Otitis in adults

Symptoms and treatment of otitis in adults

Content:

• Ear anatomy
• Causes of otitis media
• Pathogens of the disease
• The clinical picture is the symptoms of otitis
• General principles of diagnosis
• Treatment of external otitis media
• Treatment of otitis media and labyrinthitis in adults
• Prevention of otitis

Otitis is an ear inflammation, a general term for any infectious processes in the hearing organ. Depending on the affected area of ​​the ear, the outer, middle and inner otitis (labyrinthitis) are secreted. Otitis occurs frequently. Ten per cent of the world's population suffered from external otitis during their lifetime.

Annually in the world 709 million new cases of acute otitis media are registered. More than half of these episodes occur in children under 5 years of age, but adults also suffer from inflammation of the middle ear. Labyrinthitis, as a rule, is a complication of otitis media and is relatively rare.

Ear anatomy

For a better understanding of the subject, it is necessary to briefly recall the anatomy of the organ of hearing.

The components of the outer ear are the auricle and auditory canal. The role of the external ear is to trap the sound wave and carry it to the eardrum.

The middle ear is the tympanic membrane, the drum cavity containing the chain of auditory ossicles, and the auditory tube.

In the tympanic cavity, there is an increase in the sound vibrations, after which the sound wave follows the inner ear. The function of the auditory tube connecting the nasopharynx and the middle ear is the ventilation of the tympanum.

The inner ear contains the so-called "cochlea" - a complex sensory organ in which sound vibrations are converted into an electrical signal. An electrical impulse follows the auditory nerve into the brain, carrying coded information about the sound.

External otitis media

Otitis externa is an inflammation of the auditory canal. It can be diffuse, and can proceed in the form of a furuncle. When diffuse external otitis affects the skin of the entire ear canal. Furuncle is a limited inflammation of the skin of the external ear.

Average otitis media

With an average otitis inflammation occurs in the tympanum. There are many forms and variants of the course of this disease. It can be catarrhal and purulent, perforative and non-perforative, acute and chronic. When otitis can develop complications.

The most common complications of otitis media include mastoiditis (inflammation of the occipital bone of the temporal bone), meningitis (inflammation of the brain membranes), abscess (abscess) of the brain, labyrinthitis.

Labyrinthite

Internal otitis almost never is an independent disease. Almost always it is a complication of the inflammation of the middle ear. Unlike other types of otitis, its main symptom is not pain, but hearing loss and dizziness.

Causes of otitis media

• After getting contaminated water - most often the external otitis occurs after the ingestion of water containing the causative agent of the disease into the ear. That is why the second name of this disease is "swimmer's ear".
• Injury of the skin of the external auditory canal - in addition to the presence of infection in the water, there must also be local conditions predisposing to the development of inflammation: microcracks of the skin, etc. Otherwise, each of our contact with unboiled water would result in the development of inflammation in ear.
• Complication of SARS, sinusitis - in this case, the causative agent of middle otitis penetrates into the tympanum completely from the other side, the so-called rhinotubar path, that is, through the auditory tube. Usually, the infection gets into the ear from the nose, when a person is sick with ARVI, runny nose or sinusitis. In case of a serious inflammation of the middle ear, the infection can spread to the inner ear.
• With infectious diseases, kidney diseases, diabetes mellitus, hypothermia against a background of reduced immunity, the risk of inflammation in the middle ear increases. Bruising through 2 nostrils (wrong), coughing and sneezing increase the pressure in the nasopharynx, which leads to the ingress of infected mucus into the middle ear cavity.
• Mechanical removal of earwax - it is a protective barrier against infections.
• High air temperature and high humidity.
• Contact with foreign objects in the ear.
• Use of hearing aids.
• Such diseases as seborrheic dermatitis on the face, eczema, psoriasis.
• The causes of development of acute otitis media are also genetic location, immunodeficiency states, HIV infection.

Pathogens of the disease

Pathogens of external otitis can be bacteria or fungi. Especially often found in the ear canal are microorganisms such as Pseudomonas aeruginosa and staphylococcus aureus. For the fungi of the genus Candida and Aspergillus, the skin of the ear canal is one of the favorite places in the body: it's dark, and after bathing it's still wet.

The causative agents of otitis media, and therefore internal, can be viruses and bacteria. Fungal infection of the middle ear is also found, but much less often than the external one. The most common bacterial pathogens of otitis media are pneumococcus, hemophilic rod, moraxella.

The clinical picture is the symptoms of otitis

• Pain is the main symptom of otitis media. The intensity of pain can be different:
  • from barely perceptible to unbearable
  • character - pulsing, shooting

  It is very difficult, it is often impossible to independently distinguish painful sensations with external otitis from painful sensations with inflammation of the middle ear. The only clue can be the fact that with external otitis pain should be felt when touching the skin at the entrance to the ear canal.

• Hearing loss is a fickle symptom. It can be present with both external otitis media, and with an average, may be absent in both these forms of ear inflammation.
• Increase in temperature - most often there is an increase in body temperature, however, this is also an optional feature.
• Discharge from the ear with external otitis occur almost always. After all, nothing prevents the inflammatory fluid from escaping outward.

With the average otitis, if the perforation (hole) is not formed in the tympanic membrane, there is no secretion of their ear. The suppuration from the ear canal begins after the appearance of a communication between the middle ear and the auditory meatus.

I emphasize that perforation can not be formed even with purulent otitis. Patients suffering from otitis media often ask where pus will go if it does not break out. It's very simple - he will go out through the auditory tube.

• Ear noise (see Fig. causes of noise in the ears), ear congestion is possible with any form of the disease.
• When the inflammation of the inner ear develops, dizziness (causes) may appear.

Acute otitis media occurs in 3 stages:

Acute catarrhal otitis - the patient experiences severe pain, worse by night, with coughing, sneezing, she can give in temple, teeth, be stabbing, pulsating, drilling, hearing loss, appetite, weakness and high fever 39C.

Acute purulent otitis - there is accumulation of pus in the middle ear cavity, followed by perforation and suppuration, which may be on day 2-3 of the disease. In this period, the temperature drops, the pain decreases, the doctor can make a small puncture (paracentesis), if there is no independent rupture of the tympanic membrane.

Restorative stage - suppuration stops, the defect of the tympanic membrane closes (fusion of the edges), the hearing is restored within 2-3 weeks.

General principles of diagnosis

In most cases, the diagnosis of acute otitis media does not cause difficulties. High-tech research methods are needed infrequently, the ear is well visible to the eye. The doctor examines the tympanic membrane with a head reflector (a mirror with a hole in the middle) through the ear funnel or a special optical device - the otoscope.

