Middle ear disease symptoms causes prevention. Inflammatory diseases of the middle ear. Mastoiditis: symptoms and treatment

The human ear in medicine is divided into three sections: external, middle and internal. Various diseases can occur in any part of the ear and cause negative consequences. Therefore, it is necessary to protect the hearing organ from possible mechanical damage, atmospheric influences, as well as observe hygiene rules and carry out timely prevention.

The main causes of diseases

Many factors can contribute to hearing loss. Naturally, for the correct diagnosis and the appointment of subsequent treatment, you should consult a specialist.

If there has been a decrease (complete or partial) in the susceptibility of sounds, urgent measures must be taken in order not to suffer further from complete deafness. Particular attention should be paid to this problem if it arose during a stroke or injury.

There can be several reasons for hearing loss:

• Damage to any part of the brain or a violation of its blood circulation;
• Blockage of the auditory organ, including foreign objects;
• Mechanical damage;
• Colds or infectious diseases (for example, measles, rubella, otitis media, sinusitis, influenza). In addition to hearing loss, there are others;
• Sudden pressure drops;
• Stressful situations, accompanied by high nervous tension;
• Sports activities (snorkeling, heavy lifting);
• Side effects of certain medications.

Common symptoms and types of human ear diseases

The main symptoms of a beginning ear disease in a person include: headache, dizziness, fever and general malaise. But, since many other diseases are characterized by such signs, you need to know that with ear diseases, there may be a violation of coordination of movement, nausea, and vomiting. Ear diseases can be caused by both inflammatory processes and other factors.

Diseases of the middle ear: otitis media

Diseases of the middle ear occur quite often and occur in people of any age. But they are especially dangerous for children. If left untreated, they can lead to severe hearing loss. In addition, the middle ear is located very close to the membranes of the brain. Therefore, inflammatory processes in it can negatively affect the state of the brain.

Inflammatory diseases of the middle ear are divided into catarrhal and purulent. Most often, these are various forms of otitis media, ear diseases that occur during the transition of an infection located in the nasopharynx.

Diseases of the inner ear: hearing loss and others

Diseases of the inner ear can occur for several reasons:

• congenital anomaly;
• The transition of an infection that has arisen in the middle ear or meninges;
• Transfer of inflammatory processes and intoxication through the blood;
• Damage to nerve cells;
• Prolonged exposure to noise;
• Contusion and rupture of the eardrums.

The most common diseases of the inner ear are: labyrinth, hearing loss, Meniere's disease and otosclerosis.

Diseases of the outer ear: plugs, eczema and others

Diseases of the external ear can be caused by:

• mechanical damage,
• inflammatory processes,
• allergic reactions,
• penetration of foreign bodies.

The most common are the following diseases:

• Exostosis (bone growth in the ear canal);
• Sulfur plugs;
• External otitis;
• Otohematomas;
• Erysipelas;
• Herpetic lesion;
• Eczema.

Read about otitis externa in children.

Common types of diseases: symptoms and treatment

Otitis

This is one of the most common ear diseases. It is characterized by the occurrence of pain in the ear, and possibly in both at once. The pain can be aching or shooting, keep constant or periodically pass. If you do not take timely measures to treat otitis, then the general condition worsens sharply, the temperature rises, pain intensifies, and pus may appear.

The causes of otitis media can be:

• infections brought by foreign bodies (for example, sticks, toothpicks) or passed from the respiratory tract;
• congestion in the ear canal fluid.
• Low immunity or long-term use of antibiotics can provoke the disease.

According to their type, otitis media are internal, middle and external. This disease often becomes chronic. Only a qualified specialist can recognize the type of otitis media and prescribe the required treatment after passing tests to the patient and passing an additional examination. It could be:

• complex treatment of the ears and nasopharynx (the main focus of infection),
• ointments and compresses for the skin,
• physiotherapy procedures.

In certain cases, conservative treatment alone cannot be dispensed with and surgical intervention has to be resorted to.

Acoustic neuritis: symptoms and treatment

Acoustic neuritis can be either congenital or acquired. It can be called:

• Infections (eg, ear infections, influenza);
• Diseases of the heart and kidneys;
• Tumor or circulatory disorders of the ear;
• allergic reactions;
• Traumatic brain injury.

With the development of neuritis, auditory properties are disturbed, severe pain, noise or a sensation of ringing in the ears appear. In severe forms, balance is lost, coordination of movements is disturbed, and hearing may completely disappear. Such cases require urgent diagnosis and treatment, as the auditory cells can finally die. An untimely visit to a doctor can also lead to the transition of the disease to a chronic form, which requires constant monitoring and treatment procedures.

Neuritis has no external manifestations, so an accurate diagnosis can only be made after passing an auditory examination (audiometry). At this stage, the stage of the disease is revealed, and then the appropriate treatment is already prescribed (diuretics and vasodilators, antibiotics, biostimulants, vitamins, and others).

