Is otitisperous? What is the risk of chronic otitis media? And what can be the consequences if it is not treated?
Few have never had ears hurt, even in childhood. Pain in the ears can sometimes be no less intolerable than dental. In addition, the ears are located near the brain, and therefore, it can also be involved in the process. Therefore, the inflammation of the ear should be treated carefully and under the supervision of the doctor, in order to avoid big troubles in the future.
The problem of chronic otitis media today is relevant because of the very high prevalence of this disease. Here are the figures given by the surdologist of the surdophoniatric department for adults at the Otolaryngology Scientific and Technical Center "Ivan Gornostay: in the Republic of Belarus in 2008, there were 209 cases of chronic otitis media per 100 000 population, of which 4 cases were registered first. Chronic otitis media lead to temporary and sometimes permanent disability and occupy the second place in the structure of otolaryngological morbidity.
Chronic median otitis media are the main cause of hearing loss, in which people find it difficult to contact, their professional activities are limited.
The average acute otitis often occurs against the background of respiratory viral infections and is therefore more common in autumn, winter and spring. The average acute otitis can go to the chronic stage because of prolonged inflammation of the middle ear.
The disease begins suddenly with a general malaise (chills, fever) and with severe pain in the ear. There is a headache, when you touch the nipple after the ear, pain is felt, on the 4th-5th day the tympanic membrane breaks out - pus comes out of the ear.
Chronic otitis media is very dangerous for its complications. It can cause such serious complications as brain abscess, meningitis, sepsis. Mortality with such pathologies is from 14 to 30%.
To the doctor it is necessary to address on the first day of an acute ear disease. In the subsequent treatment is recommended complete rest and bed rest.
Prevention of chronic otitis should be conducted from the day of birth. Of great importance is the proper breastfeeding and the timely adjusted diet of the child in the future. As a rule, children who grew up on natural breastfeeding, and then had an appropriate diet, used rich in vitamins, less respiratory-viral diseases, contributing to the emergence of acute inflammation of the middle ear.
Immunity to colds contributes to hardening. When it is recommended cold baths, cool wipes, physical education and sports, a long stay in the fresh air.
Adenotonzillar pathology, the curvature of the septum of the nose, hypertrophy of nasal concha, and vasomotor rhinitis play an important role in the development of chronic otitis media. Therefore, conservative and surgical methods of treatment aimed at sanitation of chronic and pathological conditions of pharynx, nose and nasopharynx are an effective means of prevention. Prevent recurrent disease with acute otitis media will help timely removal of adenoids, subnea tonsils or planned systematic conservative treatment of this pathology. And in many cases, such activities will lead to a complete cure for the inflammatory process in the middle ear.
After suffering acute inflammation of the middle ear with the presence of perforation (opening) in the tympanic membrane, you should not allow water to enter the auditory canal. If you wash your hair or take a shower, then a cotton swab impregnated with petroleum jelly must be put in the ear canal. Perforation, long lasting after acute otitis media, must be surgically treated in specialized departments of hospitals.
You can be deaf.
Otitis can cause loss of hearing or partial loss. .
consequences in not treatment in any case will be
Dangerous development of deafness. Chronic complications (near the brain).
destroys the vestibular apparatus
Inflammation of the ear in a child, symptoms and treatmentInflammatory process of the middle ear is a frequent illness of children (both very young and older). Inflammatory process of the middle ear is accompanied by extremely unpleasant symptoms, which worsen the baby's well-being. The condition of the child can be described as flaccid, weak. The child may have fever, a cold starts. If you do not stop this difficult process in time, then there is a risk that otitis from the acute form will pass into purulent.
The consequences of purulent otitis are:
- Inflammation begins to amaze and destroy the tympanic membrane;
- If the child or parent with a purulent form of otitis will perform inaccurate manipulations with the ear, then the risk of injury increases;
- Chronic purulent form of otitis quickly spreads to the sinuses of the nose, tonsils in the pharynx, and also - there is a risk that the infection will penetrate into the brain.
Treatment of ear inflammation at home - yes or no?
No, it is strictly forbidden to put any diagnoses to the child independently and even more so - to engage in self-medication. You, as an attentive parent, can determine in time the deterioration of the child's well-being, and write to the otolaryngologist.
Further, the full diagnosis of the inflammatory process of the ear, as well as the diagnosis and treatment is the right to appoint only a doctor.
What is included in the treatment of otitis in a child?
