Adhesive otitis media

What is the adhesive otitis and how is it treated?

Chronic adhesive otitis media of the middle ear is a serious inflammatory disease that can lead to complete or partial hearing loss. A characteristic feature of the disease will be the formation of adhesions and cords, the deterioration of the permeability of the auditory canal and the mobility of the bones that create the structure of the hearing aid. All this is accompanied by a sharp deterioration of hearing and painful sensations. If the slightest suspicion arises, immediately consult a doctor - an otolaryngologist for further diagnosis and treatment.

Causes

Among the most common factors of the onset of the disease can be considered the transferred ENT diseases, congenital anatomical features of the structure of the auditory canal and many other reasons. Often the disease is "masked" for normal otitis and the true nature can be recognized only by a specialist after extensive research. There are described the symptoms and treatment at home of different types of otitis media. The link describes the signs of otitis in the baby.

The causes of this disease:

• The consequences of the inflammatory processes of the hearing aid.
• Uncontrolled administration of antibiotics and improper treatment.
• Acute forms of ENT diseases.
• Seasonal exacerbation of maxillary sinusitis.
• Complications after sinusitis or even an ordinary rhinitis (runny nose).
• Curvature of the nasal septum (congenital or acquired).
• Adenoids.
• Polyps and tumors of the nasal cavity or pharynx.
• Frequent inflammatory processes that are tolerated without proper treatment.
• Dental problems.

The video describes in detail about the adhesive otitis:

The best prophylaxis of this disease will be the professional help of the doctor for all kinds of ENT problems, as well as the refusal of ill-considered antibiotic treatment. All medicines must necessarily be agreed with the attending physician, otherwise there is risk of severe consequences not only for the hearing organs, but also for the functioning of the whole organism in whole. Possible treatment of otitis antibiotics in adults is described by reference.

Diagnostics

As mentioned earlier, it is only the specialist who can determine the adhesive otitis, and several examinations are needed to exclude other variants and an accurate diagnosis.

Measures for the diagnosis of adhesive otitis media:

• Examination of a doctor - an otolaryngologist.
• Conducting audiometry - a special procedure consisting in "blowing" the auditory canal using the method of the Politzer. If there is another disease, purging guarantees a very effective effect, and in the case of an adhesive otitis media, there will be virtually no result.
• Otoscopy is an enlarged examination that allows you to see exactly the possible adhesions or scar changes in the structure of the middle ear.
• Determination of the degree of patency of the auditory canal.
• Acoustic impedance measurement is also a very useful test, determining the mobility of the auditory ossicles and the degree of dilatation of the tympanic membrane.If the normal operation of the hearing aid is impaired, the extensibility of the membrane is limited or absent altogether, it can be concluded that there is an adhesive otitis.

Do not be afraid to undergo a complete examination, because that's how you can create a complete picture of the disease and determine its severity and future prospects. In the absence or incomplete treatment, the threat can be a complete loss of hearing, as well as the progression of the disease and the defeat of other organs. The results of all special examinations will confirm or refute the diagnosis of "adhesive otitis which will allow the doctor to write out a treatment plan.

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How to treat

What is the treatment regimen for otitis in this disease? In order to get rid of the disease in the first place, it is necessary to remove the provoking factor. For this, medicinal treatment is attributed. In the case of a pathological structure of organs, surgical intervention is required. To the causes that led to the disease can be attributed to any kind of infection, so it may be necessary to completely sanitize the oral cavity, nasal sinuses and larynx.Children may need to remove adenoids, but only in emergency cases, if other types of treatment are ineffective.Curvature of the nasal septum can also cause adhesive otitis, so it is necessary to remove this factor.

The second stage: manipulation with the help of special equipment. According to the treatment plan, this is usually a blow on the method of the Politzer, already mentioned earlier as diagnostic measures. The difference is the simultaneous carrying out of the pneumomassage of the tympanic septum and the introduction of special medications in the auditory canal.

