Traumatic otitis media and mastoiditis. Questions Acute suppurative otitis media

Post-traumatic otitis media is a type of illness that can be the result of an injury or ear injury. An ENT doctor will be able to help from suffering and cure the disease.

The Metropolitan Clinic employs qualified specialists - otolaryngologists. Each patient will receive all the necessary services. Reception is by appointment only.

Children of any age are most ill with otitis media. As for the post-traumatic form, it cannot be protected or prevented. Up to 3 years of age, almost 80% of children have this disease. Statistics show that post-traumatic otitis media is on an equal footing with such dangerous diseases as tonsillitis. scarlet fever and flu.

Types of post-traumatic otitis media

This type of disease has one form. This is otitis media, when inflammatory processes take place in the labyrinth of the auricle. It arises as a complication after an injury. With otitis media, pus may appear due to bruises of the middle ear. Then the infection gets through the punctured hole in the eardrum. Post-traumatic otitis media can become chronic if you do not consult a specialist in time.

Start post-traumatic otitis media often accompanied by tinnitus. Severe pain is felt, which increases in the evening. Dizziness and nausea appear. Lost appetite. The temperature rises. Vomiting may begin. A person complains of general weakness, loses a sense of balance. The quality of hearing decreases. If the disease is started to heal on time, the fluid accumulated in the ear tube can dissolve on its own. Otherwise, it will accumulate in the inner ear. The person may become deaf.

Otitis media is easy to recognize. However, for this, you should seek the advice of an ENT doctor. Stolichnaya Clinic specialists deal with problems post-traumatic otitis media... They can conduct a qualified differential diagnosis of diseases that are similar in symptomatology to post-traumatic otitis media.

Methods for the treatment of post-traumatic otitis media in the "Capital Clinic"

Only a qualified otolaryngologist should be involved in the treatment. You can find one in the "Capital Clinic" in the city of Kiev. The specialist will suggest the following treatment options:

Warming up procedures. Compresses will help to avoid large purulent discharge;

Flushing toilets of the ear canal to remove pus;

The use of vasoconstrictor nasal drops. The goal is to relieve swelling of the nasopharynx;

Turundas moistened with boric alcohol solutions. This contributes to the rapid release of pus and early wound healing;

Eardrum puncture. It is carried out to prevent pus from entering the brain.

Before starting treatment in the "Capital Clinic", you should undergo a general examination. Now there are many allergy sufferers. Perhaps taking blood tests will help determine the best method of recovery.

The ENT doctor of the Capital Clinic will provide a full and qualified consultation. It will help determine the type of detailed examination of the auricle. The diagnosis will be made as soon as possible. The level of provision of the clinic with the latest equipment is the highest.

Barotraumatic otitis media is a complex of symptoms that arise in response to changes in the pressure of the environment surrounding a person. The classic situations leading to ear barotrauma are:

• Diving / surfacing
• Aircraft ascent / landing

Barotraumatic otitis media is related to the middle ear. It includes the Eustachian tube and the tympanic cavity, which is normally filled with air. The middle ear is separated from the outer ear by an impenetrable flexible tympanic membrane. On the other hand, the exit of the Eustachian tube into the nasopharynx is also closed most of the time, which protects the tympanic cavity from the penetration of excess bacteria into it. Thus, the middle ear is a relatively isolated part of the ear system.

However, it cannot be completely isolated, since metabolic processes in the mucous membrane of the tympanic cavity lead to the discharge of the present air and a decrease in its pressure. As a result, the eardrum changes its curvature and loses sensitivity when it perceives external sound waves. To prevent this from happening, the mouth of the Eustachian tube sometimes opens slightly (when swallowing or artificially increasing pressure in the nasopharynx), due to which a portion of air enters the tympanic cavity and equalizes the pressure.

Thus, the correspondence of the pressure in the middle ear cavity to the environmental pressure is a fundamental condition for the correct functioning of the human auditory system, which is one of the most perfect among living beings.

Man and the species immediately preceding him evolved on land with a predominantly sedentary nature of life. Therefore, our ears can distinguish hundreds of tonalities, but are absolutely not adapted for immersion in water and for flying in the air.

When immersed in water, a person is exposed to an increased pressure of a medium denser than air. Water is poured into the ear and presses on the eardrum from the outside. The eardrum is an elastic membrane. The degree of its elasticity in people is different: in some it is thin, in others it is quite dense. The elasticity parameter changes with age: for example, in small children, the membrane is very thick. In addition, it may have defects and thinning resulting from previous otitis media. In the presence of predisposing factors, the force exerted on the membrane by increased pressure in some cases can lead to its perforation and to the leakage of water into the middle ear cavity.

The symptoms that a person feels during barotraumatic stress develop in the following sequence:

• Increasing pressure in the ear.
• Ear congestion.
• At first mild continuing pain, then sharp.
• Cold deep inside the ear is the result of water entering the tympanic cavity.
• Severe itching, sneezing, ear irritation.

The described scenario may threaten the general state of the diving person. There is a possibility of disorientation, gagging, dizziness. loss of consciousness.

Post-traumatic symptoms of water leakage into the tympanic cavity are manifested in the development of otitis media in the middle ear in a purulent form. It is characterized by:

It should be noted that rupture of the membrane during immersion is rare. More often barotraumatic otitis media develops according to the second scenario.

As you know, in order to avoid traumatic otitis media when immersed in water, they resort to equalizing the pressure in the tympanic cavity in the following ways:

• You can yawn or swallow saliva.
• It is possible to create an area of \u200b\u200bincreased pressure in the nasopharynx when the nose is closed, due to which the passage into the Eustachian tube will open and air will enter the tympanic cavity (so-called "blowing").

The second option is the most effective, but in some cases it is dangerous. If a person is sick with a respiratory disease and has a pathogenic environment in the nasopharynx, carrying out blowing, he risks throwing infectious agents into the Eustachian tube, than causing at least otitis media in the catarrhal stage with a transition to an exudative form or, in the future, purulent otitis media.

Initial traumatic symptoms:

• Ear congestion
• Creaking, wet sounds in the ear when swallowing
• Loss of hearing
• No pain

Over time, the symptoms will worsen and change. Depending on the course of the disease, they can take the following form:

• Severe pain
• Temperature increase
• Feeling of pressure in the ear
• Feeling of fluid overflow in the ear
• Ear discharge (usually purulent)
• Significant hearing loss

All of the above about barotraumatic otitis media is true not only for situations with diving, but also applies to flying on airplanes.

The term "barotraumatic" indicates the cause that influenced the onset of otitis media. In terms of its content, post-traumatic otitis media from pressure drop is a standard otitis media of the middle ear with its own treatment methods.

For the treatment of the catarrhal stage, use:

• drugs that relieve edema of the mucous membrane of the Eustachian tube (e.g. Tavegil),
• anti-inflammatory drugs (e.g. Erespal),
• drugs that increase the secretion of mucous membranes (eg Sinupret).
• vasoconstrictor drugs (eg Nazivin).

Physiotherapeutic warming and blowing are of great importance for the cure. To prevent further reflux of the infectious environment from the nasopharynx, the treatment of barotraumatic otitis media should involve the therapy of primary inflammation of the upper respiratory tract.

With a purulent form of traumatic otitis media, antibiotics are the first-line drugs. local (drops Otipaks, Tsipromed, etc.) and systemic (tableted Amoxicillin. Ketocef, Clarithromycin, etc.). In case of purulent discharge, the key to successful treatment is thorough cleaning of the ear.

The following recommendations should be classified as preventive:

1. See an otolaryngologist before diving.
2. Do not dive under water or fly an airplane if you have respiratory problems.
3. Learn to equalize the pressure in the middle ear by "blowing" and use this method when submerging in water and when landing an aircraft (but not during ascent and takeoff).
4. Do not use earplugs when diving: they can aggravate pressure imbalances.

Observing these rules, you can not worry about barotraumatic otitis media.

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Chronic diseases: not specified

Good time of the day! Please tell me about this question: a month ago I was robbed and beaten, there was a strong blow to the ear, after which there was a hum in my ear and began to hear poorly on it (it did not hurt and there was no discharge). I went to the doctor, he said that the eardrum was cherry, hearing loss, prescribed treatment: Sofradex, Compress with Dimexide, Pharmazolin, Loratodin, Augmentin. I was treated. But the hum remained, only a little bit better to hear. Will the rumor return? What to do?

