Otitis inflammation. Types of otitis media, medical treatments for the disease

Both children and adults are susceptible to such a disease as otitis. Depending on the place of localization, all types of otitis are divided into three types: internal (arising in the inner ear), medium (developing in the middle ear) and external (affecting the auricle itself). The disease can be both sluggish and accompanying sharp pains. For information on what are otitis in children and adults, what are their symptoms, and what methods are used to treat them, read in this article.

Serous type of otitis media

This type of otitis in children and adults manifests as sluggish inflammation of the middle ear, which is characterized by accumulation of fluid of a purulent nature in the tympanic cavity. The exudate is sometimes sterile, but more often includes pathogenic bacteria, even if there are no obvious signs of inflammation. Otoscopy has a yellowish or grayish color. eardrumthat depends on the color of translucent fluid in the tympanic cavity. When the air is thickened and rarefied in the external auditory canal with the help of a Sigle funnel, the eardrum is immobile.

The main symptoms of serous otitis media:  hearing loss, pressure sensation or ear congestion. The disease is determined by the appearance of the eardrum and using tympanometry. Under normal conditions, ventilation of the middle ear occurs 3-4 times per minute when the auditory tube is opened during swallowing. When the ventilation function of the auditory tube is impaired, a reduced or negative pressure appears in the middle ear, which can lead to the appearance of serous exudate, which causes impairment of the auditory function.

Usually for the treatment of serous otitis requires only the supervision of a physician. Allergy sufferers are prescribed antihistamines and topical glucocorticoids. In the absence of improvement, a myringotomy is performed within 1-3 months. For continuous drainage and aeration of the tympanic cavity, shunting is done: a special Teflon tube is inserted into the tympanic cavity, through which drugs. The shunt is left for various periods. In this form of otitis of the middle ear, also blowing through the method of Politzer and Valsalva is also shown.

When taken using the Valsalva method, the patient must forcefully exhale the air through the squeezed nostrils with the mouth closed. According to the method of Politzer, a doctor with a special balloon blows air into one patient's nostril and blocks the other in the process of swallowing. It helps the air flow into auditory tube  and middle ear. These techniques are prohibited in case of a cold or rhinorrhea. In case of recurrent serous type of otitis, thorough treatment of the main diseases is shown. In children, improvement is possible after adenoidectomy. Antibiotics are prescribed for bacterial rhinitis, sinusitis and rhinopharyngitis. Useful immunotherapy and elimination of allergens.

Medium purulent chronic otitis in a child and its treatment

Medium purulent chronic  - is a form of middle ear inflammation, which has three signs: persistent perforation, persistent or periodic suppuration and progressive hearing loss. The disease is usually the result of acute inflammation of the middle ear. There are general and local causes that contribute to the development of the process.

Common causes:

• high virulence microflora, which is represented hemolytic streptococcus, Proteus, anaerobes (heavy common), Pseudomonas aeruginosa, staphylococcal or atypical bacteria (chlamydia, mycoplasma);
• malnutrition, severe;
• genetic predisposition (heredity factor);
• allergy, reduced body immunoreactivity;
• chronic diseases respiratory tract  and;
• irrational treatment of acute otitis media;
• frequent acute inflammation  middle ear.

Local causes:

• dysfunction of the auditory tube;
• chronic inflammatory diseases of the nose and paranasal sinuses, nasal polyposis;
• hypertrophy of the posterior and anterior ends of the inferior nasal concha, leading to tubootitis and impaired function of the auditory tube;
• anatomical features of the structure of the middle ear in children:
• poor communication between the attic (epitimpanum) and the cells mastoid  due to the mastoid cave block, easy edema of the mucous membrane, many folds, pockets of the mucous membrane, worsening the drainage;
• outflow of pus from the middle ear in acute otitis media;
• poor pneumatisation of the mastoid process, its spongy or sclerotic type;
• tight vascular connection in the ear of the child between the mucous membrane and bone marrow cavities, which leads to the development of osteomyelitis.

It flows in two forms: relatively favorable - mesotympanitis (about half of the cases) and more severe - epitimpanitis (about 20% of the disease), the remaining 30% are in a mixed form - epimesympimpanitis.

In mesotympanitis, only the mucous membrane of the middle ear is involved in the pathological process; in epitimpanity, it affects the bone tissue. Therefore, it is extremely important to differentiate these two forms of chronic inflammation. The disease can occur in two ways. At the first stage, the symptoms of a chronic process are permanent dry perforation of the eardrum and persistent hearing loss. Periodically, as a rule, due to an infectious disease or infection of the tympanic cavity through a perforation hole (usually with water), there is an exacerbation with pain in the ear, fever, symptoms of general intoxication, secretions, hyperemia of the eardrum, and sometimes neurological symptoms. In the second variant, children with good general condition constantly have purulent or mucous discharge from the ear. Exacerbations in such patients are accompanied by general symptoms ( headachefever, signs of intoxication) and increased discharge from the ear, which
   accompanied by pain. Chronic suppurative otitis media is fraught with intracranial complications. Such complications can occur with acute otitis media. For intracranial complications, urgent ear surgery is required to sanitize the lesion. Without surgery, the patient often dies, despite active antibacterial and other therapy.

