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ACUTE OTITIS MEDIA
急性中耳炎
What is Acute Otitis Media?
什么是急性中耳炎？
"Acute" stands for abrupt onset, "ot" stands for ear.
“Acute”代表突然发作，“ot”代表耳朵。
"itis" stands for infection and inflammation; While "media" stands for middle ear.
“itis”代表感染和炎症，而“media”代表中耳。
So, Acute Otitis Media means inflammation of the middle ear.
所以，急性中耳炎意味着中耳发炎。
What are the stages of acute otitis media?
急性中耳炎的分期是什么？
1) Stage of Tubal Occlusion: Since the middle ear drainage is entirely dependent on Eustachian tube, the first step in acute otitis media is the blockage of Eustachian tube.
1）咽鼓管阻塞阶段：由于中耳引流完全依赖咽鼓管，急性中耳炎的第一步是咽鼓管阻塞。
Children are particularly predisposed to acute otitis media because their Eustachian tube is shorter, wider and more horizontal as compared to adults, which increases the chances of the Eustachian tube getting blocked.
儿童特别容易患急性中耳炎，因为与成人相比，他们的咽鼓管短而宽，开口位置低，这增加了咽鼓管被堵塞的机会。
2) Stage of Pre-Suppuration: After the Eustachian tube is blocked, the microorganisms start infecting.
2）化脓前期：咽鼓管堵塞后，开始出现微生物感染。
3) Stage of Suppuration: This is marked by formation of pus in the middle ear.
3）化脓期：以中耳化脓为标志。
Tympanic membrane starts bulging to the point of rupture.
鼓膜开始膨胀到破裂点。
4) Stage of Resolution: The tympanic membrane rupture with a release of pus and subsidence of symptoms.
4）消解期：鼓膜破裂，脓液排出，症状消退。
Inflammatory process begins to resolve.
炎症开始消退。
If proper treatment started early or the infection was mild, resolution may start even without rupture of tympanic membrane.
如果早期就开始正确治疗或感染程度较轻，甚至在没有鼓膜破裂的情况下炎症也可能开始消退。
5) Stage of Complication: If virulence of organism is high, or resistance of patient is poor, resolution may not take place and disease spreads beyond the confines of middle ear.
5）并发症阶段：如果病菌毒性大，或患者抵抗力差，炎症可能无法消除，疾病可扩散至中耳以外。
Treatment 1) Antibacterial therapy: It is indicated in all cases with fever and severe earache.
治疗1）抗菌治疗适用于所有发烧和严重耳痛的患者。
2) Decongestant Nasal Drops: Nose drops should be used to relieve Eustachian tube edema and promote ventilation of middle ear.
2）减充血剂滴鼻剂：滴鼻剂可减轻咽鼓管水肿，促进中耳通气。
4) Analgesics and Antipyretics: Help to relieve pain and bring down temperature.
4）止痛药和退烧药：有助于止痛降温。
5) Ear Toilet: If there is discharge in the ear, it is dry mopped with sterile cotton buds and a wick moisten with antibiotic may be inserted.
5）清除中耳积液：如果耳朵里有分泌物，用无菌棉签擦干后，可以插入用抗生素湿润过的棉签。
6) Dry Local Heat: It helps to relieve pain.
6）局部热敷：它有助于止痛。
7) Myringotomy: It is incising the drum to evacuate pus and is indicated when a) drum is bulging and there is acute pain,
7）鼓膜切开术：当有以下症状时需要切开鼓膜以排出脓液；a）鼓膜水肿膨隆并有急性疼痛，
b) there is an incomplete resolution despite antibiotics when drum remains full with persistent conductive deafness c) there is persistent effusion beyond 12 weeks.
b）持续性传导性耳聋时，尽管使用了抗生素，但仍不能完全消除耳聋，c）积液持续渗出超过12周。
All cases of acute suppurative otitis media should be carefully followed till drum membrane returns to its normal appearance.
所有急性化脓性中耳炎均应密切跟踪，直至鼓膜恢复正常。
