Sometimes acoustic neuritis is called sensorineural hearing loss, but this is incorrect. Sensorineural hearing loss is a hearing loss caused by damage to the nervous system, and acoustic neuritis is one of its causes.
The worldwide prevalence of hearing loss caused by damage to the auditory nerve is approximately 6%. The disease is most common among people over 55 years of age. Men are more often affected.
Acoustic neuritis and its consequences are more common in large cities than in rural areas. This is due to the fact that in the city the human ear is constantly exposed to background noise, which is much stronger than the natural noise that the ear is accustomed to.
Most often, young or middle-aged people with acoustic neuritis consult a doctor. Older people often do not give due importance to hearing loss and believe that this is normal for their age.
Anatomy and physiology of the auditory nerve
The auditory nerve originates from hair cells that are located in the inner ear. Hair cells are essentially nerve receptors: they perceive vibrations of the fluid filling the inner ear and generate nerve impulses.The impulse generated by the hair cells is carried to the brain by the auditory nerve, which exits into the cranial cavity through an opening in the temporal bone.
First, the auditory nerve enters the brain stem, where the primary, unconscious perception of sound occurs. The nerve signal then travels from the brainstem to the temporal lobes of the cerebral cortex, where it is recognized, processed by the conscious mind, and compared with other sensations. A person recognizes a sound and its source.
Anatomically, acoustic neuritis affects one of three structures:
- hair cells;
- auditory nerve;
- nerve centers in the brain stem (subcortical hearing centers).
Head injury
During a traumatic brain injury, pathological changes occur in the cranial cavity:- circulatory disorders;
- swelling, which varies depending on the severity of the injury;
- pinpoint microscopic hemorrhages from capillaries or more massive ones from cerebral arteries.
Occupational hazards
Acoustic neuritis is an occupational disease for people who have the following occupational hazards at their workplace:- Constant exposure to high noise conditions: work in workshops where presses and other equipment are installed that make a lot of noise. Typically, neuritis of the auditory nerve, and then hearing loss in these cases, develop gradually over time, with constant regular exposure to noise.
- Acoustic trauma- acute impact on the ear of a loud sound. This is a short, loud sound that causes a strong increase in pressure in the ear and injury. A shot, whistle, etc. can act as a traumatic agent.
- Effect of vibration on the body. Acoustic neuritis and hearing loss are manifestations of vibration disease. Its other symptoms: increased fatigue, headaches and dizziness, poor circulation in the hands and feet (pallor, coldness, pain, tingling and other unpleasant sensations).
Age-related changes in the body
A higher prevalence of acoustic neuritis among older people is associated with:- Arterial hypertension, hypertension. Poor circulation in all organs and systems is a typical complication of high blood pressure. When the auditory nerve stops receiving enough blood, inflammation develops.
- Poor circulation in the arteries of the brain. Most often it is caused by atherosclerosis and thrombosis of cerebral vessels as a result of their age-related changes.
- Age-related changes in the hearing aid- most often occurs at the age of 60–70 years and is a natural phenomenon of aging of the body.
- Consequences of a stroke.
Other reasons
In relatively rare cases, acoustic neuritis develops due to allergic reactions. It can be a consequence of barotrauma (trauma caused by a sudden change in pressure), for example, in divers with decompression sickness.Symptoms of acoustic neuritis
Characteristic symptoms of acoustic neuritis:- Hearing loss– associated with damage to the auditory nerve. The severity of hearing loss can vary widely from minor to complete loss. Usually there is a gradual decrease in the patient's hearing, which can lead to complete deafness. Timely contact with a specialist is an important factor in the successful treatment of this disease.
- Ringing or tinnitus- worries the patient constantly, regardless of external stimuli. In complete deafness there is no ringing.
- Dizziness and nausea, imbalance– these symptoms can occur if the inflammatory process simultaneously involves the vestibulocochlear nerve, which carries impulses from the balance organ to the brain.
- Acute ear pain - characteristic at the time of acoustic trauma, as a consequence of mechanical damage.
- Weakness, headache, pallor- may appear if toxic neuritis is caused by acute poisoning and the patient’s symptoms of general intoxication come to the fore. Nausea and dizziness in this case may worsen.