An interesting device for the diagnosis of otitis was developed by the famous corporation Apple. It is an oscopic attachment for the camera phone. It is assumed that with the help of this gadget, parents will be able to photograph the baby's eardrum (or their own) and send photos for consultation to their doctor.

Diagnosis of external otitis media

Examining the ear of a patient suffering from external otitis, the doctor sees redness of the skin, narrowing of the auditory canal and the presence of liquid secretions in its lumen. The degree of narrowing of the ear canal is such that the tympanic membrane is not visible at all. When inflammation of the external ear of other examinations except for the inspection is usually not necessary.

Diagnosis of otitis media and labyrinthitis

In acute inflammation of the middle ear, the main way to establish a diagnosis is also an examination. The main signs that allow diagnosing "acute otitis media" are reddening of the tympanic membrane, limitation of its mobility, and the presence of perforation.

• How is the mobility of the tympanic membrane checked?

People are asked to inflate their cheeks without opening their mouths, that is, "blowing their ears". This reception is called the maneuver of Valsalva, named after the Italian anatomist, who lived at the turn of the 17th and 18th centuries. It is widely used by divers and divers to equalize the pressure in the drum cavity in deep water descent.

When a jet of air enters the middle ear cavity, the eardrum moves slightly and this is noticeable with the eye. If the drum cavity is filled with inflammatory fluid, no air will enter it and the eardrum will not move. After the appearance of suppuration from the ear, the doctor can observe the presence of perforation in the tympanic membrane.

• Audiometry

Sometimes to determine the nature of the disease may need audiometry (hearing on the apparatus) or tympanometry (measurement of pressure inside the ear). However, these methods of hearing tests are more often used in chronic otitis media.

The diagnosis of the labyrinthitis is usually made when the acuteness of the middle otitis suddenly sharply decreases acuteness of the hearing and dizziness appears. Audiometry in this situation is mandatory. You also need an examination of a neurologist and an oculist.

• CT and X-ray

The need for X-ray studies occurs when there is a suspicion of complications of the disease - mastoiditis or intracranial infection. Fortunately, such cases are rare. In a situation where complications are suspected, a computer tomography of the temporal bones and brain is usually performed.

• Bacterial sowing

Do I need a smear to determine the bacterial flora? A unequivocal answer to this question is not easy. The problem is that, due to the peculiarities of bacterial culture, the response of this examination will be received 6-7 days after the removal of the smear, that is, by the time when the otitis is almost gone. Moreover, with a medium otitis without a perforation, a smear is useless, since the microbes are behind the tympanic membrane.

And yet a smear is better to do. In the event that the application of the first-line drug does not bring recovery, after receiving the results of a bacterial study, treatment can be adjusted.

Treatment of external otitis media

The main treatment for external otitis media in adults is ear drops. If a person does not have immunodeficiency (HIV infection, diabetes mellitus), antibiotics in tablets are usually not needed.

Ear drops can contain only an antibacterial drug or be combined - have an antibiotic and an anti-inflammatory substance. The course of treatment takes 5-7 days. Most often for the therapy of external otitis media apply:

Antibiotics:

• Ciprofarm (Ukraine, ciprofloxacin hydrochloride)
• Normax (100-140 rubles, norfloxacin)
• Otofa (170-220 rubles, rifamycin)

Corticosteroids + antibiotics:

• Sophradex (170-220 rub., Dexamethasone, Framicetin, gramicidin)
• Candybiotic (210-280 rub., Beclomethasone, lidocaine, clotrimazole, Chloramphenicol)

Antiseptic:

• Miramistin (250-280 rubles, with a nebulizer)

The last two drugs also have antifungal properties. If the external otitis has a fungal origin, antifungal ointments are actively used: clotrimazole (Candide), natamycin (Pimafucin, Pimafucort).

In addition to ear drops, the doctor can recommend an ointment with the active substance Mupirocin (Bactroban 500-600 rub, Supirocin 300 rubles) for the treatment of external otitis media. It is important that the drug does not have a negative effect on the normal skin microflora, and there are data on the activity of mupirocin against fungi.

Treatment of otitis media and labyrinthitis in adults

Antibiotic therapy

The main treatment for middle otitis media is an antibiotic. However, the treatment of otitis antibiotics in adults is another controversial issue of modern medicine. The fact is that with this disease is very high percentage of self-recovery - more than 90%.

There was a period of time in the late 20th century, when on a wave of enthusiasm antibiotics were prescribed to almost all patients with otitis. However, it is now considered permissible the first two days after the onset of pain to dispense with antibiotics. If after two days there is no tendency to improve, then an antibacterial drug is already prescribed. For all types of otitis media may be required for oral administration.

In this case, of course, the patient must be under medical supervision. The decision on the need for antibiotics is very responsible and should only be taken by a doctor. On the scales on the one hand, the possible side effects of antibiotic therapy, on the other - the fact that every year in the world of complications of otitis deaths of 28 thousand people.

The main antibiotics, which are used in the treatment of otitis media in adults:

• Amoxicillin - Ospamox, Flemoxin, Amosin, Ecobol, Flemoxin solute
• Aamoxicillin with clavulanic acid - Augmentin, Flemoclav, Ecoclav
• Cefuroxime - Zinnat, Aksetin, Zinacef, Cefurus and other drugs.

The course of antibiotic therapy should be 7-10 days.

Ear drops

Ear drops are also widely prescribed for inflammation of the middle ear. It is important to remember that there is a fundamental difference between drops, which are prescribed before the perforation of the tympanic membrane and after its appearance. Let me remind you, the sign of perforation is the appearance of suppuration.

Before the appearance of perforation, droplets with an analgesic effect are prescribed. These include drugs such as:

• Otinum - (150-190 rub) - choline salicylate
• Otipaks (220 rubles), Otirelaks (140 rubles) - lidocaine and phenazone
• Otizol - phenazone, benzocaine, phenylephrine hydrochloride

Drops with an antibiotic does not make any sense to dig in this phase, as the inflammation goes behind the impenetrable eardrum for them.

After the appearance of the perforation, the pain passes and it is no longer possible to drip painkillers, as they can damage the sensitive cells of the cochlea. When a perforation occurs, access for drops inside the middle ear appears, so you can instill drops containing an antibiotic. However, ototoxic antibiotics (gentamicin, Framicetinum, Neomycin, Polymyxin B), preparations containing phenazone, alcohols or choline salicylate can not be used.

Drops with an antibiotic, the use of which is acceptable in the treatment of otitis in adults: "Tsiprofarm "Normaks "Otofa "Miramistin" and others.

