Otitis media ( ear infection ) - Causes, Symptoms and Treatment .MF .
Otitis - a general definition of inflammatory diseases of the ear.
ear - a rather fragile body, whose work is dependent on the accuracy of the smallest movements of all the elements of which it is composed, so nature has taken care of its protection.The main part of the ear is in the depth of the temporal bone.From the outside world it communicates with the hearing organ by means of two channels.This is a channel for the sound - the external auditory canal, and the channel for air - Syrinx.
external auditory meatus ends blindly.From the middle ear cavity it is separated by the eardrum.Eustachian (auditory) tube is an element informing the cavity of the middle ear and the nose.In addition to the ventilation function is responsible for maintaining the pressure equal on both sides of the eardrum, which is necessary for the smooth conduct of sound.
Since inflammation of the nasopharynx for us is almost commonplace, it is clear that the auditory tube is the most common
Recently, more and more of our compatriots settled in the fashionable classes such extreme forms of dispute as diving and climbing.And are at risk for inflammation in the ear.This is due to the rapid changes of pressure in the environment, that injures the hearing aid (barotrauma).There
ear and mechanical damage various objects, impact, or in combination with head injuries.
hearing organ is divided into several departments that perform different functions.What is commonly called the ear in everyday life - the pinna and external auditory canal is used to capture sounds and carrying them to the eardrum.The latter converts the sound into vibrations that are transmitted to the bones of the middle ear system.In the inner ear is the cochlea, which delivered vibrations are converted into nerve impulses.Next to scroll to the inner ear cavity is ravnovesiya- labyrinth organ, which gives information to the brain about body position in space.
Symptoms of otitis
According to anatomical features, otitis media, as the disease is classified in the outer, middle and inner.Clinically it is manifested dysfunction of a particular department.
Otitis externa - is the inflammatory changes of the skin and subcutaneous tissue of the external auditory canal.It can occur as a local inflammation (boil) or have a diffuse character.
furuncle of external auditory canal occurs when the penetration of infection in the sebaceous hair follicles, or ear canal.The main manifestations of this is a pain in the ear canal, which increases with the movements of the lower jaw (chewing, speaking) as the joint of the lower jaw has pressure on him.The general condition suffers slightly, perhaps a slight fever.Usually the boil opened independently after ripening, and it leads to better health.Hearing a patient with this disease do not suffer.
diffuse otitis externa in most cases develops as a complication of chronic suppurative otitis media.The reason for this is the constant purulent discharge through the damaged eardrum and infection of the tissues of the outer ear canal.It is manifested by pain, redness in the ear canal.Sometimes diffuse (diffuse) otitis media may be caused by irritation of the auditory meatus chemical or mechanical trauma to the accession of infection.
most common acute inflammation of the middle part of the organ of hearing.
Tubotit (evstahiit) an inflammation of the Eustachian tube.She was the first reacts to the penetration of infection from the nasal cavity swelling, redness.In this clearance it is often closed due to swelling and pressure in the middle ear is reduced.The patient will feel it in the form of hearing loss, the feeling of fullness and a sense of his own voice in the great ear.Usually congestion slightly decreases if swallowed saliva or chewing, as this short-term clearance of the auditory tube is opened.
If at this stage the disease was not stopped by the immune system or via a physician, it covers the whole inflammation of the middle ear cavity.There are a pain in the ear, shoot, smack in the jaw, temple and neck, fever up to significant numbers, reduced hearing.This is due to the appearance in the middle ear cavity fluid (exudate), which soon becomes purulent.
On the third - the fourth day of the disease is developing the next stage of inflammation when under the influence of pus formed by a hole in the eardrum (perforation), and through it there is an outflow of fluid in the ear canal.That is, the patient can see that the fluid escapes from the ear canal.After perforation usually occurs some improvement in the patient's condition, the temperature is reduced, the pain decreases.
If not carried out proper treatment of otitis media, the cavity fluid becomes thick, it appears the strands of fibrin formation and adhesions, and scarring.Recent impede proper operation of the auditory ossicles, which is fraught with persistent hearing impairment.
main complaint of patients with otitis internal (labyrinthitis) is dizziness, combined with persistent hearing loss and tinnitus.This is located in the inner ear labyrinth chamber (equilibrium organ).Dizziness can be in various diseases, but if it came suddenly, after undergoing a cold, accompanied by nausea and vomiting, you should get advice about ear disease.The infection can get into the inner ear with the inflammation of the middle of his department, with a current of blood from other foci of inflammation, or inflammation of the brain at the site adjacent to it.
diagnosis of otitis
How to identify otitis media?To do this, be sure to should consult an ENT doctor.Otolaryngologist deals with problems of diseases of the ear, nose and throat as well as diseases of these organs often interrelated.If the ENT doctor's consultation is not possible, you should contact your GP or therapist.
physician must conduct inspection of the ear, nose and throat with the help of special tools and assessing the patient survey data, to appoint additional examination (if necessary) and treatment.
as methods of confirming and clarifying the diagnosis, blood tests can be assigned, which revealed signs of inflammation (erythrocyte sedimentation rate increase, an increase in the number of white blood cells, etc.).
To check the extent and the level of destruction carried out audiometry hearing.The penetration of sound waves takes place in the organ of hearing by air and bone path.bone the way work is checked by using tuning forks.Air conductivity through audiograph examined.The patient wears headphones, and he is asked to press the alarm button as soon as he hears the sound.The doctor gradually increases the strength and frequency of the beep on audiograph, noting the patient's level of perception.