- Increased blood pressure, symptom of “floaters before the eyes”- are noted if, in addition to everything else, disorders of the cerebral vessels are added.
- Fever, general malaise, cough and runny nose- are possible only if infectious processes occur, such as influenza or ARVI.
The degree of sensorineural hearing loss is determined by an ENT doctor during a special study - audiometry:
- I degree - the patient hears only sounds that are louder than 26 - 40 dB. He can hear whispered speech at a distance of 1 - 3 meters and spoken speech at a distance of 4 - 6 meters.
- II degree - sounds quieter than 41 - 55 dB are not perceived. This corresponds to whispered speech at a distance of 1 meter and spoken speech at a distance of 1 to 4 meters.
- III degree - hearing impairment up to 56 – 70 dB. The patient does not hear whispers at all, but can perceive spoken speech at a distance of 1 meter.
- IV degree - hearing loss to 71 – 90 dB. It is diagnosed if the patient can fundamentally distinguish at least some sounds.
- V degree - complete deafness.
Treatment of acoustic neuritis
Treatment of auditory nerve associated with infectious diseases
Treatment of viral diseases is carried out with antiviral drugs, bacterial infections - with antibiotics. Only a doctor can adequately select antibacterial drugs after bacterial culture has been carried out and the sensitivity of microorganisms to antibiotics has been determined.In order to reduce the effect of viral and bacterial toxins on the auditory nerve, use:
- Vitamins, primarily ascorbic acid. It is a powerful antioxidant and prevents cell damage.
- Drinking plenty of fluids helps eliminate viral and bacterial toxins from the body through urine.
- The patient is prescribed rest; his nutrition during illness should be complete.
Treatment of auditory neuritis associated with intoxication
Treatment of chronic poisoning with various substances that lead to damage to the auditory nerve is a long and complex process, including the following points:- the use of special antidotes - substances that bind and remove the toxin from the body;
- symptomatic therapy - medications that help eliminate individual manifestations of intoxication;
- physiotherapy, balneotherapy, mineral baths, mud therapy, stay in sanatoriums.
- detoxification therapy aimed at removing toxins from the body: intravenous infusions of fluids, special antidotes;
- symptomatic therapy aimed at eliminating the manifestations of poisoning;
- vitamins, medications that protect nerve cells and improve their functions;
- if poisoning is accompanied by a state of clinical death, then resuscitation measures are carried out.
Skull injuries
Only timely treatment of traumatic brain injury will help prevent the development of auditory neuritis and other complications. It must be carried out in a hospital. The doctor prescribes:- painkillers;
- medications that improve blood flow in the vessels of the brain;
- diuretics that help relieve swelling in the cranial cavity.
In the future, periodic medications are prescribed that improve blood circulation in the brain and the function of nerve cells, as well as vitamin and mineral complexes.
Treatment of acoustic neuritis caused by occupational hazards
Treatment of acoustic neuritis and hearing loss caused by damage to the auditory nerve will have little effect if the person continues to work in conditions of increased noise and vibration. The most effective treatment measure in this case is to change the place of work to one where these occupational hazards will not be present.The following are prescribed as specific and nonspecific therapy:
- Vitamins- play a vital role in the metabolic processes of the auditory nerve.
- Biostimulants (adaptogens) and biologically active substances- increase the resistance of the auditory nerve to a wide range of harmful effects of both physical and chemical nature.
- Physiotherapeutic procedures (electrophoresis on the skull area)- under the influence of an electric field, it promotes the penetration of drugs to the auditory nerve through the skin.
- Balneotherapy, spa treatment, mud therapy and radon baths- have a general strengthening effect and promote healing processes in nerve fibers, including the auditory nerve.
- Magnetotherapy- change for the better the physicochemical properties of water structures, including nerves.
- Acupuncture- has a therapeutic effect and helps relieve pain symptoms.
For acute acoustic trauma, the following are used:
- painkillers;
- drugs that improve blood circulation in small vessels and the state of the nervous system;
- sedatives;
- the use of antibiotics and antiseptics to prevent the development of ear infections;
- In the long-term period after injury, physiotherapy, vitamins, and biostimulants are used.
