Perforated otitis media: symptoms, diagnosis, treatment

Perforated otitis media in people occurs in the process of complicating the acute purulent form of this ailment. At the same time, a violation of the integrity of the eardrum that separates the middle and outer ear is observed in patients. As a result, people experience deafness along with hearing loss and impaired perception of sounds. This disease is dangerous. Against its background, a secondary infection may occur, which occurs due to perforation of the membrane.

acute perforated otitis media

The rupture of the membrane most often occurs in the lower quadrant. This is a triangular gap, its edges are uneven, pus can come out of it. If this happens, the doctor will take a small amount of fluid for bacteriological analysis in order to determine the causative agent of the disease and select antibacterial therapy. The greater the perforation, the more severe the hearing impairment. A sharp pain in the ear may indicate a rupture of the eardrum.

Otitis can be characterized as follows:

  1. The sudden onset of the disease, an increase in body temperature to 39 degrees.
  2. Pain in the ear radiating to the temple and teeth on the affected side.
  3. Hearing impairment and noise in the ear.
  4. General weakness and malaise.

The main causes of the development of pathology

Factors that provoke perforated otitis media may be as follows:

  • Chronic inflammation, in which discharge accumulates in the ear cavity, which acts on the eardrum, causing it to quickly thin.
  • Foreign objects that have a traumatic effect.
  • Infectious migration from closely located organs: from the oropharynx, maxillary sinuses, nasal passages and so on.
  • Incorrect execution of medical manipulations.
  • The presence of traumatic injuries of the skull.
  • Skid infection with a blood stream with flu, scarlet fever and more.

Now we learn how the diagnosis is made in modern clinics in the framework of such a disease.

purulent perforated otitis media

Diagnosis of the disease

Diagnosis of perforated otitis media is carried out using otoscopy, which is carried out by a specialist. It is a painless, simple procedure in which a plastic or metal funnel is inserted into the ear canal, and the auricle is pulled up to align the ear canal and the eardrum is visually examined.

Rupture of it most often happens in the lower quadrant. If available, the doctor takes a small amount of liquid for bacteriological analysis to determine the origin of the causative agent of the disease and the selection of antibacterial treatment. The larger the perforation, the more severely impaired in patients is hearing.

Now we find out what signs indicate the appearance of this ailment in the body.


Perforated otitis media is characterized by:

  • The sudden onset of the disease with an increase in body temperature to thirty-nine degrees.
  • Pain in the ear, which is given to the temple and teeth, as a rule, from the side of the lesion.
  • Hearing impairment and noise.
  • General weakness and malaise.

There are more serious forms of the disease.

Purulent otitis media and its symptoms

Purulent perforated otitis media is characterized by:

perforated otitis media treatment
  • A sharp and very severe pain.
  • Weakening or hearing loss on the affected side.
  • The outflow of pus with an unpleasant odor mixed with blood from the area of ​​the affected ear.
  • Ringing, noise and discomfort.
  • Dizziness and nausea.
  • The pain subsides as a result of the discharge of fluid from the ear.

The exit of air from the organ indicates a complete rupture of the membrane. After its perforation, with successful removal of fluid from the middle ear, a gradual restoration of auditory sensitivity occurs. The small size of acute purulent perforated otitis media can heal independently. In other cases, it is necessary to be treated, observing a degenerative change in the affected membrane.

Acute otitis media

This is a fairly fast proceeding infectious lesion of the ear cavity. The clinical picture of the disease includes the presence of severe pain along with sensations of congestion and noise, hearing loss, the appearance of an opening in the membrane with further suppuration.

As part of the diagnosis of acute perforated otitis media, data from otoscopy and a blood test are used. Radiography of the skull and examination of the auditory tube are possible.

General treatment of the disease is carried out with antibiotics, anti-inflammatory and antihistamines. As for local therapy, it consists in blowing the auditory tube, and, in addition, in instilling drops, the introduction of proteolytic enzymes and so on.

perforated otitis media

In children

Often, acute perforated otitis media affects children under three years of age, this is facilitated by their anatomical features. In infants, the auditory tube is much shorter and more horizontal than adult patients. Their drum cavity is filled with a peculiar connective tissue, which predisposes to the development of inflammation in this area.

In children, the body's resistance to infections is less, in addition, they have a weaker immune system. Diseases like adenoids, acute tonsillitis and adenoiditis only contribute to frequent relapses and the occurrence of otitis media.

It is extremely important to have time to pay attention to the symptoms of the disease. In that case, if the baby is not yet two years old, then it will become an anxiety, a refusal of food and crying to indicate pain. As part of the pressure on the ear tragus, the crying of the crumbs will increase, which will only confirm the diagnosis.

When confirming this disease in a baby, in no case should water be allowed to enter the ear canal. This can cause various complications, which is fraught with complete loss of hearing. Now we will understand the methods of therapy.

otitis media


Treatment of such an ailment as perforated otitis media should be carried out in a hospital by an otolaryngologist and may include:

  • The use of a special patch for the membrane, which helps to restore its integrity.
  • Treatment with ear drops with anesthetic local and antibacterial effect (we are talking about "Anauran", "Otof").
  • Therapy with antihistamines (Tavegilum, Tsetrinom, Loratadinom).
  • The use of vasoconstrictive drops that facilitate nasal breathing and promote better fluid outflow from the ear (for example, Otrivin or Naphthyzin).
  • Conducting systemic antibiotic therapy (prescribed after examination by a doctor).
  • The use of a warming half-alcohol compress on the ear.
  • Performing surgery may be appropriate in the case of large perforations or as a result of the lack of effect from the previously described treatment methods.

Surgical treatment of perforated otitis media is the application of bone patches to the site of perforation. A skin flap is taken from the area above the ear, then its absorbable thin material is sewn along the perimeter of the rupture of the membrane. Subsequently, the transplanted area reliably survives, and the hearing, in turn, is restored.

In the case of the presence of symptoms characteristic of acute or perforated otitis media, it is necessary to immediately contact an otolaryngologist.

otitis media treatment


Such measures play an important role, especially in children, since this disease, unfortunately, is prone to relapse. So, you need:

  • Correctly and timely treat any infection along with diseases of the throat, ears and nose.
  • You should not use sharp objects to cleanse the auditory external passages.
  • Exposure to excessive noise must not be allowed.
  • Requires support for the body’s immune system.
  • It is important to teach your baby the right sneezing and blowing your nose.
  • It is necessary to protect the external auditory meatus from the action of noise, for example, wear protective headphones in an airplane, suck a lollipop during take-off, and so on.
    acute purulent perforated otitis media

The inflammatory process of the middle ear will require a correct approach, and at the same time, immediate treatment. Such a condition does not pose a threat to the patient’s life, but it is important to follow all preventive measures in order to avoid relapse and complications of the disease.


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