Treatment of moderate purulent otitis in children depends on the period of the disease, is associated with the duration of the disease, the frequency and severity of exacerbations, x-ray data, otoscopic picture, hearing condition, etc. As a rule, conservative mesotympanitis is indicated in chronic suppurative .

With the exacerbation of the process with the occurrence of earaches, intensification or the appearance of suppuration, active general anti-inflammatory antibiotic therapy is required, as well as local therapy.

During remission, when the general symptoms disappear and suppuration remains, local therapy is indicated (antiseptic, more often alcohol drops, injection of sulfanilamide powder).

A good result exists when using low-energy radiation from a helium-neon laser. Contraindications to laser therapy are chronic otitis with ear polyps, cholesteatoma, mastoiditis, and suspected intracranial complications. Laser irradiation helps to reduce otorrhea, swelling and hyperemia of tissues.

During the remission period, preventive measures are taken: rehabilitation of the nasopharynx; therapy of chronic inflammatory processes in the nasal cavity and paranasal sinuses; general and local hardening for prophylaxis respiratory diseases; preventing the ingress of water into the ear, which can cause suppuration (when bathing the patient, it is necessary to close the external auditory canal with cotton wool, which is soaked in sterile vaseline oil).

To close the perforation hole, semi-surgical (refreshing of the perforation edges, cauterization thereof) and surgical methods (high-energy laser and myringoplasty) are used.

In chronic purulent epitimpanitis, it is more difficult to conduct effective conservative treatment in the first place, when it is accompanied by the development of polyps, granulations or the formation of cholesteatoma.

Methods of treatment (local and general), used for epitimpanitis, can stop only the exacerbation of the process, but do not eliminate osteomyelitis. It seems that the easiest way is to be surgically treated, but after that hearing is usually reduced.

Therefore, in recent years, limited operations have been performed in which only carious bone is removed and, if possible, they retain the middle ear sound system (hearing-preserving operations). In 75% of cases, they allow to sanitize the ear and at the same time preserve the auditory function.

If a patient’s hearing is already lost due to a chronic purulent process, then a radical obese cavity surgery is performed, when all pathological contents are removed: polyps, cholesteatoma, granulations, carious bone, affected bones, etc. Postoperative period  in sick children proceeds more difficult than in adults, due to the tendency to excessive growth of granulations, frequent reinfection of the cavity through the auditory tube, exacerbations of the process after infectious diseases, difficulties of dressings.

In about 5–10% of cases, the purulent process after the operation persists, although intracranial complications are practically not observed due to a good outflow.

With a radical ear surgery, hearing is inevitably reduced by approximately 30 dB due to the removal of carious auditory ossicles and remnants of the eardrum. But with severe carious processes that are not amenable to conservative treatment, surgery is necessary, since the greatest danger comes from the likelihood of the development of otogenic intracranial complications.

To improve hearing, tympanoplasty is performed. Depending on the degree of destruction, the founder of tympanoplasty A. Volshtein identifies five types of tympanoplasty: the simplest is myringoplasty or tympanoplasty type I (elimination of the defect of the eardrum), the most difficult is type V, when the entire sound-conducting system is destroyed. Tympanoplasty type V is used quite rarely. Mandatory condition for tympanoplasty - sufficient preservation of the function of the receptor apparatus inner ear.

Tympanoplasty in children is performed from 8-10 years of age, preferably in two stages, after sanitizing surgery. At an earlier age, this operation is indicated only with a bilateral process and hearing loss.

Chronic suppurative otitis media in the middle ear: symptoms and treatment

Chronic purulent otitis  middle ear  accompanied by specific features of allergic inflammation, while the general allergic background may be pronounced or absent.

The mucous discharge from the ear is viscous, less often liquid serous-mucous with a small admixture of pus, central perforation, large sluggish swollen granulations and polyps. Polyps are prone to relapses. Often there is itching in the ear, persistent dermatitis of the outer auditory canal. Cytological examination of the discharge, and first of all of the polyps, shows marked eosinophilia. In the pus there is the usual flora (streptococci, staphylococci). To identify a common allergy important carefully collected history (sensitization to food, medicinal substances  etc.), the presence of concomitant allergic diseases ( bronchial asthma,), identification of sensitivity to intracutaneous samples with different allergens (bacterial and non-bacterial), as well as blood zosinophilia.

