What is a sharp middle otitis. Otitis Middle Ear: Treatment in adults. Appendix G2. Topic antibacterial therapy at

Human's ear is a pair body and consists of the following departments:

Outdoor ear represented by outer auditory passage and ear sink. With his inflammation, the otitis is developing. The middle department bordering the outer ear through the eardrum and having an auditory bone and eardrum. The development of the inflammatory process in it indicates the otitis average. When they say about acute otitis, then the acute inflammation of the middle ear is most often meant.
The inner ear, consisting of a webbed and bone mazes, with inflammation of the mucous membranes, the internal otitis occurs, called the labyrinth.

Otitis are classified depending on the origin:

• infectious;
• non-infectious (post-trammatic or allergic).

As well as in depending on the type of inflammation:

• exudative;
• purulent (diffuse or local);
• catarial.

Causes of disease

Contrary to the adopted opinion of the acute form of secondary otitis in adults is not directly related to the effects of drafts, supercooling, the walking without a headdress in cold weather or in the ear of water.

Otitis develops most often when:finding various pathogenic microorganisms - viruses and bacteria in the drum cavity during:

• inflammatory diseases of the ENT organs through a hearing tube;
• infectious diseases (influenza, ORVI, scarletin, measles) through blood;
• incorrect blowing 2 nostrils at the same time when the contents of the nose.

In addition, Otitis can develop if the air intake in the middle ear is difficult, the reason can be:

• the presence of adenoids, which are the born tissue of pharyngeal almond;
• an increase in the rear ends of the nasal shells;
• sharp curvature of the nasal partition;
• the injury of the eardrum and the penetration of infection in the middle of the ear of the external environment (post-stram otitis).

Acute outer diffuse Otitis is expressed in an inflammatory process covering the skin and subcutaneous layers of the outer ear. The cause of the disease in adults can be infected with fungi or bacteria damage resulting from:

• injuries;
• unsuccessful manipulations when carrying out hygienic procedures at home;
• burns;
• chemicals and foreign objects.

Signs of the disease

Acute diffuse otitis is characterized by the following symptoms:

• edema of the outdoor ear;
• the appearance of one or more boils in the place of damage;
• pain;
• increased temperature;
• increased lymph nodes.

Symptoms of acute otitis of the middle department of ear in adults are very diverse and can manifest themselves to varying degrees. One of the main signs is noise, mortgage and pain in the affected body. The pain can be both insignificant and very strong, and, felt in the depths of the ear, spread to the occipital or temporal area, sometimes giving it in the teeth. At the same time, the dental pain is so sharp that the patient does not pay attention to other symptoms of otitis and resorts to the help of a dentist. The pain violates the appetite and the sleep of the patient, can carry a pulsating, stitching, suitable and intensifying with blowing, swallowing, sneezing and cough.

Other characteristic acute average otitis symptoms:

• reduction of hearing;
• soreness and increase in lymph nodes;
• out of ear.

Symptoms may be present both by both ears (bilateral otitis) and one ear (one-sided).
The acute average otitis in adults is often accompanied by such signs of body intoxication, as a general malaise, a sharp increase in body temperature. In this case, the reaction from the nasopharynx side can be observed: pain and sore throat; discharge from the nose and its constriction.

Stage of Middle Otita

This disease occurs in adults in several stages. Adequate treatment conducted on the reparative stage, or the process resolution stage leads to the relief of the flowing inflammatory process and pain, cessation of the expiration of the pus, the scarring of the eardrum, the view of which during the inspection comes to normal.

Catarial Otitis (initial stage) - manifests itself:

• noticeable worsening of general well-being;
• mortgage of ear;
• pain of affected organ.

When examining the ear, there is observed:

• there is a wide outer hearing pass;
• own sink is painless;
• fluids behind the drum blade is not observed.

The absent or improper treatment of the patient during this period can lead to the fact that the acute catarrhal average otitis will go into purulent form.

Doparph stage (or purulent otitis) - manifests itself:

Purulent inflammation in adults in turn is divided into 2 stages. The propulsion stage corresponds to the state at which under the conditions of the integrity of the eardrum as a result of the progressive inflammatory process in the cavity of the middle ear accumulates the pussy. The following symptoms are characteristic:

• strengthening of ear and headaches;
• feeling of stations and noise in the ear;
• worsening hearing in the affected ear.

When examining the ear, it is observed: there is no release from it, the purulent discharge is shifted behind the red eardrum.

Perforative stage (or purulent otitis) - manifests itself:

Perforated Otitis is an inflammation of the average hearing body, in which:

• due to the growing pressure inside the ear cavity, the eardrum is ruined;
• basic poverty begins;
• the intensity of pain decreases noticeably.

When examining the ear, there is observed: the absence of the integrity of the eardrum, the presence of the purulent separated in the auditory passage, which flows through perforation when purging the ears.

Diagnostics

Effective treatment of acute ear inflammation, whether it is a catarrhal or diffuse, post-traumatic or infectious Otitis, is impossible without proper diagnosis, which is carried out on the basis of patient's complaints and anamnesis of the disease.

The development of the disease indicates such clinical symptoms as:

• congestion and ear pain;
• worsening hearing;
• selection from the ear;
• general malaise;
• heat.

For a more careful inspection of the affected organ, eardrum, the nasopharynx and the area of \u200b\u200bthe mouth of the hearing pipe, an endoscope, otoscope or otomicroscope are used. In addition, the ENT specialist can carry out: a challenge examination in order to determine the reasons for the reduction of hearing, tympanometry, allowing to assess the mobility of the eardrum, an audiometry for the study of hearing acuteness.

Therapy

The treatment of acute average otitis in adults depends on the stage of occurrence. In the absence of a purulent process at the beginning of the disease, a blue lamp and warming compresses at home on the parole region, as well as physiotherapeutic treatment.

Medical therapy provides for use:

• painkillers and antibacterial (in the case of perforated eardrum) drops;
• vasoconstrictor nasal sprays;
• antipyretic and analgesizing means (if necessary);
• antihistamines;
• antivirus drugs.

During this period, the concomitant treatment of diseases of the nasopharynx, throat and nose is also carried out. The urgent purpose of systemic antibiotics is necessary only in the difficult course of the disease and the availability of immunodeficiency or severe pathology. In other cases, the patient recommends local treatment under the supervision of a specialist during a couple of days, after which the final decision on the appointment of antibiotics occurs.

Lor doctors advise to treat acute outdoor diffuse otitis, applying:

• medication therapy;
• physiotherapy (UHF, UFO)
• treatment of folk medicine at home.

In the presence of serious complications of acute inflammatory processes or the existing danger of their development, surgical treatment is carried out, in particular the paracentesis - a small puncture of the eardrum under local anesthesia. This allows not only to relieve pain, but also significantly speed up recovery.

At home, acute otitis can be treated with the help of folk remedies:

• clean the hearing pass by tampons moistened in the juice juice or chamomile brave;
• entering turb in the ear impregnated with iris mint leaves, plantain, faunch;
• include products with a high content of ascorbic acid - rosehip, hawthorn, lemons).

Prediction and prevention of sharp otitis

With competent timely treatment and strong immunite, acute otitis usually ends with recovery and full recovery of hearing acuteness. However, the late appeal to the doctor, negative factors of external influence, failures in the immune system and background diseases may cause a perfect other outcome of the disease.
Acute Middle Otitis can be transformed into chronic purulent average otitis with recycling of poverty and progressive hearing loss. In severe cases, the disease is accompanied by the development of a number of serious complications, some of which can lead to a fatal outcome. Among them:

• purulent labyrinthitis;
• mastoid;
• petrosis;
• neurith face nerve;
• brain abscess;
• sepsis.

The prevention of acute otites in adults is: the fight against chronic and acute infectious diseases, the timely adequate treatment of ENT diseases and the oral cavity, hardening the body, the right higen of the ears at home.

