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

Otitis media is an acute infectious disease with specific symptoms. The disease must be treated, as it is dangerous with the development of complications. Not a single person is immune from the disease, therefore 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 proceeds in the form of acute or chronic inflammation. Pathology develops as a result of hit pathogenic microorganisms into the Eustachian tubes, and from there into the middle ear.

Causes:

ear infection with bacteria or viruses;
complication after influenza or SARS;
inflammation of the nasopharynx;
sinusitis;
mechanical damage ear.

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

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

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

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

Symptoms and signs of the disease

Otitis media refers to inflammatory diseases with acute onset and rapid onset of symptoms.

Classic clinical picture:

heat and fever;
sharp "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 peculiarity of the structure of ENT organs, the work of which is closely interrelated. Otitis media can be due to inflammation maxillary sinuses or rhinopharyngitis, 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, an accumulation of exudate occurs. By the type of this liquid, otitis media subdivided into purulent and catarrhal.

In the overwhelming majority of cases, cocci (staphylococcus, pneumococcus) and other opportunistic microorganisms become the cause of ear inflammation. Their activation is due to a decrease in immune defense, or proceeds against the background of severe inflammatory processes of the nasopharynx. The reasons for the 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 rise in body temperature and pain. The main signs of the disease are severe pain and high body temperature. The surrounding tissues can be involved in the pathological process, which leads to the spread pain syndrome all over the affected part of the head.

A characteristic feature of acute inflammation is a 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 or 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, 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 syndrome and an increase in temperature to subfebrile values. At the same time, there is aseptic inflammation of the middle ear, loud 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 is worse when swallowing and when trying to blow your nose to clear your nose. The body temperature rises to 39-400 C. After some time, the tympanic membrane 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 purulent masses are removed.

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

Chronic otitis media

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

Each time the tympanic membrane ruptures to drain the purulent contents from the middle ear to the outside, a small perforation is formed. Over time, it tightens, but a scar appears in its place. In the case of chronic otitis media, these scars become inflamed or do not heal completely due to a 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 resolve when the eardrum is restored. Chronic otitis media can lead to irreversible hearing impairment, but we are talking about weakening, but not complete loss the ability to hear.

Diagnostic measures

There are no problems with the diagnosis. It is enough for an experienced doctor to interview the patient and examine the ears with an endoscope and an otoscope to suspect the cause of the ailments. To confirm availability purulent inflammation X-ray is prescribed temporal bone or performing a computed tomography.

Treatment of otitis media in adults at home

Otitis media should be treated on an outpatient basis. The therapy regimen depends on the form and stage of the inflammation. In the absence of purulent discharge, therapy is carried out local funds using ear drops... In the presence of an abscess, antibiotic therapy is prescribed. Alternative methods of treatment also take place, but they are recommended to be used as an auxiliary, and not the main therapeutic agent.

Chronic otitis media 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 antiseptic and antibacterial drugs in the form of drops.

Popular medicines:

Sofradex;
Tsipromed;
Otipax;
Normax.

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

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

Otipax is an analgesic and anti-inflammatory agent. The drug contains phenazone and lidocaine. Drops are used for acute otitis media to reduce pain. With severe suppuration, the drug is combined with antibiotics. The tool is allowed to be used 4 drops 4 times a day.

Normax is an effective antimicrobial agent based on 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

With otitis media, antibacterial drugs of a wide spectrum of action are used. The combination of ear drops with antibiotics in tablets helps to minimize the risks of complications and the transition of the disease to chronic form.

Most often, drugs of the following groups are prescribed:

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

The first line drugs are penicillins. Amoxicillin, Amoxiclav or Augmentin is prescribed. Fluoroquinolones are antimicrobial agents a 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 the course of antibiotic treatment is selected individually for each patient.

Treatment with folk remedies

Alternative treatment of otitis media is an extremely dubious measure that cannot replace a conservative drug therapy... Such methods can be used as additional, but only after consulting a doctor. It is important to remember that wrong treatment otitis media can lead to hearing loss.

Mix in equal proportions Dimexide and solution 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, pour over a glass hot water and boil for 20 minutes. Then cover with a lid, wrap with a towel and leave to infuse for another two hours. The remedy is taken in a tablespoon three times a day, at the same time instilling 2-3 drops into the inflamed ear.
When the eardrum breaks out 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 media into a chronic disease.

