What is catarrhal otitis media? It has these common symptoms

Catarrhal otitis media, also known as secretory otitis media, is most common in infants and children. Patients will experience hearing loss, ear pain, tinnitus, and numbness of the surrounding skin. This disease is mostly caused by Eustachian tube dysfunction or infection.

1. Symptoms

1. Hearing loss: Hearing decreases, self-hearing increases, and when the head tilts forward or toward the healthy side, the hearing may be temporarily improved (positional hearing improvement) because the effusion leaves the cochlear conduction. When the effusion is viscous, the hearing may not change with changes in head position. Children often react slowly to sounds, have difficulty concentrating, and have poor academic performance and are brought to the doctor by their parents. If one ear is affected and the other ear has normal hearing, it may not be noticed for a long time and is only discovered during a physical examination.

2. Earache: Acute cases may cause dull earache, which is often the first symptom of the patient. It may be continuous or cramping. Chronic cases may not have obvious earache. This disease is often related to a feeling of blockage or stuffiness in the ear, which can be temporarily relieved by pressing the tragus.

3. Tinnitus: It is mostly low-pitched and intermittent, such as "crackling", buzzing and running water sounds. When the head moves or yawns or blows the nose, a sound of air passing through water may be heard in the ear.

4. The skin around the patient feels "numb" and the patient feels psychologically depressed.

2. Causes

Eustachian tube dysfunction (30%)

Eustachian tube dysfunction

This is generally considered to be the basic cause of the disease. The Eustachian tube cartilage has poor elasticity. When the tympanic cavity is in a negative pressure state, the wall of the Eustachian tube cartilage segment is prone to collapse. This is one of the anatomical and physiological bases for the high incidence of secretory otitis media in children. Patients with cleft palate are prone to this disease because their muscles have no midline attachment point and lose their contraction function.

Infection (30%)

In the past, secretory otitis media was believed to be a sterile inflammation. However, recent studies have found that about 1/2-1/3 of the middle ear effusions tested positive for bacteria in culture, with the main pathogens being Haemophilus influenzae and Streptococcus pneumoniae. The results of bacteriological and histological examinations as well as clinical signs indicate that secretory otitis media may be a mild or low-toxic bacterial infection of the middle ear, and that bacterial products such as endotoxins may play a role in the pathogenesis, especially in the process of chronic progression of the disease.

Immune response (30%)

The immune system of children is not yet fully developed, which may be one of the reasons for the high incidence of secretory otitis media in children. Inflammatory mediators such as prostaglandins are present in the middle ear effusion. Bacterial-specific antibodies and immune complexes have also been detected in the effusion, as well as the complement system and the appearance of lysosomal enzymes. This suggests that chronic secretory otitis media may be a pathological process mediated by anti-infection immunity. Damage to the middle ear mucosa by soluble immune complexes (type III hypersensitivity reaction) may be one of the causes of chronic secretory otitis media.