External Otitis Symptoms and Treatment

External otitis in children and adults: symptoms and treatment

According to official statistics, otitis externa, the symptoms and treatment of which will be discussed in this article, are carried by 5 people per 1000 people worldwide every year. In 3-5% of people, this disease is observed in chronic form.

It was noted that, despite the prevalence among residents of all countries, this disease is more likely to be found in places with a warm and humid climate. In addition, the otitis of the external auditory canal is predisposed to the nationalities, in which this passage is narrow.

At its core, the described pathology is nothing more than an inflammatory disease developing in the field of the external ear sections, which are known to include the auricle, the external auditory canal and the tympanic membrane.

This ailment is caused mainly by representatives of the bacterial genus, but there are other causes of the disease that will be described below.

External otitis, a photo of which can be seen below, is equally common in both men and women:

From the viewpoint of occupational morbidity, the development of the disease is characteristic primarily of people engaged in diving and / or swimming, as well as for other people who often get water in their ear.

The maximum incidence rate falls on the age from 7 to 12 years. Physicians associate this with the immaturity of the defense mechanisms and, of course, with the peculiarities of the anatomy of the child's ear. Outer otitis in a child is an actual pediatric problem.

Limited, diffuse, allergic and fungal otitis externa

In medicine, it is common to distinguish two main types of the described disease - it is limited external otitis and diffuse:

• A limited variant of the disease manifests itself as an inflammatory process of the hair follicle in the ear canal, or in the form of a furuncle. At the same time, this boil will not be visible from the outside. The patient can only guess about his presence. The basis of this conjecture is always pain, which is aggravated by chewing or touching the ear. After a couple of days, the abscess reaches its peak of maturity and bursts because of what the pain goes away.
• For the diagnosis of diffuse external otitis furuncle is not typical. The inflammatory process is more common and affects the entire auditory canal.

This form of the disease is further subdivided into three varieties, the names of which reflect the main culprit of their development.This includes: the bacterial form of the disease, caused mainly by group A streptococci, an allergic variant of the disease, which is based on an allergy, and fungal otitis externa, the causative factor of which are fungi.

Acute and chronic otitis media of the external ear

According to the clinical course, the described disease can be acute or chronic:

• Chronic external otitis develops, as a rule, as a result of the absence or insufficiency of therapy of the acute form of the disease. Also, quite often the reason is the regular cleaning of the ears with cotton buds. This leads to the removal of the protective layer of sulfur and as a consequence to traumas of the ear canal. The result of such processes is the coarsening of the stratum corneum of the epidermis, the appearance of itching in the ears and the reduction of resistance to inflammation. The skin of the auditory canal thickens and overlaps its lumen.
• It is believed that if the acute otitis of the external ear recurred more than 4 times during a year or its duration is more than 4 weeks, then this is already a chronic form of the disease.

Otitis media of the middle ear and other causes of otitis media of the external auditory canal

In most cases, the causes of external otitis causes an infectious nature. First of all, they are bacteria and, in particular, staphylococcus, as well as fungi.

Predisposing to the development of this disease factors can be attributed to the constant moisture of the skin of the auditory canal.This condition becomes the reason that the skin protective barrier is broken:In normal for the skin of the auditory canal, an acid reaction is characteristic, with the help of which a reliable protection is created from penetration of infection, and under the influence of water, this acidity rapidly decreases and opens the way for microbes.

Of great importance is also the presence of small wounds, for example, scratches or cuts of the skin of the ear canal:they can easily be obtained by trying to clear the ear of sulfur, especially if it uses matches, hairpins or toothpicks and other unintended objects.

External otitis media also has its own risk factors:

• For example, the development of this ailment in children is facilitated by a skin pathology such as eczema, which is the cause of peeling and the appearance of erosions in the ear. A significant role in the formation of otitis belongs to the so-called sulfur plugs. This increases the risk of traumatizing the auditory meatus when trying to clean it, because many patients believe that they themselves can get rid of the plug.
• Another risk factor that can eventually cause external otitis media is the otitis media of the chronic middle ear. In this case, the introduction of infection is facilitated by the constant presence of a purulent discharge in the auditory canal.
• The risk of skin lesions in the area of ​​the auditory canal exists also in diseases accompanied by a decrease in immunity (say, diabetes mellitus), as well as with the narrowness of the auditory tube.

Signs of external ear otitis

The symptoms that arise when the disease is called otitis externa are, as a rule, observed only on one side. the disease is characterized by the defeat of one ear. Patients are concerned about persistent pain in the hearing organ itself or in its area. In this case, the pain is intensified by the movement of the tragus or the auricle as a whole.