For the treatment of chronic suppurative otitis media, nonspecific desensitization therapy is indicated with 10% calcium chloride solution (1 tbsp spoonful 3 times a day), calcium gluconate (0.5 g 3-4 times a day before meals). Antihistamines are prescribed: diphenhydramine (0.05 g, 2 times a day), diprazin (0.025 g, 2 times a day), suprastin (0.025 g, 2 times a day), and so on.

Also in the treatment of chronic purulent otitis of the middle ear, great attention is paid to a balanced diet rich in vitamins; products causing the patient allergic reactionsare excluded from the diet.

Medium purulent chronic otitis in children

Chronic suppurative otitis in a child  occurs most often at an early age, often in children under 7 years of age. In infants, the transition of acute purulent otitis media to chronic occurs due to malnutrition (in hypotrophic children). Frequent appearance of purulent otitis media in children early age  due to anatomical features  and hyperergic reaction to a variety of stimuli. Hypersensitivity to various allergens is the cause of the exudative-catarrhal diathesis, primarily in children under 3 years of age. In older age, these manifestations are suppressed due to an increase in immunity. Such children have chronic purulent otitis media  proceeds, as a rule, in the form of mesotympanitis with pronounced swelling of tissues, itching and dermatitis of the outer ear, and abundant mucopurulent discharge. But quite often there are necrotic forms of otitis.

Main symptoms:creamy discharge, swelling of the mucous membrane of the tympanic cavity, a slight tendency to the formation of granulations, rare exacerbations. In chronic purulent otitis media in children, which is complicated by cholesteatoma, the latter is characterized by rapid growth, quickly leads to the destruction of the mastoid process and quite often breaks through its cortical layer outwards, primarily during the period of otitis exacerbation. Cholesteatoma in children often occurs after antrotomy. At the age of 3 to 7 years, the disease often occurs on the background of lymphatic diathesis with hyperplasia of the lymphadenoid pharyngeal ring, a tendency to edema of the mucous membrane, pastos facial skin, severe lymphocytosis in the blood, reduced nervousness of the nervous system.

In the treatment of purulent otitis in a child against the background of exudative diathesis, the main importance is given to a balanced diet rich in ascorbic acid, D and PP. A 10% solution of calcium chloride, diprazine, diphenhydramine is prescribed as desensitizing agents. For local treatment  apply ointment with zinc oxide, streptocidal ointment (streptotsida 1 part, vaseline 9 parts). The skin of the external auditory canal is smeared with lanolin, petroleum jelly, etc.

What are otitis in adults: medium purulent and osteomatous chronic

With mild clinical manifestations of purulent otitis in adults, there is a significant bone destruction, which is the cause of the operation. In addition, the disease in the elderly extremely rarely leads to the formation of cholesteatoma.

Treatment of this form of otitis is possible only with the help of surgery.

The average osteomatous chronic otitis ear is a rare and unusual form of chronic otitis media. It is a chronic inflammatory process  with a bone formation of an ostematous type, representing the alternation of zones of bone structure with zones of osteolysis. There are three types of otitis: localized, diffuse, in which the inner wall of the middle ear cavities is affected, and massive, with the involvement of the attic, the antrum, the auditory ossicles. To confirm the diagnosis shown tomography of the temporal bone.

In the treatment of chronic purulent otitis of the middle ear, the hearing-improving operation excludes the spread of the process and its severity. Perhaps malignant degeneration with a rapid and progressive course of the disease.

Diffuse otitis of the outer ear in adults: symptoms and treatment

With the complication of the flu, diffuse otitis of the outer ear occurs with specific bubbles that are filled with hemorrhagic exudate. Diphtheria develops dirty gray with difficulty removing. fibrinous raids. The special form is represented by granulation otitis.

Diffuse purulent external otitis  sometimes accompanied by the appearance of granulations all over the skin and even on the eardrum. Symptoms of external diffuse otitis media and myringitis (inflammation of the eardrum) may not be detected, the disease can occur without concomitant inflammation of the external auditory canal.

In the treatment of otitis externa in adults, the affected areas are powdered. boric acidpenicillin sulfonamide powder. In case of granulation otites, the cauterization of granulations with 40-50% silver nitrate solution or chromic acid, dusting with sulfonamides or antibiotics is carried out. Also for the treatment of external diffuse otitis shows UHF-therapy, if necessary, scraping with a sharp spoon.

Limited otitis externa in adults and antibiotic treatment

Acute external otitis media in adults occurs due to the penetration of infection into the glands and hair follicles, for example, when cleaning the ears with various objects, primarily during suppuration. The disease is also a consequence of common furunculosis in diabetes mellitus, hypovitaminosis, etc.