Active lifestyle, which includes long-term walks in the fresh air, the rejection of bad habits, regular sports, will help preserve the health of the hearing organ strong, and the hearing is sensitive.

Useful video about the reasons and treatment of acute otitis.

The acute average otitis (OSO) is an acute inflammatory process localized in the tissues of the middle ear, namely in the drum cavity, the area of \u200b\u200bthe auditory pipe and the predominant process. This disease is more often diagnosed in children, however, in adults it is about 30% of all Lor pathology.

Etiology, classification and mechanisms for the development of the disease

Acute Middle Otitis is an infectious disease, which can cause viruses, bacteria or viral-bacterial associations.

The viruses-pathogens of sharp respiratory infections play a major role in the development of OSOs, namely:

• paragrippa,
• adenoviruses
• enteroviruses
• respiratory and synticial viruses,
• coronaviruses
• rinoviruses
• metapnemoviruses.

In 70% of patients with an exudate study obtained from the middle ear, bacteria detect. Most often it is:

• Streptococcus Pneumoniae,
• Haemophilus influenzae,
• Moraxella Catarrhalis.

Promote the development of the disease:

• reduced immune status of the body (congenital immunodeficiency, recently transferred acute infectious diseases, concomitant severe somatic pathology (bronchial asthma, diabetes mellitus, kidney disease);
• the presence of the deceit of the sky in the child;
• active and passive smoking;
• low socio-economic status of the patient.

According to the nature of inflammation, 3 stages of OSO are distinguished:

• catarry
• exudative (serous),
• purulent.

The mechanisms of their development are also vary.

Catarial mid Otitis (Other names -, Torobotitis) more often develops with sharp respiratory viral infections - edema caused by inflammation in the field of the upper respiratory tract, spreads to the mucous membrane of the auditory pipe, which worsens its permeability. As a result, all 3 functions of the pipe are disturbed:

• ventilation (the air contained in the pipe is absorbed, and the arrival of the new is difficult),
• protective (as a result of insufficient ventilation, the partial oxygen pressure is reduced - the bactericidal activity of the pipe cells is weakening),
• the drainage (violation of the free outflow of the liquid from the pipe - leads to the reproduction of bacteria in the middle ear).

The consequence of these processes is a decrease in pressure in the drum cavity, leading to the suction of the secretion from the nasopharynx and the release of non-inflammatory fluid - transudate.

Also, the cause of the eustachiotic can be sharp drops of atmospheric pressure - during immersion and flooding of submariners (mareotite), lifting and descent of the aircraft (Aerootite).

Exudative average Otitis (Secretorial, serous, mucosic otitis) is a consequence of a catarrhal: against the background of the dysfunction of the hearing pipe, a decrease in the general and local immunity, the inflammatory process progresses - inflammatory liquid, or exudate, is reinforced into the drum cavity. The restoration of the ventilation function of the middle ear at this stage will lead to recovery, and in the case of non-appearances of the patient aid, the process can take a chronic course, transforming into the fibrusing average otitis (the scacerication process in the drum cavity), leading to pronounced.

Acute purulent middle otitis - This is an acute purulent inflammation of the mucous membrane with the involvement of other middle ear departments. The causative agent of this form of the disease is bacteria. They fall into the drum cavity more often through a hearing tube - a toothed way. Through the wound of the deputyid process or during the injury of the eardrum, the infection can also get into the drum cavity - in this case, Otitis is called traumatic. There is a third possible way of penetration of infection in the middle ear - with blood flow (hematogen). It is observed relatively rare and possible in some infectious diseases (measles, scarletten, tuberculosis, typhoid).

With acute purulent average, otitis inflammatory changes occur not only in the mucous membrane, but also in. The inflammatory liquid is released first serous, and then a purulent nature. The mucous is sharply thickened, ulcerations, erosion appear on its surface. In the midst of the disease, the drum cavity is filled with inflammatory liquid and thickened mucous membrane, and since the drainage function of the pipe is broken, it leads to a swelling of the eardrum. When unwise of a patient's assistance at this stage, there is a melting of the drumpoint area (its perforation), and the contents of the drum cavity flows outward (this is called sediers).

Against the background of treatment, inflammation subsides, the amount of exudate decreases, the poverty from the ear is stopped. The hole in the eardrum is chopped, but the patient has a long time permanently perfection in the affected ear. The criteria of recovery are the normalization of the painting when examining the ear - otoscopy, plus a complete recovery of hearing.

Why acute average otitis occurs more often in children

The ear structure of the child is such that the nasopharynx infection in a short time can spread to the structure of the middle ear.

There are age features of the structure of the middle ear, contributing to a more rapid spread of the nasopharynx infection in the middle ear. The auditory tube in children is short, wide and is located almost horizontally (deprived of physiological bends characteristic of adults). The drum cavity of young children is filled with a special, so-called mixoid, cloth is a student, loose embryonic connective tissue, which is a favorable soil for the development of an infectious process.

In addition to anatomy-physiological features, some pathological conditions that contribute to the development of the OSO are characteristic of children. First of all, it (hypertrophic changes in lymphoid tissue of nasopharynx) - streptococci and hemophilic wand are often found in them.

Children visiting children's teams are constantly in contact with each other's infectious agents. For one child, a specific pathogen may be conditionally pathogenic and not cause illness, and for the other it can be a virulent, aggressive and cause inflammation of the upper respiratory tract, from which the process may turn to the middle ear.

Children are often sick with respiratory viral infections, which can be complicated. In addition, these infections not only weaken immunity, and lead to morphological changes in the mucous membrane of the respiratory tract, reducing its immunity (resistance) to a potentially dangerous (pathogenic) microflor.

There are so-called transient (physiological) immunodeficiency states characteristic of young children - they are also a favorable background for the occurrence of infectious diseases.

Clinical picture of acute medium otitis

Often, the OSO proceeds with pronounced symptoms, but they meet and latent otitis - when the clinical manifestations of the disease are negligible.

For OSO, as for any other infectious disease, common symptoms are characterized:

• general weakness;
• feeling of ailment;
• deterioration of appetite;
• increase body temperature to febrile digits.

With the catarial average, otitis patients make complaints to:

• a minor reduction of hearing is a violation of sound mainly at low frequencies; After swallowing saliva or yawns, hearing is temporarily improved;
• resonating his voice in a sick ear - Autofonia.

The pain in the ear is usually low intensity or is generally absent.

The flow of exudative otitis is usually small. The patient notes:

• sensation of pressure, sometimes noise in the ear;
• light autofonia;
• some decline in hearing.

Painful sensations are usually absent, and to a decrease in hearing a patient after a while adapts and ceases to notice it.

A sharp purulent middle Otitis can proceed easily and quickly resolve, sluggishly and continue for a long time, sharply and rapidly. It usually ends with complete recovery, but sometimes the inflammatory process is chronized. In the absence of timely treatment, purulent average otitis can be complicated by mastoid, intracranial infectious processes and even sepsis.

Clinically, during the acute purulent average otitis, it is customary to allocate 3 stages:

• proper;
• perforative;
• reparative.

Not necessarily, the specific Otitis will pass all 3 stages - already on the initial (proper) stage, it can be resolved.

1. Dermeffutive stage. The leading complaint of the patient is pain in the ear, especially in the position lying on the side of the defeat. The pain is pronounced, sharp, shooting, giving in the temple. Gradually increasing, it becomes unbearable, painful, deprives sick peace and sleep. Consistence may be occurred when touched to the presenter process. Simultaneously with pain, there is a sense of occurrence of the ear, the noise in it is reduced. The overall condition of the patient is broken: there are signs of intoxication, the body temperature is increased to febrile digits. The duration of the initial stage: 2-3 hours - 2-3 days.
2. The perforative stage is determined by the beginning of this thread from the ear, which arose as a result of the drumpacing. The discharge from the ear is first abundant, the character of their mucous-purulent or purulent, often with blood admixture. Over time, the number of discharge decreases, they are thick and acquired purulent. The patient's condition at this stage is dramatically improved: the pain in the ear subsides, the body temperature decreases, sometimes even normalizes. The length of the thread - 5-7 days.
3. On the reparative stage, the poverty of their ear ceases, perforation is chosen, the hearing is gradually restored.