There is a feeling of stuffiness of the ear and a clear decrease in its function:patients note that they are hearing impaired. The external auditory canal swells, the lymph nodes located in the ear area increase.

In the case of eczema or fungal damage, the above mentioned signs of external otitis may well be caused by an earache.

Furuncle with limited external otitis

With a limited version of external otitis, the first sign appearing in the patient is a throbbing pain, the intensity of which increases during conversation and / or chewing. If you push on the tragus or pull the ear, the soreness also increases.

Patients diagnosed with limited otitis externa ear symptoms usually do not include hearing impairment. It decreases only when the lumen of the auditory canal completely overlaps.

As mentioned above, the main sign of this form of the disease is furuncle. When examining the auditory canal on one of its walls you can notice flushing and swelling of the skin. After some time in the center of this area is formed softening, the boil is opened, which is accompanied by the release of pus.

Symptoms of acute diffuse otitis media

If there is diffuse acute external otitis, the symptoms developing in the patient differ somewhat from the manifestations with limited otitis. Pain in the ear is insignificant, it may be replaced by an itch, which sometimes is quite significant. Body temperature remains at normal level or slightly increases. Hearing is usually preserved and reduced only with significant swelling of the skin with the closure of the entire lumen of the auditory canal.

During examination of the ear canal, swelling, redness and thickening of the skin are revealed. When the process spreads to the tympanic membrane, a small amount of transparent secretions appears from the ear, the hearing decreases, the eardrum becomes hyperemic.

Diffuse external purulent otitis is characterized by the release of pus from the ear. The temperature is increased and the general condition of the patient suffers.

Complications of external ear otitis

Acute external otitis usually does not often lead to the development of any complications, but there is a small risk in this regard.

The result of this disease can become abscesses, and in simple words filled with pus and quite painful abscesses. They appear in those places where the ear infection with inflammation began. As a rule, such abscesses disappear on their own. Although in some cases, to speed up recovery, the doctor has to drain abscesses.

Complications of external otitis in the form of a narrowing of the external auditory canal are usually formed in patients with a chronic form of ear damage. As a result, such patients may worsen hearing or even complete deafness, but this is rare. The described constriction is easily treated with special drops. If they are appointed on time, then the hearing will later be all right.

External otitis in adults and children can lead to inflammatory processes, and sometimes to perforation of the tympanic membrane. This is due to the fact that in some cases, as a result of inflammation of the external ear, the fluid in the inner ear begins to accumulate. This fluid presses on the membrane and eventually breaks it, which is accompanied by loss of hearing, pain, ringing and viscous secretions from the ears.

In most cases, the membranes heal in a couple of months without any treatment. If this does not happen, then surgical intervention is prescribed.

How to treat external otitis media

When treating patients with a diagnosis of external otitis treatment, as a rule, includes the use of anti-inflammatory and antibacterial agents. The most popular among such medicines were acquired by Garazon and Sofrex, combining both of these effects. However, it is not recommended to use them without prescribing a doctor, which should be remembered especially if the described disease affects the child. After all, wrong selection of medicines or failure to adhere to adequate measures for their use usually leads to undesirable consequences in the form of certain complications and / or side effects of the drugs.

With the diagnosis of otitis externa, treatment with antibacterial drugs is aimed at eliminating the infectious focus. In this case, due to the fact that the composition of almost all drugs used in addition to the main active substance includes still anti-inflammatory, as well as analgesic components, the patient gradually eliminated and pain. Such therapy of the described disease is most effective.

Complex treatment of acute external otitis media

In addition to the course of antibiotics, appointed strictly on the recommendation of the attending physician, in patients diagnosed with acute external Otitis treatment includes the use of warming compresses, and the elimination of nasal congestion, and increased immunity.

There was a time when with this disease the treatment with boric alcohol was widely used. This substance was moistened with turundas, which were then placed in the ear. However, these days this procedure is recognized as a gross error, because alcohol causes severe irritation and as a result intensifies the inflammatory reaction.

It must be remembered that the treatment of the described disease should be comprehensive.

Drops with external otitis, no matter how qualitative they were, can not eliminate inflammation. And if you only use them, then this will not be enough for a complete cure.

We must not forget about the hygienic procedures that must be performed according to a certain scheme, because incorrect use of them can lead to plug-in. In addition, a too moist environment can contribute to the development of microorganisms in the ear, so it is worth preserving this body from washing.

