How to treat otitis in adults: the main symptoms and diagnosis
Despite the fact that the inflammation of the hearing organs of an adult person is much less common than that of children, the question "how to treat otitis in adults" remains quite relevant and in demand.There are many prerequisites for the development of the disease in adults, as well as in the case of sinusitis.
Even an elementary cold or hypothermia can turn into a serious form of otitis.
In addition, inflammation of the outer, middle or inner ear can be affected by the following factors:
- viral diseases of the upper respiratory tract;
- viral diseases of the nasopharynx;
- neglected forms of the common cold;
- adenoids in the nasopharynx arch;
- violation of the rules of ear hygiene.
Depending on the infection of certain departments of the ear, otitis in adults and children is divided into three types:
- External otitis media: most often the cause of its occurrence is the accumulation of water in the ear canal, this form of the disease is often called "swimmer's ear."
- Average otitis media: mainly develops as a complication of the upper respiratory tract, this form is commonly referred to in the everyday life as "otitis."
- Internal otitis media: develops mainly on the background of neglected purulent inflammation, as well as infections.
In order to determine how to treat otitis in adults, it is necessary first to study the clinical picture, compare it with the characteristic symptoms of the disease, and also carry out a diagnosis.
The main symptoms of otitis in an adult are:
- feeling of stuffiness and noise in the ears;
- acute or aching pain in the ears;
- a sharp increase in temperature;
- partial hearing loss;
- headache;
- general weakness and malaise;
- lack of appetite;
- sleep disturbance;
- purulent discharge, possibly with an admixture of blood from the auditory canal.
It is important to know
Even the presence of the above symptoms does not give the right to engage in self-treatment, for the full diagnosis of the disease is necessary in urgent the order will seek help from an otolaryngologist who, with the help of special ENT equipment, will establish a definitive diagnosis and prescribe a course treatment.
For the diagnosis of otitis, the doctor usually uses an overhead reflector in tandem with an ear funnel or a modern optical device called an otoscope. In most cases, the examination of the ear does not cause any difficulties, in the first place the eardrum, ear canal and auricle are subject to examination.
Thus, in the diagnosis of external otitis, redness of the skin in the ear, narrowing of the auditory passage, and the possible presence of fluid in the lumen is observed. In this case, the auditory canal can be narrowed so much that through it it is simply impossible to examine the eardrum.
On average, any inflammatory process in the ear (otitis) lasts up to two weeks, during this time In no case should the treatment process be stopped, even if a significant improvement. Otherwise, serious complications and the formation of chronic forms may occur.
How many otitis media are treated in adults with basic medication
Regardless of the nature of otitis, viral or bacterial, it must necessarily be treated. Passage of the disease itself can in rare cases, but it is quite likely that it will develop into chronic forms and complications with serious consequences. It is from the course of the prescribed therapy and it depends how much otitis is treated in adults in time.One of the main means for treating the disease are ear drops in otitis.
They can be exclusively antibacterial or combined and consist of antibiotics and anti-inflammatory components. The course of treatment with such drops is 5-7 days, depending on the clinic of the disease.
Antibiotics are often used in the treatment of otitis media in adults, especially acute and purulent forms. The course of their treatment is 7-10 days, depending on the drug and the degree of complexity of the disease. In this case, treatment of otitis in adults and children at home by folk remedies is undesirable.
It is important to know
Take antibiotics should be exclusively after the appointment of a doctor strictly according to the scheme of the entire course. Even if after a few days of taking the symptoms of the disease significantly reduced or even disappear some of them, to stop treatment of purulent otitis with antibiotics to adults and children is prohibited in order to avoid complications and repeated exacerbation disease.
Anesthetic for otitis in adults is another type of medication used to relieve the condition of particularly acute forms with pronounced pain.Such treatment should be carried out necessarily under the supervision of the attending physician, not to cause allergic reactions and side effects.
Anesthesia therapy for otitis symptoms does not have a definite course of action and is used whenever necessary in each case.
In some cases, otitis media of the middle ear requires little surgical intervention. This procedure is called paracentesis or tympanotomy of the tympanic membrane. Usually it is performed when there is no improvement after antibiotic therapy during the first three days. The essence of it is to perform under the influence of local anesthesia in the tympanic membrane of a small incision, through which the pus accumulated in the ear can freely flow. After the cessation of discharge, the incision successfully heals and traces completely.
If there is no temperature in the otitis and there is no purulent discharge, often doctors recommend using dry heat - this can be folk methods of warming up at home or physical therapy.
Proceeding from the above-described factors, it becomes absolutely clear that it is impossible to give an unambiguous and precise answer to the question of how long otitis in adults lasts and how many days it is necessary to treat it.
The process of treatment and recovery depends on many factors, from the form of the disease, its clinical picture, ending with properly appointed therapy, created conditions for the patient, not to mention the individuality of each individual human organism. One thing is obvious - the duration of the disease can be significantly reduced with timely treatment to the otolaryngologist and strict observance of all his prescriptions.
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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:
- Otitis of the external ear.
- Otitis of the middle ear.
- 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:
- Viral.