Hearing loss: causes and types

Hearing loss is a persistent hearing loss that causes significant inconvenience in communication. There are different types of deafness. The disease may be conductive, neurosensory and combined type. Depending on the severity of the disease, three degrees of hearing loss are distinguished. Also she can be sudden, acute and chronic forms.

conductive hearing loss is provoked by obstacles that interfere with the normal perception of sound. It can be sulfur plugs in the outer ear or its pathology. For the middle ear, these are damage to the eardrums, pathology of the auditory ossicles, and the consequences of otitis media. The auditory canals can be blocked by liquid or purulent discharge that has appeared due to diseases of the nasopharynx. In certain cases, surgical methods of treatment are used (for example, replacing the auditory ossicle with a ceramic or plastic prosthesis). You may also need to wear a hearing aid.

At neurosensory hearing loss occurs damage to the organs that perceive sounds. In addition to the fact that the patient's ability to perceive sounds decreases, he perceives them in a distorted form. The causes of sensorineural hearing loss can be:

• Acoustic neuritis;
• Meniere's disease;
• Injuries in the temporal region and damaged inner ear;
• Age changes.

For this type of ear disease in humans, surgical treatment is not suitable. If the disease was diagnosed at the initial stage, then complex therapeutic treatment is applied (drugs, physiotherapy, electrical stimulation). If the disease has reached a severe stage, you need to use hearing aids.

mixed hearing loss is characterized by a combination of conductive and neurosensory forms. For its treatment, both medical and surgical methods of treatment are used.

Otomycosis: causes and treatment of the disease

Otomycosis of the ears, like all types of mycoses, refers to fungal diseases. At the initial stage, it is difficult to recognize: slight tingling, mild itching. Then there are noises, dark discharge, pain, redness of the skin, hearing disappears.

Otomycosis can occur for several reasons:

• Unreasonable, too frequent procedures in the auditory canal, leading to serious violations of the microflora;
• Foreign bodies in the ear;
• Profuse perspiration;
• Dermatitis, accompanied by severe itching;
• allergic reactions;
• Low immunity;
• Injuries.

Otomycosis, like most fungal diseases, is easier to treat in the early stages of the disease, when it has not yet had time to penetrate deep inside. When he has already begun to actively multiply, the treatment is complicated and requires a lot of effort and time.

Otosclerosis of the ear: enlargement of the cochlea

The causes of this disease have not been fully identified. It is believed that its development is mainly due to hereditary factors. It can also be triggered by infectious diseases against the background of an existing predisposition to it.

Otosclerosis is characterized by an increase in the cochlea, which interferes with the mobility of the ear bones. There are three stages of the disease, which can develop over decades. A feature of the disease is that hearing loss occurs immediately in both ears.

Medical methods do not bring the desired result. Surgical intervention (installation of stirrup prostheses) is indicated, as a rule, after forty years. In this case, the operation is performed alternately on each ear with an interval of at least six months. Hearing recovery is noticeable already a week after the operation. In individual cases, it is possible to help the patient only with the use of a hearing aid.

Eustachitis or tubo-otitis

Eustrachiitis (turbo-otitis) occurs when the auditory tube and tympanic cavity become inflamed. Caused by colds. The characteristic features are:

• ear congestion,
• noises,
• hearing loss.

If the disease is not too advanced, then it is easily amenable to complex treatment of the ears and nasopharynx. Sprays or drops for the nose are prescribed, washing it with special preparations. Shown blowing the auditory canals, physiotherapy. If all recommendations are followed, hearing is restored in a couple of days.

Meniere's disease: cochlear, vestibular and classical

There are many versions of the occurrence of this disease. The main one is that Meniere's disease is caused by a large volume of fluid that accumulates in the area of ​​​​the inner ear.

The most severe symptom of the disease is intermittent severe dizziness. It is often accompanied by:

• vomiting,
• tachycardia,
• imbalance,
• general severe condition of the body.

The duration of attacks can be from several minutes to several hours. At the end of the relapse, a painful condition and weakness of sound perception may be observed for some time.

The disease is progressive in nature, and over time, attacks become more frequent and stronger. At the same time, residual effects (hearing loss, noise, weakness) can be felt in the intervals between them. Tinnitus or tinnitus is often isolated as a separate disease. After each attack, hearing deteriorates, and as a result, final deafness occurs.

Treatment of the symptoms of Meniere's disease is carried out both by medical methods and by surgical methods. They are selected after examining the patient and determining the type of disease ( cochlear, vestibular, classic). A certain diet is also selected and restrictions on physical effort are introduced.

Most common ear problems in children

Children are most susceptible to ear diseases in the first three years of life. During this period, almost every infectious disease is accompanied by mild inflammation of the ear, mainly otitis media. If timely measures are taken for treatment, then this does not lead to serious problems. Allergic reactions, which often occur in children of this age, can also provoke ear diseases. It is important to identify the causes in the early stages in order to prevent the development of a chronic form of the disease. If there are people in the family with any hearing impairment, the child should be checked for the presence of hereditary forms of the disease.