The video tells how to treat and cure adhesive otitis:

Procedures of physiological direction are also very effective. It can be UHF - heating, microwave therapy, ultrasound massage and even mud therapy. All these procedures do not abolish drug treatment, but they provide a complex effect and help to cope with the disease more quickly.

Patients during treatment are recommended the use of multivitamins, especially the B group. This measure contributes to better progress and recovery. In order to avoid allergic manifestations, you should also take antihistamines.

Home methods, unfortunately, are not suitable for the treatment of adhesive otitis, moreover, they can cause disease progression and severe consequences, so you should not take risks. Additional measures, like warming up the "blue" lamp, the introduction of tampons with various home broths and mixtures must necessarily be agreed with the doctor.

Some "grandmother's" methods of treating inflammation of the middle ear can alleviate the symptoms of the disease and enhance the effectiveness of official treatment. The main requirement is that all activities should be coordinated with the attending physician, and not with the advice of "knowledgeable" people without proper qualification.

On the video - the review "How I Cured Adhesive Otitis

Surgical methods of treatment of adhesive otitis are the excision of scars on the surface of the auditory ossicles. This is an extremely complex and unpredictable procedure, the implementation of which does not guarantee the restoration of the work of the body.Often, such operations do not bring tangible benefits and require prosthetics of some elements.Especially disappointing prognosis for the youngest patients: in childhood, such operations are almost not carried out because of the high risk of repeated scarring of tissues. This deprives the cost of expensive and dangerous surgical intervention.

The main danger of adhesive otitis is the irreversibility of the existing changes. Treatment can only stop the progression of the disease, but not return the body to its original state. With timely treatment it is possible to avoid complete deafness, but the acuity of hearing will still be a little lost.

Adhesive otitis media of the middle ear is a serious disease, the treatment of which must be treated with all responsibility. Correct diagnosis and timely access to a specialist will help to stop the disease in time, but it was not possible to completely restore the affected organ. Perhaps you will also be useful information about the symptoms of catarrhal otitis. The link describes ear drops in otitis in adults. And here you will find children's ear drops during otitis.

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Chronic adhesive otitis media: symptoms and treatment

Chronic adhesive otitis is an inflammatory process that covers the entire middle ear and leads to the formation of connecting strands and adhesions. These formations disrupt the patency of the auditory tube and impair the mobility of the auditory ossicles. Adhesive otitis is manifested by noise in the ear and a decrease in hearing, aggravated with time.

Causes of development of adhesive otitis

In most cases, an adhesive medium otitis is preceded by a catarrhal non-perforative or exudative tubo-otitis. To provoke the development of the inflammatory process after the diseases listed above, irrational therapy with antibiotics can be used. After removal of the inflammatory process and complete dissipation of the exudate that accumulated in the tympanum, it retains the fibers of fibrin, which promote the formation of scarring and adhesions.

Heavy attach to the eardrum and tightly braid the auditory ossicles, thereby blocking or limiting the mobility of these structures. As a result, the process of sound conduction is disrupted and hearing is reduced. Also, spikes can form in the auditory tube and violate its patency.

Quite often in clinical otolaryngology there are cases when this type of otitis develops without previous inflammation of the ear. In this case, the cause of its occurrence are pathological processes that disrupt and obstruct the patency of the auditory canal and prevent the drum cavity from normally ventilating. Such processes include:

• acute diseases of ENT organs - pharyngitis, SARS, tracheitis and laryngitis);
• inflammatory processes of chronic course in the nasal cavity and paranasal sinuses - sinusitis, sinusitis and rhinitis;
• adenoids;
• tumors of the nasal cavity and pharynx.

Also often the development of adhesive otitis occurs in the presence of curvature of the nasal septum of any origin.

Symptoms of bilateral adhesive otitis

The most frequent complaints are a sense of noise in the ears and a gradual loss of hearing. In the history of such patients, there are almost always chronic or acute otitis. The study of the ear shows the conductive nature of the development of hearing loss, that is, the hearing loss occurs due to inferior sound production.