Treatment of a limited otitis externa ear with drops or ointment

When deciding how to treat external otitis of limited form, the first thing the doctor prescribes is usually antibacterial ointment or drops.

The first kind of medicinal forms is Triderm or Celestoderm:These drugs lubricate turunda and inject into the ear.

Of the most popular drops:Neomycin and Ofloxacin.

A careful treatment of the affected area should be performed before using these medications. This is usually done with silver nitrate.

Analgesics and anti-inflammatory drugs are prescribed to eliminate pain.

Sometimes it is carried out as a treatment for external otitis in adults, an incision is made of the furuncle, followed by treatment with antiseptics and antibiotics.

To restore the immune system that is broken in the disease, vitamin therapy, autohemotherapy and immunocorrective therapy are prescribed.

Treatment of diffuse otitis in a child

Otitis of the outer ear of the diffuse type is also treated mainly by antibacterial drugs with the addition of multivitamins and immunocorrection.

In the ear injecting turuns with Burov ointment or hormonal ointments, instill antibacterial drops. In the presence of purulent discharge, the affected area is washed with a solution of antibiotics.

When the diagnosis of otitis externa in a child, the treatment must necessarily be controlled by the treating doctor. Independent attempts to cure a baby can lead to serious consequences.

Therapy,as a rule, is limited to conservative methods and is based on the same principles as treatment of the described ailment in adults: the use of drops and ointments based on antibiotics, anti-inflammatory and analgesic medicines.

In the case of occlusion of the auditory canal, the doctor performs manipulations aimed at clearing it of serous contents. After that, he carefully examines the eardrum. And after that, he makes the appointment of the necessary medicines.

NasmorkuNet.ru

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 development inflammation: microcracks of the skin, etc. Otherwise, every contact with unboiled water would result in the development of inflammation in the 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, which increases by night, when coughing, sneezing, she can give in the temple, teeth, be stabbing, pulsating, drilling, hearing loss, appetite, weakness and high temperature up to 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 make it possible to diagnose "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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External diffuse otitis media: causes

Most diseases of the ears, throat and nose (angina, otitis, sinusitis and others) are caused by infection.

If everything is normal, the glands of the auditory canal produce in the prescribed amount fat and earwax. Ear wax produces an environment with high acidity, which does not allow growing and multiplying bacteria.

These two components form a protective barrier that prevents bacteria, viruses and fungus from penetrating.

Often an infection in the external auditory canal appears after the sulfur is removed by a variety of devices: earbands, matches, pins, etc.

It should be remembered that with the use of pointed objects, the tympanic membrane can be damaged, which leads to acute perforated otitis media. It is also possible to scratch the epithelium in the ear canal, then there is an acute external diffuse otitis.

If wands with cotton wool are used, the sulfur is pushed into the ear, eventually a sulfur plug is formed. And this is the cause of the development of external diffuse otitis. In this case, the process of inflammation of the epithelium begins in the ear canal, later it reaches the eardrum. Often, this kind of appearance occurs when a foreign body or aggressive substances enter the auditory canal.

Symptoms that characterize acute external diffuse otitis media

With external otitis, the inflammation process is actively developing. It happens in different forms, maybe its limited and diffuse form.

Diffuse otitis is characterized by inflammation throughout the auditory canal. The process develops due to a bacterial infection, but the skin is also affected due to fungi and allergies. With limited otitis, the cause is an inflamed hair follicle, represented as a furuncle.

Limited otitis in the initial stage is indicated by itching, which is followed by a bursting pain in the ear. The pain becomes more during a conversation, when pressing a tragus or chewing. If you open the abscess, there is a stagnation of pain and pus from the ear canal is released. The hearing does not decrease, the exception is a large furuncle, since it completely closes the auditory canal.

Diffuse otitis differs in more pronounced symptoms:

• severe pain;
• stuffiness in the ear;
• hearing loss;
• redness and swelling of the epithelium in the ear canal.

Also, the temperature may rise slightly and the lymph nodes increase. With an inflamed eardrum, a small amount of transparent secretions may appear, with the addition of a headache.

Acute otitis externa is characterized by a swollen ear canal, and it can completely close. Lymph nodes around the ear and on the neck become painful. If acute external otitis has developed due to the fungus, the auditory passage is covered with thick epithelium, its color is red.

The development of chronic external otitis in severe form can be with diabetes, kidney infection and thyroid diseases.