Tags: trauma of the tympanic membrane, post-traumatic otitis media, post-traumatic otitis media, post-traumatic otitis media, post-traumatic otitis media treatment

Otitis media of the ear I was at the doctor's appointment, he diagnosed me with acute otitis media, prescribed it.

Hearing loss Today was at the ENT doctor with a complaint of hearing loss in the right ear, examined.

Ears are malignant, otitis media. Otitis media of the middle ear / treatment - 4 days amoxicillin tablets.

Otitis media Six years ago came to the operating table due to severe ear pain.

Acute otitis media The child first developed a strong cough, treated for a week, cough.

Acute exudative otitis media. My daughter is 8 months old. 24 were admitted to the hospital.

Acute otitis media of the middle ear My whole extended family and I have been planning a vacation for a long time.

Acute otitis media Three days ago, ENT diagnosed me with Acute middle bilateral.

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Also, don't forget to thank the doctors.

Hello! It is possible that a hematoma has formed on the eardrum as a result of an injury. When the hematoma resolves, hearing resumes. At the moment, electrophoresis with lidase will be useful to you. piercing the auditory tubes.
p. S. Be healthy!

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Acute otitis media is an acute inflammatory process that can develop in all parts of the ear, but in most cases, this term refers to acute inflammation of the middle ear, i.e., acute otitis media.

The ear is a complex organ that not only perceives sound vibrations, but is also responsible for the position of the body in space and the ability to maintain balance. The ear is divided into three sections - outer, middle and inner. The outer ear is formed by the auricle and the auditory canal, which ends with the eardrum. The function of the outer ear is to pick up sound signals and transmit them further to the structures of the middle ear. The middle ear consists of the tympanic cavity located between the tympanic membrane and the opening of the temporal bone. In the tympanic cavity there are sound bones (malleus, incus and stapes). The function of this section of the ear is to conduct sound. The middle ear cavity is connected to the nasopharynx by the Eustachian tube, through which the pressure in the tympanic cavity and external atmospheric pressure are equalized.

The inner ear is formed by a system of canals (cochlea) located in the temporal bone. The cochlea is filled with fluid and lined with hair cells that convert mechanical vibrations of the fluid into nerve impulses that enter the corresponding parts of the brain through the auditory nerve. The function of the inner ear is to maintain balance. Inflammation of the inner ear (internal otitis media) is usually called labyrinthitis.

Differential diagnosis of acute internal otitis media with brain pathologies that can cause dizziness, including neoplasms, is required.

Acute otitis media can occur at any age, but children are more susceptible to it - they have this most common otorhinolaryngological disease. In the first years of life, about 80% of children suffer from acute otitis media, and by the age of 7 years - up to 95%. In about 30% of cases, otitis media transferred in childhood is the cause of hearing loss in adults.

The causative agents of acute otitis media are most often staphylococci, pneumococci, Haemophilus influenzae, Klebsiella, Pseudomonas aeruginosa, Moraxella, microscopic yeast-like fungi of the genus Candida, influenza virus.

Risk factors include:

• infectious and inflammatory diseases of the ENT organs;
• mechanical or chemical ear injuries;
• the presence of a foreign body in the ear;
• water entering the ear;
• improper ear hygiene;
• hypothermia;
• operations on the nasal cavity and / or nasopharynx;
• allergies;
• immunodeficiency states;
• diabetes;
• children and old age.

Depending on the nature of the middle ear inflammation, acute catarrhal otitis media and acute purulent otitis media are distinguished.

By origin, acute otitis media is of the following forms:

• bacterial;
• viral;
• fungal (otomycosis).

Acute otitis externa can be limited and diffuse.

Limited otitis externa is manifested in the form of inflammation of the hair follicle or the development of a furuncle in the external auditory canal.

In the clinical picture of acute otitis media, the following stages are distinguished:

1. Catarrh.
2. Purulent inflammation, which, in turn, is subdivided into pre-perforated and perforated stages.
3. Recovery or transition to a chronic form.

Symptoms of acute otitis media depend on the form of the disease.

In acute otitis media, an intense shooting pain in the ear, a feeling of ear congestion, and hearing loss initially appear.

Local signs are accompanied by general malaise: weakness, lethargy, fever - usually to subfebrile, but sometimes to febrile values. In some cases, acute inflammation of the middle ear is accompanied by a sore throat, nasal congestion, and nasal discharge.

Children in the first years of life with acute otitis media refuse to eat, as when sucking and swallowing, pain in the ear increases. In addition, in children, acute otitis media is often accompanied by regurgitation, vomiting, and diarrhea.

A few days after the onset of the disease, the tympanic membrane perforates and the outflow of serous (catarrhal otitis media), and then purulent (in some cases, bloody) contents. At the same time, the general condition of the patient improves. The body temperature returns to normal, the ear pain subsides. Suppuration usually lasts no more than a week. After scarring perforation, hearing is usually restored. In the case of an unfavorable course of the disease, purulent exudate may not pour out, but spread into the cranial cavity with the subsequent development of meningitis or brain abscess. Acute otitis media lasts an average of 2-3 weeks.

For internal acute otitis media (labyrinthitis), severe attacks of dizziness are characteristic, which are accompanied by nausea, vomiting, tinnitus, and hearing impairment. Labyrinthitis in most cases is a complication of acute otitis media, so the appearance of vestibular disorders in acute otitis media should alert to the deepening of the inflammatory process.

The manifestation of acute limited external otitis media is at first itching, and then pain in the ear canal, which can radiate to the upper and lower jaw, temple, occiput. Pain sensations increase when chewing, as well as at night. Limited otitis externa is manifested in the form of inflammation of the hair follicle or the development of a furuncle in the external auditory canal. The furuncle can completely block the lumen of the ear canal, which causes hearing loss. When the boil is opened and its contents expire, the pain subsides, the patient's condition improves.

In acute diffuse otitis externa, patients complain of a feeling of fullness, itching, and then severe pain in the ear, which increases during a conversation, when chewing food, and palpation of the ear. There is hyperemia of the ear canal, its edema and slit-like narrowing, an increase in regional lymph nodes. Discharge from the ear in acute diffuse otitis externa is usually scanty, at first serous, and then purulent. The spread of the inflammatory process to the soft tissues of the parotid region and the auricle is possible.

To determine acute otitis media, anamnesis and complaints are collected, an objective examination, and, if necessary, instrumental and laboratory diagnostic methods are used.

If acute otitis media is suspected, otoscopy is usually performed, which makes it possible to examine the tympanic membrane, detect its thickening, hyperemia, injection, protrusion or perforation. X-ray examination of the temporal bones reveals a decrease in pneumatization of the middle ear cavities. Tympanometry is used to determine the ability of the eardrum and ossicles to conduct a wave of auditory pressure. Audiometry is indicated to detect hearing impairment.

In order to identify the pathogen and determine its sensitivity to anti-infectious drugs, a bacteriological study is carried out.

Children in the first years of life with acute otitis media refuse to eat, as when sucking and swallowing, pain in the ear increases.

Differential diagnosis of acute internal otitis media with brain pathologies that can cause dizziness, including neoplasms, is required. Acute otitis media is differentiated from histiocytosis, a tumor of the tympanic cavity. Acute otitis externa should be differentiated from mumps, other types of otitis media, eczema of the external auditory canal, mastoiditis, boils of the ear canal. For the purpose of differential diagnosis of acute otitis media with other diseases, a computed or magnetic resonance imaging of the brain may be prescribed.

Treatment of acute otitis externa is local, in most cases it consists in washing the external auditory canal with antiseptic solutions.

With pronounced pain syndrome, an increase in temperature, pain relievers of the group of non-steroidal anti-inflammatory drugs are prescribed. If necessary, the ripe boils are opened, after which the ear canal is washed with antiseptic solutions.

Treatment of acute otitis media is carried out with anti-infectious (in most cases antibacterial) drugs, non-steroidal anti-inflammatory drugs. Vasoconstrictor drugs are used locally to eliminate swelling of the nasal cavity and nasopharynx in order to drain the tympanic cavity. If the tympanic cavity is not drained on its own within a few days from the onset of the disease, the tympanic membrane is dissected (paracentesis). If, after scarring the eardrum, the patient's hearing is not restored, blowing and pneumatic massage are indicated.

