Otitis ear inflammation. Otitis - all about symptoms, signs, complications and treatment with traditional and folk remedies. Home remedies

Otitis media is an acute infectious disease manifested by specific symptoms. The disease must be treated, as it is dangerous for the development of complications. No person is immune from the disease, so it is necessary to be able to recognize otitis media in time, the symptoms and treatment of which depend on the form of inflammation.

The disease refers to infectious diseases and occurs in the form of acute or chronic inflammation. Pathology develops due to exposure pathogenic microorganisms into the Eustachian tubes, and from there into the middle ear.

Causes:

infection of the ear by bacteria or viruses;
complication after influenza or acute respiratory viral infection;
inflammation of the nasopharynx;
sinusitis;
mechanical damage ear.

Otitis is considered more of a childhood disease, as it is rare among adults. In children, this disease most often results from a too narrow Eustachian tube. Any inflammation in the nasopharynx or nasopharyngitis leads to the spread of infection through the Eustachian tube into the ear.

In adults, otitis media in the vast majority of cases develops against the background of a general decrease in immunity. The disease is often a complication of inadequate therapy for infectious and viral diseases, including sinusitis.

The risk group includes adults with chronic sinusitis, patients with immunodeficiency and patients with diabetes.

Middle ear disease is accompanied by severe symptoms and requires timely treatment.

Symptoms and signs of the disease

Otitis is an inflammatory disease with acute onset and rapid progression of symptoms.

Classic clinical picture:

heat and fever;
acute “shooting” pain in the ear;
hearing loss, feeling of congestion;
discharge from the external ear canal.

Usually, with otitis media, nasal congestion and inflammation of the nasopharynx are observed. This is due to the structural features of the ENT organs, the work of which is closely interconnected. Otitis may be a consequence of inflammation maxillary sinuses or nasopharyngitis, but if it acts as an independent disease, it necessarily entails general deterioration well-being and the spread of the pathological process to nearby organs.

Types and stages of otitis media

There are two forms of otitis media – acute and chronic. Against the background of the inflammatory process, exudate accumulates. According to the type of this liquid, otitis media divided into purulent and catarrhal.

In the vast majority of cases, the cause of ear inflammation is cocci (staphylococcus, pneumococcus) and other opportunistic microorganisms. Their activation is due to a decrease immune defense, or occurs against the background of severe inflammatory processes in the nasopharynx. Causes of development of the disease with acute and chronic course are the same, only the severity of the symptoms differs.

Acute otitis media

Acute inflammation of the middle ear is characterized by a rapid increase in body temperature and pain. The main signs of the disease are severe pain and high body temperature. The pathological process may involve surrounding tissues, which leads to the spread pain syndrome over the entire affected part of the head.

A characteristic feature of acute inflammation is sharp, excruciating pain, the so-called “lumbago”. After some time, the inflammatory process resolves, the pain subsides, and purulent fluid begins to ooze from the ear canal.

Acute otitis media occurs in 3 stages:

Stage 1: acute eustachitis;
Stage 2: acute catarrhal inflammation;
Stage 3: acute purulent inflammation.

Acute eustachitis is accompanied by tinnitus, a feeling of pulsation and congestion, and a slight increase in temperature (up to 37-37.4). This stage lasts up to several days, and then turns into acute catarrhal inflammation, which is accompanied by severe pain and an increase in temperature to subfebrile levels. In this case, there is aseptic inflammation of the middle ear, strong noise and pulsation in the ears, severe congestion, accompanied by hearing impairment.

Acute purulent inflammation is the next stage of the disease. This is accompanied by severe pain that radiates to the teeth, lower jaw, eyes and temporal region. The pain intensifies when swallowing and when trying to blow your nose to clear the nose. Body temperature rises to 39-400 C. After some time, the eardrum is perforated, a wound is formed, through which pus flows out. At this stage, symptoms begin to subside.

Acute purulent inflammation will be accompanied by pain until the discharge finds a way out. If this does not happen for a long time, the otolaryngologist makes a puncture through which the purulent masses are removed.

After complete cleansing of the inflamed cavity and removal of the purulent contents, the perforation gradually heals and the disease completely resolves.

Chronic otitis media

Chronic otitis media is a consequence of inadequate treatment of acute inflammation. It develops in two cases: with frequent relapses of acute inflammation with the formation of perforation and discharge of discharge, or as a result of lack of treatment for acute inflammation.

Each time the eardrum ruptures to drain purulent contents from the middle ear to the outside, a small perforation is formed. Over time, it heals, but a scar appears in its place. In the case of chronic otitis, these scars become inflamed or do not heal completely due to the small amount of residual purulent masses in the perforation.

As a rule, the acute form of the disease does not cause pathological hearing impairment. Ear congestion and hearing loss are temporary symptoms that disappear after the integrity of the eardrum is restored. Chronic otitis media can lead to irreversible hearing impairment, but we are talking specifically about weakening, not complete loss ability to hear.

Diagnostic measures

There are no problems with making a diagnosis. An experienced doctor only needs to interview the patient and examine the ears using an endoscope and otoscope to suspect the cause of the ailment. To confirm availability purulent inflammation, radiography is prescribed temporal bone or performing a computed tomography scan.