Diffuse otitis externa: treatment and prevention

To relieve pain, use heat on the area around the ear and drug therapy: codeine or aspirin. After washing the ear doctor prescribed drops from otitis with antibiotic.

If there is fungal otitis, the ear canal is thoroughly rinsed with a disinfectant solution.

If slightly acidified ear drops are used, an environment that is unfavorable for the fungus is created in the ear canal.

Inflammation of the external ear is treated by rinsing. As a supplement, use drops, ointment or cream with an antibiotic, for example, neomycin or polymyxin B. Of course, if there is inflammation of the external ear, the patient needs a bed rest to avoid the development of complications. Often in the treatment of external otitis resort to folk remedies. For example, boric acid is buried in the instructions for use in the ear is quite simple. Use of this tool requires caution, so be sure to consult with your doctor, whether it is appropriate for you to use this tool.

Otitis often develops after a cold, so its timely treatment will be the best prevention of middle ear inflammation.

Diffuse otitis media of the external ear is also treated with the help of washes, for which a disinfectant or one-percent vinegar is used. If the inflammation is severe - lubrication with a 1% solution of brilliant green or 3-5% solution of silver nitrate, corticosteroid ointments Flucinar, Oxicort or Lokakorten.

After acute acute inflammation subsides, in order to prevent relapse, three-percent acetate is used in drops.

Diffuse otitis of the external ear with a complicated course is treated with antibiotics. Severe pain is eliminated by sedatives, allergy manifestations - diazolin, tavegil, dimedrol, etc. Physiotherapeutic procedures are represented by UHF currents, ultraviolet irradiation, alternating magnetic field with low frequency.

gajmorit.com

Than to treat an external otitis in house conditions

With such a disease as external otitis people face more often than they think. It is a focus of inflammation located in the cavity of the external ear or auditory canal (passage). Often this disease falls under the definition of "pain in the ear," which is written off for changes in atmospheric pressure, a strong wind "puffed in the ear," a runny nose, etc. However, the true causes of the development of the inflammatory process differ somewhat from these concepts.

The essence of the disease is inflammation of the skin of the external ear and auditory canal, which can be caused by bacteria or fungi, less often by viruses. Outer otitis occurs in people of different ages, but most often the disease develops in children. Treatment of external otitis media at home, with drugs selected and prescribed by a doctor in most of cases, is a very effective measure and allows you to quickly get rid of the disease. How to treat external ear otitis and avoid complications?

Medicines for the treatment of external otitis media in the home

What can I do to treat external otitis, what drugs will be needed for this? Treatment of the disease is carried out using modern anti-inflammatory drugs based on steroids, as well as antibiotics. Preparations are issued in several dosage forms. It can be ointment when otitis external ear or drops, depending on the extent and location of the inflammation focus.

Among the medications frequently used for external otitis media are "Sofradex" and "Garazon", which can be prescribed only by a doctor.

In addition to taking antibiotics for external otitis in adults in children, treatment involves the carrying out of hygienic procedures according to a special scheme. They help to cleanse the skin and accelerate recovery.

It is important to understand that when using cotton buds incorrectly, earwax is rammed and corks are formed that injure the skin in the ear.

Treatment of external ear otitis by antibiotics

Antibiotics for external otitis are used to kill the foci of infection and gradually reduce pain, since most ear drops also contain painkillers. In this case, their use will be more effective, since after suppression of microbial activity by an antibiotic, the steroid reduces the inflammatory process and the pain decreases and then disappears.

What exactly is the treatment of otitis externa, and according to which scheme to take the drug can only be determined by a doctor. In the event that the antibiotic is selected incorrectly, serious complications may occur. Sometimes, when using antibiotics, there are side effects in the form of partial or complete hearing loss, as well as a decrease in overall performance and worsening of well-being.

Treatment of external otitis with antibiotics should be performed under the strict supervision of a physician with a regular evaluation of the effectiveness therapy, in the absence of improvements in time to replace the drug and prevent the transition of the disease into a chronic form.

The recommended ways to treat external otitis media, which can quickly and effectively cope with the disease, are:

• passing the full course of antibiotics, the type and dose of which is prescribed by the doctor;
• use of warm compresses;
• treatment of rhinitis;
• reception of vitamin complexes, which increase the body's defenses.

How to treat external ear otitis in folk ways

The first and most important stage of treatment, of course, is radical therapy with the use of antibiotics and hormonal topical agents. Further, to accelerate the recovery process, you can use folk methods to combat this ailment in addition to drug therapy.