Treatment of acoustic neuritis caused by age-related changes
Chronic neuritis of the auditory nerve, which is caused by age-related changes in the body, is treated with great difficulty. Typically, the patient takes medications for life:- antihypertensive drugs- used for high blood pressure;
- drugs that lower blood cholesterol levels- prescribed for cerebral atherosclerosis;
- medicines that reduce blood clotting- relevant in the presence of thrombosis or the risk of developing such;
- medications that improve blood flow in the vessels of the brain- promote adequate delivery of oxygen and nutrients to the auditory nerve;
- drugs that improve the condition and function of brain cells;
- vitamins and biologically active substances;
- physiotherapy;
- spa treatment, balneotherapy.
Prognosis for acoustic neuritis
The prognosis for acoustic neuritis and sensorineural hearing loss depends on the form and stage of the disease, and the time of initiation of treatment. In case of infectious diseases, injuries and acute poisoning, the prognosis in terms of hearing restoration is most often favorable. Deafness occurs only when the disease is severe and there is no adequate treatment.
With chronic diseases, the prognosis is usually less favorable. Complete restoration of hearing is possible only with early treatment, when significant changes have not yet occurred in the auditory nerve. With age-related changes in the ear, with the help of high-quality treatment, the process can be slowed down, but not completely eliminated.
Prevention of acoustic neuritis
To prevent the disease, it is necessary to eliminate the factors that lead to its development: - Prevent and promptly treat all infectious diseases that affect the head, neck, and respiratory organs.
- Avoid bad habits, contact with toxic substances, and use protective equipment at work.
- Avoid the use of antibiotics that are ototoxic in children.
- People aged 40–50 years should undergo annual tests to control blood cholesterol and measure their blood pressure daily.
- At production, measures must be taken to protect personnel from constant noise and vibration (earplugs, protective screens, etc.).
What traditional methods can be used to treat acoustic neuritis?
Acoustic neuritis is a disease that, if left untreated for a long time, leads to complete hearing loss. By delaying a visit to the doctor, the patient only aggravates the problem. Traditional medicine cannot be an alternative to treatment prescribed by a doctor. However, it can improve the condition and help cope with symptoms.
Before using any folk methods, medicinal plants, or dietary supplements for auditory neuritis, be sure to consult your doctor.
How to restore hearing after acoustic neuritis?
If neuritis of the auditory nerve lasts for a long time, then hearing cannot be restored. Treatment in this case includes wearing hearing aid, cochlear implantation, periodic courses of therapy aimed at preventing further hearing loss.Wearing a hearing aid
Indications for wearing a hearing aid for acoustic neuritis are determined by an otolaryngologist (ENT doctor) after examining the patient and audiometry– a special study that helps determine the degree of hearing loss. It is important to choose and adjust your hearing aid correctly. This is done by a specialist using a special computer program.
A hearing aid for auditory neuritis is worn like glasses for decreased vision - it is put on if necessary. Once a year, testing of acoustic parameters and servicing of the device is required. If necessary, it is repaired.
Main models of hearing aids:
- BTE. The device consists of a plastic or titanium case (including a sound emitter, microphone and amplifier), located behind the auricle, and an earmold, which is usually made from a cast of the patient's ear.
- Miniature BTE. Less noticeable compared to conventional earbuds.
- In-ear. Such devices are almost completely invisible, since they are completely located inside the ear canal.
Cochlear implantation
A technique that is used for severe hearing impairment when wearing a hearing aid is ineffective. Used cochlear implantation system, which includes the following parts: - electrode chain which is placed inside snails(an organ located inside the skull and containing auditory receptors);
- receiver - implanted under the skin;
- speech processor– a module that is attached to the hair or scalp, includes a transmitter, a microprocessor and a microphone;
- compartments for battery or batteries;
- additional accessories such as remote control.
- Selection of patients who need surgery. The level of hearing loss is determined using audiometry. Candidates are patients who have not responded well to hearing aids.
- Operation, during which the cochlear implantation system is installed.
- Postoperative rehabilitation. The doctor’s task is to teach the patient to live with the implanted system and prevent possible complications.
Antineuritis treatment
Once every six months, the patient undergoes treatment, which is necessary in order to prevent further hearing loss. The course of therapy usually includes:- drugs to improve blood supply to the auditory nerve;
- diaphoretics and diuretics to remove toxins from the blood that damage the auditory nerve;
- detoxification agents;
- vitamins;
- biostimulants.