Treatment of otitis media in adults at home

Otitis media should be treated on an outpatient basis. The treatment regimen depends on the form and stage of inflammation. In the absence of purulent discharge, therapy is carried out local means using ear drops. If an abscess is present, antibiotic therapy is prescribed. Traditional methods of treatment also exist, but they are recommended to be used as an auxiliary rather than the main therapeutic agent.

Chronic otitis media of the middle ear requires complex therapy, self-medication in this case is unacceptable. Inadequate therapy is dangerous for the development of hearing loss.

The most effective drops for otitis media

Used for treatment antiseptics And antibacterial drugs in the form of drops.

Popular medicines:

Sofradex;
Tsipromed;
Otipax;
Normax.

Sofradex is combination drug based on a corticosteroid and antimicrobial agent. Ear drops are effective at the initial stage of the disease, before pus begins to accumulate in the middle ear. The product is used 2-3 drops up to four times a day. The course of treatment takes on average 4-5 days.

Tsipromed drops contain the fluoroquinolone ciprofloxacin. This is an antimicrobial agent wide range action that quickly relieves inflammation caused by opportunistic microorganisms. The drug is used in ophthalmological and otolaryngological practice. Drops are used up to 3 times a day, 1 drop in each ear.

Otipax is a drug with analgesic and anti-inflammatory effects. The drug contains phenazone and lidocaine. Drops are used for acute otitis media to reduce pain. In case of severe suppuration, the drug is combined with antibiotics. The product can be used 4 drops 4 times a day.

Normax is an effective antimicrobial agent based on the fluoroquinolone norfloxacin. This drug has broad antimicrobial activity and quick action. It is used 5 drops three times a day for 4-5 days.

Antibiotics for otitis media in adults

For otitis media, broad-spectrum antibacterial drugs are used. The combination of ear drops with antibiotic tablets helps to minimize the risks of complications and progression of the disease to chronic form.

The following groups of drugs are most often prescribed:

penicillins (Amoxicillin, Amoxiclav, Augmentin);
fluoroquinolones (Tsipromed, Norfloxacin)
cephalosporins (Ceftriaxone)
macrolides (Sumamed, Azithromycin).

The first-line drugs of choice are penicillins. Amoxicillin, Amoxiclav or Augmentin are prescribed. Fluoroquinolones are antimicrobials broad spectrum of action, used for intolerance or ineffectiveness of penicillins. Cephalosporins or macrolides are also prescribed as substitutes for penicillin intolerance.

The dosage and duration of antibiotic treatment is selected individually for each patient.

Treatment with folk remedies

Traditional treatment of otitis media is an extremely dubious measure that cannot replace conservative drug therapy. Such methods can be used as additional ones, but only after consultation with a doctor. It's important to remember that incorrect treatment otitis media can lead to hearing loss.

Mix Dimexide and solution in equal proportions boric acid, apply to cotton wool and place it in your ears for an hour. Repeat this manipulation three times a day.
Place 5 large bay leaves in a bowl and pour over a glass hot water and boil for 20 minutes. Then cover with a lid, wrap in a towel and leave to steep for another two hours. The product is taken one tablespoon three times a day, while 2-3 drops are instilled into the inflamed ear.
When the eardrum ruptures and pus is released, hydrogen peroxide is used, which is instilled with a pipette, or used in the form of an ear turunda. This helps to quickly clear the ear canal of purulent contents and avoid the transition of acute otitis into a chronic disease.

The only one folk method, used in modern medicine- This is hydrogen peroxide. The product has a number of limitations, and in rare cases can provoke the development of complications, but it really effectively clears pus and prevents its re-accumulation. However, it is recommended to consult a doctor before using peroxide.

Possible complications of the disease

Despite the frightening symptoms, acute otitis media practically does not lead to hearing loss if treated correctly and in a timely manner.

Complications are characteristic of an advanced chronic form of the disease and manifest themselves:

inflammation meninges(meningoencephalitis);
defeat facial nerve;
sepsis, when purulent masses enter the general bloodstream;
hearing loss.

Timely detected otitis media can be treated quite successfully. Typically, treatment for otitis media takes about one week. Pain and discomfort disappear on the second day after starting drug therapy.

Prevention of otitis media

Otitis in adults is often a consequence of problems with nasal breathing. This may be due chronic inflammation maxillary sinuses or deviated nasal septum. Otitis media can be prevented only through timely treatment of these disorders.

It is also important to prevent weakening of the immune system and promptly treat any viral and infectious diseases.

Otitis media is general type definition implying ear inflammatory diseases. Otitis media, the symptoms of which are, accordingly, associated with inflammation, is mostly a disease observed in children; it often occurs against the background of exposure to an infection that has entered the middle ear; somewhat less often, otitis media can be triggered by an ear injury or allergy.

general description

The ears are actually quite fragile organs; their work is directly determined by the smallest movements of each of the elements that make them up. Nature has reliably provided the protection your ears require. Thus, the main part of these organs is located in the temporal bone; communication with the outside world is ensured thanks to a pair of canals in the form of the external auditory canal and the Eustachian tube.