Conservative treatment of acute internal otitis media is mainly symptomatic. To eliminate nausea and vomiting, antiemetic drugs, antihistamines are used. In case of ineffectiveness of conservative therapy, surgical intervention is indicated. According to the indications, a labyrinthotomy is performed, an opening of the temporal bone pyramid.

In the absence of timely and adequate treatment, acute otitis media can become chronic, which is associated with a high risk of hearing loss.

In about 30% of cases, otitis media transferred in childhood is the cause of hearing loss in adults.

In addition, the disease can be complicated by the development of sepsis, inflammation of the mastoid process of the temporal bone, encephalitis, meningitis, brain abscess, cerebral sinus thrombosis, and facial nerve paralysis. The occurrence of intracranial complications can be fatal.

With timely and adequate treatment of acute otitis media, the prognosis is favorable. In the presence of underlying diseases, immunodeficiency states, late seeking medical help, self-medication and the appearance of complications, the prognosis worsens.

In order to prevent the development of acute otitis media, it is recommended:

• timely treatment of infectious diseases, especially diseases of the ENT organs;
• strengthening the body's defenses;
• avoiding hypothermia;
• avoidance of ear injury (including refusal from attempts to independently remove foreign bodies from the ear and use objects that were not intended for cleaning the ears);
• compliance with the rules of personal hygiene.

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Otitis media occurs not only as a complication after viral infections. Various kinds of injuries can serve as a harbinger and provocateur of the disease. Which are accompanied by damage to the outer and inner parts of the ear cavity. Traumatic otitis media is considered in the context of the formation of an inflammation focus, hearing impairment, additional penetration of bacteria. This form of the disease may be associated with a change in the functioning of nerve fibers, parotid glands and joints.

Otitis media is traumatic caused by damage to the ear cavity during cleaning, blow, bruise, fall, industrial injury, with the ingress of foreign small objects or substances.

Usually, this form of the disease provokes an acute inflammatory process, accompanied by infection, damage to the eardrum, hearing impairment or deafness.

The consequences formed after injuries of the external ear cavity and the inner ear are identified by specialists as post-traumatic otitis media.

External injuries usually occur in adults. Children love to stick foreign objects into the ear canal for themselves and each other.

After the injury, the first sign of the manifestation of the disease is extraneous noise in the ears. Next comes a set of key symptoms that characterize traumatic otitis media:

• dizziness, accompanied by nausea,
• acute headache
• increased body temperature,
• imbalance.

In this state, appetite disappears, hearing deteriorates and constant weakness prevails in the body. The extreme point of symptomatology of the disease is blood and mucous discharge from the ear.

One of the types of traumatic otitis media is baratraumatic otitis media. It occurs during submersion and ascent (important for divers), during takeoff and landing of an aircraft. This injury occurs due to changes in external pressure. Typical symptoms:

• ear congestion
• feeling of increasing pressure inside,
• pain of a different scale from slightly noticeable to acute,
• itching in the ear canal.

Dizziness, disorientation, up to loss of consciousness is also possible.

Whatever the trauma that portends post-traumatic otitis media, without waiting for the above symptoms, you should seek a medical cavity.

After the examination and depending on the neglect of the disease, the doctor selects a treatment option. With a mild form of post-traumatic otitis media, less aggressive intervention can be dispensed with than with visible complications.

In any case, the external auditory canal should be decontaminated and closed for infections, using a sterile cotton-gauze swab.

To prevent the formation of massive purulent accumulations, warming procedures are done in the form of compresses. When you need to remove the already accumulated pus, you should rinse the ear canal and insert a flagellum moistened with a solution of boric alcohol into the cavity. Nasopharyngeal edema is removed by vasoconstrictor nasal drops. And in order to prevent the pus from spreading further and not reaching the brain, the doctor decides to pierce the eardrum and thereby free the ear canal from fluid. The patient loses hearing, but after a while he will recover.

To remove the resulting focus of inflammation and reduce pain, the doctor prescribes antibacterial drugs. The use of antihistamines is possible.

Surgical intervention is applicable in urgent cases, with an urgent need. When a patient needs to restore hearing, both after the injury itself, and as a result of the consequences of the progression of the disease.

Folk remedies are only an auxiliary element. Washing the ear canals and warming up the cavities are performed only with the permission of a specialist, so as not to aggravate the current situation.

The progressive purulent form of traumatic otitis media requires antibiotic intervention.

When in case of post-traumatic otitis media, untimely or unskilled care was provided, or when the patient himself improperly performed all the appointments, a number of protracted processes may occur that worsen the state of health.

Traumatic otitis media can easily turn into acute or catarrhal. Acute - occurs when the ear canal is completely blocked by fluid. It is accompanied by hearing loss, a feeling of fluid movement from side to side, and general congestion. Catarrhal otitis media with inflammation of the tympanic membrane, appears due to the presence of pathogens of streptococci, staphylococci.

The onset of mastoiditis is characterized by purulent infection of the mucous membrane and bone tissue of the temporal bone. Otogenic sepsis, with the same purulent formations that can spread through the veins, leads to damage to the vessels of the brain, joints, and kidneys.

Meningitis is a common problem. The disease is an inflammation of the lining of the brain and spinal cord.

The main rule of prevention is to prevent and prevent any injury. If such a situation could not be avoided, you should immediately seek medical help, determine the severity of the damage, learn about the possible consequences and start treatment. To avoid post-traumatic otitis media, you should show your ear canal at the examination to a specialist, pay attention to your feelings.

Any hypothermia, viral infections, vitamin deficiency, kidney problems, a number of serious diseases such as diabetes are provocateurs. It is worth avoiding the gathering of people so as not to become infected with ARVI, to monitor the current state and stage of existing diseases. Support immunity with a standard and basic complex: balanced nutrition, physical activity, healthy sleep and less stressful situations.

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Otitis media is an infectious inflammatory process characterized by rapid development and localized in the middle ear cavity. The ear cavity is located inside the temporal bone and is covered from the outside by the tympanic membrane. This membrane separates the middle ear from the ear canal. When the infectious process begins to develop, it includes not only the ear cavity itself, but also nearby structures. We are talking about the air cells of the mastoid process, extending from the temporal bone, and the Eustachian tube.

This pathology is extremely common in otolaryngology and accounts for up to 30% of cases of all diseases of the ENT organs. In addition, otitis media is often a concomitant disease and joins other ear pathologies - as a rule, this occurs in 30% of cases.

Both children and adults are susceptible to the disease, but babies suffer from otitis media more often, which is due to the peculiarities of the structure of the middle ear in childhood. As for men and women, they suffer from otitis media with the same frequency. Recent statistics indicate that there is an increased incidence of sluggish otitis media in the adult population and relapses in children. Up to 62% of babies suffer from acute otitis media during the first year of life.

The duration of the disease is on average 3 weeks. During this time, otitis media goes through all stages of its development.

The symptoms of the disease are manifested vividly, among them the following can be distinguished:

The very first symptom that characterizes the onset of the disease is the onset of pain. Moreover, it can manifest itself in different ways: it can be pulsating and incessant, it can be pulling and shooting, with short-term breaks. Sometimes the pain is localized not only in the ear, but also radiates to the temporal region or the back of the head. With otitis media, teeth may start to hurt;

The disease is manifested by the fact that a person's hearing decreases. This symptom can appear both at the initial stage of otitis media, and at all subsequent ones. Ear congestion may disappear after swallowing saliva or yawning deeply;

The patient often suffers from autophony, which manifests itself in the resonance of his own voice during speech;

A person experiences congestion in the ear, sometimes there is a feeling of a foreign object inside or a pressing sensation;

Sometimes there are extraneous noises;

Purulent or serous contents begin to separate from the ear. Although sometimes the discharge is not observed or is present, it is quite insignificant;

In parallel, the nearby lymph nodes increase and become painful;

The behind-the-ear region of a person suffering from otitis media begins to ache, redden and swell. The pain is aching;

In the inflammatory process, both one and both ears can be involved. In the latter case, it is advisable to talk about bilateral otitis media;

The body temperature almost always rises. It can reach high values, up to 39 ° C and above. Vomiting may occur at very high temperatures;

A person suffers from general intoxication of the body: sleep is disturbed, appetite decreases, fatigue increases, a feeling of general weakness and malaise appears;

Often, the nearby ENT organs are involved in the process, the patient suffers from rhinitis, may experience pain and dryness in the throat.