The only one folk method used in modern medicine Is hydrogen peroxide. The tool has a number of limitations, and in rare cases it can provoke the development of complications, but it really effectively clears pus and prevents it from re-accumulating. However, it is recommended that you consult your doctor before using peroxide.

Possible complications of the disease

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

Complications are characteristic of the advanced chronic form of the disease and are manifested:

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

Timely detected otitis media is quite successfully treatable. It usually takes about one week to heal otitis media. Pain and discomfort disappear on the second day after the start of drug therapy.

Prevention of the appearance of otitis media

Otitis media in adults is often the result of nasal breathing problems. This may be due to chronic inflammation maxillary sinuses or curvature of the nasal septum. Otitis media can only be prevented by timely treatment of these disorders.

It is also important to prevent weakening of the immune system and to treat any viral and infectious diseases in a timely manner.

Otitis media is general type a definition that implies ear inflammatory diseases. Otitis media, the symptoms of which, respectively, are associated with inflammation, is for the most part a disease noted in children, it often occurs against the background of exposure to an infection that has entered the middle ear; ear injury or allergies can provoke otitis media somewhat less often.

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 up them. Nature has reliably provided the protection that ears require. So, the main part of these organs is located in the temporal bone, communication with the outside world is provided thanks to a pair of canals in the form of the external auditory canal and the Eustachian tube.

The ear canal (external) ends blindly, eardrum acts as a barrier to him and the middle ear cavity. The auditory tube acts as an element that provides communication between the nose and the middle ear cavity. Apart from ventilation as one of its functions, this tube is responsible for distributing pressure in such a way that it is equal to both sides of the eardrum. It is extremely important function, because it is due to it that the required sound conduction is provided.

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

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

Otitis reasons

The main causes of otitis media are the following:

, in which the nasal mucosa is damaged, against the background of which there is a blockage of the outlet area in the auditory tube. 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 vegetation.
Development of otitis media as a result of diving and surfacing by submariners, divers (or mareotitis).
Development of otitis media against the background of sharp changes in atmospheric pressure, which are relevant during the ascents / descents of aircraft (which is defined as aerootitis).
Lowered immunity as a result of changes in the seasons, exposure to stress different types and scale.

Otitis media: symptoms

Based anatomical features, otitis media can manifest itself in accordance with the classification of its varieties as otitis externa, otitis media and otitis interna. On the basis of this classification, accordingly, violations of the functions of a particular department are determined.

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

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

Gain Explained pain joint pressure lower jaw... In general, the condition of patients changes slightly, in some cases it is possible subfebrile temperature... As a rule, the opening of the boil occurs spontaneously, after it has matured completely. This outcome provides an improvement in well-being. By the way, at this current diseases, hearing of patients is not negatively affected.

External (diffuse) otitis media. Mostly this form of otitis media begins to develop as complications against the background of purulent chronic otitis media. Their cause is continuing education purulent discharge in the affected tympanic membrane, as well as infection of tissues in the ear canal. The manifestations of this form of otitis media are reddening of the ear canal and the appearance of pain in this area. In some cases, diffuse otitis media (diffuse otitis media) is provoked by skin irritation that occurs in the area of the ear canal under the influence chemical substances or under the influence of mechanical injury, accompanied by the addition of infection.

Most often, the middle ear is inflamed, which is defined as tubo-otitis (or eustachitis). You can familiarize yourself with this disease in more detail in the section "Otolaryngology" on our website in the article, now we will briefly dwell on the main provisions of the symptomatology.

Tubo-otitis as a disease consists of inflammation auditory tube, and it is this pipe that first of all reacts to the process of penetration of infection, which manifests itself in the form of redness and swelling. As a rule, this is accompanied by the closure of the lumen against the background of the influence 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 itself 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 a doctor, the inflammation of the middle ear cavity in the complex is captured by inflammation. This, in turn, leads to the appearance of pain in the ear, which has a shooting character and radiates to the area of the lower jaw, neck and temple. The temperature rises significantly, hearing falls, which occurs as a result of the formation of exudate in the middle ear cavity, subsequently it becomes purulent.