The auditory canal (external) ends blindly, eardrum acts as a barrier for it and the middle ear cavity. The auditory tube acts as an element that provides communication between the nose and the middle ear cavity. In addition to ventilation as one of its functions, this pipe is responsible for distributing pressure so that it is equal on both sides of the eardrums. This is extremely important function, because it is precisely through it that the required sound conduction is ensured.

As we have already noted, otitis media is most often observed in children, despite the fact that in general the disease is also relevant for other age groups.

As for the reasons for the greater susceptibility of children to this disease, they lie in age-related anatomical features, which include, in particular, the structure of the middle ear. Thus, in children the auditory tube is somewhat shorter than in adults. In addition, it is almost straight, without bends, which greatly facilitates the path for infection to enter the middle ear. It is noteworthy that during the first three years after birth, about 80% of children are diagnosed with otitis media, and this happens at least once.

Causes of otitis media

The main causes of otitis media include the following:

, in which damage to the nasal mucosa occurs, against which the area of the outlet in the auditory tube becomes blocked. For this reason, in turn, the ventilation and cleaning processes required for the tympanic cavity are disrupted.
The relevance of chronic diseases of the nasopharyngeal region (, etc.), tumors of the nasopharynx region, adenoid vegetations.
Development of otitis media as a result of diving and ascents made by submariners, divers (or mareotitis).
The development of otitis against the background of sharp changes in atmospheric pressure, which are relevant during the ascent/descent of aircraft (which is defined as aerootitis).
Reduced immunity as a result of changes in the season, exposure to stress various types and scale.

Otitis: symptoms

Based anatomical features, otitis media can manifest itself in accordance with the classification of its varieties as otitis externa, otitis media and otitis internal. Based on this classification, accordingly, dysfunctions of a particular department are determined.

Otitis externa. In this form, the disease represents inflammatory changes affecting the skin in combination with subcutaneous tissue in the area of the auditory (external) canal. The course of external otitis, in turn, is possible both as a local inflammation (in the form of a boil) and as a widespread inflammation.

The formation of a boil occurs when an infection gets into the hair or sebaceous sacs in the ear canal. The main manifestation of symptoms in this case can be pain concentrated within the ear canal area, and this pain intensifies as a result of movements made by the lower jaw (during conversation, chewing food, etc.).

Gain Explained pain pressure exerted by the joint lower jaw. In general, the condition of patients changes slightly, in some cases it is possible low-grade fever. As a rule, the opening of the boil occurs spontaneously after it has completely matured. This outcome ensures improved well-being. By the way, when this current diseases, the hearing of patients is not negatively affected.

External (diffuse) otitis media. Mostly this form of otitis begins to develop as complications against the background of purulent chronic otitis. Their cause becomes continuing education purulent discharge in the affected eardrum, as well as infection of tissue in the area of the ear canal. Manifestations of this form of otitis include redness of the ear canal and the appearance of pain in this area. In some cases, diffuse otitis media (otitis diffuse) is provoked by skin irritation that occurs in the area of the ear canal under the influence of chemical substances or under the influence of mechanical trauma accompanied by infection.

Most often, the middle part of the ear is affected by inflammation, which is defined as tubootitis (or eustachitis). You can find out more about this disease in the “Otolaryngology” section on our website in the article, but now let’s briefly look at the main points of the symptoms.

Tubootitis as a disease consists of inflammation auditory tube, and it is this tube that reacts first to the process of infection, which manifests itself in the form of redness and swelling. As a rule, this is accompanied by closure of the lumen due to the effects of edema, as a result of which the pressure in the middle ear decreases. In turn, directly for the patient, a number of these processes will manifest themselves in hearing loss in combination with congestion. In addition, this state is accompanied by a sensation in the area big ear his own voice.

As a rule, chewing and swallowing saliva slightly reduces these manifestations, which is explained by the short-term opening of the lumen of the auditory tube at these moments.

Without the appropriate influence from the immune system or the doctor, inflammation occurs in the middle ear cavity as a whole. This, in turn, leads to pain in the ear that has a shooting nature and radiates to the area of the lower jaw, neck and temple. The temperature rises seriously, hearing decreases, which occurs as a result of the formation of exudate in the middle ear cavity, which subsequently becomes purulent.

By 3-4 days of the disease, development begins next stage in the inflammatory process, in which, as a result of exposure to pus, a hole appears in the eardrum (which is defined as perforation) and through this hole the exudate enters the external auditory canal. In other words, at this stage the patient will notice that fluid is coming out through his ear canal on the affected side. As a rule, perforation is accompanied by some improvement general condition, the pain gradually decreases, the temperature drops.

In the absence of the required treatment, the liquid acquires a certain thick consistency with the simultaneous formation of fibrin threads in it, and adhesions with scars begin to form. In this case, due to scars, it becomes difficult to normal functioning, inherent in the auditory ossicles, this, in turn, can lead to permanent hearing impairment.

Internal otitis (labyrinthitis) . The disease in this form is accompanied by complaints of dizziness, accompanied by severe tinnitus and persistent hearing impairment. Dizziness itself can manifest itself at very various diseases, however, if it suddenly appears following a previous cold the patient suffered in combination with nausea and vomiting, there is every reason to consult a specialist for advice regarding the relevance of the ear disease.