Which doctor should I contact?
Acoustic neuritis is treated by two specialists:- Neurologist– specialist in the field of nervous diseases.
- Otolaryngologist (ENT doctor)– specialist in the treatment of diseases of the ears and upper respiratory tract.
What to do if acoustic neuritis is detected in a child?
The most important thing is not to waste time! The success of treating the disease and the chances of restoring hearing directly depend on how early the diagnosis is made and therapy prescribed. You need to contact a neurologist or ENT doctor. The doctor will prescribe outpatient treatment or give a referral to a hospital.Measles can lead to acoustic neuritis, which manifests itself as hearing impairment.
Acoustic neuritis is a “problem” of the inner ear and auditory nerve. The disease occurs quite often, especially in chronic form. The main symptoms of acoustic neuritis are decreased hearing acuity and the appearance of noise in the ear, which can be unilateral or bilateral. This disease has many causes. A number of additional research methods are required for diagnosis. Treatment of acoustic neuritis is largely determined by the cause that caused it. In most cases, vascular drugs, drugs that improve microcirculation, vitamins and antioxidants are indicated. This article contains information about everything related to acoustic neuritis.
A synonym for the term “auditory neuritis” is cochlear neuritis. Sometimes, even in common parlance, acoustic neuritis is called sensorineural hearing loss. From the point of view of official medicine, the last statement is not entirely correct. Sensorineural hearing loss is a hearing loss associated with damage to any nerve structures, from the receptor cells of the inner ear to the nerve cells of the brain. Acoustic neuritis involves damage only to the receptor cells of the inner ear and the nerve itself.
It should be said that the auditory nerve is an integral part of the VIII pair of cranial nerves (vestibular-cochlear), that is, its fibers pass in the same bundle with the vestibular ones. Therefore, quite often damage to the auditory nerve occurs simultaneously with damage to the vestibular conductors. And then, in addition to hearing loss and the appearance of tinnitus, other symptoms may occur (in particular, dizziness, nausea, vomiting, trembling of the eyeballs, impaired balance and gait). But they have nothing to do directly with acoustic neuritis.
Causes of the disease
Acute respiratory viral infections can be complicated by acoustic neuritis. What causes damage to the auditory nerve? There are quite a few reasons. They can be grouped approximately like this:
- infections (viral and bacterial). These are influenza viruses, rubella, mumps, pathogen,;
- vascular disorders, that is, disturbances in the blood supply to the inner ear and auditory nerve. Most often this is hypertension, cerebral atherosclerosis;
- , surgical interventions on the brain (in the area of the temporal bone and brain stem), acoustic trauma and barotrauma (diving, air travel);
- toxic effects. Particularly dangerous for the inner ear and auditory nerve are salts of heavy metals (mercury, lead), arsenic, phosphorus, gasoline, and alcohol. This group also includes drugs such as aminoglycoside antibiotics (Gentamicin, Kanamycin, Streptomycin and others), antitumor agents (Cyclophosphamide, Cisplatin), drugs containing Acetylsalicylic acid;
- long-term (occupational) exposure to noise and vibration;
- tumors (most often vestibular schwannoma and metastatic tumors).
Of course, these are not all the causes of damage to the auditory nerve, but the most common. Also, the occurrence of acoustic neuritis can sometimes be “blamed” on allergic reactions, autoimmune diseases (systemic lupus erythematosus, sarcoidosis and others). In some cases, the cause of hearing loss remains a mystery, and then the auditory neuritis is considered idiopathic.
Symptoms
Hearing loss in sensorineural hearing loss is often combined with noise and ringing in the ears. The disease is characterized by the appearance of only two symptoms:
- hearing loss;
- the appearance of additional sounds in the ears (noise, ringing, whistling, etc.).
Hearing loss can affect one ear in a unilateral process or both ears in a bilateral case. With a slight decrease in hearing in one ear and a slow progression of the disease, this symptom may go unnoticed due to compensation by the healthy ear. Such changes can only be detected by conducting additional research methods (audiometry). And in general, hearing loss may not be noticed by the patient. Especially when the disease occurs gradually and is not yet accompanied by other signs.
