Generality
Catarrhal otitis is a pathological condition that results from inflammation of the middle ear . This condition is frequently found in pediatric age, but can also affect adults.
Catarrhal otitis is characterized by increased secretion of mucus at the ear level ( tubal catarrh ).
The process underlying the disease can depend on various causes. In most cases, catarrhal otitis is a complication of pathologies of the upper respiratory tract, not adequately treated (eg colds, flu, pharyngitis, etc.).
The medical evaluation makes use of the direct vision of the ear canal and the eardrum membrane (otoscopy) and of the execution of instrumental tests (audiometry and tympanometry) which confirm the presence of phlegm. Treatment varies according to the type of process that generated catarrhal otitis.
What's this
Catarrhal otitis media (also called effusive) is an inflammatory process that develops in the region between the tympanic membrane and the inner ear structures.
The age group most affected by catarrhal otitis is pediatric age (but cases of disease are also commonly reported in adults).
This form of congestion is characterized by excess mucus, redness and high blood supply at the level of the tympanic membrane.
Catarrhal otitis can be confined to one ear (unilateral) or extend to both (bilateral).
What is phlegm?
- Catarrh is a type of mucus that typically develops during an inflammatory process. This secretion is produced by the glands attached to the mucosa of the respiratory tract .
- Unlike mucus secreted in normal physiological conditions, having the functions of lubricating the walls and facilitating the elimination of external agents that penetrate the body, the phlegm is more abundant, dense and sticky .
- The catarrh in the ear is a manifestation that can be seen when there is an accumulation of mucus at the level of the Eustachian tube and there is no possibility of spontaneous drainage of the same through the nasopharynx. The increase in mucus in the auditory organ typically results from an inflammatory pathology.
Causes
Catarrhal otitis is favored by numerous factors.
In most cases, catarrhal otitis is a complication of pathologies of the throat and upper respiratory tract, not adequately treated, such as:
- Cold (inflammation of the respiratory tract);
- Sinusitis (inflammation of the nasal and paranasal sinuses);
- Pharyngitis;
- Influence.
On the basis of this consideration, it is necessary to emphasize the close association with previous episodes of an infectious nature . Exposure to bacteria, viruses and other pathogens from a neighboring site can be one of the triggers of this process, especially in the winter months, when you are more susceptible to so-called colds.
Catarrhal otitis can be a consequence of other diseases, including:
- Allergies (excessive or abnormal reaction of the immune system towards harmless substances such as dust, plants, animals, food, etc.);
- Congenital malformations;
- Adenoid hypertrophy and tonsillitis (especially in children);
- Breaking of the eardrum;
- cholesteatoma;
- Gastroesophageal reflux;
- Cancer of the auditory canal;
- Nasopharyngeal tumor.
Beyond the specific framework with which they occur, all these pathologies act with the same mechanism, ie inflammation of the middle ear.
Risk factors
Often, catarrhal otitis is supported by subjective factors (age, immune status, etc.) and local factors (such as adenoid hypertrophy, structure of the Eustachian tube or malformations of the palate).
The conditions predisposing this pathological condition are:
- Seasonal variations : catarrhal otitis tends to have a greater incidence in certain periods of the year. In particular, the disorder is more frequent in the winter months, during which the organism is more vulnerable, due to low temperatures and the greater risk of incurring air blows. Furthermore, the colder temperatures tend to weaken the immune defenses: viruses and bacteria pass more easily from the throat to the ear, through the Eustachian tubes.
- Childhood : catarrhal otitis occurs mainly for anatomical reasons . In children under the age of 2, in fact, the Eustachian tube is thinner and shorter than that of an adult, in addition to having an inclination that is not yet definitive; the combination of these characteristics makes the flow of mucus from the middle ear to the nasopharynx more difficult. Furthermore, during childhood, the immune system is still developing: this makes the child more susceptible to infections . The anatomical conformation of the ear predisposes to the development of inflammatory processes also due to the concomitant tendency to adenoid hypertrophy (correlated to recurrent infections), able to favor the occlusion of the outlet point of the Eustachian tube.
