(1) Syndrome of pathogenic wind attacking the lung:
Main symptoms and signs: The patient has distension or slight pain inside the ear and hypoacusis. But when the patient hears his own voice which is louder than the actual voice at ordinary times. Tinnitus looks like hearing wind. The patient often presses the tragus gently to relieve the discomfort of the ear. Examination sees clean auditory canal, slightly red tympanic membrane, mild invagination or a horizontal shadow behind the tympanic membrane which can move as the head moves. Audiometry finds conduction deafness. Possibly, accompanying symptoms exist such as headache, nasal obstruction, nasal discharge, sore throat, fever and aversion to cold. The tongue tip is red and the pulse is floating and rapid. Continue to read Chinese Medicine Treatment for Chronic Suppurative Otitis Media.
(2) Syndrome of blood stasis due to qi stagnation:
Main symptoms and signs: Fullness, obstruction and discomfort inside the ear last long without recovery, which is like being blocked by an object in severe cases. Hearing declines, and worsens gradually. Tinnitus is like hearing a cicada's singing, or with murmur. Examination finds marked invagination of the tympanic membrane, even adhesion and declined activity. There exists the pale sedimental plaque on the tympanic membrane. Audiometry proves conduction deafness. The tongue is deep purple with thin and white fur. The pulse is taut and unsmooth.
(3) Syndrome of excessive fire of the liver and gallbladder:
Main symptoms and signs: Otalgia is severe like being punctured by an awl. It manifests as cry and restlessness in children. Hypoacusis is even more obvious. Examination shows deep red tympanic membrane with evagination, or small yellow spots which is the premonitory sign of perforation of the tympanic membrane. Or there exists the small hole on the tympanic membrane. But profuse pus still exists without being discharged. The tongue is red with yellowish fur. The pulse is taut and rapid.
(4) Syndrome of dampness intermingled with asthenia of the spleen:
Main syndromes and signs: Pyorrhea inside the affected ear is mostly intermittent, profuse in quantity, thin in quality, white in colour and free from odour. The perforation of the tympanic membrane lies in the tense part and is larger. The mucosa of the tympanic cavity is reddish or pale. The patient has pale complexion, poor appetite, lassitude, fatigue and loose stool. The tongue is pale with white and greasy fur and the pulse is soft.
(5) Syndrome of deficiency of the kidney:
Main symptoms and signs: The pus discharge inside the ear is prolonged, sticky and thick, with odour, and is often intermingled with blood. There exists granulation or polyp inside the tympanic cavity. Tympanic membrane perforates in the marginal part. There exists severer conduction deafness. X-ray film of the mastoid process sees the vague transparent area. The patient suffers from dizziness, fatigue and aching pain in loins and knees. The tongue is red with a bit of fur and the pulse is thready and rapid. Continue to read TCM Treatment Evaluation for Chronic Suppurative Otitis Media.
(6) Syndrome of hyperactivity of the liver due to asthenia of the kidney:
Main symptoms and signs: Pyorrhea inside the ear is sometimes profuse and sometimes scanty. There exists the substance like bean dregs with special foul odour in the pus. The patient has severer conduction deafness or mixed deafness. The perforation of the tympanic membrane lies in the flaccid portion, or posterosuperior part of the tense portion. Through the perforation, the examiner can see the squamous substance with grayish white colour and foul odour, or the indefinite-shaped substance like bean dregs. X-ray film of the mastoid process or CT scan of temporal bone can see the cholesteatomatous cavities of the upper tympanic cavity, antrum tympanicum or mastoid process.