The effectiveness of otitis treatment is enhanced by the use of such medicinal plants as:

• flowers of calendula;
• yarrow herb;
• buds of pine;
• leaves of eucalyptus and plantain;
• liquorice root.

All these ingredients are mixed in equal proportions and brewed with hot water (for each tablespoon of a mixture of herbs you need 0.5 liters of water). The resulting composition is infused under a closed lid for 30 minutes, then filtered and taken inside at 100-150 ml before meals 3-4 times a day. The remaining cake can be used for a warm compress on the sore ear.

Ointments for the treatment of external otitis media: tetracycline and Levomecol

Ointments with external otitis are used very often, since they are easy to use and tested for years. One of them is the ointment of levomecola with external otitis, which has pronounced anti-inflammatory and antibacterial properties. The main active ingredients of the drug are the antibiotic levomitsetin, methyluracil, responsible for the regeneration of tissues and the production of interferon. The auxiliary component of levomekol - ethylene glycol, it provides absorbing properties of the drug.

Also often used tetracycline ointment with external otitis, which is a broad-spectrum antibiotic. The active substance of the drug inhibits the synthesis of protein bacteria and promotes the speedy recovery and healing of inflamed skin.

Ointment for the treatment of external otitis should be applied with a sterile cotton swab, gently laying it on the affected area. For each procedure it is necessary to take a new cotton "tool". How many times to apply ointment, and in what quantities determines the attending physician based on the severity of lesions.

Risk factors for external otitis media

In order not to provoke the development of this disease, it is necessary to exclude all risk factors and provide your body with adequate protection.

The main risk factors for the development of external otitis media are:

1. The presence of minor erosion on the skin of the auditory canals, resulting from improper hygiene of the ears;
2. Sulfuric plugs, traumatizing the skin of auditory courses;
3. Narrow passageways and the presence of otitis media of chronic course;
4. Diseases, accompanied by a decrease in body immunity (HIV, diabetes).

In addition, frequent ingress of water into the auricle due to swimming in open water can lead to the development of external otitis media, therefore, after similar water procedures it is recommended for the prevention of burying ears with antibacterial ear drops.

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Treatment of otitis in adults. Effective treatment of otitis

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

Ear structure

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

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

The concept, types of otitis. Causes

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

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

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

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

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

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

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

External otitis media. Classification. Symptoms

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

In most cases, limited inflammation is represented by furunculosis - the formation of boils. Furuncle - acute purulent process of the sebaceous gland or hair follicle, caused by pyogenic bacteria. If there are favorable factors in the human body, including chronic infection, diabetes, 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 body temperature may rise. 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 outer ear is considered the easiest type of disease in comparison with otitis media of the middle ear and internal otitis and often does not lead to serious complications, although sometimes it can cause an increase in the nodes of the lymphatic system. Inflammation of the mucosa grows into a malignant form (tissue necrosis) in the presence of a person associated with severe functional diseases (diabetes) or the virus of immunodeficiency. But such cases, fortunately, are rare.

Otitis media. Classification and symptoms

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

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

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

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

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

Acute otitis media. Forms

If the inflammatory process is classified according to the nature of the course (clinical picture), then the otitis can be catarrhal or purulent, Thus, the development of the disease undergoes three stages - acute catarrhal otitis, acute purulent otitis and the stage of 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, worsening general condition, there are inherent complications in the form of hearing loss and persistent perforation of the tympanic membrane. Usually the chronic course of the disease is a consequence of previous sinusitis or acute purulent otitis media. In some cases, this form of otitis occurs as a result of rupture (or perforation) of the tympanic membrane or curvature of the nasal septum after the injury. Depending on the localization of the perforation, and also on its size, three stages of chronic otitis are distinguished:

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

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

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

Epitimpanoanthral form of otitis is characterized by rupture of the upper, most pliable and fragile areas of the membrane. This stage of the disease, as well as epimezotimpanit, is dangerous by the occurrence of pathological processes associated with the formation of granulomas, polyps and cholesteatoma - a capsule filled and surrounded by 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 media outer and middle ear, but is the most dangerous in terms of threat to human health and life. Purulent processes that affect bone tissue can cause severe complications, for example, meningitis (inflammatory process in the membranes of the brain) or sepsis (contamination of blood due to ingestion of 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 cases of suspected purulent 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 allows you to avoid complications, as the puncture is done in a favorable and correct place, pus comes out outside through a specially installed tube, and the pain syndrome is reduced, and recovery is 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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