The symptoms of the disease can be both bright and blurred. The clinical picture varies, the disease can be very difficult, with a temperature up to 40 ° C and purulent-bloody discharge from the ear canal. In some cases, on the contrary, the symptoms are mild, for example, with the exudative form of the disease.

The causes of otitis media are diverse, among them the following can be distinguished:

The first reason for the development of the disease, which is the leading among other factors, is a person's infection with streptococcal infection. The next most common microbes that cause otitis media are pneumococci and staphylococci. It is the ingress of streptococcus into the tympanic cavity in 65% of cases that causes the development of an acute infectious process in the middle ear. This is facilitated by diseases of the nasopharynx, nose, paranasal sinuses, throat;

Incorrect blowing of your nose often causes a person to develop otitis media. If a person tries to remove mucus from the nose, and at the same time closes his mouth, then under the influence of the pressure that has arisen, some of it can penetrate into the middle ear;

Adenoids are another reason leading to the development of otitis media;

Enlargement of the posterior ends of the turbinates, making it difficult to open the auditory tube;

Curvature of the nasal septum;

Acute otitis media can develop against the background of multiple infectious diseases, since pathological microorganisms enter the middle ear cavity also through the blood;

Eardrum injury is another factor that predisposes the development of the disease. In this case, pathological bacteria and viruses can enter the body in a tubogenic way, that is, from the external environment into the ear cavity;

Benign tumors of the pharynx, such as fibroma, angioma, neuroma are all potential factors that can lead to the development of otitis media;

A decrease in general immunity also leads to the fact that an inflammatory process can occur in the middle ear;

General hypothermia of the body, prolonged stay in a damp climate with sudden changes in pressure can provoke the onset of the disease;

Recent data indicate that allergies can trigger the development of otitis media;

As a secondary pathology, otitis media of the middle ear can occur against the background of many diseases, in particular, meningitis, tonsillitis, scarlet fever, flu, measles and other diseases lead to it.

There are several stages of acute otitis media. They follow each other and have characteristic clinical manifestations. However, it is not necessary that the disease must go through all stages of development. With timely and adequate treatment, otitis media is a reversible process.

The initial stage of the disease, which is called pre-perforative, is characterized by the presence of severe pain and general symptoms. Its duration can vary from several hours to several days. Painful sensations arise against the background of irritation of the ternary and glossopharyngeal nerves. Pain is given to both the temporal and parietal regions. A person's hearing decreases due to the fact that the auditory ossicles in the tympanic region become less mobile.

At this stage, pus builds up, but does not yet break the eardrum. She herself becomes swollen, blushes. The painful sensations intensify when a person lies down or bends towards the damaged ear. During otoscopy, the doctor observes a thickening of the tympanic membrane through which the purulent contents shine through. Sometimes it can be covered with a bloom of white.

The tympanic membrane, under the influence of the accumulated pus, breaks through, and the contents come out. The discharge is of a mucopurulent nature, at first there are many of them. Sometimes blood impurities can be found in the contents separated from the ear. At the same time, the pain subsides, the person feels significant relief. Body temperature drops, symptoms of intoxication weaken.

At this stage, otoscopy gives the following picture: the discharge comes through the damaged membrane in portions, it itself pulses synchronously. Over time, they become less and less, the amount of mucus decreases, and purulent masses become the main contents.

This stage can last up to one week. With regard to the size of the perforation, then with purulent otitis media, they are small. Extensive perforation occurs when the disease occurs against a background of scarlet fever, tuberculosis, or measles. Sometimes the perforated stage can be characterized by the fact that the purulent masses do not break out, but into the cranial cavity. In this case, there is a serious threat not only to health, but also to the patient's life.

The final (reparative stage) is the one at which scarring of the perforation occurs. In this case, the pus ceases to stand out, the patient's hearing begins to recover. The infiltration of the tympanic membrane decreases, its edema decreases. During otoscopy, the doctor observes its shine and more or less outlined contours. If the perforation was insignificant and did not exceed 1 mm, then it is completely tightened without leaving a scar.

If the breakthrough was significant, then fibrous tissue is formed in its place, which does not have the ability to regenerate. Salt deposits are often formed in this place. Fibrous adhesions can often be observed in the middle ear cavity, which contributes to a decrease in the mobility of the auditory ossicles and, as a result, hearing impairment.

If the otitis media is uncomplicated, then the general blood test reveals a slight increase in ESR and a slight shift in the leukocyte formula to the left. Sometimes it happens that at the perforated stage, pus breaks out, but the patient's condition remains stably severe. In most cases, this indicates the development of mastoiditis. If pus is secreted for a month and begins to fill the ear again after cleansing, then this condition is called mastoid empyema.

Otitis media can be both acute and chronic. Each of these forms has its own characteristics, differs in the course and recommended methods of treatment. The main difference between otitis media is the rate of development and duration of the disease.

Acute otitis media begins suddenly and rapidly increases in symptoms. First, the patient complains of tingling in the ear, then the pain becomes more and more intense. If acute otitis media develops in childhood, then those children who do not know how to speak go into continuous crying. The pain may subside, but the time period is very short.

After the eardrum breaks through and the purulent contents come out, the pain stops, the person's condition returns to normal. Then there is scarring of the eardrum to restore hearing. Acute otitis media lasts on average up to 3 weeks. However, it is fraught with complications, such as inflammation of the temporal bone process - mastoiditis, temporary paralysis of the facial nerve - paresis, as well as inflammation of the inner ear, meningitis, brain abscess and other intracranial diseases. Therefore, it is so important to consult a doctor on time and start timely therapy.

As for chronic otitis media, this is a disease characterized by a sluggish course. Most often, the chronic form of the disease is a consequence of acute purulent otitis media. The share of mesotympanitis, in the form of which chronic otitis media occurs, accounts for up to 55% of cases of this type of disease. At the same time, the mucous membrane lining the auditory tube, the middle and located under it section of the tympanic cavity becomes inflamed. It is there that the tympanic membrane is perforated, but its main one often remains intact and stretched.

Chronic otitis media is characterized by the following complaints presented by the patient: hearing loss, constant or periodic appearance of purulent discharge from the auditory canal, in rare cases - dizziness and tinnitus. Pain can only bother a person when otitis media enters the acute phase.

The course of mesotympanitis is favorable, the disease rarely leads to serious consequences. Hearing will be reduced depending on how much the ossicles are damaged at the time of treatment. Diagnosis of acute otitis media is based on patient complaints and inoculation of the microflora of the separated contents.

The second form, in the form of which chronic otitis media can occur, is purulent epitimpantitis. In this case, the tympanic space is damaged. The rupture site is localized in the upper part, so the purulent contents are not completely separated from the ear cavity. This form of chronic otitis media is more often fraught with complications than mesotympanitis.

In order to adequately assess the condition of bone structures, standard examinations are often not enough, and an X-ray examination is required.

There are other forms of otitis media, which include exudative, catarrhal, purulent, serous and adhesive otitis media. Each of them has its own characteristic features that allow diagnosing the disease and prescribing adequate treatment.

Exudative otitis media differs in that exudate accumulates in the middle ear cavity, while there is no pain syndrome. Another characteristic feature of this type of otitis media is hearing loss in the patient and the preservation of the eardrum. It is the absence of pronounced symptoms that makes it difficult to diagnose this type of otitis media. Most often, it develops against the background of previous pathologies of the upper respiratory tract, which are infectious. It is especially difficult to identify this type of disease in children who do not complain of hearing loss. Among other reasons leading to the development of exudative otitis media, one can single out smoking, an unfavorable environmental situation, allergic reactions, curvature of the nasal septum, autonomic dysfunction, acute otitis media, old age, decreased immunity, nasal tamponade, etc.

As for the pathogenesis of the disease, it begins with the fact that a vacuum is formed inside the tympanic cavity, and the function of the auditory tube is impaired. Against this background, oxygen is absorbed, pressure drop and transudate appears. Over time, the mucous glands are activated and the volume of secreted secretions increases. It becomes denser, its viscosity increases. Against this background, degenerative processes begin to progress, which subsequently cause hearing loss. Depending on the duration of the course of exudative otitis media, several forms are distinguished: chronic, which lasts more than 2 months, subacute, which lasts up to 2 months, and acute, which lasts less than 3 weeks.