The above described the typical course of acute medium otitis, but in terms of cases, its clinical manifestations are sharply different from the classic.

• Sometimes the disease occurs extremely difficult: with a sharp deterioration in the overall state, the highest, up to 40 c, temperature, nausea and vomiting, headache and dizziness.
• In some cases, the camberring of the eardrum does not occur, and purulent masses apply from the middle ear to the skull cavity, causing complications that cause the threat of the patient's life.
• Otitis can already at the initial stage, adopt a low-shimptomic, sluggish, protracted character. In this case, general symptoms are slightly expressed, the pain is non-intensive, the drumpoint will not be perforated, and thick, viscous pus accumulates in the cavity of the middle ear.

If the patient's condition does not improve and the temperature does not decrease after perforation of the eardrum, this means that the inflammatory process switched to a mastoid process - developed.

Not stopped in 5-7 days, and the next to a month, points to the accumulation of ingestion inside the deputyid process, or empi.

In the children of early and preschool age, the diagnosis of acute average otitis can represent some difficulties, since the child does not always soundly voiced by his complaints, and parents and pediatricians can take the fever and whims of the child for the SMI symptoms (acute respiratory viral infection).

The child should be aimed at consulting Laura if available:

If you suspect a sharp middle otitis, the child must be examined by the ENT doctor.

• Pronounced violations of the overall condition of the child;
• 2 sleepless nights;
• severe pain syndrome and long fever;
• hopping of ear shell;
• smoothness of the exhaust fold;
• leakage of liquid from ear - disposal;
• soreness with a sudden press on the kid of the patient's ear;
• pains in tackling or tapping on a predominant process.

Acute Middle Otita Diagnosis

Based on the patient's complaints and data from the history of the disease, the doctor only suggests the presence of an inflammatory process in the middle ear. Confirm or refute this diagnosis will help the otoscopy - the visual inspection of the drummeal with the help of a special instrument - the otoscope. The eardrum has a form specific to each of the surroundings of the disease:

• at the stage of acute tobobotitis, the membrane is only a little drawn;
• the exudative stage is characterized by hyperemia (redness) and thickening of the eardrum, and hyperemia covers it first slightly propagating it, spreading to the entire surface of the membrane;
• the propropic stage of acute purulent otitis is commemorated with bright hyperemia and eulders of the eardrum and empty in the cavity of the outer ear of various severity;
• on the perforated stage, the presence of a hole on the eardrum, from which serous-purulent, purulent, or with an admissions of blood exudate is distinguished;
• on the reparative stage, the perforated hole is closed with a scar cloth, a gray-colored eardrum, turbid.

In order to determine the quality of hearing, a chalktonal study is carried out, the results of which are also vary at different stages.

Changes in the overall analysis of blood are non-specific - the signs of the inflammatory process are determined (leukocytosis, neutrophilez (if a bacterial infection occurs), an increase in ESR).

Bacterioscopic examination of the exudate, taken from the focus of inflammation, will determine the type of pathogen and its sensitivity to antibacterial drugs.

Treatment of acute medium otitis

Since during acute average otitis is determined clear staging, the treatment of this disease is also specific to each of the stages.

In general, the treatment of the OSO may include:

• osmotically active pain relief and anti-inflammatory drugs of local action (in the form of ear droplets);
• system and topical decongestants ();
• systemic antibiotic therapy;
• antihistamines;
• toilet and anemic of the nasal cavity;
• anemic and catheterization of the hearing pipe;
• miringotomy and shunting of the drum cavity.

Multiple means in this case are considered:

• anti-ease therapy in the form of tablets and syrups (accepted through the mouth) - there is no evidence of their effectiveness, and side effects happen often;
• mukolithic (drugs that dilute mucus) orally - the causes of the same;
• antibacterial drugs of local action (in the form of ear drops) - the antimicrobial component of these drugs does not have the desired effect on microorganisms in the drum cavity; The use of drugs of this group is justified only on the perforated stage of acute purulent otitis, since the membrane has a hole through which the active ingredient will fall into the drum cavity. In this case, the prescribed drug should not have a dysotoxic effect (they have antibiotics such as Polymixin B, neomycin, gentamicin).

Ear drops

Ear drops in the treatment of acute medium otitis are used often. Many patients appoint them themselves than risks to inflict irreparable harm to their health. Drops containing anti-inflammatory and painkillers are applied only with a whole eardrum, since it can be negatively affected by the patient's hearing through the perforated hole in the drum cavity.

For more accurate injection, the drops should be hand, opposite to the inflamed ear, slightly delay the ear shell up and forth - this technique lines the auditory passage and the drops will come to the destination. After instillation, it is necessary to close the auditory passage of a cotton-moistened vaseline, for 2-3 hours - in this case, the active agent will not evaporate and will have maximum therapeutic effects.

As mentioned above, antibacterial drops are prescribed only in the case of perforated average otitis.

Drops with an antihistamine component in their composition are prescribed to reduce edema and eliminate a possible allergic factor.

Topic decongestants (xylometazoline, oxymetazoline) is a necessary part of the treatment of the OSO, since the dysfunction of the hearing pipe develops precisely against the background of edema of the mucous membrane of the upper respiratory tract. It is possible to add to the drugs of this group, so they are prescribed only by short courses - not more than 4-5 days.

Antibacterial therapy

In time, adequate treatment will help the child suffering from otitis, as soon as possible to cope with the disease.

Antibiotics treatment requires not all forms of acute average otitis, but treatment with drugs of this group reduces the risk of developing complications of this disease. In the absence of serious symptoms of intoxication, such as vomiting, intense increasing headache, with an antibiotic assignment can be closed for 48-72 hours, since it is often solved independently, without their use. Antibiotics are required to be appointed with any forms of acute medium otitis in children under 2 years and in patients with immunodeficiency. First, the antibiotic is appointed empirically taking into account the spectrum of typical pathogens of this disease. In the case when the laboratory is determined by the pathogen and the medicinal substances are known to which it is most sensitive, should be replaced.

At the first stage, it is recommended that the catheterization of the auditory tube should be carried out daily. A mixture of a solution of naphtizin and a water-soluble corticosteroid with a vasoconstrictor and anti-inflammatory effect is introduced through the catheter. From drug drugs, the patient may be appointed topical decongestants.

In the second stage, some experts recommend introduction into the outer hearing passage of a thin cotton turtle, moistened with an inspection (a mixture of ethyl alcohol 90% and glycerol in a 1: 1 ratio). Tourund must be closed outside with a cotton tampon with a vaseline. This reception prevents the turndage with an inspection and fully the effects of this means are fully heating, anesthetic, dehydrating. The compress remains in the ear during the day. In parallel with the compress, it is necessary to use vasoconstrictor drops into the nose.

In the 3 stages of the process of the patient, the catheterization of the hearing pipe and the microcompressses with the inspection were recommended. Also shows systemic antibiotic therapy. In case, after 24-48 hours, the effect of the treatment conducted is absent, the patient needs a paraventision procedure or typanopunction. From medication tools shows the reception of strong analgesics (based on paracetamol and ibuprofen).

At the perforated stage, antibacterial drugs of a local action in the form of ear droplets are added to the preliminary treatment, except for this, the patient continues to obtain vasoconstrictor drops in the nose and analgesic drugs. The catheterization of the auditory pipe, a frequent toilet of an external auditory passage is also shown.

On the reparative stage of acute otitis, the observation of the Laura is not always necessary. However, if the perforative hole was large enough, it is important to control the scarring process to prevent the chronosis of the inflammatory process.