To avoid serious consequences, it is necessary to start diagnosing and treating diseases of the ears, as soon as the first signs of hearing loss appear.

Middle ear disease is the most common form of hearing loss. They affect adults and especially children. To date, doctors have developed a large number of modern techniques that can provide treatment for the middle ear, the symptoms and treatment of the most common diseases of this localization will be discussed below.

This disease of the middle ear occurs in two main forms: catarrhal and purulent.

In the catarrhal form, the tympanic cavity, mastoid process and auditory tube are affected. The main pathogens are bacteria (pneumococci, streptococci, staphylococci). The development of the disease is also facilitated by:

• infectious diseases;
• hypothermia;
• diabetes;
• avitaminosis;
• kidney disease.

The penetration of pathogenic microflora occurs mainly through the auditory tube from the nasal cavity in diseases of the mucous membrane (influenza, SARS, acute respiratory infections, rhinitis).

This is facilitated by improper blowing your nose (through two nostrils at the same time), sneezing, coughing.

In childhood, infection occurs more easily due to the structural features of the tube (it is wide and short). Also, cases of infection through the blood with scarlet fever, measles, and tuberculosis are not uncommon. Adenoid growths that overlap the mouths of the auditory tubes often lead to relapses and transition to a chronic form.

Symptoms characteristic of this disease of the middle ear:

• severe pain (aching or throbbing), radiating to the temporal and occipital region of the head;
• feeling of congestion and noise;
• hearing loss;
• temperature rise;
• deterioration in sleep and appetite;
• tympanic membrane reddened and painful to touch.

Treatment, as a rule, is carried out at home, bed rest is prescribed. Hospitalization is carried out only with signs of complications (meningitis, mastoiditis). Conservative treatment of catarrhal otitis is carried out as follows:

• Removal of pain syndrome with special drops (otinum, otipax) or other means (novocaine, carbolic glycerin, 70% alcohol). You can use slightly warmed vodka or vaseline oil. 5-7 drops of the medicine are instilled into the ear canal and covered with gauze or cotton turunda.
• Lowering the temperature with antipyretics (paracetamol, ibuprofen, analgin, aspirin).
• The use of local heat to warm up a sore spot (heater, blue lamp, UHF, vodka compress).
• Vasoconstrictive drops and aerosols in the nose (sanorin, naphthyzine, galazolin, ephedrine) 5 drops at least 3 times a day.
• Bactericidal drops (protargol, collargol);
• Sulfonamides, antibiotics.

Washing the nasal cavity, especially in children, without medical supervision is undesirable in order to avoid worsening the condition.

The acute purulent form mainly develops as a result of advanced catarrhal otitis media. Weakening of the body due to past infections, reduced immunity, diseases of the blood and upper respiratory tract (sinusitis, deviated nasal septum, adenoids) contribute to the development of the disease. This is a serious disease of the middle ear, the symptoms in adults and children make up the following clinical picture:

• suppuration from the ear canal (periodic or constant);
• perforation of the eardrum;
• hearing loss (the degree depends on damage to the auditory ossicles).

Discharge from the ears is most often purulent-mucous and odorless. Sometimes unilateral lesions can last for years without serious complications. The diagnosis is established by visual examination of the organ and characteristic symptoms, sometimes an x-ray of the temporal lobe of the head is taken and cultured for bacteria.

The preperforative stage is characterized by pain radiating to the head, a feeling of congestion and hearing loss, the eardrum is edematous and protruding. After the rupture of the membrane, pus flows out, and the patient's condition improves markedly. Small holes overgrow without a trace, after larger ones, scars and adhesions may appear.

Therapy consists in curing diseases of the upper respiratory tract, as well as in the regular removal of pus and the use of astringents and disinfectants. The otolaryngologist may prescribe washing with a 3% hydrogen peroxide solution or antibiotics, which are also blown in powder form into the auditory tube. Drugs are changed every two weeks to prevent the development of microbial resistance to them. Physiotherapy (UHF, UVI, laser therapy) gives good results. Polyps and granulations are removed surgically.

If adequate treatment is not carried out, then serious complications are possible - hearing loss, mastoiditis, meningitis. In addition, when a large number of coarse adhesions and scars occur, the mobility of the auditory ossicles is severely limited, hearing deteriorates, that is, adhesive otitis media develops.

With exudative otitis media, the Eustachian tubes are blocked and fluid accumulates in the middle ear, the treatment is somewhat different from other types of inflammation. If within a month and a half the exudate (sticky or watery) does not come out naturally when nasal breathing is restored, it is suctioned (myriigotomy) and the cavity is ventilated, or adenoidectomy.

mastoiditis

It is an inflammation of the mastoid process of the temporal bone, mainly occurring as a complication of acute otitis media. At the same time, a purulent process develops in the cells of the process, which is able to go into a destructive stage, in which the bone bridges of the mastoid process are destroyed, and a single cavity (empyema) filled with pus forms inside. The disease is dangerous because pus can get into the meninges and lead to meningitis.