The clinical symptoms of otitisus are few and all are similar to those of other ear disorders. That is why for a reliable diagnosis of the disease and identify the true causes of its development, it is necessary to conduct a number of activities, especially in cases where discomfort and pain are felt in both ears and it is a question of suspicion of a bilateral adhesive otitis.

Ignore the symptoms of adhesive otitis in no case can not, because a prolonged course of the disease can lead to a decrease in the sensitivity of cells and a significant decrease in the flux of impulses emanating from them to the brain.

Diagnosis of bilateral adherent otitis media

If there is a suspicion of chronic adhesive otitis media, compulsory diagnostic tests are visual examination of the doctor of the otolaryngologist, audiometry, otoscopy, impedance measurement and examination of the permeability of the auditory passage.

It is very important in diagnosing otitis of this type to clearly determine the otoscopic picture of the disease. Otoscopy is distinguished by simple and increased, it allows you to determine the tympanic retraction, the presence of cicatricial changes or its turbidity. Also in the cavity of the auditory tube can be visualized strands and adhesions, which sometimes completely fill its lumen.

Conducting audiometry with bilateral adhesive adhesive helps to identify the severity of hearing loss in patients. To determine the patency of the auditory tube, it is purged through the Politzer. If the patient has really adhesive otitis, then this procedure gives a weak effect or does not give it at all. However, for the final confirmation of the diagnosis, pipes with mandatory otoscopic control are used to catheterize.

The mobility of the auditory ossicles, as well as the extensibility of the tympanic membrane, is measured during the procedure called acoustic impedance measurement. The essence of the procedure is to consecutively discharge and thicken the air in the auditory tube. As a result of such manipulations, the tympanic membrane should straighten and retract. When diagnosing adhesive middle otitis, the movements of the membrane are very limited or absent at all, and muscular acoustic reflexes are not caused.

Treatment of chronic adhesive otitis

At the first stage of treatment of adhesive otitis, elimination of factors that lead to violation of patency of the auditory tube is performed. First, sanation of the nasal sinuses and nasopharynx is performed, adenotomy is performed in children, normal nasal breathing is restored.

Effective in the treatment of adhesive otitis are considered to blow through the Politzer, supplemented by pneumomassage of the tympanic membrane. Transtemial administration of fluimycil, lidase, chymotrypsin and hydrocortisone via a catheter is used.

To stimulate the body's defense reactions, patients are advised to take B vitamins. Also shown are antihistamines. It is necessary to supplement the medication of adhesive middle otitis media with UHF, microwave therapy, ultrasonic massage and mud therapy, but only according to the doctor's prescription.

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Features of adhesive otitis media: symptoms and treatment

Often inflammatory processes of various complexity occur in the body. Adhesive otitis, the symptoms of which begin to manifest with weakening of auditory activity, is also not uncommon. The disease itself is an inflammatory process in the middle ear region, which results in adhesions with strands. Because of such processes, the mobility of the bones is disturbed, as is the patency of the auditory tube.

The main manifestations of adhesive otitis is noise and further decrease in auditory activity. To diagnose this disease, a doctor's examination is necessary. In addition, otoscopy is carried out - studies aimed at studying the patency of the auditory tube - and impedance measurement.

Treatment of adhesive otitis is, as a rule, in the introduction of lidase, proteolytic enzymes. In addition, to the activities aimed at treating this disease, and physiotherapy. Prevention is the necessary measure in case of prevention of the disease. If these methods do not bring the desired result, resort to radical measures, that is, surgery: tympanoplasty and tympanotomy.

Features of adhesive otitis

The middle ear is a drum cavity with auditory ossicles and an auditory tube. The drum cavity separates the membrane from the auditory tube, through which the sound is transferred to the bones. It is through them that the signals go to the inner ear, that is, to those responsible for transmitting sounds along the nerve to certain structures in the brain department.