Paracentesis or tympanotomy

In some situations with inflammation of the middle ear may need a small surgical intervention - paracentesis (or tympanotomy) of the tympanic membrane. It is believed that the need for paracentesis arises, if the background of antibiotic therapy for three days, the pain still continues to bother the person. Paracentesis is performed under local anesthesia: a special incision in the tympanic membrane makes a small incision through which pus begins to exit. This incision is beautifully overgrown after the cessation of suppuration.

Treatment of labyrinthitis is a complex medical problem and is conducted in a hospital under the control of an ENT doctor and neurologist. In addition to antibiotic therapy, funds are needed to improve microcirculation inside the cochlea, neuroprotective drugs (protecting the nervous tissue from damage).

Prevention of otitis

Preventive measures for external otitis are the thorough drying of the ear canal after bathing. Also, avoid traumatizing the ear canal - do not use keys and pins as an ear instrument.

For people who often suffer from inflammation of the external ear, there are drops based on olive oil, which protect the skin when swimming in a pond, for example, "Vaxol".

Prevention of otitis media consists of general strengthening measures - hardening, vitamin therapy, administration of immunomodulators (drugs that improve immunity). It is also important to treat diseases of the nose in a timely manner, which are the main causative factor in inflammation of the middle ear.

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Treatment of otitis in adults. Effective treatment of otitis

Otitis is an inflammatory ear disease. In order to understand why the disease occurs and what processes are taking place, consider the anatomical structure of the hearing organ and the process by which it perceives information.

Ear structure

The human ear has a very complex structure, which can be divided into three sections: the outer, middle and inner ear. The outer ear is the auricle, which perceives sound waves, directing them into the external auditory canal. The outer and middle ear are separated by a tympanic membrane, which conditionally represents a hymen or a film.

The middle ear is a cavity, a space in the temporal bone with three hearing bones located in it - a hammer, an anvil and a staple. It should be noted that the middle ear is closely related to the nasopharynx. Functionally, bones strengthen the received sound vibrations and transmit them to the inner ear. The inner ear is a labyrinth of membranes in the stony section of the temporal bone with many bends filled with liquid. The vibrations coming from the middle ear are transferred to a liquid that already affects the receptors. So information is transmitted to the brain in the form of nerve impulses.

The concept, types of otitis. Causes

Otitis is a disease that can develop in any of the three parts of the ear, depending on the place in which the inflammatory process occurs, distinguish:

1. Otitis of the external ear.
2. Otitis of the middle ear.
3. Inflammation of the inner ear (or labyrinthitis).

Causes that contribute to the onset of the disease or aggravate its course, many, but the main ones include:

• diseases of the nasopharynx, leading to swelling and inflammation of the mucous membranes of the middle ear;
• diseases that suppress and weaken the immune system (influenza, measles);
• supercooling;
• getting into the ear of cold water;
• trauma and various injuries of the tympanic membrane, which may cause infection in the middle ear cavity;
• genetic predisposition.

By nature, the causative agent causing the disease, otitis is divided into:

1. Viral.
2. Bacterial.
3. Fungal.

Let us consider in more detail the inflammatory processes that occur in each of the three parts of the human ear, the symptoms and possible complications of otitis.

External otitis media. Classification. Symptoms

External otitis is an inflammation of the skin of the auricle along with the external auditory canal, which is caused by a bacterial or fungal infection. There are two types of external otitis media: limited and diffuse.

In most cases, limited inflammation is represented by furunculosis - the formation of boils. Furuncle - acute purulent process of the sebaceous gland or hair follicle, caused by pyogenic bacteria. If there are favorable factors in the human body, including chronic infection, diabetes mellitus, local trauma and skin contamination, insect bites, staphylococcal microflora begins to actively provoke the inflammatory process.

Sometimes the disease is a complication of a previous flu or may be caused by an allergic reaction to medications. Signs of external otitis are itching; pain that occurs when touching an inflamed ear; redness and swelling of the skin of the external auditory canal, or auricle; sometimes the temperature may rise body. Hearing, as a rule, while not suffering.

Spilled otitis externa is an inflammation of the external ear, which very often can spread to the eardrum.

According to the duration of the disease, the external otitis is classified into acute and chronic. The latter is a consequence of the lack of treatment or incorrect treatment of the acute form of the disease.

Otitis of the external ear is considered to be the mildest type of disease in comparison with otitis media of the middle ear and internal otitis media and often does not lead to serious complications, although sometimes it can cause an increase in the lymph nodes system. Inflammation of the mucosa grows into a malignant form (tissue necrosis) in the presence of a person associated with severe functional diseases (diabetes) or the virus of immunodeficiency. But such cases, fortunately, are rare.

Otitis media. Classification and symptoms

Of all forms of otitis, both in children and adults, inflammation of the middle ear is most common. As noted earlier, the nature of the disease can be bacterial and viral. Among the bacteria, the main pathogens are streptococci or a hemophilic rod. To viruses that cause inflammation, you can include rhinovirus, influenza virus or respiratory syncytial virus.

The first signs of inflammation of the middle ear are pulsating, shooting or aching pains in the organ, which are intensified by swallowing, sneezing or coughing. Characteristic for this disease is also noise in the ear, weakness, sleep disorder, lack of appetite, severe deterioration of hearing.

In general, the inflammation of the middle ear is the result of a previous cold or flu, in which the immunity decreases and the number of bacteria in the nasal cavity increases. The nasal cavity is connected with the middle ear by the auditory tube, in which liquid and various microorganisms accumulate, which trigger the onset of the inflammatory process. The tympanic membrane undergoes pressure and expands in volumes to the outside, which causes pain.

The course of the disease can be different in speed of development, as well as in duration, according to what distinguish:

1. Acute otitis media (the ear accumulates fluid). This is the reason for the audibility of your own voice in your head.
2. Chronic otitis (the ear is filled with pus).

Acute otitis media. Forms

If the inflammatory process is classified according to the nature of the course (clinical picture), then the otitis can be catarrhal or purulent, thus, the development of the disease undergoes three stages - acute catarrhal otitis, acute purulent otitis and stage recovery.

Acute catarrhal otitis is an inflammatory process associated with the localization of fluid in the middle ear cavity. For this form of the disease, in addition to pain and increased body temperature (38-39 ° C), reddening and swelling of the tympanic membrane, ear congestion are characteristic. The patients note that they hear their own voice in the head during the conversation.

The appearance of foci of pus and its accumulation in the cavity of the middle ear is acute purulent otitis. Treatment for the first 2-3 days is not carried out, because as usual during this period, the eardrum ruptures and the pus outward. In this case, the patient becomes better, the body temperature returns to normal, the pain stops. In addition to pus, blood and serous discharge can be observed. If the course of the disease passes without complications, then the third stage comes in - a recovery stage.