By 3-4 days of the course of the disease, development begins next stage in the inflammatory process, in which, as a result of the action of pus, a hole appears in the eardrum (which is defined as perforation) and already through this hole the exudate enters the external auditory canal. In other words, at this stage, the patient will notice that fluid comes out through his ear canal from the side of the lesion. 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 consistency density with the simultaneous formation of fibrin threads in it, adhesions with scars begin to form. Because of the scars in this case, there is a difficulty in normal functioning inherent in the ossicles, this, in turn, can lead to permanent hearing impairment.

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

Diagnosis

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

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

Otitis media treatment

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

Otitis media treatment follows certain rules, focused on the following:

reduction of pain sensations;
reduction of puffiness;
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 to combat infections localized in the middle ear;
local treatment using compresses and certain hygiene measures;
surgical intervention (a method of bypassing the tympanic cavity, in the absence of effectiveness, the tympanic membrane is cut, which is defined as paracentesis).

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

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

To diagnose otitis media, it is necessary to contact the attending pediatrician (therapist), subsequently, consultation and treatment with an otolaryngologist (ENT) will be required.

Otitis media is an inflammation of the ear that can be localized inside or outside. In terms of severity, otitis media are different, they are often found in children. Often this disease is caused by microbes or viruses, this disease is usually infectious in nature. The otitis media code according to ICD is 380.10.

Usually, otitis media can accompany colds, runny nose and cough. Ear disease can become chronic, possibly damage to the eardrum, which threatens frequent inflammation and hearing problems if treatment is not started on time and the disease is started.

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.
Trauma, mechanical damage to the auricle.
Ingress of water, especially contaminated water, into the ear.
Improper ear hygiene leading to waxy plugging and damage to the tympanic membrane.
Hypothermia.
Features of the structure of the ear canal.

In some cases, the reasons can be combined.

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

Limited. It is characterized by the appearance of boils, an 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 with water entering the ear, especially dirty water. Therefore, swimmers often encounter diffuse otitis externa.

External form - often a complication of the flu and other strong colds... Sometimes it can be caused by fungus, allergies, seborrhea, dermatitis, and others skin diseases.

Otitis externa symptoms

The symptoms of this disease can be similar to those of an internal or intermediate form, so the correct diagnosis can only be made after a doctor's examination.

Otalgia - ear pain. It can be different in character.
Changes auditory perception, up to a severe loss temporarily.
Congestion, pressure in the ear.
Noise, ringing, itching in the ears.
Various discharge, most often purulent.
Pain when pulling and touching auricle – distinctive feature it is the outer form.

On examination, the doctor will notice swelling, contamination of the ear canal, and inflammation of the tympanic membrane.

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

Important! It is impossible to independently open the boils formed with otitis media.

Antibiotics They are prescribed if the 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 an increase in temperature and severe pain... Usually drugs based on ibuprofen, aspirin or paracetamol are used.
Drops in the ears. They often already contain corticosteroids or antibiotics. Normaks, Candibiotic, Otinum, Otofa and others are widespread.
Ointments. They are used for the speedy healing of damaged, inflamed areas. For example, Levomekol, Triderm.
UFO therapy and UHF therapy. Physiotherapy accelerates recovery and enhances the effect of drugs.

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

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

There are several stages acute illness, each symptom is different.

Acute eustacheitis. At this stage, there is a congestion in the ear, noise, the temperature rises only if there is an infection.
Acute catarrhal inflammation. There is a sharp severe pain, the temperature rises, an inflammatory process in the ear is observed.
Stage of purulent inflammation. The pain reaches its peak, it can give to the teeth and other parts of the head. Hearing decreases. The inflammation is noticeable on blood tests.
Postperforative stage. The pain decreases, the temperature drops, while congestion and deafness remain, exudate is released from the ear.
Reparative stage. The inflammation subsides, the damage to the tympanic membrane is closed with a scar.

Important! Treatment should start 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 threatens with inflammation of the brain or meningitis. Therefore, it is advisable to consult a doctor in any situation.

How is otitis media treated?

Treatment must necessarily take place under the supervision of the attending physician, it is important to establish the nature of the disease and the extent of the lesion. Recommended anyway bed rest and rest, otherwise the risk of complications increases. Also, the doctor must cleanse the ear canal of secretions. The main treatments for otitis media are as follows.

