Chronic inflammation of middle ear

Chronic inflammation of middle ear is also known as chronic suppurative otitis media.The middle ear is connected to the nasopharynx via the eustachian tube. When this tube is blocked, fluid collects in the middle-ear and mastoid cavities, providing a culture medium for any bacteria present. Otitis media, like upper respiratory tract infections, is most common in fall, winter, and spring. In chronic suppurative otitis media, patients have painless hearing loss and intermittent purulent ear drainage. On examination, there is a central perforation in the tympanic membrane and purulent drainage from the middle ear. If a cholesteatoma is present, the perforation is peripheral. For therapeutic purposes, patients are divided into two groups: those with and without cholesteatoma. In western medicine, those in the former group are cured with surgical excision of the cholesteatoma. Those without cholesteatoma require repeated courses of topical antibiotic drops for relapse of "active" (draining) disease, and true cures are rare. The role of systemic antibiotics is unclear. In one study, a course of intravenous antibiotics produced long-term success in 78% of children without cholesteatoma who had persistent otorrhea despite topical and oral antibiotic therapy.ComplicationsExtracranial complications include hearing loss, labyrinthitis and resulting vertigo, and facial-nerve palsy. Additional complications from mastoiditis develop when infection tracks under the periosteum of the temporal bone to cause a subperiosteal abscess or breaks through the mastoid tip to cause a neck abscess deep to the sternocleidomastoid muscle (Bezold s abscess). Intracranial complications include epidural abscess, dural venous thrombophlebitis (usually sigmoid sinus), meningitis, and brain abscess. In the traditional Chinese medicine studies, it considers that chronic suppurative otitis media as damage of kidney Yuan (vital Qi), wet and laziness of the spleen which is due to affection of the middle ear. Treatment: nourish kidney and spleen, eliminate wet and pus. This disease belongs to the category of nong er (purulent ear). The causes of the disease include:1. external factor such as Feng (wind), Re (heat) and xie du (??evil?? substances), or due to entrance of contaminated water during a bath, resulting in accumulation of bad substances and wet , then, it will cause the increasing of heat steam in liver, gall bladder and later, in the middle ear that resulted in death of tissues (necrosis), formation of pus and penetration of tympanic membrane; 2. or after recovering from warm disease with lowered immunity along with non-complete clearance of evil substances remains, resulted in affection of the middle ear.If there are weakness of spleen and kidneys or imbalance of functions adjustment, prolonged accumulation of xie du in middle ear accompanied with disturbances in homeostasis (internal regulation of functions) or ascending of xu huo (false heat) which causes the its inflammation, all these can develop into chronic form of disease.Clinical treatment resultsThere were 3790 cases adopted the traditional Chinese medical therapy, all cases recovered completely (healing of tympanic membrane penetration). There was no reoccurs of the disease during the follow-up visit in one year.