Diagnosis

Diagnosis of otitis is made on the basis of patient complaints, however, a significant obstacle in its implementation for young children is the limited oral contact due to the age of the children with the doctor. Detection of the disease is carried out using methods such as:

X-ray of the skull;
otoscopy;
hearing test (audiometry, tuning forks).

Treatment of otitis media

Treatment of otitis can be medicinal or surgical, which is in particular determined by the characteristics of its course, form, manifestations of symptoms and diseases associated with it. In any case, the effectiveness of treatment directly depends on how early treatment began.

Treatment of otitis media follows certain rules focused on the following:

reduction of pain;
reduction of swelling;
measures to improve the outflow of pus from the middle ear;
measures to reduce swelling of the mucous membrane of the auditory tube;
the use of antibiotics as a suppressive measure aimed at combating infection localized in the middle ear;
local treatment using compresses and certain hygiene measures;
surgical intervention (method of bypassing the tympanic cavity, if ineffective, the eardrum is cut, which is defined as paracentesis).

In addition to the measures listed, physiotherapy procedures are used:

UHF for the nose area;
laser therapy for the area at the mouth of the auditory tube;
pneumomassage focused on the area of the eardrum.

To diagnose otitis, you must contact your treating pediatrician (general practitioner), and subsequently you will need consultation and treatment with an otolaryngologist (ENT).

Otitis is an inflammation of the ear that can be localized internally or externally. Otitis varies in severity and is often found in children. Often caused by germs or viruses, this disease is usually infectious in nature. The ICD code for otitis media is 380.10.

Typically, otitis media can accompany colds, runny nose and cough. Ear disease can become chronic, possibly damaging the eardrum, which threatens frequent inflammations and hearing problems, if treatment is not started on time and the disease develops.

The causes of this disease can be different.

Viral and bacterial diseases, inflammatory processes in organism.
Other diseases of the nasopharynx, for example, runny nose, sinusitis, adenoids in children.
Injuries, mechanical damage to the auricle.
Getting water into the ear, especially contaminated water.
Improper ear hygiene, leading to the formation of wax plugs and damage to the eardrum.
Hypothermia.
Features of the structure of the auditory canal.

In some cases, the reasons may be combined.

External otitis – inflammation of the ear canal from the outside, middle and inner ear not affected. This form can become chronic if treatment is not started in time. Otitis externa can be of two types.

Limited. It is characterized by the appearance of boils, abscess of the tissues of the outer ear, and the formation of abscesses. Most often caused by Staphylococcus aureus.
Spilled or diffuse. This is an extensive lesion of the tissues of the outer ear and ear canal, which sometimes reaches the eardrum. Most often, infection occurs when water, especially dirty water, gets into the ear. Therefore, swimmers often encounter diffuse external otitis.

The external form is often a complication of influenza and other severe colds. Sometimes it can be caused by fungus, allergies, seborrhea, dermatitis and others skin diseases.

Symptoms of external otitis

The symptoms of this disease may resemble those of the internal or intermediate form, so the correct diagnosis can only be made after examination by a doctor.

Otalgia is pain in the ear. May be different in character.
Changes auditory perception, up to severe loss temporarily.
Congestion, feeling of pressure in the ear.
Noise, ringing, itching in the ears.
Various discharges, most often purulent.
Pain when pulling or touching auricle – hallmark precisely the outer form.

During the examination, the doctor will notice swelling, contamination of the ear canal, and inflammation of the eardrum.

Important! If you are concerned about these symptoms, you should consult an otolaryngologist.

For diagnosis, an external examination by a doctor is usually sufficient; sometimes exudate, if any, is taken for analysis to determine the pathogen. In rare cases, the following studies are required:

otoscopy;
tympanometry;
computed tomography and others.

How to treat otitis externa?

Treatment for this form begins right in the doctor's office. The specialist must open the boils, if any, and remove all pus and the ear canal. Next, the necessary medications are prescribed.

Important! You cannot open boils that form during otitis on your own.

Antibiotics. They are prescribed if otitis media was caused by bacteria, so they cannot be taken without tests. Examples: Oxacillin, Cefazolin, Amoxiclav and others.
Antipyretic, anti-inflammatory and analgesic drugs. You cannot do without them if ear disease is accompanied by fever and severe pain. Usually drugs based on ibuprofen, aspirin or paracetamol are used.
Drops in the ears. Often they already contain corticosteroids or antibiotics. Normax, Candibiotic, Otinum, Otofa and others are common.
Ointments. Used for speedy healing of damaged, inflamed areas. For example, Levomekol, Triderm.
UV therapy and UHF therapy. Physiotherapy accelerates recovery and enhances the effect of medications.

All medications and procedures are selected depending on the type of otitis externa, the extent of the damage and what caused the disease. If it occurs due to an allergy, then therapy is definitely needed. antihistamines, if it is a consequence of the flu, you need to cure it completely and prevent a relapse.