If the visit to the doctor is the same with suppuration step in breaking the eardrum, is to more accurately determine the causative agent of the disease produces microscopic and direct microscopic examination.That is, try to see the pathogen through a microscope, or grow a large number of "individuals" in the medium and determine the type of microbe.It may take 3-4 days.But the results of this survey, you can specify the treatment is specific to the identified microbe.
Otitis in a child
Almost every child under three years of age at least once transports otitis.To do this, there are a number of predisposing factors.
- Anatomically ear in children is characterized by a broad and short auditory tube, which is also horizontal.This facilitates the penetration of the infection.
- The mucous membrane of the middle ear cavity in children more thick and loose.This impairs its power, and it promotes inflammation.
- Imperfection of the baby's immune system, lack of acquired immunity leads to frequent colds in children, which, in turn, complicated otitis.
- In the period from one year to three years actively developed lymphoid tissue.This thymus and tonsils (adenoids).They are not only a hotbed of chronic infection, and, upon reaching a significant size, may overlap the lumen of the auditory tube, disrupting air exchange between the middle ear and the nose.
- during childbirth because of anatomical features may occur from entering the amniotic fluid in the middle ear cavity.They carry not only a breeding ground for germs, but also can be infected by them directly.
- Infants are constantly in the horizontal position.When the food arrives in this position promotes wicking milk or formula into the auditory tube.Therefore, it is necessary to feed the children in the position raised to 45 °.
- eardrum in children is thicker, it is very difficult to break.Since the normalization of the outflow of fluid from the middle ear cavity significantly improves the condition of the patient and accelerates the healing, the perforation is delay indication for punctured eardrum.
Communication with children is difficult, they can not express their complaints, the doctor is difficult to evaluate subjective outcomes.Young patients are worried, wake up at night screaming, rub the affected ear on the pillow, touched his pen.It is deteriorating and appetite, as earaches enhanced by sucking due to increased pressure in the ear.Significantly worsens and the general condition of the child: fever (up to 38-40 degrees), there is a weakness, lethargy, and sometimes nausea and vomiting due to severe intoxication.
so-called childhood diseases - scarlet fever, measles, chicken pox - are also often complicated by otitis.In this case, it takes place especially hard, sometimes even hitting the inner ear, and leads to substantial hearing loss.
All children with acute otitis media should be immediately hospitalized in ENT - Hospital.After all, the deterioration of the trade sometimes requires urgent action.
treatment of otitis
treatment of otitis media varies depending on the region and the extent of damage, but in any case, should be comprehensive.
It is imperative that the appointment of antibiotic therapy.Only when the local manifestations of otitis externa is enough purpose antibacterial agents locally.In all other cases, the treatment is added to the local oral treatment, and sometimes injections.To protect the intestinal microflora appropriate drugs are taken in parallel (Hilak fort baktisuptil).
to remove edema may antihistamines (allergy) preparations.
If the cause of otitis steel inflammatory diseases of the nasopharynx, then spend treatment aimed at their elimination.Required appointed vasoconstrictor nose drops, preferably in the form of a spray.They are used after the reorganization of the nasal passages to the drug got into the auditory tube (this allows you to remove the swelling and its lumen and improve patency).
These assets are not used longer than 4-5 days, since to them develops addictive.In addition, they are contraindicated in children under one year, so the child can drip into the nose only Protargolum or sodium sulfatsil (sulfacetamide) for the same purpose.
to lower the temperature and reduce pain in the ear prescribe NSAIDs on the basis of paracetamol (Panadol), ibuprofen (Nurofen), Nise.
Local treatment depends on the stage of the disease.In doperforativnoy stage otitis actions aimed at restoring the drainage function of the auditory tube.Perhaps the use of painkillers and anti-inflammatory drops into the ear canal (otipaks, otirelaks).Sometimes you need to conduct micro-incision of the eardrum (paracentesis) to facilitate the state.
also helps physiotherapy: VHF, UHF, light solljuks, poluspirtovye compresses to the affected ear.
If all the above steps have not led to the regression process or treatment was initiated at the stage of the tympanic membrane perforation, the first step is to ensure a good outflow of pus from the middle ear cavity.To do this, carry out regular cleansing of the external auditory meatus secretions.Sometimes through a hole in the eardrum, the introduction of drugs into the area of inflammation including prescription of antibacterial drops (tsipromed, Otofa et al.).
After calming down the process, it is desirable to hold several sessions of massage of the eardrum and the auditory tube blowing.This greatly facilitates removal of liquid residues from the cavity of the middle ear and tear thin fresh adhesions formed due to the inflammatory process.
While improving patient to recuperate recommended polivitaminoterapii course.
Complications of otitis
Do not think that otitis media - a harmless colds.In addition, for a long time that he knocks out man "off track", reducing its ability to work not less than 10 days, may develop irreversible changes to the persistent deterioration or complete hearing loss.
One of the serious complications of otitis media is otogenny meningitis (inflammation of the meninges, the cause of which is an infection of the ear).Since the ear has a rather complex structure with many small cavities, it is often at unreasonably early termination of antibiotic therapy or no treatment occurs chronic process with suppuration of the mastoid (mastoiditis), the transition of inflammation on the joint of the lower jaw and salivary glands.Often, for the treatment of these processes require surgical treatment.In this case, often the patient's disability.
Otitis requires serious and careful attitude.
prevention of otitis
For the prevention of otitis to avoid hypothermia, time to treat nasopharyngeal infection, during a cold I clean the nasal passages (not dramatically, at one time with only one hand, not to involve mucus in itself), and to prevent other situationdecreased immunity.
Therapist Moskvina Anna