In the treatment of otitis includes antibiotic therapy, then, the use of medications aimed at eliminating the inflammatory process. Your child may be prescribed a set of physiotherapeutic procedures, as well as a prophylactic wash of the nasal sinuses.
Naturally, parents who do not have a special medical education have no right to treat a child.
If the child is diagnosed with a chronic form of otitis, then be ready for the appointment - removal of adenoids for medical reasons.
It is forbidden at otitis!
In no case is it advisable to make warming compresses in your ear if your child has a fever of up to 38 degrees or more. Such treatment can only worsen the health of children and vice versa - intensify the inflammatory process.
Without the appointment of the attending physician, it is not recommended to do inhalations to facilitate breathing with nasal sinuses.
In folk medicine and home therapy, it is customary to use boric alcohol for ear inflammation. But, remember that if you misuse this tool, it will lead to heat a burn of the entire ear canal, and can also lead to serious damage to the drum webbeds. Do not risk the health of a child!
Effects of otitis media on children
If you do not go to the doctor on time and do not confirm the diagnosis, then the child can expect such complications as:
- Hearing loss - in some, very severe cases - complete or partial deafness;
- Chronic otitis - that is, if any external negative factors occur, the child will have an inflammatory process of the ear.
- Paresis of the facial nerve.
- Inflammation of the temporal bone.
- Defeat of the membranes of the brain.
Otitis in children
How does the ear start in children? When you need to see a doctor, under what conditions? What should alert parents to the child's physical well-being?
Inflammation of the middle ear begins as an ordinary cold disease. The child complains of weakness in the body, muscle pain. Children in the very beginning of the inflammation of the ear are sluggish, they are capricious. Then, the temperature starts to rise, a runny nose appears, the upper respiratory tract swells, the eyes water.
If the child is very small - from a year old and older, then the characteristic symptom is that he constantly touches his ear.
When parents start to treat ARI, and do not notice that the child has an earache, the state of health begins to worsen with each passing day. As a result, the acute form of inflammation of the middle ear turns into purulent and begins the rapid destruction of the tympanic membrane by an infectious process. At this stage, the pus may leak from the patient's ear.
Otitis in concealed form in young children
If your child is not yet 1 year old, his otitis will have a latent form. What does it mean? It is very difficult for young children, and sometimes even impossible to establish the correct and the only true diagnosis.
Characteristic signs of malaise and inflammation of the middle ear in a young child will be: nervousness, capriciousness, rejection of the breast, constant rotation of the head, tears.
Also, a characteristic phenomenon may be that children at this age will try to put a pen to the head and rub their ear. Remember! This is an important criterion and a sign that the baby needs a qualified medical examination.
If you still doubt - the ear hurts the child or something else, then gently, if you touch, click on the tragus of the ear. If there is an inflammatory process in the ear, the child may begin to cry, frown, and curl. If the child does not feel any painful sensations, then the cause of the indisposition in something else.
The cause of chronic otitis
If your child has an inflammation of the middle ear that takes on a chronic form, that is, otitis occurs 3-4 times or more per year, this may be due to factors such as:
- A short eustachian tube in children up to a year (the eustachian tube connects the throat and the drum cavity). As soon as a child gets a cold, the infection (virus) very quickly penetrates the eustachian tube into the ear canal.
- Infections from the nasopharynx, inflammation of the tonsils, pathological enlargement of the adenoids, as well as SARS in chronic form - all this leads to damage to the inner ear.
- Anatomic obstruction of outflow of mucus accumulating in the nasopharynx, in children under 1 year.
For the diagnosis of otitis, the child will have to undergo such studies as audiometry (determines the degree of hearing loss), typeometry - to confirm the diagnosis - inflammation of the middle ear.
When the pus accumulates in the auricle, an MRI is prescribed.
What are the complications of otitis?
Deterioration of hearing or complete loss of it are complications of otitis, but these are not all problems that may occur in a person who did not start treatment of the disease in time or neglected it.
Otitis and itself is a complication of colds.More often it affects children, but adults also get sick of it. Since the treatment began to use antibacterial therapy, otitis has become a great cure. But it has a tendency to repeat.
This disease is of two types:
- otitis media - with accumulation of purulent fluid in the middle ear cavity;
- otitis externa - the infection develops in the outer part of the ear.
Complications after otitis media in adultsMany people consider otitis a harmless disease that brings temporary discomfort. Of course, the patient is in pain, but this quickly passes. In fact, this ailment is not for everyone is so harmless that it does not deserve attention.