Due to a decrease in the mobility of the ossicles in the ear, as well as the membrane, the hearing deteriorates. With adhesive otitis this is due to a violation of the sound. Often, adhesive middle otitis, which lasts for quite a long time, leads to a change in the perception of sounds due to the deterioration of the sensitivity of hair cells to endolymphic vibrations. In addition, the cause is also a decrease in pulsation, which is transmitted to the brain from hair cells.

What are the causes of the disease?

Adhesive otitis media is most often the result of exudative and catarrhal non-perforative otitis media.In this case, a frequent cause is incorrectly conducted therapy with the use of antibiotics.

After removal of inflammation and resorption of the exudate accumulated from the tympanic cavity, strands of scarring with spikes are formed. The first attach to the membrane, braiding the auditory ossicles. During the formation of cords with spikes in the pipe, there is a change in patency for the worse with adhesive middle ear otitis.

Often in otolaryngology, the appearance of adhesive otitis other forms of the disease, for example acute and chronic, do not precede. In this case, the main cause of the disease, as a rule, are pathological processes that make it difficult for the tube to pass through with the ventilation of the tympanum.

Such diseases include diseases associated with the upper respiratory tract: tonsillitis, adenoids, sinusitis in the chronic form. In addition, hypertrophy of nasal conchae, tumors of the nose and throat, as well as curvature of the septum in the nose can be included here.

Symptoms of adhesive otitis

As a rule, the main reason for people to consult a doctor with adhesive otitis is hearing loss and the appearance of noise.

Often when questioning such patients, it is found that previously they practically all had otitis of other forms: acute and chronic. Hearing loss with adhesive otitis occurs as a result of a disturbance in the sound.

As for the clinical manifestations of the disease, they are practically not different from other diseases associated with the ear. Therefore, in order to make an accurate diagnosis, it is necessary, first, to exclude the pathologies that lead to deterioration of hearing (sulfur plugs, damage, otosclerosis), and secondly, to carry out a number activities.

How is the diagnosis of adhesive otitis

Diagnosis begins with a visual examination by a doctor. Further, otoscopy, patency testing, endoscopic catheterization of the auditory tube and audiometry are performed.

With the help of such a procedure as audiometry, the extent to which auditory activity has decreased in patients is determined. The degree can be different, down to absolute deafness.

Checking the patency is carried out by blowing on the Politzer. However, if we are talking about a disease such as an adhesive mid otitis in the middle ear, then such a procedure, as a rule, does not give a positive result. Although in this case it is too early to talk about obstruction, because not always such results testify to this. In order to confirm the diagnosis, a catheterization of the tube will be required.

The main point in the diagnosis is the otoscopic pattern peculiar to the adhesive ear otitis of the middle ear. Otoscopy, which is simple and with an increase, makes it possible to determine how much the membrane is drawn, its and whether there are changes in the form of scars, which most often cause deformation webbeds.

Acoustic impedance measurement allows you to explore the mobility of the ossicles and membranes. This is done by thickening with subsequent dilution of air in the pipe. In the process, the web is stretched and straightened. With adhesive otitis, the membrane does not move at all, or does it limitedly.

How is the treatment of adhesive otitis

The initial (first) stage of treatment of the disease is to eliminate the factors that are the main cause of obstruction. Such measures include sanation of the sinuses and nasopharynx, as well as restoring breathing. As for the last event, this is the straightening of the septum with the nasal shells.

A positive result will help to achieve blowing through the Politzer, which is combined with pneumomassage.

Treatment of this disease with the use of drugs, usually supplemented by the appointment of physiotherapy. This includes microwave therapy, UHF, ultrasound massage, mud treatment.

It is worth noting that most often conservative treatment is ineffective, therefore, with rapid development of hearing loss, surgical intervention is used. In particular, this is tympanotomy, in the process of which there is a dissection of scars, adhesions and cords to restore the mobility of the auditory ossicles. However, this operation usually leads only to a temporary improvement, since more often after some time the spikes are formed again.

In this case, tympanoplasty will be more effective when the bones are replaced by artificial ones. There is another method of surgical intervention, which is used, as a rule, by elderly people in the presence of bilateral adhesive otitis - this is a hearing aid.