Otitis is inflammation and swelling of the ears. It can be chronic or sharp, purulent or catarrhal. Most often, this disease occurs in children. According to statistics, approximately 80% of children up to 3 years of age at least once sick otitis.

It is manifested by pain in the ear (pulsating, shooting, minor), elevated body temperature, hearing impairment, ears noise, mucous-purulent discharges from an external auditory passage.

Otitis is the most common cause of hearing loss (reduced hearing). This disease suffer from people of all ages, but children are most susceptible to death, due to the peculiarities of the anatomical structure of the Eustachius pipe.

Causes of Otita

The inflammatory process at the middle ear level is most often secondary. This means that, initially infection penetrates the drum cavity from other departments communicating with it. The secretory average otitis is observed when the liquid formed by the cold or an allergic reaction penetrates into the middle ear through the Eustachiev pipe.

Depending on the location of the pathological process mix three molds otitis:

• interior;
• outer;
• otitis the middle ear.

Two main causes of otitis, it is infection and the spread of inflammation from nasopharynx in the middle ear, as well as ear injuries. Also, the disease may arise due to:

• injury to the skin of the outer auditory passage;
• after entering polluted water;
• conducting surgical operations in the zone of the nasopharynx or nasal cavity;
• as a consequence;
• in infectious diseases, diseases of the kidneys, overcooling.

The average otitis can be caused by various pathogenic microorganisms: bacteria, viruses, mushrooms (otomycosis) and various microbial associations.

Symptoms otitis of the middle ear

First of all, Otitis and his symptoms will depend on the form and location of the inflammatory process. It is possible to describe the overall picture of acute otitis of the middle ear and its symptoms by the following signs:

• pain in the ear wears a sharp, strong and sometimes inturerable character, irradiages into the temporal and dark areas;
• reduction of hearing;
• hyperthermia;
• increased temperature;

After 1-3 days from the moment of the beginning of the disease, a breakpoint is formed in a drumpoint, which begins mentally. In this period, the temperature drops, the pain decreases, the overall state is improving.

With the unfavorable development of the pus's disease, it can not break through, but inward, cranial cavity, provoking the development of brain abscesses, meningitis and other dangerous diseases.

Symptoms of otitis in chronic form are similar, but less pronounced. As a rule, pain there are pain, a decrease in the hearing is more significant than at an acute stage.

Children are more often sick, due to the features of the structure of the middle ear and often the purulent process can develop during the day or two. The child often cries, screams, keeps behind the ear, can not sleep. In such cases, it is immediately necessary to consult a doctor.

Treatment Otita

First of all, local treatment of the disease depends on its form. The treatment of otitis should be immediate, due to the danger of the development of severe consequences: the spread of the disease into the skull space or to the inner ear, which may threaten the complete loss of hearing.

Under the condition of timely appeal to the doctor, the treatment of otitis of the middle ear is successfully carried out by drugs and physiotherapeutic procedures. For treatment, anti-inflammatory agents and antibiotics are widely used, as well as antipyretic preparations in the presence of a patient with high temperatures. To remove the edema of the nasal mucosa, the vasoconducting drops are instilled.

If the drum cavity is not drained independently during the first three days, the dissection of the eardrum is shown.

In general, the otitis treatment regimen at home consists of the following components:

• bed mode;
• nasal vessels;
• antimicrobial preparations;
• antibacterial agents;
• physiotherapeutic treatment;
• warming compresses;
• vitamins.

Acute purulent Otitis requires the use of antibiotic therapy, as well as the evacuation of a pus from the cavity of the middle ear. After passing the main course, the patient is prescribed restorative and absorbing therapy. The treatment of otitis in chronic form also consists in carrying out anti-inflammatory and antibacterial therapy, with enhanced immunocorrection.

It is worth noting that the treatment of otitis at home should be carried out only with the permission of a otolaryngologist. Do not self-medicate. In cases where conservative methods do not help - resort to surgical operation.

Ear drops when otitis

The use of any of these drugs is allowed only after receiving the appropriate advice from the doctor.

1. Garason, Sofradex, Deckon, Anaran - glucocorticosteroid drops;
2. Otinum, Otipeks - anti-inflammatory drops;
3. Otofa, Tsipromed, Regise, Fuggestin - Antibacterial drops.

To achieve the maximum medical effect, it is recommended to combine the use of droplets with antibiotic reception, they must be assigned by a specialist after diagnosis.

The main prophylactic activities of otitis in children and adults are the warning and timely treatment of inflammatory diseases of the nose and nasopharynx, chronic nose diseases, the incomplete sinuses. Proper to spend your nose toilet.

Otitis is an infectious and inflammatory process that can affect absolutely all ear departments. It is one of the most famous pathologies in the practice of ENT Doctors, is accompanied by discomfort and can cause even a hearing loss. Therefore, the question of how to treat acute otitis in adults is relevant to many patients.

Nature of the disease

This is a notch who amazes ears. At the moment of ailment, an active inflammatory process is developing, which gives discomfort. The person's ear does not end only on the ear shell, thanks to which you can catch the sounds. This body is considered quite complicated, because all its main elements are located deep in the head. It is divided into outdoor, internal and secondary. Each of these fractions can be subjected to an inflammatory process.

Otitis is a rather serious illness. All dangerous complications are developing when it is not timely treatment. Events must be carried out only under the supervision of a otolaryngologist. If self-treatment is present, the disease may be translated into a chronic form or even bring to the deadly outcome.

Classification

Otitis in adults is manifested in different ways and includes a large group of ear disease. Depending on the rapidness and duration of the course, the following stages are observed:

• acute;
• chronic.

On localization, you can distribute diseases for three forms:

• the outer is the inflammatory process of the skin in the ear sink or the hearing outdoor, manifests itself in the form of eczema, drimites, corrosive inflammation, furunculosis and sulfur tube;
• middle - is considered the most frequent form and arises after infectious colds as a complication;
• inner is an inflammatory process that is formed in the inner ear.

By the nature of the manifestation of the disease is distributed on:

• purulent - in the course of its flow, a lot of grinding deposits are formed;
• catarial - characterized by hyperemia and swelling, in the process of which the blood vessels are overwhelmed;
• exudative - proceeds with the formation of traffic.

Depending on the occurrence, allocate:

• bacterial;
• traumatic;
• viral.

The reasons

Contrary to the general opinion, acute otitis in adults is most often not associated with the impact of only drafts, supercooling, in the ear of water and walking in the cold season of the year without a hat.

Most often, such a disease is developing due to the fall of various pathogenic viruses and bacteria in the ear region during:

• inflammatory diseases of the ENT organs directly through the auditory tube;
• irregular blowing, which is performed immediately by two nostrils and during this period the contents of the nose falls into the inflammation area;
• infectious diseases (ARVI, flu, measles, scarlet) with blood flow.

In addition, the acute average otitis in adults can develop if air hurts due to:

• the presence of adenoids, which represent the increased tissue of pharyngeal almond;
• sharp curvature of partitions;
• expansion of the rear ends of the nose shell;
• at the time of injury, the eardrum, when exposed to which the infection in the middle department falls from the external environment, it is also called post-traumatic otitis.

Acute appears in a period of inflammatory processes that significantly cover the subcutaneous layers of the external ear and the skin. The main reason for the appearance of the disease can be infected with the nasopharynx by bacteria or fungi, which are obtained as a result:

• incorrect manipulations in hygiene, which are held at home;
• injuries;
• chemicals and foreign objects;
• burns.

Symptoms of acute otitis in adults

The disease is characterized by the following signs:

• the appearance of several or one boils in the place of damage;
• edema of the outdoor ear;
• a significant increase in temperature, not lower than 38;
• pain;
• expansion of lymph nodes.