- Exposure to active or passive smoking : it can be counted among the factors that predispose to the onset of catarrhal otitis due to its intrinsic irritating and damaging capacity on the auditory system. Nicotine then acts by stimulating increased production of tubal catarrh.
Symptoms and Complications
Catarrhal otitis typically occurs with:
- Catarrh in the ears;
- Rumble of noises or sense of rumble felt while speaking (autophony);
- Sensation of auricular fullness (plugged or clogged ears);
- Secretion from the external auditory canal of thick mucus (in case the tympanic membrane is broken or permeable);
- Redness of the affected ear or increase in its temperature.
- Perception of one's heart rate at ear level.
Depending on the underlying cause, catarrhal otitis can be accompanied by various other symptoms, including:
- Acute and persistent ear pain (otalgia);
- Enlarged lymph nodes behind the ear or in the neck;
- Local itching;
- Nausea, dizziness or alterations in the perception of balance (related to the propagation of inflammation also at the level of the inner ear);
- Tinnitus (perception of sounds similar to buzzing);
- Hearing impairment (hypoacusis);
- Otorrhagia (blood from the ear);
- Fever and general malaise (especially in the case of infections or tumor phenomena);
- Chewing pain;
- Headache;
- Accentive tear in the eyes;
- Cough, sore throat and runny nose (generic symptoms due to cold or flu);
In most cases, catarrhal otitis is almost never severe and can regress completely. In a small percentage of cases, however, if the causal pathology is particularly serious, there is a risk of incurring a reduction in permanent hearing.
Diagnosis
Evaluation of catarrhal otitis can be performed initially by your primary care physician. If he deems it necessary, he can advise the patient to undergo an otorhinolaryngological examination, which includes the patient's medical history and physical examination.
The diagnosis of catarrhal otitis takes advantage of the direct vision of the ear canal ( otoscopy ) to highlight the reddening of the tympanic membrane, the increase in local temperature or the possible secretion of mucus; neighboring areas can be palpated to check their tenderness.
During the visit, moreover, the otolaryngologist must search for symptoms suggestive of possible causes, including otalgia and reddening of the eardrum (otitis); fever and facial pain (sinusitis); watery eyes, itchy eyes (allergies) and sore throat, general malaise, fever and cough (viral infection of upper respiratory tract).
In more complex cases, it could be indicated to perform other investigations, such as the impedometric test, whose purpose is to evaluate the elasticity of the tympanic membrane and the degree of movement of the internal ossicles (hammer, anvil and stirrup).
The doctor may decide to resort to other investigations, such as audiometry to highlight any changes in hearing or the tympanogram, which allows the pressure to be measured at the level of the middle ear chamber.
Therapy
The treatment is directed to the triggering cause, therefore it varies according to the type of process that generated the catarrhal otitis.
If the disorder is the result of a bacterial infection, for example, the doctor may indicate the intake of specific antibiotics; when the origin is viral, however, it is possible to resort to a pharmacological treatment aimed at alleviating the symptoms.
Once the basic problem is managed, it is possible to physically remove the phlegm from the ear. For this purpose, the patient can undergo steam inhalation to thin the mucus and make it easier to expel it.
It is possible to use nasal and / or ear decongestants, aerosol therapy with mucolytics, NSAIDs or corticosteroids (anti-inflammatories) to facilitate drainage of the phlegm and clear the middle ear and the Eustachian tube.
In cases of failure of all medical options, it can be considered a surgical approach. In adults, to allow the elimination of the stagnant phlegm, a microdrenage can be applied to the tympanic cavity . In children subject to recurrent infections, adenotomy, sometimes associated with a tonsillectomy, may be indicated in cases of evident adenoid hypertrophy.
Some advice
- Cover your ear well to prevent it from being subjected to excessive temperature variations and try not to expose yourself to drafts;
- Avoid diving / swimming during the period of illness;
- Drinking plenty of water and / or herbal teas, broths and soups of hot (non-boiling) vegetables during the day maintains proper hydration and helps to make the ear secretions less dense;
- Undergo thermal cycles of aerosol based on sulphurous waters to facilitate nasal breathing and middle ear aeration;
- Sleep with the head slightly raised to help the spillage of the phlegm.