The appearance of additional sounds in the ear is almost always immediately noticed by patients. This symptom sometimes leads them to the doctor, and after the examination, hearing loss is discovered. Noise, ringing, whistling, tapping, rustling intensifies at night, when there is silence around. In fact, the intensity of these sound phenomena remains the same, it’s just that against the background of a decrease in sounds from the outside, they seem stronger. If the hearing loss reaches the level of deafness, then all additional sounds disappear.
All other signs of the disease (for example, fever, runny nose, vomiting, headache, etc.) are not specific, that is, they do not in any way indicate damage to the auditory nerve. But they help to establish the true cause of damage to the auditory nerve.
If hearing loss occurs acutely, within a few hours or a couple of days, then this indicates acute neuritis of the auditory nerve. Most often, it is caused by viral or bacterial infections or injuries. If symptoms persist for more than a month, then they speak of a subacute course of the disease. When signs of the disease are present for more than three months, then this is chronic neuritis of the auditory nerve. Naturally, the earlier the disease is diagnosed, the greater the chances of complete relief from the disease.
Diagnostics
During the initial examination, the doctor may only suspect damage to the auditory nerve. To confirm this guess, a set of additional examination methods is needed.
First of all, a patient with complaints of hearing problems undergoes audiometry. The method is quite simple and does not require special preparation of the patient. Audiometry allows you to determine the level and degree of hearing impairment (that is, is it related to the structures of the outer or middle ear or to the inner ear and auditory nerve). Test methods such as auditory evoked potentials and neuroimaging (computed tomography or magnetic resonance imaging) may also be needed. Neuroimaging techniques make it possible to clarify (or exclude) a number of causes of auditory neuritis.
Treatment
In acute cases of hearing loss, the patient is indicated for inpatient treatment. In subacute cases, a decision on this issue is made individually; in the chronic form, they almost always begin with outpatient examination and treatment. In acute and subacute cases, they strive to restore hearing to 100%; in chronic cases, this is most often impossible to do, so it is primarily about stabilizing the condition and preventing the progression of symptoms of the disease. Therapeutic tactics are formed, first of all, based on the established cause of the disease.
So, if the culprit is a viral infection, then antiviral drugs are prescribed. If the type of virus is established, then selective therapy is preferable (for example, if the auditory nerve is damaged by the herpes virus, Acyclovir drugs are prescribed). For a bacterial process, antibiotics are indicated. In this case, the use of known ototoxic drugs (aminoglycosides) should be avoided. Typically, high doses must be used to achieve sufficient therapeutic concentrations of the antibiotic.
If the cause of hearing loss is poisoning with any toxic substance, then detoxification therapy is carried out (intravenous drip infusion of solutions of Reopoliglucin, Ringer, physiological sodium chloride solution, and so on).
For traumatic injuries, painkillers and diuretics are indicated (the latter are prescribed to reduce swelling of the auditory nerve). For autoimmune processes, hormonal agents are used.
Drugs that improve blood flow and nerve nutrition are widely used. This is a group of vascular agents and drugs that improve microcirculation (for example, Cavinton (Vinpocetine), Vasobral, Nicergoline (Sermion), Pentoxifylline (Trental)). Mexidol (Neurox, Mexicor), vitamins E and C can be used as antioxidants. Vitamin B complexes (Milgamma, Benfolipen, Neuromultivit and others) have a positive effect.
Sometimes it is possible to use drugs that improve the conduction of impulses along the nerve. These are drugs such as Neuromidin (Amiridin, Ipigrix, Aksamon) and Proserin.
In the treatment of acoustic neuritis, non-drug treatment methods are actively used: electrophoresis with drugs, acupuncture, hyperbaric oxygenation,.
In cases where the cause of hearing loss is a primary tumor process, surgical treatment is resorted to. This can be a gentle stereotactic operation (using a gamma knife) or a more traumatic craniotomy (when the skull is opened to get to the tumor). 
If the cause is metastasis of another tumor, then radiation therapy is usually limited.
Complete loss of hearing in one or both ears raises the question of hearing aids for the doctor. This area is quite widely developed at present, allowing us to help people who have not heard for many years.