Typical symptoms:

• poor general condition of the patient;
• changes in the composition of the blood;
• elevated temperature;
• suppuration from the ear and throbbing pain;
• redness and swelling in the ear area;
• protrusion of the shell.

On examination, the overhang of the posterior upper wall of the ear canal is noticeable. An X-ray of the temporal bones and a comparison of the hearing organs with each other play a particularly important role. MRI and computed tomography data are also used.

Conservative therapy consists in the use of broad-spectrum antibiotics, facilitation of the outflow of pus, parallel treatment of the nasopharynx and mucous membranes of the paranasal sinuses. With signs of a destructive stage, surgical intervention is immediately performed. It consists in trepanation of the mastoid process and removal of all affected tissues through an incision behind the auricle. Endotracheal or local infiltration anesthesia is used. With a normal outcome of the operation, the wound heals in 3 weeks. However, sometimes, as a result of surgery, damage to the facial nerve can occur, especially in children.

Glomus tumor of the middle ear is a benign neoplasm that is localized on the wall of the tympanic cavity or the bulb of the jugular vein, and is formed from glomus bodies. It is impossible to completely remove it. Despite its benign nature, the tumor can grow and affect healthy tissues, including vital organs (brain stem, medulla oblongata, blood vessels), which can be fatal.

Signs of a glomus tumor are a pulsating red mass behind the eardrum, facial asymmetry, hearing loss, and dysphonia.

To more accurately determine the location and size of the formation, MRI, CT, angiography and histological examination are used.

Sometimes embolization (cessation of blood supply) of the neoplasm is carried out first, which leads to a suspension of its growth. After that, the tumor is surgically removed (in whole or in part). Gamma Knife or radiation therapy is also used. A positive result is more likely with early detection. Timely intervention can significantly improve the patient's quality of life.

Sources: medscape.com,

Chronic purulent otitis media (otitis media purulenta chronica)

This disease is a continuation of an acute purulent process in the middle ear. Its occurrence is due to the virulence of the microflora in the focus of inflammation, the weakness of the immune defense reactions of the body, irrational treatment, past general diseases, the presence of adenoids, and insufficient function of the auditory tube.

The disease can last for years, decades and requires compliance with many mandatory conditions during the treatment period. Often chronic inflammation of the middle ear is associated with otitis media suffered in childhood, especially with scarlet fever, measles, influenza. The causative agent and the factor supporting persistent inflammation in the ear is the coccal flora, but the process caused by Proteus, Pseudomonas aeruginosa, is especially persistent.

Clinically, two forms of chronic suppurative otitis media are distinguished - mesotympanitis and epitympanitis.

Mesotympanitis is characterized by prolonged purulent discharge from the ear, sometimes with remissions. Pus is viscous, sticky, viscous, in large quantities, odorless. As a rule, mesotympanitis does not give complications. Perforation of the central type occupies part of the pars tensa, has different sizes, but its edge does not reach the edge of the tympanic membrane, its rim remains.

Hearing is reduced due to a violation of sound conduction (deterioration in the audibility of low sounds, lateralization of sound towards the worse hearing ear, negative Rinne experience, bone conduction curve may be normal, air conduction curve drops to 40-60 dB).

For mesotympanitis, it is typical that the lesion is mainly only of the mucous membrane of all parts of the middle ear.

epitympanitis

On the roentgenogram of the temporal bones, destruction is revealed in the area of ​​the epitympanic space.

Epimesotympanitis

Treatment

In addition to alcoholic solutions of boric acid, collargol, protargol, sofradex, dioxidin, solutions and powders of antibiotics, a weak solution (0.25%) of formalin, a solution of furacilin, a 0.25% solution of silver nitrate are used, ozone preparations (gaseous ozone and ozonated isotonic sodium chloride solution). The latter are especially indicated for patients in whom multi-resistant pathogenic microflora is sown to antibacterial drugs or their intolerance (allergic reactions), etc. is observed. Often it is necessary to restore the function of the auditory tube. To do this, use the blowing of the ears according to Politzer, catheterization of the tubes.

To evacuate the contents from the upper floors of the tympanic cavity, the outflow from which can be difficult, use the method of washing the epitympanic space. In this case, together with the washing liquid introduced under a certain pressure (furatsilin, isotonic sodium chloride solution, alcohol solutions of boric, salicylic acids), thick pus, dense masses of cholesteatoma are washed out. Washing should be carried out with warm solutions in order to avoid repeated irritation of the labyrinth. The washing liquid plays the role of not only a means of evacuating pus, but also having a healing effect on the tissues of the ear.

Polyps are removed under local anesthesia (solution of trimekain, dikain, etc.) with a small loop, special forceps.

Most patients with epitympanitis require surgery on the temporal bone. Operations can be economical ("sparing" operation on the ear) and "radical", "general cavity", combining the cavity of the mastoid process, the tympanic cavity and the external auditory canal. The goal of a "radical" or economical operation is to prevent the possibility of severe complications of epitympanitis (meningitis, otogenic sepsis, abscess of the brain and cerebellum, labyrinthitis, paresis of the facial nerve).