If a person has good health, then the consequences of the disease are not terrible for him. And people with weakened immunity must necessarily treat otitis, because they are the potential victims of complications. It is possible that such patients will not prescribe antibiotics, but will advise people to be treated with folk methods. But everything should happen under the supervision of the doctor and his appointments.
Complications of otitis in adults are the following health problems:
- intracranial abscess;
- paralysis of the facial nerve;
- hearing loss;
- loss of hearing (often temporary).
Intracranial abscess is the penetration and accumulation of pus in the brain substance. Pus appears from nearby organs. It is diagnosed with the help of laboratory and instrumental methods. Treatment stationary.
Paralysis of the facial nerve - weakness of facial muscles due to facial nerve lesion. Typically, the violation affects only one part of the person. Thus at the patient the smile is skewed, and the eye can not be completely opened.
Encephalocele - craniocerebral hernia.
Meningitis is an inflammatory lesion of the brain envelope. A dangerous disease. The patient immediately needs to see a doctor.
Otitis is a disease that lasts at least a month. After 2-3 days after the beginning of treatment, the pain in the ear can weaken or disappear altogether. The patient calms down and can stop the medical process. And this can not be done. Possible sad consequences.
Complications after otitis in childrenTreatment of otitis in children is sometimes delayed by several weeks. Not all parents strictly follow the doctor's instructions. Some can interrupt treatment as soon as the pain in the small ears ceases. It is possible and a situation where the mother of the baby, after listening to the advice of girlfriends, begins to treat the child on their own. It happens that the grandmother will prepare some kind of miracle-compress and starts applying it to the grieving ears of the grandson. Do not do anything. Otitis is treated under the supervision of a doctor. This is the only way to avoid complications that can lead to unfortunate consequences.
It's good that these complications do not occur so often, but they do exist. It can be:
- Deafness and hearing loss. More often these phenomena last not for long. But there are cases when hearing is not restored and even lost completely. Everything depends on the shape and severity of the underlying disease - otitis media. Parents need to remember that any hearing impairments affect the formation of the child's speech and its intellectual development.
- Because of accumulated pus and pressure on the tympanic membrane, a breakthrough occurs in it. The hole left after this, requires a certain time for its healing (at least two weeks).
- Untreated otitis in children brings the disease to a chronic form. And this is a constant purulent discharge from the auditory canal. This, as a rule, leads to a significant decrease in hearing in the child.
- Cholesteatoma - proliferation of a special tissue in the ear area behind the eardrum. It is fraught with the fact that its rapid growth leads to the closure of the auditory canal and, as a result, to deterioration.
- Inflammatory process passes to the bone tissue, which leads to the disease of the mastoid process of the temporal region.
- Meningitis (as in adults).
On the part of parents, constant monitoring of the condition of the child who has suffered otitis media is necessary. This disease tends to recur. And in chronic otitis, periods of calm are followed by periods of exacerbation.
If a child's hearing is disturbed, it will make it difficult for him to communicate with others. He may become closed, which is fraught with autism. There may be new problems.
Is the forecast favorable?
If the patient is correctly diagnosed and timely treatment is started, which he went through completely, then the prognosis is favorable.
As a rule, the disease is completely cured both in children and adults. Intracranial complications are very rare. The transition of acute otitis to chronic, of course, is observed, especially in children. Treatment of such cases in the hospital should be immediate. This will not allow the disease to progress and lead to more serious illnesses.
Not a particularly favorable prognosis of otitis in the presence of diseases associated with the metabolism, especially diabetes. The fact is that with such diseases the immunity is reduced, the body's resistance to infections is extremely low. This category of people should pay more attention to their health, and at the slightest sign of manifestation of otitis immediately go to the doctor.
Illness is better to warn. Therefore, one should not forget about prevention, which consists in the constant hardening of the body, in increase the protective properties of the immune system, in the planned intake of vitamins, in a full and healthy nutrition.
This list can be continued for many more points. If the patient is an adult, then he can take care of himself. And their parents should take care of their children, especially for babies. It is the little children who are most vulnerable to otolaryngological diseases.
Otitis media of the middle ear: causes and symptoms
Symptoms of otitis media of the middle ear are found mainly in early childhood, although older children and adults also suffer from this infection. Otitis can occur both in itself, and against the background of other ailments: sinusitis, influenza, sinusitis, etc.
Complication associated with this disease is fluid retention, resulting in the "glue" of the ear.