This type of otitis media is fraught with complications such as the development of purulent otitis media, immobility of the ossicles and hearing loss, the formation of perforation or cholesteatoma, persistent traction of the tympanic membrane.

Catarrhal otitis media is another type of disease characterized by an acute course and inflammation of the auditory tube, tympanic membrane and mastoid process. This form of otitis media is dangerous with formidable complications and, if not treated promptly, can lead to complete hearing loss.

Among the causes of the development of catarrhal otitis media, one can single out frequent infections, chronic diseases of the ENT organs, proliferation of adenoids, lack of vitamins, decreased immune forces, coughing and sneezing, leading to increased pressure in the nasopharynx.

The symptoms of catarrhal otitis media are bright, the disease manifests itself with acute pain, most often shooting. She gives both to the temple and teeth. Therefore, it is not difficult to recognize this form of otitis media. If treatment is not started on time, catarrhal otitis media often turns into a purulent or exudative form.

Purulent otitis media is characterized by the fact that inflammation of the mucous membrane of the middle ear proceeds with the appearance of purulent contents. All parts of the middle ear are involved in the pathological process, and not only the tympanic cavity. Acute suppurative otitis media occurs most often among other types of otitis media and can lead to hearing loss, which cannot be restored.

Another danger of purulent otitis media is that it can cause intracranial complications, such as meningitis, brain abscess, and otogenic sepsis.

Viruses rarely cause the development of purulent otitis media, only in 4% of cases. Most often, bacteria lead to inflammation.

The infection gets into the ear through the auditory tube, this process is especially easy against the background of diseases of the nose and nasopharynx. But bacteria can also enter the middle ear cavity through the blood, which most often occurs during the flu. In childhood, purulent otitis media occurs much more often than in adults.

After the infection enters the mucous membrane of the middle ear, processes are started that cause the accumulation of exudate, which after a short time transforms from serous into purulent. Its volume gradually increases, which leads to increased pressure on the eardrum and its subsequent breakout. The danger is that the purulent contents may not come out, but fall into the cranial cavity. Treatment is based on rinsing the ear cavity with a special solution, antibiotics and disinfectants.

Serous otitis media is an inflammation of the middle ear that has mild symptoms and is characterized by the accumulation of non-purulent exudate. Fluid begins to accumulate in the tympanic cavity, and the person feels some pressure, congestion in the ears and unexpressed hearing loss.

To diagnose serous otitis media, a standard examination of the tympanic membrane and listening to patient complaints are often sufficient. The danger of serous otitis media is that it can transform into a more serious form of the disease and cause complications. This happens especially often when a person ignores hearing loss and discomfort in the ear for a long time, and when the disease develops in young children.

Depending on what caused the development of otitis media, appropriate treatment will be prescribed. If within 3 months serous otitis media does not go away, then the patient is shown myringometry, that is, the artificial creation of a hole in the tympanic membrane through which the necessary medications are injected.

If serous otitis media often recurs, then it is necessary to look for and eliminate the cause that causes it. Recently, cases of serous otitis media have become more frequent against the background of severe allergic reactions.

Adhesive otitis media, like other types of this disease, is determined by the presence of inflammation in the middle ear cavity, however, the process is chronic and leads to the formation of adhesions and cords, which significantly reduces hearing in humans.

The symptoms of this type of otitis media are expressed in the fact that the patient complains about the appearance of noise in the ear.

If the doctor suspects adhesive otitis media in the person seeking help, then in addition to otoscopy, he is assigned audiometry, impedance measurement and a study for the patency of the auditory tube.

In most cases, catarrhal or exudative otitis media leads to the formation of adhesive otitis media. Inappropriate and inappropriate antibiotic therapy also often serves as a push mechanism to start the disease. The disease can be provoked by acute infectious processes in the body, as well as chronic sluggish infections and curvature of the nasal septum.

Therapy is primarily aimed at eliminating the cause that caused the disease. It is necessary to normalize nasal breathing as soon as possible. A course of special blowing and pneumatic massage of the membrane is used. Antihistamines are indicated, as well as the introduction of chymotrypsin, lidase, hydrocortisone into the middle ear cavity. Often, conservative treatment alone is not enough, and if the hearing loss continues to progress, surgery is necessary. It is important to understand that formed scars do not have the ability to disappear. Therefore, the sooner a person turns to a doctor for help, the more optimistic the prognosis for a full recovery will be.

Treatment for otitis media depends on what form of the disease is determined in the patient. Also, therapy depends on the stage of the inflammatory process and on the presence of complications. As for acute otitis media, it is treated in most cases on an outpatient basis. If the disease causes complications, then hospitalization of the patient is indicated.

To eliminate the pain symptom, drops with anesthetic effect are instilled into the ears. It can be Otipax, Otinum, Anauran and others. Before carrying out the procedure, it is advisable to warm up the drug 2 degrees above the normal temperature of the human body. After instillation, a cotton swab must be inserted into the ear and removed after a few hours. If the doctor has not performed a preliminary examination and the risk of perforation of the membrane is not excluded, then you can use a cotton turunda dipped in a solution of boric acid.

Antihistamines, as well as vasoconstrictor nasal drops, help relieve puffiness. Among them are Tizin, Otrivin, Nazivin and others.

In order to relieve inflammation, the patient is shown drugs such as Nurofen, Ibuprofen, Diclofenac. When the pain is not relieved by the above means, and the temperature continues to rise, it is better to stop the bacterial infection with antibiotics.

When the disease is at the pre-perforative stage, blowing the auditory tube over the Politzer is a highly effective method of treatment. The therapy is supplemented by washing the ear with antibiotic solutions, which are combined with glucocorticosteroid drugs. If the purulent contents do not decrease, and the eardrum continues to protrude, then its artificial perforation is necessary. This is done in order to exclude the breakthrough of purulent masses into the cranial cavity.

When the disease has reached the perforated stage, the patient is shown the toilet of the ear and the introduction of agents to reduce edema and dilute secretions, for example, ACC, Fluimucil and others.

Do not forget about physical therapy. UFO, laser therapy, UVC are effective.

It is important to prevent the formation of adhesions and prevent hearing loss. To do this, you need to increase immunity using vitamin therapy and the use of biostimulants - Actovegin and Apilak.

If the disease requires the prescription of antibiotics, then it should be understood that only their oral intake will not be enough. Local administration of antibacterial agents is also necessary. Doctors recommend ingestion of ampicillin, amoxicillin, azithromycin, ciprofloxacin and others. Netilmicin and cefazolin are used as solutions for injection. Locally prescribed drugs such as cypromed, otofa, normax, fugentin and others.

Do not prescribe antibiotics yourself. They are prescribed only by the attending physician, since the illiterate use of these medicines can not so much help get rid of otitis media as, on the contrary, aggravate the course of the disease.

Education: In 2009 he received a diploma in the specialty "General Medicine" at Petrozavodsk State University. After completing an internship at the Murmansk Regional Clinical Hospital, he received a diploma in Otorhinolaryngology (2010)

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Post-traumatic otitis media is a pathological process that becomes the result of injury or injury. Up to 3 years old, almost 80% of babies suffered a similar disease. However, such an ailment can also be observed in adults due to injuries at work or accidents in everyday life. In accordance with statistics, traumatic otitis media is on an equal footing with angina, scarlet fever and flu. Therefore, if unpleasant symptoms appear, you should immediately seek help from a doctor.

Post-traumatic otitis media have different origins:

• due to cleaning the ear with various objects;
• blows to the ear;
• contusion;
• penetration of hot scale or shavings into the ear canal;
• trying to retrieve a foreign body.

In combination with the usual picture of the inflammatory process, the disease has features that must be taken into account during examination and therapy: it is combined with cranial and vertebral injuries. In such a situation, the diagnosis and treatment are determined by a neuropathologist and neurosurgeon. The presence of symptoms of a fracture of the base of the skull or spine indicates the need to fix the patient's head and torso. Ear trauma in some cases is associated with rupture of the membrane, which leads to re-infection of the tympanic cavity and the formation of an acute form of otitis media. If the integrity of the membrane is not compromised, the infection enters the middle ear through the ear canal. Deterioration of tissue reactivity after injury can be a provoking factor in mastoiditis. An open wound of the mastoid process in all cases becomes infected, because of this, infection of the tympanic cavity is likely with the formation of an acute inflammatory process.