Forecast and prevention of the disease
Acute forms of acoustic neuritis respond well to conservative treatment, and complete restoration of hearing function can often be achieved. Subacute cases are difficult to predict. In the chronic course of the disease, treatment rarely leads to the restoration of lost functions. More often it is only possible to stop or slow down the progression of the process.
Prevention of auditory neuritis consists of maintaining a healthy lifestyle, hardening, and a balanced diet. This all increases the body's protective properties, thereby reducing the risk of viral and bacterial infections. If symptoms of an infectious process appear, you should not self-medicate (even more so, do not take antibiotics yourself), but it is better to immediately seek medical help. In the presence of industrial hazards (contact with toxic substances, noise, vibration), occupational hygiene must be observed. Measures to prevent injuries are also relevant. Patients with vascular diseases that can cause the appearance of auditory neuritis (for example, hypertension, cerebral atherosclerosis) must be treated first.
Thus, acoustic neuritis is a disease that can make a person disabled, depriving him of one of the most important sense organs. It must be remembered that timely seeking medical help when symptoms characteristic of this disease occur, in most cases, allows you to defeat the disease at an early stage.
Otorhinolaryngologist V. Stas talks about acoustic neuritis:
A disease of the ear autonomic ganglion, manifested by paroxysms of vegetalgia, involving the parotid region and ear. During an attack, pain can radiate to the back of the head, lower jaw, neck, shoulder girdle, arm and upper chest. Paroxysm is accompanied by hypersalivation, sometimes by clicks in the ear and congestion. Hearing is not impaired. Diagnosis is carried out by a neurologist, but includes consultation with an otolaryngologist, dentist and other specialists depending on the clinical situation. The treatment plan consists of drugs for the relief of painful paroxysms, vascular, decongestant, metabolic drugs, physiotherapeutic procedures and reflexology. The important point is to eliminate the root cause of neuralgia.
General information
The auricular autonomic ganglion is a collection of interneurons of the sympathetic and parasympathetic nerve pathways. The node receives sympathetic preganglionic fibers through the plexus of the middle meningeal artery, and parasympathetic fibers from a branch of the glossopharyngeal nerve. Postganglionic fibers of the auricular ganglion are part of the auriculotemporal nerve, which is a branch of the trigeminal nerve. They go to the ear gland and vessels of the temporal region, providing their autonomic innervation.
Neuralgia of the ear ganglion is included in the group of vegetative ganglionitis of the head, which also includes neuralgia of the submandibular and sublingual ganglion, ganglionitis of the ciliary ganglion, ganglionitis of the pterygopalatine ganglion and the upper cervical sympathetic ganglion, cervical truncitis. Specialists in the field of neurology have collected statistical data indicating that neuralgia of the ear ganglion is most common in middle-aged and young women.
Causes
Etiopathogenetically, neuralgia of the ear node is an irritative disease that develops reflexively in the presence of pathological autonomic impulses coming from chronic infectious foci or chronic processes in somatic organs. The most important pathology is one that is localized in the same region as the ear node and is infectious and inflammatory in nature. These include diseases of the parotid gland (mumps, sialadenitis, stones), chronic purulent otitis, chronic tonsillitis, sinusitis (frontal sinusitis, sinusitis, ethmoiditis), dental diseases (chronic periodontitis, stomatitis, gingivitis, periodontitis).
Less common is neuralgia of the ear node, caused by the presence of a distant focus of infection (pyelonephritis, urethritis, cystitis), a general infectious process (tuberculosis, syphilis, chronic sepsis), metabolic disorders due to endocrine pathology (hyperthyroidism, diabetes mellitus) or a somatic disease (cirrhosis of the liver). , cholecystitis, chronic renal failure, chronic gastritis, gastroduodenitis, adnexitis).
Symptoms of neuralgia of the ear node
Neuralgia of the ear ganglion is manifested by attacks of vegetalgia that occur in front of the opening of the external auditory canal, in the parotid region and in the ear on the affected side. Intense burning or throbbing pain radiates to the lower jaw, behind the ear, to the back of the head, neck and shoulder girdle of the corresponding side. The reflex mechanism of pain irradiation leads to its spread to the upper chest and arm. Painful paroxysms can be provoked by ingestion of hot food or drinks, hypothermia of the face, psycho-emotional stress, and excessive physical activity. The duration of an attack of vegetalgia, as a rule, is several minutes, but can be an hour or more.