Prognosis of adhesive otitis media

With a disease such as adhesive otitis media, the depth and prevalence of fibro-cicatricial changes is of great importance in predicting. It is worth noting that these changes most often do not respond to treatment and are irreversible. The only thing that can be done is to stop the development of the disease.

The severity of hearing loss will depend on the stage at which the process was stopped. If the disease starts or does not produce any treatment measures, or conduct them inadequately and untimely, this leads to complete immobilization of the earbone joints, that is, to complete ankylosis. The result is complete deafness.

lor03.ru

Adhesive otitis media: symptoms, treatment

Very often the body develops inflammatory processes of varying severity. Adhesive otitis, the symptoms of which begin to manifest with hearing impairment, is not uncommon. Such a disease is accompanied by inflammation in the middle ear. As a result, adhesions with strands are formed, and the mobility of the auditory ossicles is disturbed. Why does this disease occur? What methods of treatment do doctors offer?

Features of adhesive otitis

The middle ear is represented by two components: a cavity with auditory ossicles and an Eustachian tube. They are separated by a tympanic membrane, which is also responsible for the transmission of sound vibrations. They go through the bones to the structures of the inner ear. Here the subsequent transmission and perception of signals through the auditory nerves occurs. After that, the sound takes the appropriate part of the brain. Adhesive otitis media appears due to decreased mobility of the tympanic membrane and bones. The disease is accompanied by a partial or complete violation of sound perception.

Causes

Most often, the cause of pathology is inflammation in the middle ear - acute otitis media and its various forms. To provoke the disease can also illiterate use of antibiotics in the treatment process. The drugs successfully fight with inflammation in the ear canal, but simultaneously dilute the accumulated exudate in it. As a result, cicatricial cords and spikes from connective tissue are formed. They braid the bones, blocking the mobility of structures and disturbing the patency of the auditory tube.

In otolaryngology, there are cases when adhesive otitis develops as an independent disease. It is preceded by a variety of pathological processes that significantly impede the permeability of the auditory tube and impede the full ventilation of the tympanum. Such violations include:

• protracted tonsillitis;
• adenoids;
• damage to the nasal septum;
• neoplasm in the pharynx;
• diseases affecting the upper respiratory tract (laryngitis, SARS);
• chronic inflammation in the nasal cavity (sinusitis, sinusitis).

Regardless of the cause of the disease, after observing its first signs, it is necessary to consult a doctor. Timely prescribed treatment can prevent the development of serious complications, avoid surgical intervention.

Clinical manifestations of the disease

The development of the pathological process begins gradually. The first symptom that patients pay attention to is the noise in the ear. Adhesive otitis is characterized by hearing impairment by conductive type, when there is a persistent deterioration in the mechanical conduct of sound vibrations. Clinical symptoms of the disease are similar in many respects to the picture of other ailments. Therefore, many diagnostic measures are used to determine the cause of hearing changes. They allow excluding other pathological processes that can lead to conductive hearing loss (accumulation of sulfur secretion, tubo-otitis, otosclerosis, etc.).

Establishing diagnosis

What principles are guided by the doctor when choosing the tactics of treatment? "Adhesive otitis media" is a serious diagnosis, for the confirmation of which a complete examination of the patient is required. It usually includes:

• visual inspection;
• otoscopy (examination of the ear cavity using a light source and a reflector);
• catheterization (examination of the auditory tube that connects the ear with the nasopharynx);
• audiometry (checking for acuity of hearing);
• impedance measurement (detection of changes in the structure of the eustachian tube, tympanic membrane).

Fundamental manipulations in the diagnosis of the disease are audiometry and subsequent catheterization. Impedanceometry allows you to check the mobility of bones and identify adhesions. Due to the latter, the tympanic membrane gradually loses its functions, which provokes a sharp decrease in hearing in the patient.