Otitis media is an inflammation of the middle ear. This form often occurs in children, even infants. Acute disease develops quickly, sometimes within a few hours there are already noticeable symptoms. The acute form without treatment becomes chronic. Based on the nature of the exudate, purulent, bullous and catarrhal otitis media are distinguished.

There are several stages acute illness, the symptoms are different for each.

Acute eustacheitis. At this stage, there is congestion in the ear, noise, and the temperature rises only in the presence of infection.
Acute catarrhal inflammation. A sharp, severe pain occurs, the temperature rises, and an inflammatory process in the ear is observed.
Stage of purulent inflammation. The pain reaches its peak and can radiate to the teeth and other areas of the head. Hearing is decreasing. Inflammation is noticeable on blood tests.
Post-perforation stage. The pain subsides, the temperature drops, but congestion and deafness remain, and exudate is released from the ear.
Reparative stage. The inflammation goes away, the damage to the eardrum is covered with a scar.

Important! Treatment should begin at initial stages illness, otherwise serious complications are possible.

After the discharge of pus, the patient’s condition usually improves, followed by recovery. However, if the pus does not come out or not all of it comes out, the infection can spread further, which can lead to inflammation of the brain or meningitis. Therefore, it is advisable to consult a doctor in any situation.

How to treat otitis media?

Treatment must be carried out under the supervision of the attending physician; it is important to establish the nature of the disease and the extent of the damage. In any case recommended bed rest and rest, otherwise the risk of complications increases. The doctor must also clear the ear canal of any secretions. The main methods of treating otitis media are as follows.

Use of antibiotics. This is important during acute otitis media. Usually Amoxicillin or Amoxiclav is used, otherwise Sumamed or Rovamycin. Antibiotics are used in tablet form; if complications develop, intramuscular or intravenous administration is possible.
Medicines to relieve inflammation and pain. Usually these are painkillers and antipyretics based on ibuprofen, aspirin, paracetamol.
Drops. At average shape it is important that they are room temperature, you can warm up the bottle in warm water before instillation. Otinum or Garazon can be used.
Drops into the nose if there is swelling. Vasoconstrictors are used, for example, Nazol or Naphthyzin.
Drugs that improve immunity. These include vitamins and vitamin complexes, may be in the form of tablets or injections.
Physiotherapy – electrophoresis or UHF.

In rare cases, surgery is required. With otitis media, heating the ear is strictly prohibited, as this contributes to the spread of infection.

Important! When treating otitis media in pregnant women, it should be taken into account that antibiotics cannot be used in most cases.

Internal otitis media - labyrinthitis

Labyrinthitis is an inflammation in the inner ear that occurs if the infection due to otitis media or other diseases penetrates deeper. With this disease, vestibular disorders occur due to damage to internal structures. Often after treatment, patients require hearing restoration using prosthetics and other methods.

Labyrinthitis can also become chronic.

Symptoms

Labyrinthitis is characterized by vestibular disorders,

Impaired coordination, movement, balance.
Dizziness, often occurs in attacks, nystagmus.
Nausea, vomiting.
Increased sweating, pale face.
Tachycardia, bradycardia, other rhythm disturbances.
Hearing loss, the onset of complete deafness if the disease is advanced.

To make a correct diagnosis, the otolaryngologist must consult with a neurologist, traumatologist, and other specialists may be involved. Otoscopy, CT and X-ray are done, other studies are possible depending on the nature of the disease and what caused it.

How to treat labyrinthitis?

When treating labyrinthitis, the same complex of drugs is used as for other types of otitis. Only excluded local methods, as the lesion spreads inside the ear.

In case of labyrinthitis, it is important to stop dizziness; this is done with the help of vestibulolytics, for example, Bellataminal. In some cases, surgery is necessary if labyrinthitis is accompanied by complications. Operations are performed on the middle ear.

If you have lost your hearing during your illness, you need to consult a hearing specialist and an audiologist. Sometimes hearing restoration surgery is performed, and in some cases a hearing prosthesis is selected.

Important! Serious complications can be avoided by starting treatment in the early stages of otitis media.

Treatment of otitis at home

Otitis externa and media in the early stages can be successfully treated at home after consultation with your doctor; they do not require constant monitoring or surgical intervention. In addition, there are several home methods that will help alleviate the patient’s condition if it is not possible to immediately consult a specialist.

For otitis media and other ear diseases, you should not use suppositories; their effectiveness has not been proven; for inflammatory diseases, they can be dangerous. Also, during otitis, you should not heat your ear, as heat promotes the spread of infection.

Compresses on the ear

You can apply a compress at home; it helps with otitis media. To do this, moisten a cotton wool roll with vodka and wrap it tightly to your head, but there should be a little free space between the cotton wool and the ear itself. This compress needs to be kept for several hours, but you can do it at night.

It's important to remember that best treatment– conservative, with the help of medications. Therefore, seeing a doctor is extremely important.

Prevention

Often the occurrence of otitis depends on the person himself. It is especially important to follow the rules of prevention during diseases of the nasopharynx, respiratory tract, with them the development of otitis is most likely.