Symptoms of such a disease can be quite varied and manifest itself in a different form. One of the main signs of pathology is the emergence of noise, foreclosure and pain in the affected body. The malaise may not be strong, but may be painfully, and even felt in the depths of the ear, spread in the temporal or occipital plot, sometimes reflecting in the teeth. It should be noted that in this case the dental pain can manifest itself as sharply and significantly that the patient does not think about other symptoms and directly appeals to the dentist. Such sensations disrupt the sleep of the patient, they can wear a stitching, pulsating and novice character, and become more significant at the moment of blowing, sneezing, swallowing and cough.

There are even additional symptoms in which it is necessary to begin treatment of acute average otitis in adults:

• reduction of hearing;
• an increase in lymph nodes that provoke soreness;

All of the above features may exist both from both ears (double-sided) and one of them (one-sided).

Such a paragraph is often accompanied by the main signs of intoxication, namely, a sharp increase in temperature and cumulative ailments. And the reaction from the nasopharynx can also be observed:

• nasal mortgage and release from it;
• pain and throat.

Stages

This disease may proceed in different ways, so it is classified in several stages.

Catarial Otitis is considered the initial stage of the disease and is expressed by the following symptoms:

• mortgage of ear;
• significant worsening of general well-being;
• strong pain of the affected organ.

When examining, the doctor watches:

• own sink is painless;
• a wide external hearing pass is seen;
• liquid in the eardrum is not assembled.

If it is incorrect to treat acute otitis in adults at this stage, then it can be achieved that it will go into a purulent form, and this is a serious indication for hospitalization.

Such inflammation, in turn, can be divided into two types.

1. The proper stage corresponds to such a state at which in the criteria of the integrity of the drum membrane in the middle ear cavity as a result of the growing inflammatory process accumulates a significant amount of pus. It is characterized by the following symptoms:

• early and headache is intensified;
• worsen hearing in the affected place;
• there is a significant mortgage of the ear and noise in it.

To diagnose the stage at the time of inspection, the doctor does not observe the outcomes, and the purulent discharge is shouted behind the red eardrum.

2. The perforative stage is the defeat of the average hearing body, in which, if you do not know how to treat acute otitis to adult, and launch it, the following signs will be manifested:

• significant poverty is formed;
• due to the fact that a strong pressure is formed, a complete breakpatch breakpoint happens inside the ear cavity
• after all the contents leaks, the intensity of the pain is gradually decreasing.

When examined, a specialist has a lack of integrity of the eardrum and purulent masses in a rumor passage, which are perfectly measured through perforation at the time of purging the ears.

Diagnostics

Often, Otitis symptoms are hidden by other diseases, so it is not recommended to independently do treatment. Only the otolaryngologist can accurately determine the diagnosis. In order to set the verdict, the specialist performs a patient survey and examines his patient's ear. Most often, information and analysis of the history, obtained in the process of physiological survey, it is enough to identify the presence of acute otitis in adults. Treatment of pathology is appointed only after the formation of an accurate diagnosis.

If the signs are unfair, the doctor necessarily sends for additional research.

1. To diagnose outdoor otitis, a otoscopy is applied, pneumonic otoscopy and otomicroscopy are the basic ways of examining an external auditory passage and the drum membrane using special medical instruments.
2. To confirm the average otitis, a tympanometry is applied - this is a special test for the mobility of the eardrum and the permeability of the auditory bones. And the acoustic reflectometry is performed - to register the internal muscles to sound stimulation. Computer and magnetic resonance imaging is done only if the formation of intracranial or purulent complications is suspected.
3. To identify internal otitis, various hearing studies are used to help check the operation of the nerve, which is directed to the brain directly from the inner ear. Electronistronicity is made to register rhythmic or arrhythmic movements of eyeballs. Computer or magnetic resonance tomography to identify various brain pathologies.

Treatment

Acute otitis in adults is not a problem. Therefore, for its therapy, you need to use the right methods.

The thorough drops into the nose are often used, as they allow you to reduce the essay tube mucosa swelling. Such drugs include "Galazolin", "Naphtizin", "Nazol" and many others, they simply become mandatory if the occurrence of pathology.

Locally, the hearing aisle is beginning to introduce solutions of antiseptics. Not so long ago, boric acid was used for this purpose, and now our doctors are often used. Although in other countries for the treatment of acute otitis of the middle ear in adults, more modern and efficient drugs are used. It happens that with significant pains, special drops are used that cause anesthesia, anti-inflammatory hormones are also used. To date, drugs that are buried in the ear, a huge set. The most popular of them are "Otinum", "Otipaks", "Sofradeks", "Garazone" and still dozens of various drugs.

The antibacterial components are played a special role in therapy, therefore sulfonamides and antibiotics in the treatment of acute otitis in adults are very often used. These include "amoxicillin", "cefuroxime", "ceftriaxone" and "azithromycin". The use of such funds has a number of features. The drug should not only act on bacteria, but also it is also good to leak into the drum cavity.

These treatments in no case cannot be taken into account as a scheme for therapy. This must be done by a doctor who has good qualifications. It must be remembered that with the timely and correct treatment of acute otitis of the middle ear in adults, the disease ends quickly and most often does not form a reduction in hearing. If you delay therapy or to engage in self-medication, it may end in difficult problems. The most harmless, if such Otitis goes into a chronic form, and the bad version is the complete loss of hearing and purulent meningitis.

It is not necessary to worry too much if it starts to manifest it from the ear, because with proper therapy at the site of the rupture of the drum membrane, a small scar is formed, which in the future almost never leads to a drop in hearing.

Procedure for the treatment of acute Middle Otitis in adults:

• immediately apply for advice to the otolaryngologist;
• when it is impossible, it is allowed to independently apply vesseloring agents into the nose, perfectly removing swelling, and in the ear to order the above-mentioned drops, which, in addition to anti-inflammatory action, are able to dissolve the ear sulfur in the ear;
• it is important that the ear is in the dry heat, for this wool invested in it, and after a cake or a hat is put on;
• you need to know that it is not allowed to apply hot warmers.

ethnoscience

In addition to the use of drugs in the treatment of acute otitis, adults also use recipes that can be prepared independently at home.

1. Onions with butter - these components are used with the purulent course of the ailment. To do this, you need to cook Cashitz or squeeze the juice from the bow and add a small amount of cream or linseed oil there. Freshly prepared mass is introduced with a tampon in the ear.
2. Chamomile is used to treat acute medium in adults. For this, the nose is washed with a warm solution from it. Cooking will require 1 tsp. Dry component on a cup of boiling water. Give it to laugh and strain. In case the pain is very strong, it is necessary, undoubtedly, to go to the doctor, since the inflammatory process quickly turns to the periosteum and causes a defeat of the brain shell.
3. For the treatment of acute purulent otitis, adults also use the collection from the forest manner, peppermint, coconut lavender 3 tbsp. l., Drug Donovnik - 2 tbsp. l., Burdi ivyovoid - 1 tbsp. l. (It is important to know that the last ingredient is poison, so it's not worth remarking with it). The prepared mixture is poured 0.5 liters of boiling water or insisted on vodka. After cooking, the tampon is wrapped in a liquid and put into the patient's ear. And also perfectly helps if hearing loss is present.
4. The juice of walnut leaves is buried 3 drops into each ear with purulent otitis.
5. Flowers of chamomile and dormon of medicinal help in the treatment of acute medium in adults. This requires to take in the same parts of 2 tbsp. l. Collection and fervent 1 hot water, after insulating 30 minutes and filter. In the infusion, mix the fabric and squeeze a little, apply as a compress.
6. Mix the bark of oak, the rhizome of Aira, the root of the laptop of a reprehension and a chamber. For infused, it will be necessary 2 tbsp. l. Gathering to overtake in the fabric and put in a glass of boiling water for 4 minutes, after pressing. Such kippers are required 3-4 times a day.
7. The juice of fresh basil leaves is buried at 7-10 drops a couple of times a day.
8. Need to prepare 2 tbsp. l. The root of the drug heel and pour it with 2 cups of boiling water, warm up in a water bath for 30 minutes, and after 15 minutes to insist. Use 3-4 times a day for 1 tbsp. l. With purulent flow.