During a sparing operation, when a "pure" epitympanitis is revealed in a patient, an atticoanthrotomy is performed, trying to preserve the elements of the sound-transmitting system of the middle ear, and, consequently, to preserve hearing.

With a "radical" operation, a thorough removal of all the smallest foci of bone tissue necrosis under a microscope is achieved and plastic surgery of the formed cavity is carried out at the expense of the surrounding skin tissues in order to achieve lining the entire wound surface with an epidermal layer. Only complete epidermization of the walls of the ear cavities allows us to hope for the cessation of purulent discharge, the progression of the destructive process.

In the postoperative period, persistent follow-up treatment is required using vitamin therapy, local application of antibiotics, enzymes, physiotherapeutic methods - UV, UHF, helium-neon laser therapy.

In the case of epimesotympanitis, depending on the degree of destruction in the ear, the activity of the inflammatory process, the nature of the discharge, combined methods of treatment are used (washing the epitympanic space, removal of granulations, cauterization, quenching of the mucous membrane with appropriate drugs), and also resort to radical surgery.

A cavity in the mastoid process after a "radical" operation. Covers the cavity of the auditory canal, mastoid process and tympanic cavity. The back wall of the ear canal is removed

After a successful sanitizing operation and the cessation of purulent discharge from the ear, in some cases, an operation to improve hearing is indicated - tympanoplasty. This operation is applicable for all three types of chronic inflammation of the middle ear.

Types of tympanoplasty (1-5)

According to these principles, there are 5 types of tympanoplasty.
1. If the tympanic membrane is destroyed, the ossicular chain is preserved, the auditory tube is passable, there is only conductive hearing loss, there is no purulent discharge, then an artificial tympanic membrane is recreated from various tissues (muscle fascia, perichondrium, periosteum, preserved tissues, for example, dura mater). It acts as a screen in relation to the window of the cochlea and concentrates the pressure of the sound wave on the ossicular chain.
2. If the tympanic membrane and malleus are destroyed, purulent discharge from the ear is eliminated, the auditory tube is passable and conductive hearing loss is detected, then the flap is placed on the preserved anvil connected to the movable stirrup. Sanitize the bone cavities of the epitympanic space, mastoid process.
3. If the tympanic membrane, hammer and incus are destroyed and a destructive process is observed in the bone structures of the mastoid process, then the flap is placed in the sanitized cavity in such a way that it touches the head of the movable stirrup and at the same time shields the cochlear window, creating a difference in sound pressure on the windows labyrinth.
4. When the entire sound transmission system is destroyed and only the movable base is preserved, the stirrup flap covers the niche of the cochlea window. The flap shields the niche, and thus provides a difference in sound pressure on the windows of the labyrinth.
5. In the case of total destruction of the sound-transmitting system with the base of the stirrup fixed in the vestibule window niche, at the first stages of tympanoplasty, a new “oval window” was created near the ampulla of the horizontal semicircular canal, and the round window, as in the fourth type of operation, was shielded with a tympanic flap. The newly created window in the semicircular canal is also closed with an elastic flap (fascia, vein wall).

The most common type of tympanoplasty is the third. The fourth and fifth types of surgery are less effective in terms of hearing improvement than the types of surgery that preserve the auditory ossicles.

With all types of tympanoplasty, the obligatory conditions are the preservation of the functions of the auditory tube (even its artificial restoration), as well as the preservation of the receptor section of the inner ear.

cholesteatoma

For the first time, cholesteatoma was described by Crouvelier (1836), who called it a "pearl tumor", emphasizing the features of the growth of cholesteatoma in layers from the center to the periphery. Virchow described cholesteatoma in more detail and singled out "primary" and "secondary" cholesteatoma. The secondary, as a rule, occurs against the background of chronic inflammation, and the primary occurs in the brain tissue. There are many theories of the formation and development of middle ear cholesteatoma. One of them explains its formation by the ingrowth of the epidermis through the marginal perforation with epitympanitis, rejection of the epithelium, impregnation with pus, and steady growth. Another theory is that metaplasia of the epithelium into the epidermis and its rejection lead to the development of cholesteatoma. The third theory - the theory of "lost" cells implies that the epidermal patches that exist in the embryonic period form a cholesteatoma in the cavities of the middle ear. The radiograph reveals a defect formed by a cholesteatoma in the bone tissues.

Treatment

Chronic exudative otitis media

Chronic exudative otitis media (gel otitis media, serous otitis media, eustachitis) is characterized by the accumulation of a large amount of sticky and viscous secretion in the tympanic cavity, auditory tube and in the cells of the mastoid process. This jelly-like secret disrupts the mobility of the ossicular chain, the tympanic membrane, and the labyrinth windows.

