Due to the complex structure of the ear, a person is able to perceive the sounds of the world.
The slightest failure in this debugged mechanism leads to hearing impairment.
Inflammatory processes that are accompanied by intense painful sensations and dangerous with their complications are also frequent.
A common type of pathology of inflammatory nature is inflammation of the middle ear, requiring immediate and specific treatment.
Causes of middle ear inflammation
The middle ear is a functional link connecting the outer and inner ear. The sound waves that cause the vibrations of the eardrum, in the middle ear, are transformed into fluid oscillations that capture the sensitive receptors of the inner ear.
Such a process is provided by special bones in the form of a hammer, a stirrup and an anvil located in the middle ear. For stability, a certain pressure in this cavity is needed, which is regulated through the Eustachian tube connecting the middle ear to the nasopharynx.
Pathogens, penetrating through the Eustachian tube into the middle ear, provoke the onset of the inflammatory process.
The occurrence of middle ear inflammation provoke:
1. Bacteria. They are related to dormant infections, which are activated under favorable conditions. The inflammatory process in the middle ear is associated with the stormy activity of streptococci, staphylococci, pseudomonas or hemophilus bacilli.
2. Viruses. Getting into the nasopharynx respiratory infections in the form of rhinovirus, adenovirus, influenza virus, parainfluenza can spread to the ear cavity and provoke catarrhal inflammation.
3. Fungi. Inflammation in the ear of the fungal form is rare. Associated with inadequate therapy with antibacterial agents that provoke the spread of the fungus Candida with dysbacteriosis, weakened immunity.
Directly in the middle ear, fluid is constantly produced, which is discharged into the nasopharynx through the Eustachian tube, creating a protective barrier against infection. In cases where mucosal edema occurs, the output is blocked and fluid begins to accumulate. Thus, a favorable environment is created for the development of pathogenic infections.
Congestion of pus with inflammation of the middle ear
The human body is able to recognize and suppress pathogens. Therefore, not every cold or viral disease ends with inflammation of the middle ear.
Failure in the protective mechanism occurs:
• with a long infectious process in the nasopharynx;
• due to swelling of the nasopharynx associated with chronic or prolonged nasal congestion;
• after severe hypothermia;
• as a result of allergic reactions;
• with reduced immune abilities of the body;
• under the influence of chronic diseases;
• with vitamin deficiency and poor nutrition;
• due to disruption of metabolic processes.
The risk of developing inflammation in the middle ear is increased:
• with an abnormal body structure;
• in children due to the shortened Eustachian tube;
• for injuries or injuries;
• under the influence of pressure drop (barotrauma).
Less common ways of infection in the middle ear include:
1. Distribution with blood or lymph in chronic low-intensity infectious diseases such as pyelonephritis, osteomyelitis.
2. Ingestion through the outer ear due to damage to the eardrum.
How does middle ear inflammation manifest?
The clinical picture of inflammation of the middle ear depends on the form of the disease.
For catarrhal acute inflammation inherent intense pain, which may have a jerking, cutting, paroxysmal character with irradiation in the back of the head, jaw.
Other signs of inflammation join the pain in the form of:
• temperature increases;
• general malaise;
• headaches;
• discomfort in the nasopharynx.
There may be a feeling of stuffiness in the ear, noise in the head, disturbances in the sound perception. But such symptoms are smeared against the background of severe pain, which can be attributed to the "business card" of inflammation of the middle ear.
In the absence of adequate therapy, the pathology becomes exudative with an accumulation of exudate in the middle ear. Further progress is accompanied by increased pain with the degeneration of serous fluid in the pus.
For purulent inflammation is characterized by a staged development of the pathology, which has its own symptoms at each stage.
1. During the pre-perforative stage, due to the accumulation of purulent discharges irritating the pain receptors in the cavity, the disease manifests itself:
severe pain, having a sharp, pulsating character;
Increased temperature up to 390;
nausea and vomiting;
signs of intoxication;
hearing loss.
2. At the perforating stage, a significant accumulation of purulent exudate causes perforation of the eardrum, which is accompanied by the outflow of pus through the resulting opening. In this case, the symptoms are muffled. Residual symptoms may occur:
pain sensations;
ear congestion with hearing loss;
subfebrile temperature.
3. At the reparative stage, the mucous coating of the middle ear is restored, and the inflammation gradually subsides. The restoration of the eardrum may be accompanied by scarring, which causes problems with hearing.