The main symptom of otitis externa in adults is severe earache, aggravated by pressure on the point of attachment of the auricle. Sometimes it becomes jerking. After this, skin swelling occurs in the parotid area. As the boil matures, inflammation increases and spontaneous opening of the boil occurs, usually in the auditory canal. This may cause swelling of the tissues around the ear and go to the back of the ear and ear region. Bile lymph nodes  become painful and increase.

For treatment, gauze turunds with synthomycin, streptocid, levomycetin emulsion are introduced into the external auditory meatus. Appointed heat to the ear in the form of a warming half-alcohol compress, physiotherapy (Solux, UHF). Also for the treatment of otitis externa in adults, antibiotics, sulfonamides, and vitamins are prescribed. With purulent inflammation of the surrounding tissue, surgical treatment is prescribed.

Variety of acute outdoor spilled otitis

Causes of acute outdoor spilled otitis  - mechanical, chemical, thermal (burn) injury with the subsequent addition of the most diverse infections.

With this form of otitis, the inflammatory process passes to the skin of the bony part of the external auditory canal, extends into the depth of the skin, captures the subcutaneous layer and often the eardrum. When persistent otitis often occur fungal lesions.

The main symptoms of this type of otitis:  swelling and reddening of the ear canal skin, weeping, peeling, mucous or purulent discharge from the ear. The pain is initially sharp, then it is replaced by severe itching and a feeling of congestion in the ear.

In the treatment of acute external spilled otitis, a diet (excluding spicy and spicy dishes), vitamin-rich food, antiallergic drugs (suprastin, tavegil, diphenhydramine), earwashing with a warm solution of rivanol (1: 5000), lubrication with a 3-5% nitrate solution are shown. silver, 1-2% alcohol solution of brilliant green. As an anti-inflammatory agent, ointments of hydrocortisone, oxycort and prednisone are prescribed. General means that increase the body's defenses: autohemotherapy, B vitamins, ascorbic acid. With severe course Diseases are shown antibiotics and sulfonamides.

Form of necrotizing otitis externa in children and adults

  Necrotizing inflammation of the external auditory canal with involvement of the surrounding soft tissues is caused by pseudomonas aeruginosa (gram-positive aerobic microbe). Occurs in children and adults, primarily in the elderly, most often in diabetics.

In adults and children, this type of otitis appears most often at the border of the cartilaginous and bony parts of the external auditory canal, from which it passes to bone, cartilage, nerves and soft tissues. The basis of the pathological process is necrotizing vasculitis with the subsequent involvement of the entire vessel wall.

There is a constant pain, the formation of granulations, necrotizing otitis media. The inflammatory process moves to the parotid gland, tympanic cavity, muscle tissue, mastoid process. The course of the disease is characterized by osteomyelitis of the temporal bone, petrosite,. Particularly severe intracranial complications and multiple paralysis of cranial nerves. In the absence of damage to the cranial nerves, mortality does not exceed 10%, with paralysis facial nerve  reaches 50, with multiple paralysis of cranial nerves exceeds 80%.

The only method of treatment is a wide surgical intervention with the removal of all necrotic tissue, including cartilage, parotid gland, bone, muscle tissue. Antibiotic therapy (gentamicin, carbenicillin, etc.) is necessarily prescribed by drugs with a broad antimicrobial spectrum. Antibiotics are administered in large doses intramuscularly or intravenously. The best effect is achieved by combining antibiotics with corticosteroids inside or using them as ointments. It should be said that aminoglycoside antibiotics are ototoxic.

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Otitis is called inflammatory damage to the ear. Often, this violation provokes hearing loss and other negative consequences. To avoid such problems, it is very important to consult a doctor at the first signs of pathology. A specialist after a thorough diagnosis will select the appropriate therapy.

Otitis classification ICD 10

Otitis is an ENT pathology of the auditory organ, which is characterized by an inflammatory lesion of a specific part of the ear. The causes of the disease may be different. These include mechanical damage, lack of adequate hygiene, viral and catarrhal diseases.

According to the classification of ICD-10, the following categories of this disorder are distinguished: H60-H95 “Diseases of the ear and mastoid process”. In turn, they are divided into a number of groups:

• H60-H62 - diseases of the outer ear;
• H65-H75 - diseases of the middle ear and mastoid process;
• H83 - diseases of the inner ear.