Antibiotic use. This is important during acute otitis media. Usually use Amoxicillin or Amoxiclav, otherwise Sumamed or Rovamycin. Antibiotics are used in pill form, if complications develop, intramuscular or intravenous administration is possible.
Preparations for relieving inflammation and pain. Usually these are pain relievers and antipyretics based on ibuprofen, aspirin, paracetamol.
Drops. At medium form 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 in the nose in the presence of edema. Apply vasoconstrictors, for example, Nazol or Naphthyzin.
Drugs that enhance immunity. These include vitamins and vitamin complexes, can be in pill or injection form.
Physiotherapy - electrophoresis or UHF.

In rare cases, surgery is required. With otitis media, it is strictly forbidden to warm the ear, this contributes to the spread of infection.

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

Internal otitis media - labyrinthitis

Labyrinthitis is an inflammation in the inner ear that occurs when an infection with 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 with the help of prosthetics and other methods.

Labyrinthitis can also become chronic.

Symptoms

Labyrinthitis is characterized by vestibular disorders,

Impaired coordination, movement, balance.
Dizziness, often attacks, nystagmus.
Nausea, vomiting.
Increased perspiration, pallor of the face.
Tachycardia, bradycardia, other rhythm disturbances.
Hearing loss, the onset of complete deafness if the disease is started.

For the correct diagnosis, the otolaryngologist must consult with a neurologist, traumatologist, 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 is labyrinthitis treated?

In the treatment of labyrinthitis, the same complex of funds is used as in other types of otitis media. Excluded only local methods as the lesion spreads inside the ear.

With 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 the labyrinthitis is accompanied by complications. Operations are performed on the middle ear.

If during the illness you have lost your hearing, you need a consultation with a hearing aid and audiologist. Sometimes a hearing restoration operation is performed, in some cases a hearing prosthesis is selected.

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

Otitis media treatment at home

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

With otitis media and other ear diseases, you should not use suppositories, their effectiveness has not been proven, in inflammatory diseases they can be dangerous. Also, during otitis media, you should not warm your ear, heat contributes to the spread of infection.

Ear compresses

At home, you can apply a compress, it helps with otitis media. To do this, moisten a cotton wool roller with vodka and tie it tightly to the head, but there should be some free space between the cotton wool and the ear itself. Such a compress needs to be kept for several hours, you can do it at night.

It is important to remember that best treatment- conservative, with the help of medication. Therefore, it is extremely important to see a doctor.

Prophylaxis

Often the occurrence of otitis media 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 media is most likely.

The use of drops with a vasoconstrictor effect during a runny nose, obligatory rinsing of the nose. With a runny nose, blow your nose gently, without doing deep breaths so that the selection does not rise higher.
Maintaining optimal air humidity. Too dry air often leads to ear problems.
Drinking plenty of fluids is especially important during illness, accompanied by a rise in temperature.
Accuracy when taking antibiotics, improperly selected medications can provoke ear diseases.
Correct ear hygiene. You should only clean the outer ear if you try to push through 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 the ENT, the occurrence of otitis media is easier to prevent than to subsequently treat it.

Otitis media - inflammatory disease ear that can leak into different forms... The main cause of otitis media is infection, most often of a bacterial nature. Therefore, the main medicine is usually ...

Acute otitis media can occur at any age, but children are more likely to suffer from it. The main symptoms of otitis media are ear pain and general malaise... For this reason, pain control is the main treatment. Despite frequent spontaneous self-healing, antibiotics may be needed in some cases.

Otitis media is usually divided into:

otitis externa - inflammation of the external auditory canal (inflammation of the external ear);
otitis media - inflammation of a small cavity behind the tympanic membrane (inflammation of the middle ear).

How does middle ear inflammation occur?

Normally, the middle ear cavity is filled with air. With the help of short muscle 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 edema or blockage of the Eustachian tubes, their ventilatory function is impaired. Negative air pressure builds up in the ear, which causes the first symptoms. The middle ear cavity may fill with an inflammatory fluid (exudate). Sometimes, this fluid can become infected with bacteria.

Middle ear inflammation can occur unexpectedly without apparent reason especially in young children.

Common symptoms of otitis media:

Ear pain is the most common symptom, but pain may not be present.
Congestion or 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 moody, cries and has a fever, the child may have middle ear inflammation.
In infants, vomiting may be a symptom of otitis media.