Complications

If it is incorrect to treat sharp otitis symptoms in adults, then this form can go into chronic. The launched stage leads to a partial or complete defect of the drum membrane and periodically renewed or incessant isolation of the pus from the ear. In the end, the patient decreases the rumor.

Complications are not found so often, many promptly and in a timely manner turn to the doctor for help, as they understand how important this treatment is important. If you launch a disease on samonek, then the following problems may arise:

• choleostom, the growth of fabrics behind the drummeal, as a result of which hearing worsen;
• the destruction of the middle ear, namely the hammer, anvil and the pile;
• mastoid is an inflammatory defeat in the temporal bone of the mastoid process;
• As a rule, such a wound healed, it takes about two weeks.

The above complications are not so dangerous as they can become intracranial. If you do not know how to treat acute otitis ear in adults, it can even lead to an abscess of the brain, meningitis, focal encephalitis and hydrocephalius. Such problems are very rare, but nevertheless they happen and are considered extremely dangerous. Complications that affect the brain can lead to death.

In order for the treatment to be successful, it is necessary to comply with bed rest. Adult and busy people need at least a couple of days to stay at home on the hospital and do not go to sports workouts. It is very important both physical and spiritual peace, as it promotes recovery.

All Doctor Tips must be performed and strictly followed. It is impossible to self-prescribe pharmaceutical preparations, the only thing that is allowed is to use drops with acutely otitis in adult otipax, as they will significantly improve the condition and help with less pain to reach the doctor. It is not allowed to interrupt the reception of drugs after the disappearance of the symptoms of the disease without appointing a doctor. And also recommended before going to it to drink Paracetamol tablet, as it will not harm health. This drug is efficient and has few contraindications.

Prevention

The best defense is always an attack. Therefore, the use of preventive measures, after the disease was cured, it is necessary.

According to experts, if you comply with recommendations, you can reduce almost to a minimum risk of otitis again:

• it is necessary to avoid water from entering the ears, if this fails, they need to be dried well;
• while cleaning the ears is forbidden to remove the whole sulfur, leave at least a little, as it is a defender from infection;
• it is necessary to comply with personal hygiene and with the slightest discomfort in the ears it is required to turn to the otolaryngologist, because even a small problem can turn into a global.

It should be noted that, with timely treatment, Otitis does not constitute anything terrible. It is not necessary to engage in self-medication, since without special equipment and knowledge it is impossible to estimate the level of the problem. Use folk remedies, of course, is recommended, but only as an addition to the basic drug therapy.

Otitis is the general name of infectious inflammatory processes occurring in the outer, medium or inner ear.

The human ear has a complex anatomical structure and consists of three departments that work simply, coordinated and interrelated. In structure and functions, they differ significantly from each other. Pathological processes proceed in them in different ways.

The function of sounding is performed by the outer and secondary ear, and sound perception - the inner ear.

Etiology

The reason for the development of otitis is viral, bacterial, fungal infection.

The main ways of penetration of pathogenic microorganisms into the hearing body:

• Tubar - through a rumor tube from the nasopharynx.
• Trantendant path - through a damaged drumpatch.
• Hematogenic path - with blood flow.
• Traumatic.
• Meningogenic or liquorgenic.

The causative agent of Otitis is most often. In more rare cases, the disease causes pneumococci, staphylococci, meningococci, protea, pathogenic mushrooms.

The following factors contribute to the development of Otitis:

1. Immunity reduction,
2. Supercooling
3. Dampness,
4. Pathology of the upper respiratory tract,
5. Surgical interventions
6. Diagnostic manipulations
7. Allergy,
8. Intoxication,
9. Foci of chronic infection in the body,
10. Slow precipitated atmospheric pressure.

In the risk group for the ears, people engaged in mountaineering or diving. The auditory apparatus is injured due to sharp pressure drops.

Head injury, blows, scratches and microcracks Ear often end otitis.

Outdoor Otit

Outdoor otitis is an infectious-inflammatory disease of the outer-ew channel.

Pathology is divided into:

• Limited Otitis - furuncle,
• Diffuse Otitis - Common inflammation of the entire auditory passage.

Depending on the origin, the otitis is classified into infectious and allergic. Viruses rarely become causative agents.

The development of pathology contributes:

Symptomatics

• Furuncle - acute purulent inflammation of the hair follicle surrounding soft tissues and adjacent silana. The only symptom of the disease is a graceful or sawing pain that enhances when talking, pulling out the ears back, eating. The general condition of the patients remains normal, the hearing does not deteriorate. By the fifth day of the disease, the furuncle ripens and reveals independently even in the absence of treatment. From the ear is distinguished by pus, the pain passes and recovery.

• Clinical symptoms of diffuse otitis are more pronounced. Patients complain about itching, discomfort and ear pain, characteristic signs of intoxication - fever, headache. During the inspection of the outer ear, it is found in hyperemia, swelling, a slight narrowing of the passage. Regional. With outer otitis, it is usually not worse. This is a distinctive feature of pathology associated with the lack of damage to the eardrum.

Malignant external Otitis is the dangerous consequence of outer otitis. This pathology is characterized by the spread of bacterial infection on bone tissue, involving it in an inflammatory process and further infected by the skull structures. The disease develops in a certain category of patients - older people suffering from diabetes, HIV-infected, children with congenital immunodeficiency. Symptoms of malignant outer otitis - and throat, paralysis of the muscles of the face, hoarseness of the voice.

Middle Otitis

The inflammation of the middle ear is divided into several clinical forms:

Pathology usually lasts 10-15 days. The average otitis takes place three consecutive stages - doparph, perforated and reparative, each of which has its own symptoms.

• Duration doparph Straty - 5 days. It is characterized by a sharp beginning and intensive pain in the ear, which over time becomes unbearable, violates appetite and sleep. The proprietary stage is distinguished by pronounced pain and symptoms of intoxication - fever, driers, chills.
• Perforative stage comes after. Purulent contents accumulated in the middle ear coming out. This process is accompanied by a decrease in pain, normalization of body temperature and improved patient's condition. The perforation stage lasts about a week and goes into reparative.
• IN reparative stages The integrity of the eardrum is restored, the poverty stops, the scarring process is activated, the hearing is restored.

Evstachitis

The inflammation of the auditory pipe is called Eustachiite. The microbes causing pathology fall into the middle ear of the pharynx or the nasal cavity. The pipe swells, blushes, its lumen is narrowed or completely closed. Evstachitis often precedes the development of the catarrhal form of otitis and in the absence of treatment ends with a decrease in hearing.

Evstachitis almost always leads to the formation of the pathology of the middle ear. Increased adenoids in children often overlap the clearing pipe, which contributes to the development of inflammation. In adults, violating the passability of Eustachius pipes can polyps or other neos-forming of the nasal cavity.

The clinical signs of Evstachirat are nonspecific. These include discomfort, noise, or sensation of fluid transfusion in the ears. Painful syndrome is almost always absent. The general condition of patients remains normal.

During the otoscopy, the pipe, drawn and slightly deformed eardrum, turbulent, muddy with separate areas of redness is detected. Inadequate or late treatment of Evstachitis leads to the chronization of the process and the development of the counter.

Catarial Otitis

Catarial Otitis

Acute catarrhal inflammation of the middle ear develops in persons with the organisms of acute or chronic infections in the body - carious teeth, or. From the nasopharynx and the appropriate sinuses of the nose, the infection falls in Eustachiyev pipe during blowing around both nostrils, cough and sneezing. This is due to the increase in the pressure in the nasopharynk. Then the infected mucus penetrates into the middle ear, where the pathological process is formed.

Clinical signs of the disease - acute, irradiating in teeth and whiskey, decline in hearing, fever. The pain is enhanced during sneezing, cough, frowning.