With the onset of the reconstructive stage, the inflammatory process decreases, the suppression stops and a progressive tightening of the damaged membrane occurs. If the treatment of otitis in adults passes in accordance with the appointments and under the supervision of a specialist, then recovery occurs in 2-3 weeks. By this time, the rumor, as a rule, is fully restored.

Chronic otitis media. Stages of

If untimely or insufficient treatment, acute otitis becomes chronic. Otitis chronic is an inflammatory process, which is characterized by a permanent or recurrent suppuration from the ear. This type of otitis, in addition to already known symptoms, such as: high fever, itching, deterioration of the general condition, there are inherent complications in the form of hearing loss and persistent perforation of the drum webbeds. Usually the chronic course of the disease is a consequence of previous sinusitis or acute purulent otitis media. In some cases, this form of otitis occurs as a result of rupture (or perforation) of the tympanic membrane or curvature of the nasal septum after the injury. Depending on the localization of the perforation, and also on its size, three stages of chronic otitis are distinguished:

1. Tubotympanal otitis (mesotympanitis).
2. Epimezotimpanit.
3. Epitimpanitis.

With tubotimponal form of otitis, the violation of the tympanic membrane occurs, as a rule, in the central part, and the pathology is manifested by inflammation of the mucous membranes of the tympanic cavity. Inflammation does not affect bone tissue.

Epimezotimpanit - a stage of chronic otitis, in which there is extensive perforation of the tympanic membrane, the damage affects its upper and middle divisions.

Epitimpanoanthral form of otitis is characterized by rupture of the upper, most pliable and fragile areas of the membrane. This stage of the disease, as well as epimezotimpanit, is dangerous by the occurrence of pathological processes associated with the formation of granulomas, polyps and cholesteatoma - a capsule filled and surrounded purulent particles of the epidermis, which, constantly expanding, presses on the tympanic membrane, destroys the bone component of the middle ear and opens the "road" to the purulent process in the inner ear.

In addition, there is another form of inflammatory process - bilateral otitis - a disease that simultaneously affects the hearing organ from both sides.

If we consider the existing complications of the disease, the perforation of the tympanic membrane is the most common. With prolonged accumulation of pus there is an increase in pressure in the middle ear, resulting in the membrane becoming thinner. There is a risk of its rupture (perforation). To prevent the transition of the inflammatory process to the stage of internal otitis and to avoid subsequent development of serious pathologies, it is necessary to resort to the puncture of the tympanic membrane surgically, and not to wait for the moment when this happens spontaneously.

Inflammation of the inner ear. Symptoms

Internal otitis has another name - labyrinthitis is a disease that occurs less frequently in comparison with otitis of the external and middle ear, but is the most dangerous in terms of the threat to health and life rights. Purulent processes that affect bone tissue can cause severe complications, for example, meningitis (inflammatory process in the brain envelopes) or sepsis (blood infection due to falling into the her pus). As a rule, the internal otitis media is the result of complications of previous otitis media, or the consequences of a serious infectious disease. High body temperature, severe headache and vomiting, loss of balance - these are all symptoms of internal otitis, in which it is necessary to seek help from a specialist as soon as possible. In addition, with such forms of the disease, there is a sharp deterioration of the hearing until its complete loss.

In order to make an accurate diagnosis and, consequently, to prescribe the correct treatment regimen for the patient, doctors resort to otorhinolaryngological examination and laboratory tests.

Diagnosis of otitis. Surveys and studies

Laboratory diagnostics is carried out mainly in order to establish the nature of the origin of otitis - bacteriological or virologic. With the serological reaction of blood serum and polymerase chain reaction, antibodies to pathogens are detected. Also, the results of a general blood test will show the presence or absence of an inflammatory process in the body.

The basic instrumental methods of otitis diagnosis:

• Tympanocenosis is the study of fluid obtained by surgical puncture of the membrane. The procedure allows you to determine the antibiotic needed to fight a particular type of infection, but in practice it is not often used.
• Tympanometry - checking the mobility of the tympanic membrane.
• Otoscopy - examination of the tympanic membrane and auditory passage by means of an otoscope.
• Audiometry is the definition of hearing acuity when suspected of reducing it.
• Computer tomography of the brain and skull structure (CT), magnetic resonance imaging (MRI) - are used in case of suspicion of suppurative inflammatory processes and intracranial complications, help to diagnose the formation of various pathologies - polyps, cholesteanomas and so on.

Conservative treatment of otitis in adults

To avoid the development of complications and to achieve recovery with minimal waste of time and effort, otitis should be treated in a timely manner, in fact, like any other disease. For each form of the inflammatory process, a special treatment is provided, with its own procedures and medical preparations.

Otitis of the external ear is treated out-patient, with the use of drops, which contain an antibiotic. Sometimes antibiotics can be prescribed together with corticosteroids or antihistamines, if the disease is caused by an allergic reaction. There are also procedures for washing the ear canal with an antiseptic solution. If this therapy does not lead to recovery or is not possible due to severe edema of the ear canal and face cellulite, oral medications are prescribed. At elevated body temperature, antipyretic agents are used, as well as analgesics if pain syndrome is present. In rare cases, with the formation of purulent inflammation of the external ear tissues, surgical intervention can be indicated.

Elimination of inflammation in the middle ear in the normal course of the disease is outpatient. Treatment of otitis in adults is performed with the appointment of antibiotics, antiseptics and bed rest. To reduce the painful syndrome, a warm 96% alcohol is used as a drop (this procedure is contraindicated in suppuration). For topical administration, physiotherapy is prescribed, it is also possible to use a blue lamp. It will be superfluous and warming the compress in otitis (alcohol, vodka or based on camphor oil), which should be kept no more than 3-4 hours. It must also be remembered that you can not put a compress at an elevated body temperature.

If the disease does not go without complications, then the patient will show signs of acute otitis - the purulent otitis will develop. Treatment can be continued with the help of antibiotics or by surgical intervention.

Surgical intervention

Sometimes it happens that conservative treatment of otitis in adults does not lead to an improvement in the patient's condition. In such situations, a surgical dissection of the tympanostomy is performed. This manipulation makes it possible to avoid complications, since the puncture is done at a favorable and correct point, pus goes out through a specially installed tube, and the pain syndrome decreases, and recovery comes faster. In addition, the biomaterial (festering isolates) is subject to a laboratory bacteriological study for sensitivity to antibiotics. If, after the performed procedures, the acuity of hearing is not restored, purges and pneumatic massage can be prescribed.

There are cases when there is a natural rupture of the tympanic membrane. This is observed mainly with inflammation of the middle ear and requires immediate surgical intervention.

With tubotimponal form of otitis, the task of surgical treatment is restoring the integrity of the tympanoplasty using tympanoplasty using its own cartilage.