The dependence of the functioning of the autonomic nervous system on external factors (lighting, barometric pressure, temperature changes, air humidity, etc.) determines the characteristic rhythm of vegetalgia - its occurrence mainly in the evening and at night, exacerbation in the autumn and spring.
In some cases of neuralgia, a paroxysm of pain is accompanied by ear congestion or a sensation of clicking in it. The latter is caused by periodic reflex spasms of the muscles of the auditory tube. Often during an attack, patients note a noticeable increase in salivation, while in the interictal period hypersalivation is not observed. Hearing function is not affected.
Diagnosis of neuralgia of the ear node
Often patients turn to a dentist or otolaryngologist for help, and then receive a referral from them to consult a neurologist. The latter makes a diagnosis based on typical complaints, the presence of sharp pain on palpation of the sclerotomal points of the auriculotemporal, mental and mandibular nerves, Richet's point - the place where the ear ganglion anastomoses with the mandibular nerve. The detection of hyperalgesia in the parotid region also speaks in favor of neuralgia. In a difficult diagnostic situation, they resort to diagnostic novocaine or lidocaine blockade of the ear ganglion.
In the diagnostic process, determining the etiology of neuralgia plays an important role. For this purpose, a dental examination and ultrasound of the parotid salivary gland, otolaryngological examination (audiometry, otoscopy, rhinoscopy, pharyngoscopy, radiography of the paranasal sinuses) are performed. If necessary, consultations with specialized specialists (urologist, gastroenterologist, gynecologist, endocrinologist, etc.) and additional studies of somatic organs (gastroscopy, abdominal ultrasound, kidney ultrasound, study of thyroid hormone levels, etc.) are prescribed.
Differential diagnosis is carried out with
Auricular ganglion neuralgia is a disease of the auricular autonomic ganglion, manifested by paroxysms of vegetalgia involving the parotid region and ear.
During an attack, pain can radiate to the back of the head, lower jaw, neck, shoulder girdle, arm and upper chest. Paroxysm is accompanied by hypersalivation, sometimes by clicks in the ear and congestion. Hearing is not impaired. Diagnosis is carried out by a neurologist, but includes consultation with an otolaryngologist, dentist and other specialists depending on the clinical situation. The treatment plan consists of drugs for the relief of painful paroxysms, vascular, decongestant, metabolic drugs, physiotherapeutic procedures and reflexology. The important point is to eliminate the root cause of neuralgia.
Symptoms of neuralgia of the ear node
Neuralgia of the ear ganglion is characterized by burning, paroxysmal pain in the temple area with irradiation (recoil) to the lower jaw, teeth and chin. The victim feels a feeling of stuffiness in the ear and increased salivation. Usually, the provocation of an attack of pain is hypothermia of the neck and face, consumption of hot or cold food, the presence of an infectious-inflammatory focus in neighboring tissues (tonsillitis, sinusitis, tonsillitis).
Treatment
For the purpose of pain relief, in contrast to anticonvulsants for trigeminal neuralgia, ganglion-blocking drugs are used: pentamine, arfonade, pyrylene, benzohexonium. Antispasmodics (No-Shpa, Halidor, papaverine hydrochloride) have a good therapeutic effect. Unlike trigeminal neuralgia, with neuralgia of the ear ganglion, muscle spasm plays a significant role in the pathogenesis of the disease. Thus, relaxing the muscles of the auditory tube can reduce pain and discomfort in the ear.
Sedatives (valerian, Persen - Forte, Phytosedan) and hypnotics (zopiclone (Imovan), donormil, phenazepam) are used. Previously, barbiturates were used (luminal, veronal, barbamyl, etaminal - sodium), but now, due to pronounced side effects, they are not used.
According to the scheme, B vitamins are used (including nicotinic acid), electrophoresis is performed with novocaine or thiamine (vitamin B 1).
If salivation is severe, platyphylline is used to reduce secretion. An important link in the treatment of possible edema is taking antihistamines.
Great importance is attached to physiotherapeutic procedures and methods: magnetotherapy, laser therapy, massage, acupuncture, electroacupuncture, warming biologically active points with wormwood cigars.
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