- Bacterial.
- 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:
- Acute otitis media (the ear accumulates fluid). This is the reason for the audibility of your own voice in your head.
- 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:
- Tubotympanal otitis (mesotympanitis).
- Epimezotimpanit.
- 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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Hello!!! Lovely mother, odskazhit, and how many days passes atit ...
Answers:
~ Serve the Coronum, the croaker ~
why boric alcohol then? Now there are excellent drops of Tsipromed, Otipaks and treat and obezbalivayut fine. for a week Otitis is treated.
irina
Otitis occurs somewhere in a week, but a pain symptom, if the correct treatment - on the 2-3rd day passes.
Anna Karcha
For a week the otitis occurs, and why born. alcohol, it now seems not to be prescribed, there are drops of antibiotic tsipromed, so they are trouble-free, my children were prescribed.
LeYa
firstly, in no case to drip into the ears, toko compress, drops drip destined for the treatment of otitis, and calm the eye on the idea should be on third day, and you need to treat 5-7 days, depending on the severity of the disease.. and what doctor prescribed to drip alcohol in your ear, kill him a little (((((((
fancy hope
It can become chronic. A sharp week for 3.
Jeanne Max
Forget everything that's written here and walk to the doctor!! !
I love ladybirds!
I suffered all this childhood, such a pain is wild. Toko compresses and helped with camphor oil. Now it's probably all different.
Ear drops in otitis: how to choose a drop?
- Varieties
- How to instill
Ear drops in otitis are an effective treatment for an inflamed ear in the home.
However, first of all, the effectiveness of the drug depends on its correct choice and reasonable application. Not every medication can provide an invaluable local anesthetic and anti-inflammatory effect.
There is such an opinion that the treatment of otitis with drops of ear pain is completely harmless and safe. But it is not so.
Each drug has its own pharmacological features and actions that must be taken into account when treating a specific disease. A person far from medicine will find it difficult to independently, and most importantly, to understand. To avoid a positive effect instead of obtaining the directly opposite reaction, it is necessary to consult a specialist.
First, the otolaryngologist will need to establish an accurate diagnosis and determine the degree of neglect of the disease. And then the doctor will be able to give you the right treatment.
It is important to know
When untimely or incorrect treatment, otitis can easily go into a chronic form, and then without surgery can not do.
Treat inflammation of the middle ear most often in a complex, combining physiotherapy, the use of antibiotics, various ear-drops and ointments.
Especially effective in the treatment of otitis are special drops in the ears for children and adults. It is to the ear drops that doctors and patients prefer, hoping for a quick effect of removing pain and reducing inflammation in the ear. Read also "Sinuforte at Otitis".
Many immediately have a question: how to choose ear drops, because the pharmaceutical market is literally full of various drugs. If you did not contact a specialist, and decided to heal yourself (which is not very desirable), then always carefully study the instructions to the drug, or at least, if possible, consult a pharmacy with pharmacists. This will help you to properly determine the medication needed to treat an inflamed ear.
Remember
Choosing ear drops for otitis, in the first place, you need to know what kind of ear inflammation you have: external, middle or internal.
Ear drops from otitis come in several forms, depending on their action:
- antibacterial(for example, Tsipromed, Otofa, Normaks, etc.);
- drops with a combined component, containing glucocorticoids ("Dexon "Anauran "Sofraks etc.);
- monopreparations, having anti-inflammatory non-steroid agents ("Otipax "Otinum") in their composition.
Given all of the above factors, listed in the list, you can safely go to the pharmacy to pick up drops in your ears when you take otitis. Being at least minimally aware of the disease and the ways of its treatment, you will quickly recover and return to a full life without pain and discomfort.
Try to start treatment of otitis even in the early stages of its course. The main thing - always correctly choose and use drugs for inflammation of the ear, including ear drops for otitis. This will help you to achieve a speedy recovery without complications and other all kinds of negative processes in the body.
Drops in the ears with otitis for children and adults: which drops are most effective?
With regard directly to the choice of the drug, the benefits should be given to those medicines that have proved themselves as the most effective and safe for health.Quite often the ENT doctor appoints to his patients such drops in the ears at the otitis, like "Otofa "Anauran" or "Otipaks "Otofa" and many others.
These medicines have positively proven themselves in the fight against otitis media. Therefore, we will consider in more detail the instruction for the use of each of the three above mentioned preparations.
Treatment of otitis Otipaksom
Drops Otypaks are a drug with a double effect: analgesic and anti-inflammatory. The pharmacological agent is administered only topically.
Bury Otypaks in the ears should be 3-4 drops twice or thrice a day. If the bottle with droplets is cold, then just warm it in your hands. The course of treatment with this drug is 10 days.
Drops from Otipaks otitis are safe enough if they are applied correctly: do not exceed the dosage and do not use at the end of the expiration date. Even pregnant women and women can apply the drug during lactation, only if they have no signs of damage to the tympanic membrane. To everyone who has a perforation of the tympanic membrane, the drug is contraindicated. It is not recommended to use Otipax also in case of hypersensitivity to the components of the medication.