Epitimpanoanthral form of otitis is associated with destruction of bone tissue. In such a course of the disease, the goal of surgical intervention is to remove bone pathology and restore the tympanic membrane using prostheses made of inert materials (titanium).

Internal otitis is the result of ineffective treatment of otitis media and is dangerous due to purulent complications with damage to the membranes of the brain. Therefore, in such forms of the disease, hospitalization of the patient with further surgical care is necessary.

It should be remembered that prevention is always better than treatment. Prevention of otitis can be the timely elimination of foci of infection within the body (caries, sinusitis), as well as the elimination of hypothermia. When the first signs of the disease appear, it is important to immediately seek medical help from specialists.

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What are the signs of otitis in an adult

Otitis is a disease that affects hearing and other life processes. Having discovered signs of otitis in an adult, you should immediately start treatment in order to avoid serious consequences (Fig. 1). Some types of otitis have irreversible effects on the hearing, from the timely detection of it and effective treatment depends on the quality of life of the patient.

Picture 1. Diagnosis of otitis in adults.

Classification of otitis

Otitis is called inflammatory processes that develop in the inner ear (labyrinth), the middle ear or in the auricle and external auditory canals. Depending on the course of the course of the disease, the following are distinguished:

Figure 2. Scheme of otitis.

• acute otitis, which occurs suddenly with pronounced symptoms;
• chronic otitis, with prolonged inflammation and periodic exacerbations.
• For reasons of development of otitis, the following forms are distinguished:
• allergic;
• bacterial;
• traumatic;
• virus.

In the course of the course of the disease, the ways of its manifestation distinguish:

• purulent otitis, in which pus accumulates behind the tympanic membrane (Fig. 2);
• catarrhal otitis with edema and reddening of tissues, but without liquid or purulent discharge;
• exudative otitis, suggesting the accumulation in the middle ear of liquids (blood, lymph), which create a favorable environment for the development of pathogens.

Otitis manifests itself in all different ways. Symptoms of the disease may differ significantly.

Causes of otitis media

To develop inflammation in the external auditory canals, a small amount of damage to the skin is enough.From an impact, a scratch or an inadvertent cleaning of the auricle, the infection gets under your skin. The cause of otitis can become a bite of an insect in the earlobe or other ear region.

During swimming or swimming, the water that gets into the ear is a favorable environment for the development of microbes. Foreign objects (crumbs, earth, sawdust) provoke otitis in adults.

Figure 3. Hydrogen peroxide for otitis treatment.

In addition to the listed reasons that cause the disease by accident or negligence, there are otitis media, provoked by the infection. They arise due to such factors:

1. Diseases of the nose and nasal sinuses (sinusitis, sinusitis, frontalitis). With swelling of the respiratory tract, stagnation of liquids in the middle ear occurs, in which pathogenic microorganisms develop.
2. With an incorrect blowing nose during a cold, the infection does not leave the body, but spreads to neighboring organs.
3. Against the background of diabetes, kidney disease, eczema, psoriasis and other diseases, immunity is weakened, which causes any respiratory disease to spread to the middle ear.

Often the profession contributes to the development of ailment. Scuba divers or pilots constantly have to experience pressure changes that adversely affect the health of the hearing.

Symptoms of otitis in adults

Depending on the localization of the inflammation focus, the sensations experienced by the patient with otitis also differ. With external otitis pain symptoms occur when pressing on the skin. If there is a furuncle, the pain is localized near it, as it ripens, a purulent discharge is formed. In the last phase, throbbing pain disturbs a person constantly, without physical impact on the skin. If the focus of inflammation is located in the auditory canal, there is a feeling of pressure on the tympanic membrane, a feeling of stuffiness in the ear.

As a result of the spread of infection, otitis media develops. It affects the area between the external auditory canals and the inner ear. The patient complains about the following symptoms:

Figure 4. Ear drops in otitis.

• temperature increase;
• severe headaches;
• shooting pain in the ear;
• noise, ringing in the ears;
• bloody or purulent discharge from the ear with perforation of the tympanic membrane;
• worsening of hearing.

When inflammation in the labyrinth of auditory canals (internal otitis), the most severe disorders are observed. This form of the disease can manifest itself after a while after recovering from a cold. Accompany it with such symptoms:

• dizziness;
• lack of coordination;
• nausea; rapid motion sickness in transport;
• complete or partial hearing loss;
• frequent movements of eyeballs.

Adhesive inflammation of the ear is characterized by a thickening of the mucosa of the auditory tubes and the tympanic membrane. As a consequence, there is a gradual decrease in hearing. Thickening prevents the outflow of exudate, in which pathogenic bacteria develop. Inflammation of the ear is accompanied by fever, headaches and weakness.

When allergic otitis in purulent discharge mucus is observed. The temperature does not increase, but the hearing loss is present. The patient is disturbed by a strong itching in the ear and a feeling of pouring liquid in the head.

Otitis begins to show symptoms of a general malaise, but the specific signs of the disease are gradually emerging.

The faster they start treatment, the less the body suffers. For example, with prolonged suppuration, there is a danger of infection of blood and brain membranes, which provokes meningitis.

Therefore, even with a small obstruction of the ear, which does not take 2-3 days, you should consult an otolaryngologist.

Ways to treat otitis media

The most common method of treatment is the reception of pharmaceuticals. They are aimed at removing the main symptoms of the disease. After examination and diagnosis, the ENT appoints the patient preparations from the following groups:

1. Antihistamines. They will help alleviate the condition with allergic otitis, and will reduce the manifestation of edema (Suprastin, Erius, Cetrin).
2. Analgesics. They will reduce the pain and will have an anti-inflammatory effect. When otitis, they are prescribed as ear drops. Adults should bury in the ear 5-8 drops 3-4 times a day. For prevention buried in both ears, even if the second does not bother (Otipax, Otix).
3. The Vagotonics. These funds remove puffiness and contribute to the outflow of pus and exudative without perforation of the tympanic membrane (Nazivin, Naphthyzin).

To purify the external auditory canal from pus use hydrogen peroxide and alcohol (Fig. 3). A cotton swab carefully removes all dirt, without immersing it deep in the ear, so as not to damage the eardrum.

If the cause of otitis is a bacterial infection, the doctor will prescribe an antibiotic. The course of taking medications is 6-9 days. During this period, the doctor conducts visual observation and prescribes tests to determine the effectiveness of the prescribed drugs.

To speed up the recovery process help physiotherapy (laser therapy, magnetotherapy, UHF, phototherapy, electrophoresis).

