nasal congestion, Magnolia lappa and Xanthium sibiricum 10g; If the ear is swollen and closed, add 10g of Agastache rugosa and 10g of calamus; If there is effusion in the tympanic chamber, 10g of Akebia stem and 10g of Alisma orientalis can be added. If the lung meridian is suppressed by wind-cold, the whole body is averse to cold, with mild fever, stuffy nose, clear nasal discharge, stuffy ear and hearing loss; Tongue is pale red, fur is thin and white, and pulse is floating. It is advisable to spread lung, dispel cold and dredge orifices. The prescription is San'ao Decoction and Xanthium sibiricum powder: Ephedra 10g, Almond 10g, Xanthium sibiricum 10g, Magnolia magnolia 10g, Angelica dahurica 10g, Mint 10g, Schizonepeta tenuifolia 10g, Saposhnikovia divaricata 10g and Glycyrrhiza uralensis Fisch 3g; Decoct in water and take orally.

2) Phlegm-dampness gathers ears: The feeling of distension, stuffiness and occlusion in the ears is heavy, the hearing is decreased, the self-sound is enhanced, and there is water noise in the ears when shaking the head. Examination shows that the tympanic membrane has curved horizontal line or convex tympanic membrane. The whole body has heavy head dizziness, burnout and fatigue, and the mouth is light and the abdomen is full; Tongue is light and greasy, and pulse is moist or slippery. It is advisable to strengthen spleen, promote diuresis and dredge orifices

The prescription is Buzhong Yiqi Decoction and Wuling Powder: Astragalus membranaceus 30g, Codonopsis pilosula 15g, Atractylodes macrocephala 10g, Bupleurum chinense 10g, Angelica sinensis 10g, Pericarpium Citri Tangerinae 12g, Magnolia magnoliae 12g, Poria cocos 15g, Alisma orientalis 15g, Acorus gramineus 10g, Plantain seed 15g, Pueraria lobata 20g and Akebia stem 10g; Decoct in water and take orally.

3) Qi and blood stasis collaterals: There is occlusion in the ear, hearing loss, tinnitus gradually rising, and it does not heal for a long time. The tympanic membrane is obviously invaginated, or thickened, calcareous and atrophied; The tongue is dark red and the pulse is astringent. It is advisable to promote blood circulation, dredge collaterals, and induce resuscitation.

The prescription is Buyanghuanwu Decoction: Astragalus 30g, Angelica sinensis 12g, Chuanxiong 10g, peach kernel 10g, safflower 10g, scorpion 12g, earthworm 12g, Polygonatum sibiricum 15g, Pueraria lobata 15g, loofah 15g and Lulutong 15g. If dizziness, soreness of waist and knees and weakness of kidney essence are combined, Liuwei Dihuang Pill or Deafness Zuoci Pill can be added for oral administration.


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