Symptoms

This pathology is accompanied by a variety of manifestations:

1. Pain syndrome. The nature of the discomfort depends on the causes of the disease and the location of the inflammation. Sometimes the pain affects only the auricle. Usually the discomfort is pronounced and aggravated at night.
2. Increase temperature. Sometimes this figure is 38-39 degrees.
3. The deterioration of the general condition. Otitis may provoke weakness, malaise, increased drowsiness. A person often worsens his appetite or develops body aches.
4. Hearing impairment. This symptom can affect one ear or affect both at once.
5.   . It may decrease and then increase again.
6. Purulent discharge or the appearance of exudate. These symptoms do not always appear. When they occur, a person notices fluid in the auricle.
7. Dizziness or problems with coordination of movements. These manifestations occur during the development of internal otitis, which provokes the defeat of the bone maze.

How does a person's ear

Kinds

Depending on the location of the anomalous process emit different kinds  otitis, each with specific symptoms.

Outdoor

This form of illness usually develops due to violation of hygiene rules. He can be provoked by cleansing with unsuitable objects.

As a result, an infection penetrates the ear, which leads to the development of a bacterial etiology. To avoid this, the ear can be cleaned exclusively with cotton buds.

At the same time, the vestibular apparatus is affected. In addition to hearing impairment and noise, there is a risk of imbalance, nausea, dizziness, and vomiting.

Phases

Otitis can be acute and chronic. The symptoms of these diseases are similar, but their intensity is significantly different.

Sharp

1. The main feature acute otitis  is a pronounced pain syndrome in the ear. He can be jerking or shooting. Discomfort usually increases in the evenings.
2. Another symptom of the disease is considered autophony, which is characterized by the appearance constant noise  in the ear.
3. A person may have a little deterioration in hearing.
4. For acute otitis is characterized by an increase in temperature and deterioration. If the anomaly has a character, the symptoms become more intense.
5. With this violation, dizziness often occurs.
6. In addition, purulent otitis media is accompanied by the accumulation of purulent contents, which can break through the membrane and spill out.

Chronic

This form of otitis has similar symptoms, but they are much less pronounced. Usually there is pain and a stronger hearing loss. There is also a symptom of autophony and a feeling of congestion in the ears.

To do this, in gauze is to make a slot, soak it in warm alcohol and attach it to your ear. It is important to consider that this method can only be used as prescribed by a doctor.

Another effective remedy for otitis is ear plugs. They are small tubes of cotton soaked in wax. On sale you can find phytocall containing useful ingredients - cinnamon oil, lavender, sage, etc.

It is considered quite a serious violation that can lead to negative consequences and lead to a severe hearing loss.

Otitis is an inflammation of the ear that can localize inside or outside. According to the severity of otitis are different, they often occur in children. Often this disease is caused by germs or viruses, this disease is usually infectious in nature. The otitis code according to ICD - 380.10.

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

The causes of this disease may be different.

1. Viral and bacterial diseases, inflammatory processes in the body.
2. Other diseases of the nasopharynx, for example, runny nose, sinusitis, adenoids in children.
3. Injuries, mechanical damage to the auricle.
4. Water in the ear, especially when it is polluted.
5. Improper ear hygiene leading to the formation of sulfur plugs and damage to the eardrum.
6. Hypothermia
7. Features of the structure of the ear canal.

In some cases, causes can be combined.

External otitis media - inflammation of the ear canal outside, moderate and inner ear  not hurt. This form can become chronic if treatment is not started on time. External otitis can be of two types.

1. Limited. It is characterized by the appearance of boils, an abscess of the outer ear tissues, the formation of abscesses. Most often caused by Staphylococcus aureus.
2. Diffuse or diffuse. This is an extensive lesion of the outer ear and ear canal tissues, which sometimes reaches the eardrum. The most common infection occurs with water entering the ear, especially dirty. Therefore, swimmers often encounter spilled otitis.

The external form is often a complication of the flu and other strong catarrhal diseases. Sometimes it can be caused by fungus, allergies, seborrhea, dermatitis and other skin diseases.

Symptoms of otitis externa

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

1. Earache is an earache. May be different in nature.
2. Changes in auditory perception, up to a severe loss temporarily.
3. Congestion, pressure sensation in the ear.
4. Noise, ringing, itching in the ears.
5. Various secretions, most often purulent.
6. Pain when pulling off and touching the auricle is the distinguishing feature of the outer form.

On examination, the doctor will notice swelling, pollution of the ear canal, inflammation of the eardrum.

Important! If you are worried about these symptoms, you should contact the otolaryngologist.

For diagnosis, it is usually sufficient external examination by a doctor, sometimes the exudate, if it exists, 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 external otitis media?

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

Important! It is impossible to open boils formed during otitis by yourself.