If drug treatment for several days does not bring significant relief, and the patient experiencing severe pain due to accumulated pus behind the tympanic membrane, then perform a surgical intervention. Under local anesthesia, in stretched tissues, a puncture is made to allow the pus to flow out freely. After the patient heals, the puncture becomes overgrown and the hearing is restored.

Folk methods for controlling otitis media

Methods of traditional medicine can be combined with home treatment. Here are a few recipes for treating otitis media at home.

1. To the tablespoon of pharmacy tincture of propolis add 3 tablespoons of olive oil. Heat the mixture to body temperature. Dampen with a cotton swab and place in the ear, change every 10-12 hours.
2. Crush the head of garlic and add to the gruel 50 ml of refined sunflower oil. To insist on light not less than 4-5 days, then strain and store in the refrigerator. Bury in each ear 2-3 drops several times a day (Fig. 4).
3. A few leaves of aloe are cleaned and squeezed out the juice, which is buried in the ear canal.

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Prophylaxis of ear diseases

Instead of long treatment, it is recommended to prevent illnesses. Here are some tips for preventing ear inflammation:

• avoid contact with people suffering from colds, strengthen immunity;
• do not allow hypothermia of the head, wear a hat in the cold season;
• During swimming, swimming or diving use special plugs to protect against water ingress;
• Avoid too careful cleaning of the ears, so as not to damage the skin and hearing organs.

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Otitis often becomes a complication of other diseases, so do not long test your body for strength. The earlier the treatment of diseases begins, the fewer additional ailments will have to be treated.

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Antibiotics for otitis

Otitis is an acute or chronic inflammatory process in various ear zones (external, middle or inner). Antibiotics in otitis are prescribed necessarily, based on the severity and stage of the process, the sensitivity of microorganisms, the degree of development of clinical symptoms, the age of the patient.

Untreated ear infections require the appointment of stronger antibiotics. Sometimes it is necessary to use not one, but several types of antibacterial agents, if the pathological process is in a neglected stage.

Consider the advisability of antibiotic therapy for inflammatory diseases of the ear.

Do you need antibiotics for otitis?

Antibiotic therapy is very important in the development of inflammatory processes. However, many experts are of the opinion that before the spontaneous perforation of the ear membrane and the exit of the exudative fluid, there is no need to prescribe antibiotics. The acute stage of uncomplicated otitis usually lasts for 5 days. Antimicrobial therapy is used in cases when symptomatic treatment of catarrhal otitis does not bring relief to the patient: the ear pain does not pass, the severity of the hearing worsens, there are signs of general intoxication organism.

When purulent discharge appears, an analysis is made of the content of microflora and the determination of its sensitivity to antibiotics. If there is no way to gain access to exudate, they make a puncture for taking samples of the intra-oral contents, or dispense with the prescription of broad-spectrum antimicrobials.

Prevention of complications, especially in patients with low immune defense, can also serve as an indication for the prescription of antibiotic therapy.

What antibiotics to drink when otitis?

The most popular remedy, amoxicillin, has an excellent antimicrobial and antiseptic effect. In the absence of a patient's allergy to semisynthetic penicillins, it can be successfully administered at any stage of the inflammatory process. However, this drug is contraindicated in patients with impaired functional ability of the liver, during pregnancy and breastfeeding.

Aminoglycoside, netilmicin, is a drug for local injection use, used for no more than 14 consecutive days. Has good therapeutic parameters and a minimum of side effects.

The question about the appointment of medications is taken by the doctor individually after the results of the tests for the microflora of secretions.

If it is not possible to test the sensitivity of microflora to the action of antimicrobial agents, broad-spectrum drugs are prescribed:

• levomycetin, alcohol solution. Used on 2-3 drops with purulent otitis;
• amoxicillin 3 gram per day;
• augmentin 375 mg 3 times a day;
• cefuroxime IM injection;
• ceftriaxone 1 time per day;
• ampicillin in / m injection.

The connection of antibiotics to the otitis treatment schedule significantly reduces the likelihood of complications and improves the prognosis of the disease.

Antibiotics for otitis in children

Immediately before prescribing any medications, the child needs to assess his general condition and determine the further treatment tactics.

If a child has signs of otitis, it should not be rushed to prescribe antibiotics. They are used only in severe, moderate and complicated cases, especially in children under 2 years old, when the immune system is still in its infancy.

With an easy course of the inflammatory process, older children are usually treated with the elimination of clinical manifestations of the disease, using analgesics, ear drops, compresses, ointments, lotions. But if there is a characteristic picture of the general intoxication of the body, there is an increased temperature, persistent headaches - you can not do without antibiotics. In such cases, the sick child is hospitalized in the hospital, where the doctor decides on the further use of the drugs. Typically, preference is given to the known and effective antibiotic amoxicillin. However, if within two days after taking the child's well-being did not improve, another drug, for example, from the cephalosporin series, is prescribed.

During the treatment with antibiotics, the prescribed dosage should be strictly observed throughout the entire prescribed course, even in cases of persistent improvement in the general condition of the patient. Because of the unmotivated dose reduction, weakened, but living bacteria can gain new strength, and then the inflammatory process will flash again.

Antibiotics for otitis in adults

Otitis in adults often has an infectious etiology. Therefore, antibacterial drugs are used quite often, along with analgesics and anti-inflammatory drugs, with warming procedures and washing with antiseptic.

The type of antibiotic administered is determined depending on the infection present in the ear. In severe cases, several types of antibiotics can be used concomitantly, for example, orally and as intramuscular injections.

In acute otitis media, antibiotics are prescribed without fail: amoxicillin, amoxiclav, doxycycline, rovamycin. The drugs are administered in the form of tablets and capsules for internal use, and for severe and unfavorable course of the disease, intramuscular or intravenous injections are used.

Antibiotic therapy with caution is prescribed to elderly people and is categorically contraindicated in women during gestation and breastfeeding of a child.

Antibiotics for acute otitis media

The acute course of otitis is characterized by a sharp increase in symptoms, a rapid deterioration in the overall well-being of the patient - worried painful pain in the ear, giving away the entire half of the head and teeth, a rapid rise in body temperature to 39 degrees.

Very effective in such situations antibacterial agents, applied topically, in the form of drops and ointments. But in many cases there is a need for taking systemic drugs. Combined antibiotics have a wider range of effects, high functional activity. Such combinations of drugs as neomycin + bacitracin, polymyxin + hydrocortisone have high performance indicators.

For the treatment of acute otitis can be used any of the antibiotics of a wide range of applications that have a pronounced bactericidal action and restore the natural weakly acidic environment of the auditory passage. The most suitable are semi-synthetic penicillins, resistant to beta-lactamases (dicloxacillin orally or oxacillin intravenously, and also a group of cephalosporins).