With trauma to the middle ear, the auditory ossicles, fracture of the malleus, incus, and dislocation can be damaged. Similar changes are noted in traumatic brain injuries. Damage can be detected by means of otoscopy and otomicroscopy, and if the integrity of the membrane is not violated, using impedance measurement. But often the nature of the lesion is diagnosed in the process of tympanotomy and tympanoplasty.

Post-traumatic otitis media is manifested in one form. Internal disease when inflammation occurs in the labyrinth of the ear canal. It is formed as a result of injury. With such a disease, purulent contents appear due to bruises in the middle ear. In a similar situation, infection occurs through an opening in the membrane. Traumatic otitis media is capable of transforming into a chronic form with an untimely visit to a doctor.

In the presence of a disease, inflammatory phenomena are observed in the mucous membrane and in the periosteum. There is a release of serous and purulent inflammatory fluid. The mucous membrane will be thickened, ulcers and erosion will form. At the peak of the pathology, the tympanic cavity will be filled with inflammatory exudate and a thickened mucous membrane. Since the drainage of the pipe will be disturbed, this will provoke the bulging of the membrane outward. If the patient is not properly assisted at this stage, part of the membrane will melt, and the contents of the cavity will flow out (otorrhea).

Traumatic otitis media has characteristic features. At the initial stage, intense pain occurs inside the ear. They are unbearable, therefore they become a provoking factor for insomnia and loss of appetite. Irradiate to the temple. Temperature indicators rise to 38-39 degrees, chills, poisoning occur. The symptoms felt by the patient during the pathological process are formed in the following sequence:

• Increasing discomfort in the ear.
• Congestion.
• Initially short painful sensations, after - sharp.
• Intense itching, irritation.

Post-traumatic symptoms are manifested in the formation of purulent otitis media. It is characteristic of pathology:

When a patient has respiratory pathology and pathogenic microflora in the nasopharynx, the risk of viral agents being thrown into the ear canal increases. This is fraught with the appearance of traumatic otitis media. Over time, the symptomatology increases and changes. Taking into account the variant of the course of the disease, it takes the following form:

• Intense pain.
• Hyperthermia.
• Pressure inside the ear.
• Purulent discharge.
• Significant hearing impairment.

Based on the patient's complaints, the specialist suggests inflammation in the middle ear. Tuning fork diagnostics are performed. It makes it possible to determine the quality of hearing. In some cases, the doctor sends the patient for general tests, bacterioscopic examination. Then he prescribes therapy. The main methods of treatment:

Often used during the treatment of traumatic otitis media. Most patients use them without prior agreement with a specialist, which can cause harm to health. They contain anti-inflammatory and anesthetic agents. They are used only with a whole membrane, since their penetration through the opening into the cavity negatively affects the patient's hearing. To accurately deliver the drops, it is required to pull the ear up and back with the hand that is opposite the injured ear. A similar method will help align the passage and the agent can get into the inflammation focus. After instillation, you should close the ear with cotton wool, which has been moistened with petroleum jelly. Most of the drops eliminate discomfort and help restore appetite. The most effective are:

They are not used for all forms of acute otitis media of the middle ear, but therapy with drugs in this group reduces the likelihood of adverse effects. If there are no dangerous signs of poisoning (gag reflex, intense pain in the head), the use of an antimicrobial drug can be postponed for 2-3 days. Antimicrobial drugs are prescribed directly by the doctor, since some of the drugs may not work. If there is no effect, after 3 days the product should be replaced with another one. Most effective antimicrobial agents:

The use of compresses makes it possible to prevent the release of pus. Should be handled carefully. It is required to agree in advance with the doctor regarding possible contraindications and side effects.

Flushing of the ear canal in order to eliminate purulent contents. It is carried out in stationary conditions under the supervision of a doctor. In order to avoid the penetration of pus into the brain and subsequent infection, such manipulations must be carried out. Contributes to a significant improvement in general condition. For the procedure, solutions of antibacterial agents are used in combination with glucocorticosteroids.

Use of vasoconstrictor nasal drops. Contribute to the elimination of swelling in the nasopharynx. The use should be carried out with the permission of a doctor, taking into account the individual characteristics of the patient's body. The most common remedies:

Turundas dipped in boric alcohol. They help in the shortest possible time to remove purulent contents and restore the wound.

It is carried out to avoid the penetration of purulent contents into the brain. It is carried out in stationary conditions by a qualified specialist.

Otitis media with proper therapy goes away without leaving any complications. However, they cause several types of consequences. Infection can go to the inner ear and provoke labyrinthitis. In addition, the disease provokes persistent or transient hearing impairment or permanent deafness. This effect occurs not only in a situation of damage to the nerve receptors located in the inner ear, but also when the auditory ossicles located in the ear cavity are damaged.

Perforation of the membrane also leads to hearing loss. Although the membrane is capable of overgrowing, the ear's sensitivity will be permanently impaired. Traumatic otitis media can provoke mastoiditis - an inflammatory process of the mastoid process of the temporal bone, which is adjacent to the ear from the back.

Mastoiditis is associated with acute pain in the parotid space. It is fraught with consequences such as the opening of purulent contents in the brain with the formation of meningitis or in the cervical region.

With an untimely started therapy, purulent otitis media and rupture of the membrane quickly appear. In some cases, purulent meningoencephalitis leads to death. To prevent the appearance of hearing loss, it is necessary to consult a specialist at the initial symptoms.

Any disease, including traumatic otitis media, is easier to prevent than to cure later. Therefore, it is necessary to carefully monitor the condition of the ENT organs and exclude all kinds of injuries. It is necessary to adhere to the following preventive measures for post-traumatic otitis media:

• Careful handling of sharp, cutting objects in a domestic environment. If it is a child, exclude contact with objects that can provoke trauma to the ENT organs.
• Implementation of hygienic measures (exclusion of contact with infected acute respiratory infections, hypothermia, etc.).
• Compliance with labor safety at work. This will make it possible to exclude injuries and avoid accidents.
• Exclusion of foreign objects entering the ear canal that can damage its anatomical integrity.
• Therapy of pathologies of a chronic nature.
• Exclusion of self-extraction of foreign bodies from the ear cavity.

By observing these simple prescriptions, it is possible to prevent the appearance of unpleasant symptoms.

Post-traumatic otitis media is an acute inflammatory process in various parts of the tympanic cavity, which is caused by trauma. In such a case, it is required to immediately contact a specialist, since if untimely or inappropriate therapy occurs, irreversible consequences arise. The prognosis will depend on the severity of the injury and the timing of seeking help.

Post-traumatic otitis media - what the disease represents is shown in the video.

• Description

  Otitis (otitis; Greek us, ōtos ear + -itis) - ear inflammation. Distinguish outer, middle and inner otitis.

  Otitis media.Acute otitis media.Among acute otitis media are distinguished banal, secretaryotitis media, otitis media for infectious diseases, traumatic otitis.

  Banal average otitis. The cause of the banal acute otitis media is a violation of the immune defense of the mucous membrane of the upper respiratory tract and middle ear, resulting from cooling, acute respiratory and other infectious diseases, and middle ear injuries. Secretory middleotitis media, which is especially common in childhood, is associated with the penetration into the middle ear of pathogens of adenovirus infection, parainfluenza viruses, diseases of the nasopharynx, nasal cavity and paranasal sinuses.

  Acute middle otitis media with infectious diseases (influenza, scarlet fever, tuberculosis) proceeds against the background of a weakening of the body's defenses, while the nature of the infection determines the characteristics of the course of the disease. Traumatic otitis media is the result of mechanical, thermal, chemical and other influences.

  Chronic otitis media.It is usually the outcome of an acute, for example, inadequate treatment of the latter. Allergies play an important role in the onset of the disease and the further course of the process. Depending on the characteristics of morphological changes and the clinical picture, chronic otitis media is divided into mesotympanitis, epitympanitis and mesoepitympanitis.

  Otitis externa(diffuse inflammation of the external auditory canal) develops mainly as a complication of chronic suppurative otitis media.