1. Antibiotics. They are prescribed if otitis was caused by bacteria, so they cannot be taken without tests. Examples: Oxacillin, Cefazolin, Amoxiclav and others.
2. Antipyretic, anti-inflammatory and analgesic drugs. They can not do without if the ear disease is accompanied by fever and severe pain. Usually use drugs based on ibuprofen, aspirin or paracetamol.
3. Drops in the ears. Often they already contain corticosteroids or antibiotics. Normaks, Kandibiotik, Otinum, Otofa and others are widespread.
4. Ointment. Used for the speedy healing of damaged, inflamed areas. For example, Levomekol, Triderm.
5. UV-therapy and UHF-therapy. Physiotherapy accelerates recovery and enhances the effect of drugs.

All medicines and procedures are selected depending on the type of external otitis, the extent of the lesion and what caused the disease. If it occurred on the background of an allergy, then antihistamine therapy is necessary, if it is a consequence of the flu, you need to cure it to the end and to prevent recurrence.

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

There are several stages acute illness, on each symptoms are different.

1. Acute Eustachitis. At this stage, there is congestion in the ear, noise, temperature rises only in the presence of infection.
2. Acute catarrhal inflammation. There is a sharp severe pain, the temperature rises, there is an inflammatory process in the ear.
3. Stage of purulent inflammation. The pain reaches its peak, can give to the teeth and other parts of the head. Hearing is reduced. Inflammation is noticeable on blood tests.
4. Postperformative stage. The pain decreases, the temperature drops, while the congestion and deafness remain, and exudate is released from the ear.
5. Reparative stage. Inflammation passes, damage to the eardrum is closed by the scar.

Important! Treatment should begin in the initial stages of the disease, otherwise serious complications are possible.

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

How to treat otitis media?

Treatment must take place 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, bed rest and rest is recommended, otherwise the risk of complications is increased. Also, the doctor must clear the ear canal from the discharge. The main treatments for otitis media are as follows.

1. The use of antibiotics. This is important during acute otitis media. Amoxicillin or Amoxiclav is commonly used, otherwise Sumamed or Rovamycin. Antibiotics are used in the form of tablets, if complications develop, possibly intramuscular or intravenous administration.
2. Drugs to relieve inflammation and pain sensations. Usually it is painkillers and antipyretic ibuprofen-based, aspirin, paracetamol.
3. Drops. With medium form, it is important that they are at room temperature, you can warm the bottle in warm water  before burying. Otinum or Garazon can be applied.
4. Drops in the nose in the presence of edema. Apply vasoconstrictor, for example, Nazol or Naphthyzinum.
5. Drugs that enhance immunity. These include vitamins and vitamin complexes, may be in the form of tablets or injections.
6. Physiotherapy - electrophoresis or UHF.

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

Important! In the treatment of otitis media in pregnant women should be aware that antibiotics in most cases can not be used.

Internal otitis - labyrinthitis

Labyrinthitis - inflammation in the inner ear, which occurs if the infection with otitis media or other diseases penetrates deeper. When this disease occurs vestibular disorders due to damage to internal structures. Often after treatment, patients need to restore hearing by using prosthetics and other methods.

Labyrinthitis can also become chronic.

Symptoms

Vestibular disorders are characteristic of labyrinthitis,

1. Violations of coordination, movement, balance.
2. Dizziness, often arising seizures, nystagmus.
3. Nausea, vomiting.
4. Increased sweating, pallor of the face.
5. Tachycardia, bradycardia, other rhythm disturbances.
6. Hearing loss, the onset of complete deafness in case the disease is neglected.

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

How to treat a labyrinthitis?

In the treatment of labyrinthitis, the same set of agents is used as with other types of otitis. Excluded only local methodsas the lesion spreads inside the ear.

When labyrinth is important to arrest dizziness, it is done with the help of vestibulolitics, for example, Bellatamininal. In some cases, surgery is necessary if the labyrinthitis is accompanied by complications. Operations are performed on the middle ear.

If the hearing has been lost during the illness, consultation of the hearing aid and audiologist is necessary. Sometimes a rumor-repairing operation is performed, in some cases an auditory prosthesis is selected.

Important! Serious complications can be avoided by starting treatment on early stages  otitis

Otitis treatment at home

Early and early otitis media can be successfully treated at home after consultation with your doctor; they do not require constant monitoring or surgery. In addition, there are several home methods that will help alleviate the condition of the patient, if you can not immediately contact a specialist.

When otitis and other diseases of the ears do not use candles, their effectiveness has not been proven, while inflammatory diseases  they can be dangerous. Also during otitis, it is not necessary to warm the ear, heat contributes to the spread of infection.

Ear packs

At home you can apply a compress, it helps with otitis media. To do this, wet the roller with vodka and wrap tightly around the head, but there should be some free space between the cotton and the ear itself. Such a compress you need to keep a few hours, you can do it at night.