Patients are concerned about persistent hearing loss, tinnitus, a feeling of fluid transfusion in the ear when moving the head. The disease occurs as a result of dysfunction of the auditory tube, which in turn is due to the pathology of the nasal cavity (adenoids, rhinitis, curvature of the nasal septum) and a sharp increase in the number of goblet cells near the tympanic opening of the auditory tube, producing a viscous secret.

Otoscopy (including a pneumatic Siegle funnel) allows you to distinguish between the level of fluid behind the eardrum, air bubbles in the fluid. The eardrum is yellowish to bluish in color.

The audiogram and tympanogram revealed middle ear dysfunction.

Treatment

Yu.M. Ovchinnikov, V.P. Gamow

Middle ear diseases are relevant at any age, but are most often observed in children. With improper treatment of diseases, the patient's condition worsens, which can lead to a decrease or loss of hearing. The middle ear is close to the meninges, so inflammatory processes can cause some complications of the inner ear, meninges and brain.

Types of inflammatory diseases of the middle ear

According to the nature of the course and inflammation, the following types of inflammatory diseases of the middle ear are distinguished:

• Aerootitis
• Acute and chronic catarrh of the middle ear
• Acute inflammation of the middle ear
• Acute mastoiditis
• Chronic suppurative otitis media
• Specific complications of the middle ear include:
• influenza inflammation
• middle ear syphilis
• Tuberculosis of the middle ear

Each of the diseases has a specific cause.

Aerootitis is an inflammation of the middle ear, which occurs due to a sharp pressure drop. This disease is most susceptible to pilots, divers, floating at great depths. In addition, aerootitis can occur as a result of explosions, blows to the ear or when falling on it.

The occurrence of aerootitis can be affected by colds, rhinosinusitis, a breathing complication in which the ventilation function of the auditory tube is impaired.

With a sharp change in atmospheric pressure, barotitis can occur. Under such conditions, the pressure in the cavity cannot equalize with the increased or decreased pressure in the environment.

Acute catarrh of the middle ear develops as a result of a passing process of inflammation from the nasopharynx to the membrane of the auditory tube and membrane. The chronic form arises from acute catarrh and has another name - adhesive otitis media.

The causes of catarrh of the middle ear are inflammatory processes in the nasopharynx (rhinopharyngitis, adenoiditis, etc.), as well as the presence of various bacteria in the nasopharyngeal cavity: streptococci, pneumococci, staphylococci, etc.

Acute otitis media (acute inflammation of the middle ear) occurs due to the entry into the ear cavity of various bacteria that cause inflammation.

The route of infection is rhinogenic or tubular. The disease can develop both independently and as a complication of sinusitis, bronchitis and other infectious diseases.

Acute mastoiditis is a complication of purulent inflammation of the middle ear. In this case, the tissues of the mastoid process become inflamed. There are 2 stages of mastoiditis - exudative and proliferative-alternative. At the first stage, the bone is not involved in the inflammatory process, the mucous membrane of the process is inflamed and thickened. At the second stage, the bone is destroyed by osteoclasts, granulations and neoplasms form on the bone itself, the cells merge together and their cavity is filled with pus.

Chronic purulent otitis with improper treatment is usually a continuation of acute purulent otitis media. The development of chronic purulent otitis media is affected by impaired nasal breathing, adenoids, and inflamed paranasal sinuses.

In the course of purulent otitis is divided into 2 forms: mesotympanitis and epitympanitis.

Mesotympamit affects mainly the mucous membrane. This form proceeds without serious complications and is treated conservatively.

Epitympanitis affects not only the mucous membrane, but also the bone tissue of the middle ear. This can lead to complications where surgery is required.

Symptoms and signs of middle ear disease

Patients with aerootitis complain of severe and sharp pain in the ear, which varies depending on the severity of the disease; stuffiness and swelling in the ear is felt. In this case, there may be a rupture of the eardrum, which is accompanied by a strong pop and piercing pain. The patient then becomes deaf.

Signs of acute and chronic catarrh of the middle ear are: congestion of both ears when blowing your nose and sneezing, tinnitus, development of hearing loss. There is an effusion in the tympanic cavity, pain is felt that radiates to the lower jaw. If you change the position of the head, then sometimes there is a "transfusion of water in the ear."

In newborns, acute inflammation of the middle ear is very rare. Already at the beginning of the development of the disease, adults complain of pain of a pulsating nature. At the same time, congestion and general malaise are felt. The pain in the ear grows rapidly and radiates to the temples, the crown of the head. In a patient, the temperature can rise to 38 degrees, and in children even up to 40 degrees. In the analyzes, leukocytes and erythrocyte sedimentation rate are increased. In addition, the vestibular apparatus can be irritated, so the patient develops dizziness, nausea and vomiting.

Signs of acute mastoiditis occur at various times after acute otitis media. Some symptoms may be observed already in the first days of the development of the disease, in other cases they occur after 2-3 weeks. The condition of patients deteriorates sharply: the temperature rises, weakness is felt, appetite decreases, sleep is disturbed. The pain is felt both in the ear and in the mastoid process, aggravated by its pressure. Noises in the head appear on the side of the affected ear. On examination, there is redness and swelling of the mastoid process, after a while, pus begins to flow from the eardrum.