  Internal otitis media(labyrinthitis) - inflammation of the inner ear. It is caused by streptococci, meningococci, mycobacterium tuberculosis, various viruses, etc. Depending on the ways of penetration of microorganisms into the inner ear, they are distinguished tympanogenic (from the middle ear), meningogenic (from the cranial cavity) and hematogenous interior otitis. By the prevalence of the pathological focus, limited and diffuse internal otitis media are distinguished, by the nature of the inflammatory process - serous and purulent. There are also necrotic internal otitis media, in which the bony walls of the labyrinth are affected, sometimes with the formation of sequesters. Necrotizing otitis media occurs mainly in childhood with scarlet fever and measles.

• Symptoms

  Otitis media. Acute otitis media.During banal acute otitis media there are three periods. First period characterized by the appearance of pain in the ear, which may be throbbing, shooting, or aching. which radiates to the parietal and temporal regions, teeth. Weakness, sleep and appetite disorders appear. Body temperature usually rises to 38-39 °. Congestion and noise in the ear are noted; hearing is sharply reduced.

  Second period usually begins with a perforation of the tympanic membrane: while the pain in the ear subsides, discharge (otorrhea) appears in the external auditory canal, which in the first 2 days are usually serous-bloody, then become mucopurulent or purulent. Body temperature drops. The general condition improves, sleep and appetite improve. Ear noise and hearing loss persist. IN third period the amount of discharge from the ear gradually decreases, and then completely disappears. Hearing restoration is noted, the noise in the ear disappears. The total duration of the disease is on average 2-3 weeks.

  Secretory otitis media.Three stages are distinguished during the course of the disease. IN the first (short) stage, the symptoms are mild. In second The (secretory) stage is dominated by the processes of production and accumulation of mucus, which is manifested by a feeling of congestion and pressure, sometimes noise in the ear, moderate hearing loss. Third (final) stage: inflammation subsides; with normalization of the function of the auditory tube, the middle ear is freed from mucus. In 40-65% of cases by the end of the 6th month from the onset of the disease, spontaneous recovery occurs.

  Acute medium influenza otitis . It is characterized by pain in the ear, head. There is a sharp decrease in hearing, noise in the ear, dizziness and nausea, malaise, fever, chills can be observed. For scarlet otitis mediathere is an early perforation of the tympanic membrane, profuse suppuration. Discharge from the ear becomes fetid, hearing decreases sharply. Korevaotitis media in clinical presentation and course is similar to otitis media with scarlet fever. Tuberculousotitis. Characterized by a creamy discharge from the ear, which becomes fetid when the bones are involved. Traumaticotitis media: the perforation of the tympanic membrane has an irregular scalloped shape, surrounded by hemorrhages.

  Chronic otitis mediatakes a long time. It is characterized by persistent or periodic discharge from the ear, hearing loss, and sometimes dizziness and headaches. Local pain in the ear is observed only during the exacerbation of the process. Discharge can be mucous and purulent, with an unpleasant odor with caries of bone formations or suppuration of cholesteatoma. Watery (serous) discharge indicates the allergic nature of the disease.

  Otitis externamanifested by itching and pain, purulent discharge.

  Internal otitis mediamanifested by the so-called labyrinth attack - dizziness, accompanied by nausea, vomiting, body imbalance, noise in the sore ear, hearing loss. A characteristic symptom, especially with a unilateral lesion, is nystagmus. When serous internalotitis media spontaneous nystagmus is directed towards the lesion, it disappears after 3-5 days. When purulent internal otitis media, nystagmus is directed in a healthy direction and disappears after 2-3 weeks.

  Patients in the Romberg position when walking forward and backward deviate towards the slow component of nystagmus. In the same direction, there is a deviation of the hands and a miss reaction. With a bilateral lesion, which is observed, for example, with meningogenic internal otitis media, vestibular disorders, incl. and nystagmus, not expressed - involvement in the process of labyrinths is usually manifested hearing loss or deafness as well as the complete absence of vestibular excitability.

• Treatment

  For medium banal spicy otitis media are shown bed rest, light high-calorie food, a warming compress on the parotid region, and vasoconstrictor drops in the nose. Within 10 days appoint antihistamines, sulfonamides or antibiotics. In the external auditory canal 2-3 times a day injected 40% ethyl alcohol, heated to body temperature. Apply UHF and microwave therapy, intra-aural laser therapy. With severe pain in the ear and especially with protrusion of the tympanic membrane, one should not hesitate with paracentesis. When otorrhea appears, it is recommended to promptly remove the discharge by first pouring 5-7 drops of a 3% solution into the external auditory canal hydrogen peroxide... To avoid maceration of the skin of the external auditory canal, it is lubricated with sterile vaseline or other liquid oil.

  Secretory middle otitis. Treatment begins with sanitizing the upper airways and restoring nasal breathing. Mandatory adenotomy, to be completed tympanopuncture (piercing the eardrum with a hollow needle) or tympanotomy(incision of the tympanic membrane with shunting of the tympanic cavity). Carry out ear blowing according to Politzer or by catheterization followed by pneumatic massage... Medicines are administered transtubarnoor transtympanally... Glucocorticoids, antibiotics, dioxidin, protargol, trypsin, lysozyme, lekozyme, mucosolvin are used.

  About severe otitis media with infectious diseases.The treatment is specific. Traumaticotitis. The course of the process and treatment are the same as for banal otitis media.

  When chronic otitis media first of all, they provide a sufficient outflow of the discharge from the affected middle ear cavities. For this purpose, polyps and granulations are removed from the tympanic cavity. With a relatively limited process, conservative treatment is used: the external auditory canal and tympanic cavity are regularly washed or soaked with cotton swabs or gauze turundas, 40% ethyl alcohol is poured into it, antibiotics (excluding ototoxic), sulfa drugs and other antibiotics (excluding anti-inflammatory drugs) are prescribed, proteolytic enzymes are introduced.

  For treatment otitis externaapply washing of the external auditory canal with disinfectant solutions, lubrication with Oxycort ointment, synthomycin emulsion. Relapses are possible.

  Treatment internal otitis media conservative and operational. With serous otitis media in the case of severe vestibular disorders, a salt-free diet is prescribed, fluid intake is limited, dehydration therapy is performed, and antibacterial agents are prescribed. With purulent internal otitis media, antromastoidotomy or radical ear surgery is indicated, followed by the appointment of the above means. With necrotizing otitis media, the labyrinth is opened and necrotic altered tissues are removed. The prognosis for life with uncomplicated otitis media is favorable. Changes in serous otitis media are usually reversible. Diffuse purulent and necrotizing internal otitis media result in complete loss of the auditory and vestibular functions of the affected ear.

• Prevention

  Prevention banal spicy otitis media and caused infectious diseases is aimed at preventing and timely treatment of acute infectious diseases, primarily respiratory, as well as eliminating the pathology of the upper respiratory tract, contributing to the development of otitis media (adenoids, rhinitis, sinusitis, curvature of the nasal septum).

  Positive effect with secretaryotitis media is rendered by restorative and hyposensitizing agents, physiotherapy procedures.

  In order to prevent the development of secondary traumaticotitis media from the very first days after the injury, it is necessary to exclude any manipulations in the external auditory canal so as not to introduce the causative agent of the infection into the tympanic cavity.

  Prevention chronic secondary otitis media consists in sanitation of the upper respiratory tract and timely and rational treatment of acute otitis media.

  Prevention outdoor otitis media. With cotton swabs we apply microtrauma on the skin of the ear canal, which easily gets infected. Rubbing sulfur into the epidermal lining, a cotton swab also irritates the cells of the sulfur glands, due to which they release even more sulfur. ... Wash the same ears needed every day. Standing in the shower, slide your soapy index finger over the ear and ear canal. Then tilt your head so that the water flows into it. Rinse your ear gently with your finger and tilt your head so that the water flows out of it.

  Prevention internal otitis media- timely and rational treatment of acute and chronic purulent otitis media, as well as other diseases that cause the development of labyrinthitis.