Exudent Otitis

The disease in which the liquid accumulates in the cavity of the inflamed medium ear, which leads to a decrease in hearing. Exudative otitis is also called serous or secretory. A distinctive feature of this pathology is the absence of pain and damage to the eardrum.

The development of exudative otitis leads:

During the disease, 3 stages are isolated - acute, subacute and chronic.

Exudent otitis happens:

• Double-sided
• One-sided - right-sided or left-sided,
• Intermittent.

The disease proceeds almost asymptomatic, which makes it difficult for early diagnosis and leads to the loss of hearing in children. Children under three years old, suffering from exudative chronic otitis, begin to speak later their peers and with difficulty mastering the tongue. Older children are distinguished by inattention and autistic behavior. Reveal the disease by chance.

With the otoscopy, a normal or slightly dull eardrum with a yellowish tint is detected, almost fixed, drawn, thickened.

Adhesive Otitis

Adhesive Otitis

Inflammation of the middle ear, in which infiltration of lymphocyte mucosa occurs, scar battles and spikes are formed, the exudate germinates with a connective tissue. These pathological processes violate the passability of the Eustachius pipe, the mobility of the auditory bones and the eardrum.

Symptoms otitis - hearing loss, dizziness. Treatment of adhesive otitis - surgical, consisting in conducting auditution or typanoplasty.

Purulent otitis

Purulent otitis

The disease develops as a result of penetration from the external environment of microbes through the hole in the drummeal. The main symptom of the purulent inflammation of the middle ear is a tear, which is purulent discharge from the ear leading to a hearing impairment.

The manifestations of purulent otitis are: ear pain of various intensity, reduction of hearing and pronounced symptoms of intoxication - fever, weakness, driers.

Chronic middle Otitis

This is a long infection, associated with an inadequate perforation of the eardrum. The cause of the disease is acute inflammation, the treatment of which was inadequate.

Otitis symptoms are determined by the form of pathology and the location of perforation in the eardrum.

Chronic middle Otitis

Chronic otitis happens three types:

1. Mesotimpanal - a hole in the central part of the membrane;
2. Epitimpa - at the top of the membrane;
3. Epimesothympanal - in the center and top of the membrane.

Patients periodically appear purulent separated from the patient earhaving an unpleasant smell. The poverty can last up to two months, periodically disappearing and appearing. In addition to the characteristic symptoms of otitis in patients, headache and dizziness appear.

The consequences of the chronic form of pathology are: inflammation of the inner ear, choleateatom, infection of the brain, paresis of the branches of the facial nerve.

Bullese Otitis

Bullese Otitis

Bullese otitis - a disease of viral etiology, in which in the drum cavity is formed Bully - bubbles with bloody content. Pathology is usually developing a field of transferred respiratory infection or complicates its current.

Bully burst over time as well. Bullese otitis flows without pronounced pain. It is characterized by the defeat of the cranial brain nerves and their branches.

Allergic Otitis

Allergic Otitis is the body's reaction to an external or internal stimulus - allergen. Otitis with allergies is the same symptom as rhinitis. Allergic Otitis is manifested by watery discharge from ear, which over time can become more viscous and thick. Patients decreased rumor, their mortgage appears. There is no pain syndrome.

Complications of Middle Otita

Otitis can be complicated by the following pathological conditions:

• Thickening in pus, the appearance of fibrin threads in it,
• Scars and spikes in ear cavities,
• Dysfunction of auditory bones,
• Purulent labyrinthitis
• Inflammation of the brain shells
• PARERS OF FACE NERVA,
• Sepsis,
• Sclerosis of the eardrum,
• Irreversible neurosensory touginess,
• Choleateatom
• Encephalitis,
• Sinusitis,
• Gidrocephalia.

Internal Otitis

Inflammation of the inner ear, which usually complicates the course of acute medium otitis.

By origin, the labyrinthitis happens:

1. Timpangenic - penetration of infection from the inflamed medium ear;
2. Meningogenic - the spread of inflammation from the brain shells;
3. Hematogenic - drift of infection with blood flow;
4. Traumatic - When blowing on the head, when damaged by sharp objects of the inner ear, during fractures of the base of the skull.

The most dangerous type of Maze is meningogenic. It often ends with development or deafness.

The labyrinthitis is usually manifested by violations of the vestibular apparatus - dizziness, gait, the nastagm of the eyes, vegetative reactions, the development of hearing loss and the paresis branches of the facial nerve.

• For labyrinthitis, a systemic dizziness with the movement of the surrounding items around the patient is characterized. Signs of non-systemic dizziness - unsure and general instability. Dizziness is permanent or bredit.
• Nistagm eyes - involuntary oscillation or twitching eyeballs.
• Patients with labyrinthitite go with widespread legs and fall when the head turns.
• Vegetative disorders - skin pallor, heart rate disruption, increased sweating, cardiac pain, dyspepsia.
• The patients decreases the rumor, noise appears in the ears, which is enhanced by head turns. Purulent or necrotic labyrinthitis can end the deafness.

Otomikosis

A separate group is allocated - otitis caused by yeast-like mushrooms of the genus of the Candida.

The causative agent of the disease is mushrooms - normal human skin inhabitants. Upon exposure to adverse factors, the number of them increases sharply, and they acquire pathogenic properties. Such factors include: injuries, foreign bodies, non-compliance with personal hygiene, dysbacteriosis, long-term antibiotic therapy, decrease in immunity.

The fungal otitis is often developing after surgery while mastoid.

Otomycosis is outdoor, medium and amazing postoperative cavities. The outdoor view of the disease occurs most often.

In the development of fungal otitis, several stages are distinguished:

1. Harbingers - itching and pasting of the ears;
2. Acute - pain, edema, isolation, hyperemia;
3. Chronic - change of exacerbations and improvements.

Common symptoms of the disease are combined with characteristic local signs of otitis and the hypersensitivity of the auricle.

Fatty film that protects the auditory passage disappears. There is a swelling that leads to the absence of ears. Rassoeing items also become an entrance gate of infection. It aggravates the pathological process.

The swollen mucous membrane overlaps the auditory passage, which leads to a loss of hearing. The pain during the otomycosis is intense, increasing at the moment of swallowing. The purulent discharge contains mycelium fungi and epithelial cells.

Extlive lymph nodes are inflamed and increase in size. In some cases, the dust of the lower jaw can be inflated.

Complication of otomycosis is Minerygit - inflammation of the eardrum, which leads to a complete loss of hearing.

A feature of postoperative otomycosis is pain in the ear region.

Otitis in children

Otitis in a child can develop immediately after birth. The accumulating waters fall during childbirth in the cavity of the middle ear of the newborn and lead to its infection.

Breast children lie most of the time. Milk during feeding often cries in the hearing tube, which leads to the development of the disease.

Features of the children's ear contributing to the emergence of otitis:

• Horizontally located wide and short hearing tube,
• Loose and thick mucous membrane of the middle ear,
• Weak blood supply to the mucous membrane.

In childhood, the active growth of lymphoid tissue occurs. Adenoids, almonds and thymus often become foci of chronic infection in children. Having achieved large sizes, these organs overlap the hearing tube, which leads to a violation of the air exchange between the cavity of the middle ear and the nose.

The imperfect immune system of the child and frequent respiratory infections also contribute to the development of otitis.

Children suffering from otitis become restless, sleep well at night, shout, they touched a big ear. Breasts cannot normally eat, because during sucking pain is enhanced. Acute Otitis is manifested by the symptoms of general intoxication - fever, lethargy, nausea.

Cort and some other children's infections are often complicated by inflammation of the ears. The labyrinthitis in children can end the loss of hearing.

The treatment of otitis in children should be carried out under the conditions of the ENT branch under the supervision of specialists.