The use of drops with a vasoconstrictor effect during a runny nose, mandatory rinsing of the nose. When you have a runny nose, you should blow your nose carefully, without deep breaths so that the discharge does not rise higher.
Maintaining optimal air humidity. Often, too dry air leads to ear diseases.
Drinking plenty of fluids is especially important during illnesses accompanied by fever.
Be careful when taking antibiotics; incorrectly selected medications can cause ear diseases.
Proper ear hygiene. You should only clean the outer ear if you try to push cotton swab deeper, you can damage the eardrum or cause sulfur plug, which leads to the appearance of otitis media.

For any diseases of the nasopharynx, you should immediately contact an ENT specialist; the occurrence of otitis media is easier to prevent than to subsequently treat it.

Otitis – inflammatory disease ear, which may leak into various forms. The main cause of otitis is infection, most often of a bacterial nature. Therefore, the main medicine is usually...

Acute otitis media can occur at any age, but most often affects children. The main symptoms of otitis media are ear pain and general malaise. For this reason, the main treatment is pain control. Although spontaneous resolution is common, antibiotics may be needed in some cases.

Usually otitis media is divided into:

otitis externa - inflammation of the external auditory canal (inflammation of the outer ear);
Otitis media is an inflammation of the small cavity behind the eardrum (inflammation of the middle ear).

How does inflammation of the middle ear occur?

Normally, the middle ear cavity is filled with air. With the help of short muscular tubes, both middle ears communicate with the posterior parts of the nose, on the left and right, respectively. These tubes are called eustachian tubes. They are needed to constantly equalize the air pressure in the ear (ventilation).

During a cold, due to swelling or blockage of the Eustachian tubes, their ventilating function is disrupted. Negative air pressure in the ear increases, which causes the first symptoms. The middle ear cavity may fill with inflammatory fluid (exudate). Sometimes, this fluid can be infected with bacteria.

Inflammation of the middle ear can occur completely unexpectedly, without apparent reason, especially in young children.

Frequent symptoms of otitis media:

Ear pain is the most common symptom, but there may be no pain.
Fullness or feeling of pressure in the ear.
Increased body temperature (chills or fever).
General malaise, weakness, nausea.
Small children cannot point to sore ear: If the child is capricious, crying and has a fever, the child may have an inflammation of the middle ear.
In infants, vomiting may be a symptom of otitis media.

Frequent touching of the ears in infants, including when crying, are not a symptom of otitis media.

Sometimes the eardrum is pierced (perforation), accompanied by the appearance of discharge from the ear for several days. Often, with the appearance of discharge from the ear, the pain goes away or decreases. Healing of the membrane usually takes no more than two weeks after the infection disappears.

Ear pain is a common symptom of otitis media, but not always the cause. ear pain in the ear itself, especially if the child looks healthy and active with pain in the ear. Sometimes the cause of ear pain is inflammation elsewhere: in the throat, nasopharynx, inflammation or stone salivary gland, damage to the larynx, tongue or esophagus, arthritis of the temporomandibular joint and other causes.

What treatment is indicated?

Typically, acute otitis media goes away on its own within a few days after its onset. The immune system, in most cases, is able to get rid of infectious pathogens without specific therapy. After recovery, the ear cleanses itself through the Eustachian tube.

Painkillers

If there is pain in the ear, you need to use painkillers:

local anesthetics containing lidocaine (for example, Otipax ear drops);
paracetamol (Calpol, Panadol, Eferalgan, etc.);
ibuprofen (Nurofen, etc.).

In addition, these medications (except local ones) may be recommended to reduce body temperature.

If antibiotics are prescribed, continue taking the pain medication until the ear pain goes away.

Antibiotics

Antibiotics are not needed in most cases, because... the infection disappears on its own after 2-3 days thanks to immune system. If you take antibiotics unnecessarily, unwanted side effects may occur. side effects: rash, diarrhea, formation resistant strains microbes

You may need an antibiotic if:

child under 2 years old, because at this age, complications from acute otitis media are more common;
the disease is severe;
there is no improvement after 2-3 days or complications have appeared.

As a rule, when ear inflammation occurs, the doctor prescribes a pain reliever for 2-3 days to improve well-being. If there is no improvement, based on the results of a re-examination, it may be recommended antibacterial therapy.

If a re-examination is not possible, for example, the doctor's day off or other circumstances, the doctor may leave a prescription for an antibiotic with a recommendation to begin treatment if there is no improvement after 2-3 days.

What are the possible complications?

Inflammation of the middle ear is characterized by the appearance of fluid (mucus, exudate) behind the eardrum, causing temporary hearing loss. Typically, the ear cleans itself during the healing phase. From the moment the ear is cleansed, hearing returns to normal. If exudate remains in the ear for a long time, it can gradually thicken, which leads to the formation of chronic exudative otitis media- “sticky ear”. If the feeling of ear congestion persists for a long time, you should consult a doctor.

Another possible complication is the formation of perforation of the eardrum. As a rule, the perforation closes spontaneously, i.e. without treatment, after a few weeks. If perforation persists for a long time, it may be necessary surgery to restore the integrity of the membrane.

In an ordinary, initially healthy child, complications from acute otitis media are unlikely. Rare severe complication - spread of infection to the temporal bone of the skull is called mastoiditis. Even more rarely, the infection spreads deeper, which can damage the inner ear or spread into the skull to form a lesion inside the brain. If your child's condition worsens after 2-3 days or new symptoms appear, contact your doctor.