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

Sometimes there is a perforation of the tympanic membrane (perforation), accompanied by the appearance of discharge from the ear for several days. Often, with the appearance of a discharge from the ear, pain disappears or decreases. It usually takes less than two weeks for the web to heal after the infection has cleared.

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 ear pain. Sometimes ear pain is caused by inflammation elsewhere: in the throat, nasopharynx, inflammation, or a stone salivary gland, damage to the larynx, tongue or esophagus, arthritis of the temporomandibular joint and other causes.

What treatment is indicated?

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

Pain medications

If there is pain in the ear, pain relievers should be used:

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

In addition, these medicines (other than topical ones) can be recommended to reduce body temperature.

If antibiotics are prescribed, continue to take the pain reliever until the ear pain disappears.

Antibiotics

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

An antibiotic may be needed if:

a child under 2 years old, because at this age, complications are more common in acute otitis media;
the disease is difficult;
no improvement after 2-3 days or complications appear.

As a rule, when ear inflammation occurs, the doctor prescribes an anesthetic for 2-3 days to improve your well-being. If there is no improvement, according to the result of a second examination, it can be recommended antibiotic therapy.

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

What are the possible complications?

Middle ear inflammation is characterized by the appearance of fluid (mucus, exudate) behind the eardrum, causing temporary hearing loss. Usually, the ear cleans itself on its own during the healing phase. From the moment the ear is cleansed, hearing is normalized. With prolonged presence of the exudate in the ear, it can gradually thicken, which leads to the formation of a chronic exudative otitis media- "sticky ear". If ear congestion persists for a long time, see a doctor.

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

A normal, initially healthy child is unlikely to develop complications in acute otitis media. Rare severe complication - spread of infection to The temporal bone of the skull is called mastoiditis. Even less often, the infection spreads deeper, which can damage the inner ear or spread into the skull to form a lesion within the brain. If your child's condition worsens after 2 to 3 days or new symptoms develop, see your doctor.

Can otitis media recur 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 with 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 after another. In addition, middle ear or ear bypass surgery (placing small tubes in the eardrums) may be necessary for very frequent recurrences. The same tubes are used to treat prolonged exudative otitis media.

Many believe that otitis media (inflammation) of the middle ear is common in children. This is actually the case, babies suffer from it more often due to physiological characteristics... However, adults are not immune from danger either. Moreover: diseases of the hearing organs transferred to early age, can develop into a chronic form, which is dangerous not only with a deterioration in the quality of life.
Otitis media is an ENT disease that develops in the middle ear. To understand what is going on pathological processes, it is important to remember how this part of the auditory organ is arranged.
The middle ear has a tympanic cavity. There is a stirrup, anvil, a hammer that transmit sound vibrations. Through the Eustachian tube, the cavity is connected to the nasopharynx. It is in these parts that all pathological changes occur.

In contact with

The spread of the disease

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

Otitis media, transferred in childhood, in a quarter of cases ends with hearing loss in adulthood.

Origin

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

As inflammation decreases, the amount discharge goes to decrease and completely cease, the eardrum is healed. But sick before complete recovery feels hearing loss.

Types of otitis media

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

Spicy

There are three stages:

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

With the wrong therapy, acute otitis media flows into chronic.

Chronic

It takes the following forms:

Purulent- has a bacterial nature, several bacteria act on the body at the same time;
exudative- develops after prolonged dysfunction of the Eustachian tube;
adhesive- occurs after repeated repetitions of acute inflammation, untreated exudative otitis media.

Causes

Acute otitis media

It is believed that the acute form of otitis media occurs due to cold, dirty water caught in 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 when various ailments other ENT organs, including due to improper blowing of the nose through both nostrils;
difficult opening of the auditory tube and deterioration of air ventilation due to a deviated nasal septum, diseases, developing nearby with pipe holes, etc.;
trauma to the eardrum and infection through the blood - for example, if a person has the flu.

Chronic

Lead to its development:

Ignoring otitis media or improper treatment;
scars on the tympanic membrane due to frequent relapses;
violation 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 in the nasal septum, due to which the pressure is disturbed;
diabetes;
decreased immunity (AIDS, etc.);
chemotherapy;
bad habits - smoking, alcohol abuse;
poor social and climatic living conditions;

Chronic otitis media also provoke low temperatures, , dirty water.