The ear consists of three different sections:
- external ear;
- middle ear;
- inner ear.
All these parts work together so you can hear normally. The outer ear and middle ear are divided by the eardrum - a very thin piece of skin that vibrates when sound waves hit.
Otitis of the middle ear is an infection (inflammation) that occurs in the air filled space, located behind the tympanic membrane. This space can be blocked and filled with mucus (liquid), which can be infected. So there is inflammation.
There are two types of inflammation of the middle ear:
- Acute infection begins suddenly and lasts for a short period of time.
- Chronic ear infection does not go away for a long time or its symptoms periodically return. Chronic ear infection can lead to long-term damage to the hearing.
Infection of the middle ear often begins as a common cold, acute respiratory viral infection, acute sinusitis or sore throat. "Infection" falls into the nose or throat and then through the Eustachian tube penetrates into the middle ear.
Ear infections of the middle ear are often found in children, because their auditory tubes are narrow and short.
The accumulation of fluid in a blocked Eustachian tube can increase pressure inside the middle ear, causing pain, and possibly rupture of the tympanic membrane. Although the tympanic membrane will gradually recover, its rupture can lead to the appearance of scar tissue and deafness.
What are the symptoms of otitis media of the middle ear?
- pain in the ear (either abrupt, sudden, or dull and continuous);
- fever and chills;
- the feeling that the ear is laid;
- all sounds are "muffled
- from the ear a liquid flows.
- poor sleep;
- irritability, anxiety;
- the liquid flows from the ear;
- decreased appetite;
- the child cries at night when lying down.
It is important to know
Pain in the ear is a common symptom of otitis media of the middle ear, but not all the unpleasant sensations are caused by infection. Excess earwax in the outer ear or changes in air height or pressure are examples of other causes of congestion or ear pain.
Treatment and prevention of otitis media of the middle ear
Ear infections usually go away on their own, so treatment can begin with the control of pain and careful monitoring of the condition. Nevertheless, ear inflammation in a child and severe cases in adults are likely to require treatment with antibiotic medications.
Amoxicillin (Flemoxin) is a frequent choice of physicians in the treatment of acute otitis media in patients who are not allergic to penicillin.
- Antibiotic in otitis should be taken in strict accordance with the instructions and do not quit treatment if symptoms become less pronounced.
- Grudnichkov and young children should be shown to a specialist after the course of taking the medicine has been completed. This is to make sure that the infection has completely disappeared.
- If no improvement is noted and the symptoms of otitis persist, the doctor may prescribe another antibiotic.
Pain and fever should be controlled by taking analgesics (acetaminophen, ibuprofen). They should appoint a specialist, since not all analgesics are acceptable for young children.
Also, ear candles are effective therapy for various ear related problems, including repetitive ear infections.
It is worth noting
Do not use cotton wool to clean the ears or put anything in the ear, if this remedy is not approved by the doctor. The tympanic membrane is thin and can easily be damaged.
If the pain has arisen in the evening, and you can visit the doctor only tomorrow, use the following tips:
- Heat from a warm behind-the-back compress brings temporary relief to the patient with otitis.
- Steam inhalations can also help, but take care not to burn yourself and protect your eyes from hot steam.
- Rinsing the throat with salt water helps to clean the auditory tube.
- Holding the head in an upright position will improve drainage of fluid from the middle ear.
The risk of otitis media in the middle ear in infants can be reduced by providing a smoke-free environment and breastfeeding in an upright position.
Try to avoid colds or flu, it will also reduce the risk of developing middle ear infection. How to do it? Wash your hands often, cover your mouth with a sneeze and get vaccinated against seasonal flu.
The use of nasal decongestants during colds, flu or sinusitis can also help prevent ear infection..
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:
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:
- 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.
- With an incorrect blowing nose during a cold, the infection does not leave the body, but spreads to neighboring organs.
- 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:
- 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:
- Antihistamines. They will help alleviate the condition with allergic otitis, and will reduce the manifestation of edema (Suprastin, Erius, Cetrin).
- 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).
- The Vagotonics. These funds remove puffiness and contribute to the outflow of pus and exudative without perforation of the tympanic membrane (Nazivin, Naphthyzin).
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.
- 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.
- 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).
- A few leaves of aloe are cleaned and squeezed out the juice, which is buried in the ear canal.
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.
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.
Symptoms and treatment of otitis in adults
- 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.
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.
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.
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:
- 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)
- 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
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 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.