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

Prevention

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

1. Use a drop with a vasoconstrictor effect during a runny nose, mandatory nasal washing. If you have a cold nose, blow your nose gently, without taking deep breaths, so that the discharge does not rise higher.
2. Maintain optimum air humidity. Often too dry air leads to ear diseases.
3. Drinking plenty of fluids is especially important during illnesses accompanied by fever.
4. Accuracy when taking antibiotics, incorrectly chosen drugs can cause ear diseases.
5. Proper ear hygiene. It is only necessary to clean the outer ear, if you try to push the q-tip deeper, you can damage the eardrum or cause sulfur plugthat leads to otitis.

For any diseases of the nasopharynx should immediately contact the ENT, the occurrence of otitis media is easier to prevent than to subsequently engage in its treatment.

Otitis is an ENT disease that is characterized by the formation of foci of inflammation in the ear. Provocateurs of inflammation are infectious pathogens (bacteria, fungi, viruses), injuries or an allergic reaction. Most often the disease occurs in children, which is associated with structural features of the ear. Late treatment of pathology can lead to hearing loss or hearing loss.

What are the types of otitis? There are many types of disease, which is caused not only by the cause of their occurrence and the characteristics of symptoms, but also by the site of localization. Inflammation can occur in one of the three main areas of the ear, namely:

• outer ear - represented pinna  and the auditory course. In the presence of foci of inflammation in these parts of the hearing aid, external otitis develops;
•   - consists of a tympanic cavity and three auditory ossicles responsible for receiving sound signals from outside;
•   - includes the semicircular canals, the cochlea and the vestibule. Inflammation in this part of the ear is most often called labyrinthitis.

Of all types of otitis media, the average is found in 82% of cases.

  Classification

There are more than 5 options for the classification of ENT diseases, varieties of which are determined by the place of localization of inflammation foci, features of inflammatory processes, causes of development and morphological features of the pathology. Depending on the duration and characteristics of the disease, the following types of otitis media are distinguished:

• acute - characterized by a bright manifestation of the symptoms of pathology, which last for 7 to 20 days;
• subacute - has less pronounced symptoms, the duration of inflammatory processes is from 3-4 weeks to 3 months;
• chronic - sluggish ENT pathology with unexpressed clinical manifestations. On the development of the disease speak in the case, if the duration of sluggish inflammation exceeds 3 months.

According to the etiological classification, the disease is divided into several types, which are determined by the causes that provoke pathological changes in the ear. Conventionally, ENT pathologies are divided into infectious and non-infectious, but in case of diagnosis, the specialist indicates a more accurate cause of the disease, as evidenced by the name of a specific type of otitis media:

• bacterial - triggered by pathogenic microbes that cause inflammation;
• viral - caused by viral agents that penetrate the ear during the development of common infectious diseases;
• fungal - occurs as a complication and development of yeast-like fungi in the middle or inner ear;
• allergic - a consequence of an allergic reaction of the body to the penetration of allergic agents that provoke swelling and irritation of tissues;
• traumatic - ENT disease that develops as a result of damage to individual organs or parts of the ear.

The development of pathogenic flora in the ear is often indicated by suppuration, severe swelling tissue and itching.

  Morphological classification

According to the picture of pathological processes and the site of localization of lesions, the ENT doctor determines the type of the disease. According to the morphological classification of otites, the following types of pathology are determined:

• exudative - accompanied by the evacuation of liquid exudate from the auditory passages;
• catarrhal - characterized by hyperemia and edema of the affected tissues;
• purulent - an infectious pathology, with the development of which suppuration is observed;
• bullous - occurs in the case of an infectious lesion of the body and is accompanied by the appearance of bubbles with bloody patches on the surface of the eardrum;
• adhesive - due to sluggish inflammation, adhesions may appear in the ear, as a result of which the patient develops hearing loss.

Depending on the place of localization of inflammation foci, the following types of ENT pathology are distinguished:

1. right otitis - lesions are located in the right ear;
2. left otitis media - lesions are located in the left ear.

In the case of infectious lesions of the hearing aid often develops. To prevent damage to both ears, you should contact the ENT doctor when the first signs of the disease appear.

  Stages of development

In the case of an acute inflammatory process, there are several main stages in the development of the disease. As a rule, acute infectious diseases do not lead to hearing loss. The exception is only purulent inflammation, due to which the morphofunctional structures of the hearing aid are destroyed. There are 5 main stages, namely:

1.   - constant feeling of stuffiness or buzzing in the ears; in the presence of infectious pathogen  perhaps a slight increase in temperature;
2. catarrhal inflammation - aseptic inflammation of the mucous membranes of the middle ear, which are accompanied by sharp pain and high temperature;
3. preperforative purulent inflammation - impairment of hearing associated with radiating pain in the eyes, teeth, oropharynx, etc .;
4. postperforate purulent inflammation - subsidence of the main symptoms of the disease with further suppuration, in which the hearing loss does not go away, but only increases;
5. reparative stage - pathological processes in the ear are stopped, and the perforations present in the tissues are tightened with scars.