The main symptoms of otitis media in adults

Symptoms can appear on one or both sides. In the first case, they talk about unilateral, in the second - about bilateral otitis media of the middle ear. Chronic and acute forms have some general symptoms, but still they appear with some differences.

Spicy

Pain in the ear, behind the ear, sometimes it is felt in the back of the head, temple, and gives to the teeth. It is felt constantly or from time to time, it is 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 thicker, their number decreases;
sometimes the symptoms spread to other organs - there is a nasal congestion, discharge from it, discomfort in the throat appears;
an acute course is accompanied by intoxication of the body, as evidenced by weakness, temperature above normal, nausea, etc. If the temperature dropped after membrane perforation, inflammation has spread to the mastoid process.

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Chronic

It is characterized by the following manifestations:

The outflow of pus is constant or episodic, which is activated during an 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-type hearing loss caused by decreasing 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;
pain syndrome is moderate and manifests itself only with exacerbation, provokes it viral infection, diseases of the ENT organs, ingress of water into the ear;
the acute period may be accompanied by a feeling of pulsation and twitching in the affected ear;
dizziness;
with advanced pathology, the mobility of the muscles of the face is impaired;
headache accompanies complications (spread of the focus of inflammation to the membranes of the brain).

Diagnostics

The main diagnostic methods for both forms are the same. They include such activities:

Analysis of the patient's complaints and anamnesis: it turns out which of the symptoms indicates otitis media, whether they were before, whether the patient breathes freely through the nose, whether there are others chronic diseases, flu, ARVI;
examination of the ear using special instruments - an otoscope, an otomicroscope, an endoscope: the condition of the tympanic membrane is examined - the presence of redness, swelling, rupture, retraction (retraction pockets), etc. audiometric - its degree;
tympanometry is relevant for intact tympanic membrane. This method assesses the mobility of the membrane, the pressure in it, the presence of scars and exudate is determined. Purulent forms require bacteriological tests that identify the pathogen and determine its susceptibility to drugs.
computed tomography, abbreviated CT, of the temporal parts allows you 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 is otitis media treated?

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 exclude the ingress of water into the sore ear, for which it is laid with cotton wool soaked in oil during water treatments... When choosing drops, it is necessary to carefully study their composition: the presence of ototoxic components can cause permanent hearing loss.

The methods of physiotherapy are popular and effective - iontophoresis using iodine, bromine, calcium, zinc, furacilin, 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 secretions, warming compresses are applied to the area near the ear. Such treatment is prohibited when pus is secreted. With an intact tympanic membrane, ear drops with an analgesic effect are shown, and after it has broken through - antibiotic drugs. Vasoconstrictor nasal sprays are shown... If acute otitis media is caused by or, they are treated in parallel.

As a rule, the first 2-3 days antibiotic therapy is not carried out, only after this period a decision is made to use it. But some conditions require the mandatory prescription of antibiotics, namely:

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

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

Chronic

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

If there is an exacerbation, carry out conservative therapy... It includes flushing the ear with a doctor, using antibiotics in the form of ear drops.
The main treatment is surgery. If the eardrum is defective, it is covered with tragus cartilage.

Membrane shunting (tube placement) is performed in the case of chronic exudative otitis media of the middle ear. Through the shunt, which the patient wears for several months, the contents of the tympanic cavity are brought out, and medications are injected.

With an adhesive form, scars are excised, 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 ailment, if timely medical care death of the patient is possible. The complications that accompany it include:

Mastoiditis - damage to the mastoid process, localized in the temporal part;
, encephalitis;
inflammation of the facial nerve, which leads to a violation of the symmetry and mobility of the facial muscles;
otogenic sepsis - infection through the blood of other organs;
the formation of blood clots in the membranes of the brain;
cholesteatoma - a neoplasm that grows into the tympanic cavity through its 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? Nobody can give a full guarantee against illness. But you can always reduce the risks. Preventive measures that will allow this to be achieved include:

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

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

At the first symptoms of otitis media (inflammation) of the middle ear, it is important to immediately consult a doctor - an otolaryngologist or therapist. You can not self-medicate, use drops on your own, warm a sore ear. It's not just about losing what's important to normal life a person's feelings - hearing, but also about a serious danger to life.