In chronic purulent otitis media, pus of a constant or periodic nature appears from the ear. Hearing is reduced, there is noise and pain in the ears, dizziness. Polyps may appear in the tympanic cavity, from which blood protrudes. If purulent otitis media of a chronic form proceeds for quite a long time, then the patient has mixed hearing loss. Pain in the ear occurs only during the period of exacerbation, which is provoked by colds and infectious diseases.

Against the background of infectious diseases, the inflammatory process in the acute middle ear is more severe.

One of the complicated forms of acute otitis media is influenza otitis media. A patient has hemorrhagic and serous vesicles in the ear area.

In this case, hemorrhages appear under the epidermis of the skin. This form of complicated otitis occurs during the period of influenza. The inflammatory process develops in the epitympanic space and affects the inner ear. This contributes to the occurrence of intracranial complications, meningitis.

Syphilis of the middle ear is a fairly rare disease that almost never occurs. It develops slowly, simultaneously with changes in the outer and inner ear. Suppuration in the ear cavity is not observed or occasionally accompanied by a small amount of pus. As a rule, the syphilitic process of inflammation proceeds without pain and without an increase in body temperature. With minor symptoms, inflammation in the middle ear may not be detected. The sound-conducting department is disturbed, low tones are heard worse than high ones.

Tuberculosis of the middle ear or tuberculous otitis occurs as a chronic disease. The infection penetrates the Eustachian tube and is observed most often in patients with lung involvement. The causative agent of tuberculosis can affect the nasopharynx and tonsils and enter the middle ear region through the lymphatic vessels.

The leading position in the occurrence of tuberculous otitis is played by a secondary infection with purulent bacteria. With tuberculous otitis, tubercles are formed, the tissues of which undergo changes.

Diagnosis and treatment of otitis, mastoiditis, catarrh of the middle ear

An ENT doctor can diagnose diseases, taking into account the patient's complaints. The doctor prescribes an otoscopy and, if necessary, an endoscopic examination of the ear, an examination of the auditory analyzer, a bacteriological culture of the discharge from the ear, and an x-ray of the skull.

Treatment of aerootitis is based on the following activities: the use of vasoconstrictor drops in the nose, treatment of the nasopharynx, laying turunda with boric alcohol in the ear. Purulent aerootitis is treated with antibiotics and using a salpingoscope. The auditory tube is cleaned using a special medical instrument - an otosalpingoscope, which is inserted through the mouth or nose.

When the tympanic membrane is ruptured, no intervention is performed. The membrane is prone to self-healing.

In acute and chronic catarrh of the middle ear, chronic foci of infection in the nasopharynx should first be eliminated. To do this, vasoconstrictor aerosols are administered, such as Naphthyzin, Nafazolin, Sanori, etc. In stationary conditions, the auditory tube is blown. For this purpose, an anemization of their pharyngeal mouth is first performed, then a catheter with Hydrocortisone (10-15 drops) is inserted into the tympanic region, or if a viscous liquid is present in the cavity, then Chymotrypsin is used. In this case, antihistamines and decongestants are prescribed.

In order for the contents of the tympanic cavity to dissolve faster, physiotherapy is indicated:

• Warm compresses
• Laser therapy
• Ultra High Frequency Therapy (UHF)
• Sollux lamp

Sometimes surgery is recommended if treatment fails.

The main treatment for acute otitis media includes both symptomatic and anti-inflammatory therapy. Patients are shown bed rest. For this purpose, antibiotics are prescribed (Amoxiclav, Ceftriaxone, Klacid), painkillers (Analgin, Ketons), antipyretics and sedatives. In some cases, physiotherapy methods are used: mud applications, UHF, laser therapy and electrophoresis. In addition, the patient is prescribed anti-inflammatory drops in the ear canal.

Acute mastoiditis is treated mainly by surgery. At the same time, the affected cavities of the mastoid process are opened, pus is removed. After scraping the pus, drug therapy and the following manipulations are performed:

• Daily dressings with ointments Synthomycin, Levosin, Levomekol, etc.
• Antibacterial treatment of mastoiditis using antibiotics Levofloxacin, Clavulanate, Cefuroxime, etc.
• The use of anti-inflammatory and antihistamine drugs: Dexamethasone, Tavegil, Diclofenac, Claritin, etc.
• The wound after the operation heals under a bandage in 3-4 weeks.
• Patients with chronic purulent otitis media are shown antibacterial agents in injections. Anti-inflammatory and antiseptic drugs are injected into the ear, such as boric and salicylic alcohols, a solution of furacilin, dimexide, silver nitrate, etc.
• Enzyme preparations Chymotrypsin, Himopsin, etc. have an effective effect. When purulent otitis media is complicated, Avelox and Sparflo are used.
• With ineffective conservative treatment resort to surgical intervention. Perform myringoplasty - restore the integral surface of the eardrum.

