In the human ear, there are:

The outer ear is the auricle and the external auditory canal with its cartilaginous and bony parts (the latter has not yet developed until the age of four months).

Middle ear – includes the auditory tube, the tympanic cavity and the mastoid process with a cave in it. The auditory tube connects the nasopharynx with the tympanic cavity. The mucous membrane of the auditory tube has cilia that actively flicker towards the nasopharynx, removing the resulting mucus from the middle ear system. The lumen of the same pipe contributes to the conduction of air into the tympanic cavity and the cells of the mastoid process when swallowing. This provides “comfort” in the middle ear system for conducting sound signals to the inner ear.

The inner ear is a labyrinth (the name emphasizes the complexity of the anatomical structure and high functional responsibility). By birth, the labyrinth of the child is formed and then its size does not increase. The labyrinth has an auditory part and a vestibular part. The latter controls the position and movement of the body in space.

The above information allows us to imagine a very complex anatomical and physiological structure of the ear, which gives painful breakthroughs in some of its links and is expressed in complaints of patients “in the ear”. In everyday life, we most often encounter acute and chronic diseases of the middle ear. The main reason is a violation of the function of the auditory tube. The mucosa of the latter is involved in the painful process along with the nasal mucosa (with rhinitis), pharynx (pharyngitis). With these diseases, the mucous membrane of the auditory tube swells. Its light is blocked. The air in the middle ear system resolves, effusion appears, but there is no outflow. A stagnant effusion is a good breeding ground for bacteria that contribute to the development of inflammatory (purulent) diseases of the middle ear. In the majority of patients, treatment ends with recovery. Some patients develop cicatricial (adhesive) otitis media, acute inflammations turn into chronic forms, give complications to the mastoid process, the inner ear, and cause brain damage. Timely treatment by an ENT specialist (otorhinolaryngologist) will undoubtedly help reduce the complications of this common and difficult disease.

In its development, acute inflammation The middle ear undergoes three stages of development, and each of them has its own characteristic features of clinical manifestations and the correct provision of therapeutic measures.

The first stage is the stage of irritation (sometimes identified with tubo-otitis or acute catarrhal otitis media). Against the background of acute respiratory diseases (rhinitis) or after them, the patient develops congestion in the ear, clapping or a streaming sensation in the ear when swallowing. In the case of breastfeeding, the child reacts by refusing to suckle the breast, if he lies on a sore ear, cries out, and begins to behave restlessly. Older children reach out with a finger or something in the ear, act up. Body temperature remains subfibrile or is normal. Big children already declare that the ear is stuffed up or hurts. An ENT specialist can detect changes in some of the signs of the eardrum. Therapeutic measures of influence can be carried out by an attentive and close person without causing harm. It:

Drip vasoconstrictor drops into both halves of the nose (protargol 1–2%, or naphthyzinum 0.05–0.01%, or galazolin) 3 drops in the position of the patient lying on his back with a slightly hung head on the sore ear. After 5-15 minutes, it is necessary to free the nose from mucus and powder the entrances to it with streptocide powder. This action will improve the function of the auditory tube, increase the outflow and air exchange.
After that, turn the patient on his side with the position of the patient’s ear up. 6-8 drops of a warm 70 ° alcohol solution, 2-3% boric acid or chloramphenicol or furacillin alcohol should be instilled into the ear canal of the diseased ear. Then insert a wick of cotton wool or gauze into the ear canal and close it with a piece the size of a two-kopeck coin from a thin plastic bag. Put some cotton on top of this patch and tie the ear. The alcohol action will be the main one, it relieves the pressure (of the emerging effusion) on the eardrum, thereby reducing pain and enhancing the resorption of the transudate in the tympanic cavity. These two events are held 2-3 times a day for 5-7 days. At night, a vodka compress is applied to the sore ear. If there is an increase in body temperature, antibiotics are prescribed without fail. The behavior of the child (patient), body temperature will indicate in which direction the inflammatory process in the ear goes. Control of an ENT specialist by 5–7 days treatment is required.
The second stage is the stage of exudation (this is acute purulent otitis media without perforation): the patient’s behavior becomes restless, pain in the ear is sharp (irritation of the branch of the trigeminal nerve), high body temperature, hearing is sharply reduced, headache, with an increase in the pressure of the “air column” in ear canal pain in the ear increases sharply. When examining the ear canal, the doctor will reveal a sharp hyperemia (redness) of the tympanic membrane, its protrusion and the absence of identification marks. The above measures for the first stage of otitis media are mandatory, only alcohol drops in the ear should be preceded by a 2-10% solution of lidocaine in the amount of 3-5 drops for 5-10 minutes. Then we tilt the diseased ear down and dry it with a piece of cotton wool or a gauze napkin and insert a wick with an alcohol (70) solution into the ear canal, as in the first stage of acute otitis media. We apply a vodka compress or heat to the ear. Antibiotics are required. Treatment is carried out for 5-7 days. By this time, we conduct a control examination of an ENT specialist with a general blood test. UHF therapy and control of an ENT specialist in dynamics are prescribed. The patient’s body temperature, complaints, a general blood test and a hearing test with whispered speech will already indicate the degree of effectiveness and reverse development of the disease process.

The third stage is the stage of resolution (its name is not very successful). The ear flowed, mucopurulent discharge appeared with an admixture of mucus and blood (acute purulent otitis media with perforation). Against the background of the second stage of acute otitis media, a rupture of the eardrum occurred. Pain in the ear does not bother the patient, the general condition has improved, the patient’s body temperature has decreased or become normal. But the disease did not go to recovery, and this should seriously alert relatives and friends. The ongoing treatment of the first and second stages of acute otitis media continues. Only alcohol drops in the ear are preceded by an ear (ear canal) toilet with 3% hydrogen peroxide. The latter is used not for treatment, but for removing mucopurulent discharge from the ear and creating conditions for the access of alcohol drops (otinum, saphrodex, hare fat, etc., they do not give a noticeable effect in stage 2 and the first days of the 3rd) with the introduction of their 2–3 times a day. Treatment of the patient in such situations is delayed. At opportunities, a study of purulent contents from the ear is carried out on the nature of bacteria and their relationship to antibiotics. Antibiotics are prescribed taking into account the results of bacteriological examination, UHF and UV therapy. Medical control – the control of an ENT specialist is mandatory with the involvement of a pediatrician in order to assess the general condition and identify other painful conditions (diseases) that reduce the protective functions of the body. The latter plays a major role in recurrent acute otitis media, their transition to chronic forms of the course, contribute to the complication of acute otitis media in the area of ​​the mastoid process (antitis, mastoiditis), cause diseases of the inner ear and brain.