Of the side effects of the drug sometimes observed hyperemia and irritation of the auditory canal, as well as allergic reactions.
It is worth noting
Information on the interaction of Otipax with other drugs at the moment there, therefore, without consulting an otolaryngologist, use the drug in combination with other drugs not recommended.
Anauran in otitis media: dosage and method of administration
The drug Anauran has a pronounced local anesthetic and antiviral effect. Such ear drops are prescribed for inflammation of the ear and only for topical application. The most effective Anauran in the treatment of acute and chronic forms of external otitis media, with chronic exudative otitis media, as well as with average otitis without signs of perforation of the tympanic membrane.
Sometimes drops in the ears of Anauran are prescribed to patients with complications after surgery, as well as to people who have suffered anthotomy, tympanoplasty, fenestratsiyu and mastoidectomy.
How correctly to drip drops from an otitis in ears? It is necessary to dig in them with the help of a special pipette and only in the external ear canal. It is advisable that immediately after instilling the head for a while was slightly inclined. Duration of the course and dosage of the drug should be determined only by a doctor, depending on the severity of the disease.
However, classically the drug is used as follows: children drip 2-3 drops of Anauran at least 3-4 times a day, the dosage for adults is 4-5 drops 2-3 times a day. Usually, the auricle is not recommended for longer than a week. However, an increase in the duration of the course is possible if the doctor sees this as a necessity.
As for the side effects of Anauran, they are:
- hyperemia;
- itching and flaking of the skin of the auditory external passage.
If the drug is used for a long time, then other side effects are possible, for example, increasing the systemic absorption of active components, and also development of nephrotoxic and ototoxic action of neomycin (antibiotic in otitis of a wide spectrum of action contained in the composition preparation).
Such drops from otitis for children are not provided if the child is under 1 year old. It is also not recommended to use a pharmaceutical agent for people with hypersensitivity to the components of ear drops Anauran.
It is important to know
With extreme caution, the drug should be taken during pregnancy and during lactation. The use of drops during this period is possible only after consulting a specialist.
You can not combine drops of Anauran otitis with medication such as netilmicin, gentamicin, streptomycin, amikacin and monomycin. They only increase the ototoxic effect of the drug.
Otoze ear drops: how to use
This drug (antibiotic), like many other drops from otitis, is used exclusively locally. Drops in the ears of Otofa act on the areas of the sore ear as an antibacterial agent.
Bury children need no more than 3 drops 3 times a day (or you can pour a drop of a minute into the 2 in the ear canal). Drops from otitis in adults have their own dosage. Adults used to dig in 5 drops three times a day (or pour the medicine for a couple of minutes in the ear).Both for adults and children, the treatment course for Otofo is 7 days. It is possible that the duration of the course of treatment will vary depending on the severity of the course of the disease. Otofu can be attributed to the relatively inexpensive pediatric ear drops used for otitis.
However, this recommendation can only give an experienced otolaryngologist.
It is worth noting
Before instillation the bottle must be warmed in the hands, so that the drops are not cold.
The drug in use is safe enough and practically does not cause side effects. The only negative consequence after the application of drops may be an allergy, but this symptom is very rare.
The drug has only one contraindication - increased sensitivity to the component of ear drops rifamycin. As for the period of pregnancy and lactation, then say about the effect of the drug on the body women in these periods is quite difficult, because no special clinical studies of the drug was conducted.
It is important to know
Any of the drugs should be prescribed only by a specialist. Drops in the ears with otitis alone is not recommended, because one treatment at home may not be enough. A prolonged course of the disease with the reception of the wrong drugs can only promote the rooting of the disease in the human body.
Drops from otitis: how correctly to dig in a sick ear?
Drops from otitis - an effective and effective way to treat the inflammatory process in the ear. However, if you use ear drops incorrectly, the effect can be directly opposite. To avoid this, it is necessary to devote only a little time to studying the rules of instilling a patient ear. And then a positive result can not be avoided.
Rules of instillation of the ear in otitis:
- It is necessary to lie on one side so that the sick ear is up.
- Bury the drops in the ear, pulled by the lobes down and back.
- The drug is strongly recommended to be warm, but not hot (ideal temperature will be the temperature of drops at normal body temperature).
- Before dropping the drops from the otitis into the ear, the dropper should be lowered into boiling water to make it warm.
- It is not advisable to heat the whole bottle with drops, since the drug can quickly deteriorate.
- The instillation of drops into the ear should be indirect, that is, it is necessary to drip as follows: first insert into the ear a cotton turunda, then carefully put it into the ear external passage and only after that you can start digging in the ear. Direct instillation can be very dangerous, especially if the tympanic membrane is damaged. In the future, such imprudence can lead to deafness.
To treat otitis was the most successful, you need to consider a variety of factors, ranging from the degree of neglect of the disease and ending with the rules of instillation of the ears.
The use of droplets from otitis for topical use is considered by ENT doctors as an additional treatment, so it is not necessary to rely on adults or children's drops in the ears. Only their combination with antibacterial and anti-inflammatory drugs will help you, in the end, get rid of otitis.
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