Pathological changes can also occur in the surrounding auditory canals of tissues. As a consequence, the parotid salivary glands are often affected, which causes severe pain.

  External otitis

With the development of this type of ENT diseases, pathological processes mainly affect the external auditory canal. It concentrates the acidic environment, which prevents the development of pathogens inside the ear. But as a result of water entering the auditory canal, the pH level may change. As a result, pathogens can easily penetrate into the tissue and provoke complications.

There are two main types of otitis:

1. limited - characterized by inflammation of the bulb or the appearance of a boil in the conductive parts of the ear. The presence of an abscess is signaled by pains that subside within a few days after opening the boil and pus evacuation;
2. diffuse - is accompanied by damage to the tissues of the entire ear canal, due to the activity of the bacterial flora, represented by streptococci. Diffuse damage to the ear is most common in allergic, bacterial and fungal types of ENT diseases.

Labyrinthitis - ENT disease, which is characterized by the occurrence of lesions in the inner ear. As a rule, the disease occurs due to inflammation of the external or middle ear, as well as the general defeat of the body by an infection that by hematogenous means semicircular canals  inner ear. Meningitis, microbial and viral pathogens, cranial injuries, etc. can become provocateurs of pathological changes in tissues.

Depending on the clinical manifestations, the following types of labyrinthitis are distinguished:

Acoustic injuries triggered by a fracture of the temporal bone lead to the development of the labyrinth syndrome. Such injuries provoke not only hearing impairment, but also the development of paresis.

  Otitis media

Inflammation in the tympanic cavity is often triggered by bacteria, viruses, or injuries. In the middle ear there is a complex bone mechanism responsible for the susceptibility of sound waves. Therefore, the defeat of the hearing aid is fraught with hearing impairment and its complete loss. The main types of otitis in adults include:

• barotraumatic otitis media - a disease resulting from unilateral strong pressure on the walls of the eardrum. Professional type of ENT disease, which is most common among divers, swimmers and snorkelers. Often, with the progression of the disease, secondary infection develops, provoking suppuration in the ear cavity;
• traumatic otitis media is a pathology in the hearing aid, triggered by injuries to the brain, skull or spine. Fractures of the bones in the skull lead to deformation of the auditory ossicles and perforation of the membrane, resulting in inflammation and hearing impairment;
• posttraumatic otitis - infectious diseaseresulting from injury to the hearing system. Reducing the barrier function of tissues against the background of their damage creates conditions for the reproduction of bacteria or viruses that provoke purulent processes in the ear;
• hemorrhagic otitis media - a pathological change in the condition of the tympanic cavity, caused by the accumulation of hemorrhagic (bloody) exudate. For this reason, the permeability of the blood capillaries in the membrane increases significantly, which leads to a decrease in its elasticity and, consequently, impairment of hearing.

The transition of the disease to the chronic form leads to a significant deterioration of health and the risk of pathological changes not only in the tissues, but also in the periosteum.

It should be noted that the ENT disease is much more common in children than in adults. This is due to the poorly developed structure of individual parts of the organ of hearing, as well as reduced body reactivity. Infectious diseases, injuries, lack of hygiene, allergic reactions, vitamin deficiency, hypothermia or internal boils   can trigger the development of pathology.

At the age of 10-12 years, the following types of ear otitis are most common:

• flu otitis - viral diseasedeveloping on the background of general infection of the body with the influenza virus. Pathogenic agents penetrate into the hearing aid by hematogenous means, as a result of which the inflammatory process develops. In 65% of cases, the disease occurs in children under the age of 12 years, which is associated with insufficient reactivity of the immune system and its inability to resist viral pathogens;
• secretory otitis (catarrhal) - occurs mainly in children aged 2 to 8 years. It is provoked by pathogens of microbial or viral origin, whose vital activity leads to inflammation and the separation of exudate from the ear. The catarrhal form of pathology may be a consequence of rhinitis, sore throats and other acute respiratory viral infections;
• perforated otitis - a pathology that occurs mainly in the mucous membrane of the tympanic cavity. One of the main signs of the disease is suppuration, which contributes to the development of hearing loss. Pathology develops predominantly in children under the age of 3-4 years due to infection of the nose (chronic rhinitis, sinusitis).

Inflammation of the ear cavity leads to the development of serious pathologies, most of which lead to hearing loss and hearing loss. For this reason, when the first signs of pathology appear, you should seek help from a doctor.