Diagnostics otita

To recognize otitis, you should contact the otorinolaryngologist. He listens to the patient's complaints and examines the ear, throat and nose. Evaluating all the data obtained, the doctor will appoint additional research methods and appropriate treatment.

The basis of the diagnosis when otitis is the otoscopy. Soscopic signs of the initial stage of the disease:

The perforative stage is omitically represented by a slightly or rounded perforation of the eardrum with visible pus.

During the reparative stage, a fragmentation of perforations, sealing and cutting of the edges occurs.

The main methods of diagnostics include:

• Audiometry
• Acoustic impedancemetry,
• Skull radiography
• Magnetic resonance tomography
• Computer tomography of the brain.

Audiometry allows you to determine the level of increasing hearing. With the help of Kameton, the bone conductivity of the sound waves is studied, and with the help of the audiographer - air.

When otitis, accompanied by minus, is carried out a microbiological study of the separated ears. The microscopic method allows you to see the pathogen with a microscope, and bacteriological - by cultivating the culture on the nutrient medium. After identifying the pathogen, its sensitivity to antibacterial drugs is determined.

Additional methods of diagnostics, allowing to determine the etiology of otitis and identify the pathology of the nasopharynx, are:

1. Rososcopy,
2. Farmingoscopy,
3. Laryngoscopy,
4. Determination of the passability of the Eustachius Pipe,
5. Radiography of the apparent sinuses of the nose.

Treatment

Etiotropic and symptomatic treatment

• Antibiotic therapy - a prerequisite in the treatment of otitis. Local signs of the disease require the use of antibacterial droplets. With the appearance of symptoms of general intoxication, patients are prescribed antimicrobial drugs inward or in the form of injections. These include: "Augmentin", "Amoxicillin", "Cefuroxin". Parallel prescribe drugs intended for the restoration of intestinal microflora - "Bacytatin", "Acipol".
• Antihistamines are prescribed to remove edema - "Supratin", "Laratodine".
• Non-steroidal anti-inflammatory agents reduce pain and reduce body temperature. Usually used "Ibuklin", "Nimesil".
• Polyvitamins are prescribed to improve the condition of the patient and the restoration of forces after severe illness.
• The reception of biostimulants is shown - "Apilak", "Aktovegin".
• To strengthen the immunity, patients prescribe parenteral administration of Aloe, ATP, vitreous body, vitamins of group V.
• For the treatment of otomycosis use antifungal agents for reception inside - tablets "Fluconazole" and for local use - drops in the ear Candibiotic.

Local treatment

Physiotherapy

• If the body temperature of the patient remains normal, then physiotherapy methods are prescribed to the main treatment -, UHF. Warming compresses and UHF can only be used during remission. When aggravating the disease is forbidden to warm ears.
• Dry heat effectively in the treatment of otitis. To do this, at home is used the heating, a bag with salt, cotton wool, polyethylene film, a shock, a hat. It is possible to carry out such procedures only after consulting with the attending physician.
• After removing the symptoms of exacerbation, a massage of the eardrum is carried out and a pipe is purged by Evstachiyev. These methods allow you to remove the remaining allocations and break the fresh spikes.
• The reparative stage shows the introduction of proteolytic enzymes in the drum cavity.
• Patients are shown by UFO, ultrafonophoresis with lidase, electrophoresis with iodide potassium, laser and therapy, microwave therapy, ultrasound, mud.

Surgical treatment Otita

Surgical treatment is applied to eliminate infectious foci and restoring the destroyed mechanism for conducting sounds.

Using grafts, you can restore or replace the damaged drumpipe. To do this, use the fascia of the temporal muscle. Artificial grafts replace destroyed auditory bones.

Long-term purulent inflammation with the formation of adhesions and scar tissue requires operations in 2 stages. On the first - sanitize the foci of infection, they remove spikes, on the second - recover the hearing.

Catheterization

The eared catheterization is carried out in order to remove the fluid accumulated in the middle ear, which disrupts the conduct of sounds, which leads to the development of hearing loss. In the first stage of the middle otitis, the liquid is transparent and homogeneous. Gradually, it is thickened, becomes muddy and similar to glue. Violation of the natural outflow of the inflamed fluid is usually associated with the blockage of the Eustachius pipe. The cause of violated passability in children often becomes adenoids, and in adults - polyps.

The catheterization of the middle ear is an operation, during which the eardrum is caught with a drum and injected into the hole thin catheter. Catheterization is designed to evacuate the exudate from the drum cavity. As it exits hearing the patient is improving. The catheter leaves about a year in the ear. It will be removed independently when the perforation of the eardrum will delay.

The main goals of catheterization are the launch of the air into the drum cavity, normalization of fluid outflow and hearing recovery.

With the help of a catheter in the drum cavity and the hearing tube introduce drugs - antibacterial, enzyme and hormonal drugs. In parallel with catheterization, it is recommended to carry out a massage with a finger of the chill's hearing pipe.

Paracentsis

Paracentsis

Paracentsis of the ear - puncture of the eardrum, made under local anesthesia. This operation is designed to eliminate the pus accumulated in the drum cavity. The puncture made on time allows preventing a breakthrough of purulent exudate to the head. Paracentesis is carried out with a deterioration in the condition of the patient and a significant increase in pain. The patient after the operation quickly goes on the amendment.

Operations on the ear

Mirningoplastic - Operation, during which the resulting hole is closed in the eardrum.

Timpanoplasty - Operation intended to eliminate the pathological process in the ear, closure of the perforation opening and restoring the work of the auditory bones. In severe cases, thympoplasty is produced in 2 stages with an interval in half a year.

Timpanoplasty with mastoidctomy Used to remove choleateatoms - cysts of the middle ear, as well as for the cessation of purulent discharge and improving hearing in patients who have suffered a radical surgery on the ear. Removal pathological formations The mastoid cavity is treated with fatty or muscle tissue. After the required amount of time, the auditory pass is restored by cartilage or bone tissue. Then restore the eardrum and transmitting mechanism.

Surgical treatment allows you to make your ear dry and closed.

ethnoscience

Folk remedies and recipes used to treat otitis:

The otitis treatment during pregnancy is carried out mainly by plant drugs, safe for the health of a woman and the future child. Ears are washed with chamomile decoction. The launched stages of the disease are treated with antibiotics, selected in accordance with the period of pregnancy. If the doctor's prescriptions are correct, the disease will pass without harm to the child.

Prevention

Diseases can be avoided if you observe simple rules and cautions:

Special attention deserves the prevention of otitis in children. It is aimed at eliminating risk factors and includes the use of drug and surgical prophylactic methods.

Risk factors include:

1. Visiting organized teams, in particular, nursery, children's pre-school institutions, early development schools;
2. Smoking in the presence of a child;
3. Feeding from the bottle of infants in a horizontal position.

A visit to the kindergarten is a generally recognized risk factor not only for the development of otitis, but also some other pathologies. The earlier the child began to go to kindergarten, the longer he is there and the more man in the group, the higher the risk of getting sick.

Passive smoking is dangerous for the child. Tobacco smoke contains allergens and carcinogens that irritate the mucous membrane and contribute to the mucus emission. The cilia of the fiscal epithelium glued and cease to perform their functions. The microbes and foreign particles begin to penetrate into the body. Harmful substances and tobacco smoke connections suppress immunity. Children of smoking parents more often sick inflammatory diseases, including otitis. Tobacco smoke toxins lead to slow poisoning of the body, the occurrence of frequent pathologies, hypo- and avitaminosis in children.

Children on artificial feeding are often fed from a bottle in a horizontal position. It is unacceptable. Kinder feed should be in a raised, half-sized position.

Medication methods of prevention include regular vaccination and the use of immunoglobulins.

Surgical prophylactic methods:

• Adenotomy - removal of adenoids in children with recurrent otitis;
• Shunting - introduction to the cavity of the middle ear ventilation tubes for air passage.

Video: Otitis in the program "School of Doctor Komarovsky"