Antibiotics for chronic otitis media

Chronic otitis develops, as a rule, with improper or untimely treatment of acute inflammation.

In chronic otitis, a wide variety of pathogens is characteristic, mixing various types of bacteria in the exudate, which greatly complicates the choice of antibiotic and the appointment of a general scheme treatment. Destruction of the polymicrobial flora requires the use of more powerful drugs, and sometimes their combinations.

In the case of long-standing and hard-to-treat chronic forms of otitis, medications such as sparflof (400 mg orally at first, on subsequent days, 200 mg daily), avelox 400 mg daily for one reception. The course of treatment should last from 10 to 14 days, with mandatory background reception of antifungal and normalizing microflora drugs and vitamin complexes.

Ciprofloxacin is a fluoroquinolone antibiotic, which is very popular in medical institutions in Europe. This drug is good in that it has a harmful effect on both active bacteria and immobile ones. It is taken on an empty stomach three times a day, the maximum daily dose of 750 mg.

Antibiotics for medium otitis media

Otitis media, the most common form of otitis media, is an inflammatory process in the middle ear region.

Antibiotic therapy is prescribed, as a rule, with the development of complications, a protracted course of the disease and the presence of fluid in the ear canal. The most suitable drug is selected based on the patient's allergic sensitivity, his condition and age. If it is impossible to clarify which specific pathogen caused the disease, a systemic antibiotic is prescribed, on a wide spectrum of the most typical pathogens of otitis media (pneumococcal infection, hemophilic rod, moraxella and other).

Most often in the treatment of otitis media preference is given to amoxicillin. The usual dosage for adults is 3 g daily, three times a day. Children take 85 mg per kg of body weight per day.

If after 2-3 days the clinical picture does not improve, it is necessary to replace this antibiotic with a stronger combination drug - for example, amoxiclav, cefuroxime.

Antibiotics for purulent otitis

The development of purulent otitis is characterized by the breakthrough of the internal membrane and the release of purulent contents outwards.

During this period it is advisable to designate rinses with antimicrobial agents (not having ototoxic action, that is, not depressing the auditory function), the introduction of combined solutions into the ear cavity antibiotics. Such procedures are carried out exclusively in a hospital or clinic by an otolaryngologist.

General therapeutic methods for purulent otitis do not differ from those in the standard inflammatory process. Antibacterial therapy is carried out by complex preparations erythromycin, clarithromycin, amoxiclav, ceftriaxone. With the development of complications and long-term course of the disease, non-steroidal anti-inflammatory drugs (diclofenac, olfen) are connected. The well-known drug of the first generation ampicillin remains popular, although more rational use of newer drugs - amoxicillin (flemoxin, ospamox).

Antibiotics for external otitis

External otitis affects the skin of the ear, the outer zone of the auditory canal and the periosteum, which is located just under the skin. If it is not possible to examine the state of the tympanic membrane and to exclude a deeper spread of the process, the treatment is prescribed simultaneously for both external and internal otitis media.

The main point in the treatment of external otitis media is the use of antibiotics in the form of ear drops (ofloxacin, neomycin). You can also use a cotton swab with an antimicrobial ointment or antibiotic solution, injected deep into the ear canal. Such a tampon should be changed every, hour during the day.

It is necessary to connect additional methods of treatment, such as warming compresses, vitamin therapy, support of intestinal microflora.

Most often, in the treatment of external otitis media, there is no need to prescribe antimicrobial agents. Antibiotic therapy is carried out only in cases of complications, or in patients with critically weakened immune forces of the body.

Drops from otitis with antibiotic

Drops used to treat ear inflammatory processes are usually very effective, since they are injected directly into the inflammatory focus. They can be of several types:

• hormonal anti-inflammatory drugs (otinum, otypaks);
• solutions of antibiotics (levomitsetin, noraks, tsipromed, fugentin);
• Combined solutions combining the action of an antibiotic and a glucocorticoid (sfradex, anauran, polydex, garazon).

The drug anauran is applicable for all types of acute and chronic forms of otitis, used by adults and children 3-5 drops three times a day.

Drops of sfradex can be used for medicinal purposes with otitis and conjunctivitis, have a strong anti-inflammatory and antiallergic local effect.

Drops, as a rule, have a fairly wide range of action. Used topically 4 drops twice a day in the affected ear, children 2-3 drops three times a day.

Ear drops, which contain corticosteroids, are cautiously prescribed to young children and pregnant women.

If you suspect a possible allergic reaction (swelling of the ear, the appearance of rash, itching) The use of drops is stopped, and the doctor reviews the treatment regimen and replaces the drug for more suitable.

The best antibiotic for otitis

The best antibiotic for otitis is determined by the results of the analysis for the microflora. As for preparations of a wide spectrum of action, it should be especially noted amoxicillin, which is most often used in medical practice with various types of otitis and in most cases has a positive therapeutic effect in all age groups.

Amoxicillin belongs to the penicillin series of antibiotics, it oppresses the action of most harmful microorganisms: streptococci, staphylococcus, E. coli, etc.

The drug is administered separately from food intake, g, g 3 times a day, with a complicated disease up to 3 grams per day. The duration of taking amoxicillin, like any other antibiotic, is at least 8-10 days. Even with a marked improvement in the patient's well-being and the disappearance of clinical symptoms, treatment continues until the indicated time. Untimely cancellation of antimicrobial agents can trigger a relapse of the inflammatory process, and in a more severe form.

How to cure otitis without antibiotics?

Therapeutic actions in uncomplicated otitis media may not include antibiotics. Sometimes there is more than enough conservative complex treatment of the inflammatory process:

• if necessary, prescribe antipyretics (aspirin, paracetamol);
• three times a day otipax preparation - 2 drops per diseased ear;
• application of a nasal spray to remove the edema of mucous membranes (nasivin, noxprey, etc.);
• at regular intervals, change ear pads with the drug substance (boric alcohol, vodka, onion juice);
• with external otitis, apply antibacterial agent to the ear and the adjacent zone;
• when inflammation should drink a lot of fluids, as with colds (tea made from raspberries, currants, dogrose, linden);
• provide the patient with peace, monitor the absence of drafts.

At the first signs of otitis, you can try to use folk methods of treating the disease. Even those plants that grow directly in the house, on the window: aloe, colanchoe, agave, geranium, can be useful. A freshly cut leaf or a portion of it is folded into a turunda and inserted into a sore ear. You can squeeze out the juice from the plants and dig it in 3-5 drops into the diseased ear.

As a drop, you can also use a warm solution of honey, celandine juice, mint tincture, boric alcohol.

During treatment, you should drink a lot of liquid, it is not superfluous to take multivitamin complexes, as well as funds that strengthen immunity.