Can otitis media happen again, and is there any prevention?

Most people experience two or more episodes of otitis media during childhood. In most cases, there are no preventive measures.

There is evidence that otitis media occurs less frequently in children breastfeeding and in children living in non-smoking families.

The doctor may recommend prophylactic long courses of antibiotics in case of frequent relapses, for example, several episodes of otitis media following one another. In addition, in case of very frequent relapses, bypass surgery of the middle ear or ears (installation of small tubes in the eardrums) may be necessary. The same tubes are used to treat prolonged exudative otitis media.

Many people believe that otitis (inflammation) of the middle ear usually occurs in children. This is actually true; children suffer from it more often due to physiological characteristics. However, adults are not protected from danger either. Moreover: diseases of the hearing organs transferred to early age, can develop into a chronic form, which is dangerous not only due to a deterioration in the quality of life.
Otitis media is an ENT disease that develops in the middle part of the ear. To understand what is happening pathological processes, it is important to remember how this part of the auditory organ works.
There is a tympanic cavity in the middle ear. There are the stapes, anvil, and malleus, which transmit sound vibrations. Through the Eustachian tube, the cavity connects to the nasopharynx. It is in these parts that all pathological changes occur.

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Spread of the disease

Otitis (inflammation) of the middle ear – enough frequent illness. Its acute form is diagnosed in 25–30% of cases among other pathologies of ENT organs. The prevalence together with the external one ranges from 0.1–4.6% of total number population. Doctors note an upward trend in the number of cases.

Otitis media suffered in childhood leads to hearing loss in adulthood in a quarter of cases.

Origin

More often than others, otitis media (inflammation) of the middle ear is diagnosed with the filling of the tympanic cavity with infected fluid. U healthy person The fluid is removed through the Eustachian tube (auditory tube). But if inflammatory processes occur in the body - for example, flu, sore throat, then the mucous membrane of the nasopharynx and nose swell, and blockage of the auditory tube is likely. Depending on how otitis media develops, pus, mucus, etc. are released from the ear. They come out through the ruptured eardrum.

As inflammation decreases, the amount discharge is coming decreases and stops completely, the eardrum becomes scarred. But I'm sick until full recovery feels hearing loss.

Types of otitis

According to the nature of the flow, acute and chronic otitis media middle ear.

Spicy

There are three stages:

Catarrhal, or initial;
purulent (pre-perforative, perforative);
reparative – final.

With improper therapy, acute otitis media turns into chronic.

Chronic

Takes the following forms:

Purulent– has a bacterial nature, the body is affected by several bacteria at the same time;
exudative– develops after long-term dysfunction of the Eustachian tube;
adhesive– occurs after multiple repetitions of acute inflammation, untreated exudative otitis media.

Causes

Acute otitis media

There is an opinion that the acute form of otitis media occurs due to cold, dirty water, got into the ear. But it is not so. Direct relationship These factors do not contribute to the development of the disease.

The main reasons are:

Attack of bacteria (pneumococci, Haemophilus influenzae, etc.) entering through the auditory tube during various ailments other ENT organs, including due to improper blowing of the nose through both nostrils;
difficulty opening the auditory tube and deterioration of air ventilation due to a deviated nasal septum, diseases, developing nearby with pipe holes, etc.;
injury to the eardrum and infection through the blood - for example, if a person is sick with the flu.

Chronic

Its development is led by:

Ignoring otitis media or improper treatment;
scars on the eardrum due to frequent relapses;
disruption of the normal activity of the Eustachian tube;
infections - for example, scarlet fever.

Risk factors also include:

The presence of chronic infections: , , etc.;
inability to breathe through the nose, for example, due to defects of the nasal septum, which causes pressure problems;
diabetes;
decreased immunity (AIDS, etc.);
chemotherapy;
bad habits – smoking, alcohol abuse;
poor social and climatic living conditions;

They also provoke chronic otitis media low temperatures, , dirty water.

The main symptoms of otitis media in adults

Symptoms may appear on one or both sides. In the first case they speak of unilateral otitis media, in the second - of bilateral otitis media. Chronic and acute form have some general symptoms, but they still appear with some differences.

Spicy

Pain in the ear, behind the ear, sometimes it is felt in the back of the head, temple, and radiates to the teeth. It is felt constantly or from time to time, it can be pulsating, pulling;
the patient complains of ear congestion, hearing loss;
lymph nodes enlarge and become painful;
discharge is observed. At the perforated stage they are abundant, with mucus and pus, and sometimes with traces of blood. As the disease develops, they become denser and their number decreases;
sometimes the symptoms spread to other organs - nasal congestion, discharge from it, and discomfort in the throat;
the acute course is accompanied by intoxication of the body, as evidenced by weakness, temperature above normal, nausea, etc. If the temperature drops after perforation of the membrane, inflammation spreads to the mastoid process.