Given the results of the examination, the doctor prescribes appropriate treatment. Adhesive otitis, revealed in the early stages, is well amenable to drug therapy and does not require surgical intervention. When the form of the disease is started, an operation is prescribed. In particularly serious cases, the patient is shown the use of a hearing aid. What other methods exist for treating pathology?

Drug therapy

At the very beginning of the pathological process, the patient is prescribed injections of vitamins B, aloe, vitreous. To improve the elasticity of the adhesions and prevent their further spread to the Eustachian tube, they designate "Lidazu "Fluimucil "Chymotrypsin".

Physiotherapy

Conservative treatment with medicines is usually supplemented by physiotherapy. The most effective are the following procedures:

• ultrasound massage;
• microwave therapy;
• UHF;
• mud treatment.

To prevent recurrence of the disease, it is recommended to repeat treatment courses 2-3 times a year.

The method of the Politzer and adhesive otitis

Treatment with the help of blowing the Eustachian tube by the method of the Politzer gives a positive effect. The procedure provides for continuous monitoring with the help of an otoscope. One olive is injected into the patient's ear, the other to the doctor. To the nostril of the patient also attach a catheter from which the balloon departs. The second nostril is clamped with a finger, after which the patient is asked to slowly say the word "steamer". With each pronunciation of the stressed syllable, the pear is squeezed. If there are no adhesions in the Eustachian tube, the air passes unhindered.

This procedure is often combined with a pneumatic massage of the drum membrane. With the help of a special device, the membrane is exposed to a stream of air, the strength of which is controlled. This procedure positively affects the mobility of the drum membrane, prevents the formation of adhesions.

Operative intervention

Not always with the help of medications and physiotherapy it is possible to defeat adhesive otitis media. Treatment with conservative methods does not bring results? In such situations, when the disease has a bilateral character, the patient is prescribed an operation - tympanotomy. During surgery, the doctor opens the tympanic membrane, thereby providing access to the auditory ossicles. Timpanotomy allows you to get rid of accumulated exudate, eliminate spikes.

Even the operation does not give 100% guarantee of a positive result. Often, against the background of a large area of ​​the spike lesion, the adhesive otitis media develops again. Symptoms of the disease after the operation do not differ from those before the start of the course of treatment. The patients are diagnosed with scars gradually deforming the tympanic membrane, which affects the quality of the hearing. It is impossible to stop the pathological process and improve the patency of the Eustachian tube. In such situations, they resort to replacing the stone with artificial polymer prostheses, and ventilation is performed through the auditory canal.

Danger of recurrence

Patients who have transferred adhesive otitis within six months after treatment should be under the supervision of an otorhinolaryngologist. After this period, it is recommended to undergo a second examination to make sure there are no pathological changes in the ear cavity. When detecting abnormalities, the course of treatment is repeated. In the future, the disease can provoke fibrinous-cicatricial changes in the structure of the middle ear. Unfortunately, such violations are irreversible. In the absence of adequate treatment, pathology can cause ankylosis of the joints of the auditory ossicles, which leads to total deafness.

Preventive measures

An acute inflammatory process in the middle ear often results in a diagnosis of "adhesive otitis." Treatment with folk remedies or medications does not always bring a positive result. Surgical intervention is very laborious and does not allow to prevent relapse of the disease. Therefore, it is necessary to prevent disease. It is recommended to begin with the first days of the child's life. Breastfeeding provides a full-fledged formation of ear muscles, resulting in reduced susceptibility to the effects of pathological agents. Moreover, it strengthens the body's immune system and reduces the risk of developing respiratory diseases.

Modern pharmacology offers a number of drugs to increase resistance to viral pathologies and quick recovery from colds. They are also an excellent prevention of adhesive otitis media. Among such medicines should be allocated "Influvak "Imudon "Bronhomunal". Before using the drugs, it is recommended to consult with a specialist about the dosage and duration of the course of prevention. If the inflammation can not be avoided, it is necessary to follow the treatment scheme that the doctor suggests. Any departure from the advice of a specialist is dangerous for relapse.

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