With a clear deterioration of the patient's condition, it is still necessary to consult a doctor to prevent further progression of the disease and the development of complications.

To avoid inflammation in the ear, remember that during the cold season it is not permissible to go out to street without a headdress, the more you should not do this immediately after showering or taking bath. After visiting the pool or swimming on the beach, you need to wipe your ears well, not allowing a long time of water, especially dirty, in the ear canals.

If the disease still comes up, treatment is best conducted under the supervision of a specialist who will prescribe the appropriate treatment and the necessary antibiotics for otitis.

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Symptoms and treatment of bilateral otitis media in adults

Bilateral otitis in adults is one of the most common infectious ENT diseases. The disease is characterized by the rapid development of inflammation of the ear tissue, as well as the rapid spread of inflammation to the surrounding tissue sites.As a rule, bilateral otitis media occurs due to the penetration of bacteria or infections into the ear cavity and entails a number of different complications.

During the period of acute inflammation development, serious complications can be prevented. If you choose the right method and begin timely treatment, you can avoid the most unpleasant consequences. That is why it is very important to recognize bilateral otitis in the first stages.

To not miss the moment when the disease can be cured, you can not ignore the following symptoms, which will accurately say about the presence of inflammation:

• feeling of stuffiness;
• pain, shooting in both ears;
• dizziness;
• acute pain, which can give in the temple, jaw or neck;
• in advanced cases, hearing loss is observed.

Stages of development of bilateral otitis media in adults

In the classic scenario of inflammatory processes, this disease has 5 stages of development, which consistently pass from one to another. But, as practice shows, bilateral otitis can develop in a different sequence or manifest in all stages simultaneously. In any case, the optimal method of treatment is selected precisely on the basis of symptoms characteristic of a certain stage:

1. The first stage is very similar in appearance to common influenza, where the patient feels weak with a slight increase in body temperature. Against the background of general malaise, noise and stuffiness in the ears.
2. The second stage of the disease involves the addition of acute shooting pain, resulting from catarrh of the middle ear. The patient has a fever.
3. The third (preperforative) stage of bilateral otitis is caused by the spread of severe pain in the eyes, neck, pharynx and teeth. The temperature rises to 38-40 °, there is severe nausea and a significant decrease in hearing.
4. The fourth stage is very dangerous and entails a great chance of developing meningitis and accumulation of pus in the brain tissues. At this stage, the pain subsides, but purulent discharge from the ears begins.
5. The fifth (reparative) stage is the last one. She is characterized by a sharp cessation of pus from the ear cavity. As a rule, most patients during this stage begin self-scarring of the hole formed due to rupture of the tympanic membrane, and also the hearing is restored.

Average bilateral otitis media in children

Unfortunately, every second child under 1 year suffers an average bilateral otitis media. The development of the disease is facilitated by such reasons:

1. Features of the structure of the mucosa in the middle ear. Unlike adults, the mucous membrane of a newborn has a loose texture with a small number of blood vessels. That is why the mucous environment of a small child is more vulnerable to attack by bacteria and viruses.
2. The key moment that affects the frequency of cases of bilateral otitis media in children is sufficiently weak immunity, which is not able to fight the infection on its own.
3. In young children, the risk of complications is significantly increased, because the eardrum is thicker, so spontaneous rupture is rare.
4. Often a child can not tell about his state of health, and parents do not always manage to understand the cause of the ailment on time.

As a rule, otitis in children is expressed by high fever and acute pain that occurs when trying to swallow. If the child is naughty, and his attempts to eat end unsuccessfully, it is worth pressing the ear cartilage in front of the auricle. If otitis is present, this action will cause severe pain in the baby, thereby indicating the presence of inflammation.

In this case, you need to urgently consult an otolaryngologist. Any attempts to treat otitis in the home are excluded.

Why it is undesirable to self-treat otitis

Bilateral or otitis media is a serious enough disease that can lead to various complications. That is why with treatment it is not necessary to delay, approach to this business costs with all responsibility. Since the treatment involves a set of different procedures, the number and direction of which the specialist assigns, it is important to seek qualified help in time. After a detailed examination and carrying out the necessary tests, the doctor prescribes treatment that will correspond to the degree of complication of the disease. Otherwise, there is a high probability of the transition of the disease into a chronic form, which means that under any conditions favorable for the disease, it will remind of itself.

General principles of otitis treatment:

1. If the otitis has reached the stage of inflammation with purulent discharge and a significantly increased body temperature, one can not resort to the use of thermal procedures. Any warming manipulations are allowed only after reduced inflammation.
2. In the course of treatment, general therapy is prescribed, which includes the use of agents fighting inflammatory processes and drugs that destroy bacteria.
3. If the development of otitis occurs in a child and has a prolonged course, there is often a need for removal of adenoids. Surgery is usually necessary in cases where the source of the spread of a chronic infection is on the tonsils or in the area of ​​the paranasal sinuses and nasal cavity. If the specialist offers reasonable surgical intervention, do not neglect this method, because in the future there can be more serious complications.
4. To obtain the maximum effect during treatment of bilateral otitis media, it is very important to follow all the recommendations a qualified specialist in the duration of the course of treatment and in no case do not shy away from general methods treatment.
5. As a rule, the otitis caused by bacteria, easily enough and quickly passes at the reference to antibiotics.
6. If the inflammation is caused by the presence of a viral infection, otitis is more difficult to treat, often there is a need for the surgical intervention, during which a small tube is inserted into the tympanic membrane for the removal of the remains of pus or blood.

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Preventative measures to prevent otitis in adults and children

Bilateral otitis media can be avoided by carrying out measures that have a preventive effect. To reduce the risk of otitis media, it is sufficient to adhere to several recommendations:

1. First of all, do not neglect the headdresses protecting the head and ears from the effects of weather. Even if the sun is outside, a strong wind can be enough to cause inflammation.
2. It is important to remember the methods of strengthening the body's immunity. Admission of vitamins, compliance with sleep patterns and proper diet, active image management life will never be superfluous for general health and will only positively affect the condition immunity.
3. Personal hygiene also plays an important role in this matter. Water entering the ear canals is extremely undesirable for the health of the ears. And if the terrain is open, even a slight gust of wind can lead to the disease.
4. It is important to monitor your health in general and in case of predisposition to ENT diseases to contact to timely treatment, because, according to statistics, most often the disease is a consequence of a flu or ARI.

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Based on the information provided, we can draw conclusions about the severity of such a disease as bilateral otitis, which is widespread both among adults and among children. Timely access to a specialist will help to quickly overcome the disease and prevent the transition of the disease in chronic form, and a number of preventive measures will avoid a collision with such an unpleasant disease.

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