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Chronic

It is characterized by the following manifestations:

The flow of pus is constant or episodic, becoming more active during exacerbation. The presence of blood usually indicates that granulation tissue or polyps are growing in the tympanic cavity. In some cases, the discharge smells unpleasant, which indicates bone destruction;
conductive hearing loss caused by decreased mobility auditory ossicles. With a long process, mixed hearing loss develops, which leads, in particular, to impaired blood circulation in the cochlea;
tinnitus due to ongoing pathological processes;
the pain syndrome is moderate in nature and appears only during exacerbation, provokes it viral infection, diseases of the ENT organs, water getting into the ear;
the acute period may be accompanied by a sensation of pulsation and twitching in the affected ear;
dizziness;
with advanced pathology, the mobility of facial muscles is impaired;
headache accompanies complications (spread of inflammation to the membranes of the brain).

Diagnostics

The basic diagnostic methods for both forms are the same. They include the following activities:

Analysis of the patient’s complaints and medical history: it is found out which symptoms indicate otitis media, whether there were any before, whether the patient breathes freely through his nose, whether there are others chronic diseases, influenza, ARVI;
examination of the ear using special instruments - otoscope, otomicroscope, endoscope: the condition of the eardrum is examined - the presence of redness, bulging, rupture, retraction (retraction pockets), etc., it is determined whether there is pus. A hearing test is carried out using tuning fork tests - the causes of deafness are determined, audiometric – its degree;
tympanometry is relevant when the eardrum is intact. This method evaluates the mobility of the membrane, the pressure in it, and determines the presence of scars and exudate. Purulent forms require bacteriological tests that identify the pathogen and determine its susceptibility to drugs.
computed tomography, abbreviated CT, of the temporal parts allows to identify complications and the depth of pathology, damage to bone tissue, the presence of neoplasms;
vestibular tests reveal the degree of dizziness and the ability to maintain balance;
In some cases, an examination by a therapist is necessary.

How to treat otitis media?

Treatment depends not only on the form of otitis media, but also on the stage. It is important to remember that during this period it is necessary to prevent water from entering the sore ear, for which it is filled with cotton wool soaked in oil during water procedures. When choosing drops, you must carefully study their composition: the presence of ototoxic components can cause permanent hearing loss.

Physiotherapy methods are popular and effective - iontophoresis using iodine, bromine, calcium, zinc, furatsilin, UHF, paraffin therapy, actinotherapy (infrared and ultraviolet radiation lamps are used), eardrum massage.

Spicy

At the beginning of the disease, without the formation of purulent secretion, warm compresses are applied to the area near the ear. Such treatment is prohibited when pus is discharged. If the eardrum is intact, ear drops with an anesthetic effect are indicated, and after it has ruptured - drugs with antibiotic action. Vasoconstrictor nasal sprays indicated. If acute otitis media is caused by or, they are treated in parallel.

As a rule, antibacterial therapy is not carried out for the first 2–3 days; only after this period a decision is made on its use. But some conditions require the mandatory prescription of antibiotics, namely:

Severe form of the disease;
severe concomitant diseases;
immunodeficiency.

If the eardrum has not ruptured and there is pus inside, they resort to surgical intervention- piercing the membrane. This will not only eliminate the pain, but also make it easier for the medications to get inside. They also resort to blowing out the auditory tube.

Chronic

Before treating this form of ear disease, it is necessary to eliminate the foci chronic infection Vother ENT organs, .

If an exacerbation occurs, carry out conservative therapy. It includes having your ear washed by a doctor and using antibiotics in the form of ear drops.
The main treatment is surgical. If the eardrum has a defect, it is covered with cartilage from the tragus.

Shunting of the membrane (placement of a tube) is carried out in the case of chronic exudative otitis media of the middle ear. Through a shunt, which the patient wears for several months, the contents of the tympanic cavity are removed and medications are administered.

In the adhesive form, scars are excised and the membrane is replaced artificial material, which can also be grown from the patient's cartilage.

Forecast

Otitis media of the middle ear is a rather serious disease, if timely treatment is not provided medical care the patient's death is possible. The complications that accompany it include:

Mastoiditis is a lesion of the mastoid process, localized in the temporal part;
, encephalitis;
inflammation of the facial nerve, which leads to disruption of the symmetry and mobility of the facial muscles;
otogenic sepsis – infection through the blood of other organs;
formation of blood clots in the membranes of the brain;
cholesteatoma is a neoplasm that grows into the tympanic cavity through damage and has a destructive effect on nearby tissues, including bone;
hearing loss up to complete deafness.

Prevention methods

Can an adult avoid otitis media? No one can give a complete guarantee against illness. But you can always reduce risks. Preventive measures that will allow this to be achieved include:

Timely request for medical assistance and compliance with all doctor’s recommendations without exception;
treatment of chronic ailments, especially ENT organs;
correction of nasal breathing;
correction of conditions associated with a decrease in the body’s defenses - diabetes, AIDS, etc.;

hardening, which allows you to strengthen the body and its resistance to viruses and infections;
proper nutrition and management healthy image life.

At the first symptoms of otitis (inflammation) of the middle ear, it is important to immediately consult a doctor - an otolaryngologist or therapist. You cannot self-medicate, use drops yourself, or heat the sore ear. This is not only about the loss of something important to normal life a person’s feelings - hearing, but also about a serious danger to life.