If the disease is of neglected nature and has become chronic, symptoms expressed:
• periodic discharge of pus or mucus;
• hearing loss;
• frequent perforations of the membrane.
For non-purulent chronic inflammation, persistent hearing loss with hearing loss is characteristic. At the same time there is a noticeable scarring of the membrane and dry perforations.
Inflammation of the middle ear: diagnosis
Diagnosis of inflammation in the middle ear does not cause much difficulty. Based on the patient's complaints and the initial ENT examination, he may make a preliminary diagnosis.
To confirm the diagnosis used instrumental examinations.
Otoscopy. With the help of a special device that looks like a cylinder with an expansion on the one hand, the doctor can visually assess the condition of the tympanic membrane:
1. With a concave membrane, which is possible due to the dilution of air in the ear cavity, tubootitis is diagnosed.
2. If the membrane is bent outward, which occurs under the influence of fluid accumulated in the cavity, the inflammation of the middle ear is determined.
3. If there are defects in the membrane, accompanied by suppuration, purulent inflammation of the perforative stage is confirmed.
X-ray examinations. Needed for suspected mastoiditis, can detect intracranial complications. For the same purpose, the survey can be conducted using CT.
Audiometry. Such a study is necessary to determine the patient's hearing ability. In chronic processes, there is a partial loss of this function.
Tympanometry. Needed to identify the sensitivity of the membrane, determining the frequency of its oscillations. Changes in the sound energy can be observed when there is a liquid substance in the middle ear or swelling of the Eustachian tube.
Timpanocentesis. Carry out only in severe cases. Using a needle, the eardrum is punctured and the accumulated fluid in the middle ear is removed. Such a procedure, on the one hand, helps to alleviate the patient’s condition by reducing the pressure in the cavity, on the other hand, the resulting fluid is material for further examination, which allows to identify the type of infection that provoked inflammation and select antibiotics to which these microorganisms are sensitive.
A visual inspection of the nasopharynx, nasal cavities is also necessary. This reveals the true origin of the inflammation.
How is middle ear inflammation treated?
Therapy of inflammation in the middle ear, primarily aimed at eliminating the spread of infection. Therefore, the pathologies of the nose in the form of rhinitis, sinusitis, sinusitis, as well as colds are taken under control.
If the type of infection is unclear, doctors resort to waiting tactics. During this period, it is advisable to use:
1. Pain relievers. To reduce the pain, prescribe local antiseptics. Ear drops in the form of Sofradex, Otipaksa are used only as directed by the doctor. When the eardrum ruptures, the penetration of drugs into the middle ear can cause damage to the auditory nerve.
2. Anti-inflammatory medication. For inflammations in the middle ear, anti-inflammatory nonsteroidal agents are used in the form of Ibuprofen, hormonal drugs like Prednisolone, Dexamethasone. Such drugs help relieve puffiness, reduce inflammatory reactions.
3. Antihistamine drugs. Assign only with allergic origin of inflammation. The use of Clemastine, Tavegila, Suprastin eliminates puffiness, which appeared in the form of a reaction to an allergen, and help to release the ear canal.
It is important to keep the nasal cavities clean during treatment. To help the patient get rid of rhinitis, vasoconstrictor drugs are recommended. Given that such medicines cause dryness of the mucous membrane, it is necessary to use them strictly following the instructions.
For the treatment of rhinitis is better to use drugs made on the basis of sea water or salt. Quite good results show multicomponent homeopathic sprays and drops.
If expectant tactics fail, after 4-5 days, antibiotics are connected to the treatment.
Antibacterial medicines are used by doctors:
• penicillin series in the form of Augmentin, Penicillin;
• cephalosporins like Cefazolin, Cefriaxone, Cefuroxime;
• macrolide group in the form of Clarithromycin, Azithromycin.
Antibiotic therapy is justified in the presence of a bacterial infection. If the inflammation is provoked by viruses, the effect of such treatment will be absent.
In viral inflammations, antiviral therapy with Amizona and Amixin drugs is advisable.
Remember! In the inflammatory process, warming of the ears is strictly prohibited.
Heating procedures are allowed after the end of the acute period of the disease.
Surgical intervention is extremely rare. Operational manipulations are required in the absence of results of conservative therapy and in case of suspected complications affecting the brain, with mastoiditis.
For prophylaxis inflammation of the middle ear is recommended timely treatment of colds and other infectious and inflammatory diseases, careful oral hygiene and teeth, as well as avoid hypothermia and ear injuries.