Treatment of complications of diseases of the middle ear involves increasing the immune-biological properties of the body and combating inflammation. The main activities are aimed at increasing the strength and resistance of the body. Local treatment involves the use of antiseptic drugs. If the disease cannot be cured by a conservative method, then it is advisable to use a surgical method. For this purpose, intra-ear surgery is performed.

In any case of inflammation of the middle ear, the outcome is favorable with the timely detection of symptoms and treatment to a specialist.

For preventive purposes, the following measures must be observed:

• Timely treat organs located near the ears (nose, sinuses, pharynx)
• Maintain ear hygiene
• Timely treat inflammatory diseases of the middle ear
• Strengthen the immune system (do hardening, eat fruits, etc.)

The ear has a very complex structure. The hearing aid consists of the middle and inner ear. Pathologies of the organ of hearing today are diagnosed very often and can affect any element. They can cause dangerous complications, including complete hearing loss. Therefore, at the first manifestations of a violation, it is worth contacting the ENT.

Human ear diseases

Doctors distinguish several categories of hearing loss. may be inflammatory, non-inflammatory, fungal or traumatic. Each group of ailments is characterized by specific symptoms.

Non-inflammatory

Such diseases of the organ of hearing occur frequently. They cause a whole range of unpleasant symptoms. This group includes the following:

1. This anomaly affects the inner ear. Symptoms of the disease are nausea, vomiting, dizziness. It also causes tinnitus. The disease is characterized by an increase in the volume of fluid in the ear. It puts pressure on the cells responsible for regulating vestibular processes. If these signs can be corrected, then the progressive hearing loss cannot be eliminated.
2. - is considered a hereditary pathology. It is characterized by damage to the bone of the ear capsule. This process usually results in hearing loss.
3. vestibulocochlear nerve - this disorder is also quite common and provokes a stable hearing loss. This symptom is considered the most dangerous, since it is almost impossible to eliminate it.

For the treatment of non-inflammatory pathologies of the hearing organs, modern technologies are usually used - laser exposure, ultrasound, endoscopic interventions. In some cases, radio wave operations or the use of advances in cryosurgery are required. Thanks to these techniques, it is possible to help even those people who have completely lost their hearing.

Pictured is the structure of the human ear.

Inflammatory

Such pathologies are diagnosed most often. These include various, etc. Such diseases usually become a consequence.

The most common disorder in this group is otitis media. This disease can manifest itself in a form that is accompanied by noticeable suppuration in any part of the ear. Also, the entire hearing aid is often involved in the abnormal process.

With inflammation of the middle ear, symptoms such as an increase in temperature and severe hearing loss appear. People often experience shooting pain in their ears.

What happens in the ear with otitis

fungal

Infection with fungal microorganisms often leads to ear diseases. Usually such problems are associated with the activity of opportunistic fungi. Such pathologies are quite difficult and can lead to the development of sepsis. Most often they are the result of traumatic injuries and surgical interventions.

These disorders are accompanied by constant itching, discomfort in the ears, the appearance of noise and discharge. Symptoms may vary depending on the type of fungal microorganism. In this case, any components of the hearing organ can suffer - the outer, middle or inner ear.

Chronic fungal pathologies require long-term treatment. They often develop against the background of weakened immunity, metabolic disorders, chronic pathologies. Often such processes occur in people with diabetes. That is why the doctor must determine the cause of the development of the disease and only after that prescribe treatment.

About the types of otitis media treatment methods for the disease:

Traumatic lesions

These violations may include:

• , which is a hemorrhage between the periosteum and cartilage - this disorder is characterized by suppuration;
• - it is due to air pressure or external influences;
• due to bites or bruises;
• burns;
• - is the result of a drop in atmospheric pressure;
• - occurs as a result of prolonged exposure to loud sounds;
• is the result of air vibrations.

Symptoms of such disorders depend on the type of damage. Thus, patients may experience the following symptoms:

Watch a video with doctor's advice on the prevention of ear diseases:

Preventive measures

To prevent the occurrence of serious diseases of the ears, you need to deal with their prevention:

1. Be sure to wear a hat in cool, windy or rainy weather;
2. Do not use cotton swabs, pencils, matches to clean the ear canal from sulfur. These measures only stimulate its formation, which leads to compaction of the plug in the tympanic membrane. As a result, the process of natural cleansing of the outer ear is difficult. In addition, there is a risk of damage to the membrane and ear canal.
3. If you need to frequently contact with loud sounds, you need to wear special headphones or earplugs.
4. Acute and chronic lesions of the nasopharynx should not be ignored. These processes can spread to the organs of hearing.
5. Systematically visit an ENT doctor for preventive examinations. Thanks to this, it will be possible to identify any violations at the initial stage of development.

Today, many pathologies of the ears are known, which are accompanied by unpleasant manifestations and can lead to a pronounced hearing loss. To prevent this from happening, it is very important to control your health and visit an otolaryngologist if any suspicion arises.