A fast-flowing infectious and inflammatory lesion of the middle ear cavity. The clinical picture of the disease includes severe pain syndrome, general manifestations, feelings of congestion and noise in the ear, hearing loss, the occurrence of a perforated hole in the eardrum, followed by suppuration. The diagnosis of acute otitis media is based on the data of a clinical blood test, otoscopy, various hearing studies, X-ray of the skull, rhinoscopy and pharyngoscopy, examination of the auditory tube. The general treatment of the disease is carried out with antibiotics, antihistamines and anti-inflammatory drugs, local therapy consists of blowing out the auditory tube, instilling ear drops, washing the tympanic cavity, introducing proteolytic enzymes into it, etc.

General information

Acute otitis media is a widespread pathology in both pediatric and adult otolaryngology. Acute otitis media is the most common form of otitis media. It is observed with equal frequency in women and men. Recently, there has been a tendency of acute otitis media to a more sluggish course in adults and frequent recurrence in children. In young children, due to the peculiarities of the structure of the ear in acute otitis media, the antrum is immediately involved in the inflammatory process - the caves of the mastoid process and the disease has the character of otoantritis. Acute otitis media can occur as a complication of eustachitis, exudative otitis media, aerotitis, ear trauma, inflammatory diseases of the nasopharynx.

Causes of acute otitis media

Up to 65% of acute otitis media are due to streptococcal infection. In second place in terms of frequency of occurrence are pneumococcus and staphylococcus. In rare cases, acute otitis media is caused by diphtheria bacillus, Proteus, fungi (otomycosis).

Most often, the penetration of infectious agents into the tympanic cavity occurs in a tubogenic way - through the auditory (Eustachian) tube. Normally, the auditory tube serves as a barrier that protects the middle ear from microorganisms in the nasopharynx entering it. However, with various general and local diseases, its function may be impaired, which leads to infection of the tympanic cavity with the development of acute otitis media. Factors provoking dysfunction of the auditory tube are: inflammatory processes of the upper respiratory tract (rhinitis, ozena, pharyngitis, laryngitis, laryngotracheitis, tonsillitis, adenoids, chronic tonsillitis); benign tumors of the pharynx (angioma, fibroma, neuroma, etc.), tumors of the nasal cavity; surgical interventions in the nasal cavity and pharynx; diagnostic and therapeutic manipulations (blowing according to Politzer, catheterization of the auditory tube, tamponade for nosebleeds).

The development of acute otitis media can occur when the tympanic cavity is infected by the transtympanic route - through the damaged tympanic membrane, which happens with injuries and foreign bodies of the ear. The hematogenous route of infection of the middle ear cavity with the onset of acute otitis media can be observed with general infections (measles, influenza, scarlet fever, rubella, diphtheria, syphilis, tuberculosis). The emergence of acute otitis media due to the penetration of infection from the cranial cavity or inner ear is considered a casuistic case.

In the occurrence of acute otitis media, the state of general and local immunity matters. When it decreases, even the saprophytic flora entering the tympanic cavity from the nasopharynx can cause inflammation. Relatively recently, it was proved that in the appearance of acute otitis media, not the last role belongs to the so-called ear allergy, which is one of the manifestations of systemic allergy along with allergic rhinitis, exudative diathesis, allergic dermatitis, asthmatic bronchitis and bronchial asthma. An important role in the development of acute otitis media is played by unfavorable environmental factors: hypothermia, dampness, sudden changes in atmospheric pressure.

Symptoms of Acute Otitis Media

Acute otitis media lasts on average about 2-3 weeks. In the course of a typical acute otitis media, 3 consecutive stages are distinguished: preperforative (initial), perforating and reparative. Each of these stages has its own clinical manifestations. With timely started treatment or high immunological resistance of the body, acute otitis media can take an abortive course at any of the indicated stages.

Pre-perforative stage Acute otitis media can take as little as a few hours or last 4-6 days. It is characterized by a sudden onset with intense ear pain and severe general symptoms. Ear pain is caused by rapidly increasing inflammatory infiltration of the mucous membrane lining the tympanic cavity, resulting in irritation of the nerve endings of the glossopharyngeal and trigeminal nerves. Ear pain in acute otitis media is severe, painful and sometimes unbearable in nature, leading to sleep disturbance and loss of appetite. It radiates to the temporal and parietal regions. Pain syndrome in patients with acute otitis media is accompanied by noise and congestion in the ear, hearing loss. These symptoms are associated with the fact that, due to inflammatory changes, the mobility of the auditory ossicles in the tympanic cavity, which are responsible for sound conduction, decreases.

Common manifestations of acute otitis media are an increase in body temperature up to 39 ° C, general weakness, chills, fatigue and weakness. Influenza, scarlet fever and measles acute otitis media often occur with simultaneous involvement in the inflammatory process of the inner ear with the development of labyrinthitis and hearing loss due to disorders of sound perception.

Perforated stage Acute otitis media occurs when, as a result of the accumulation of too much purulent contents in the tympanic cavity, the tympanic membrane ruptures. Through the resulting hole, first mucopurulent, then purulent, and sometimes bloody discharge begin to come out. In this case, the state of health of the patient with acute otitis media noticeably improves, the pain in the ear subsides, the body temperature gives. Suppuration usually lasts no more than a week, after which the disease progresses to the next stage.

Reparative stage acute otitis media is characterized by a sharp decrease and cessation of suppuration from the ear. In most patients at this stage, spontaneous scarring of the perforated hole in the tympanic membrane occurs and the hearing is completely restored. If the perforation size is more than 1 mm, the fibrous layer of the tympanic membrane is not restored. If the hole is overgrown, then the perforation site remains atrophic and thin, since it is formed only by epithelial and mucous layers without a fibrous component. Large perforations of the tympanic membrane do not close; along their edge, the outer epidermal layer of the membrane fuses with the inner mucous membrane, forming the calcified edges of the residual perforation.

Acute otitis media does not always have a typical clinical picture. In some cases, there is initially a prolonged and mild nature of the symptoms, the absence of a spontaneous rupture of the tympanic membrane. On the other hand, an extremely severe course of acute otitis media with severe symptoms, temperature up to 40 ° C, headache, nausea and dizziness is possible. A delay in the formation of perforation of the tympanic membrane in such cases leads to a rapid spread of infection into the cranial cavity with the development of intracranial complications. In cases where, after perforation of the tympanic membrane, there is no improvement in the condition, there is an aggravation of symptoms after some improvement, or there is a prolonged (more than a month) suppuration, one should think about the development of mastoiditis.

Diagnostics of the acute otitis media

The diagnosis of acute otitis media is established by an otolaryngologist based on the patient's complaints, the characteristic sudden onset of the disease, the results of otoscopy and microotoscopy, and hearing studies. In the clinical analysis of blood in patients with a typical course of acute otitis media, moderate leukocytosis and a mild acceleration of ESR are revealed. Severe forms of the disease are accompanied by pronounced leukocytosis with a shift of the formula to the left, a significant acceleration of ESR. An unfavorable sign indicating the development of mastoiditis is the absence of eosinophils.

The otoscopic picture of acute otitis media depends on the stage of the disease. In the initial period, the injection of the radial vessels of the tympanic membrane is detected. Then the hyperemia becomes diffuse, infiltration and protrusion of the membrane towards the ear canal is noted, sometimes a whitish coating is present. In the perforated stage, with otoscopy, a slit-like or rounded perforation of the tympanic membrane is visible, a pulsating light reflex is observed - a pulsation of pus, synchronous with the pulse, visible through the perforation. In some cases, there is a prolapse through the perforation of the mucous membrane of the tympanic cavity, resembling granulation tissue. In the reparative stage of acute otitis media during otoscopy, the perforation may become infected or its organization in the form of compaction and calcification of the edge.

Treatment of acute otitis media

Acute otitis media is treated depending on the stage and usually on an outpatient basis. With the development of complications, hospitalization of the patient is indicated. In order to relieve pain in the pre-perforative stage of acute otitis media, ear drops containing anesthetics are used. Effectively instillation of drops heated to 38-39 ° C, followed by closing the ear canal with cotton wool and petroleum jelly, which is removed after a few hours. Turundas moistened with alcohol solution of boric acid are also used. To relieve puffiness and improve the drainage function of the auditory tube, antihistamines and nasal vasoconstrictor drops are prescribed: oxymetazoline, xylometazoline, naphazoline, tetrizoline, xylometazoline.

General therapy for patients with acute otitis media is carried out with anti-inflammatory drugs: diclofenac, ibufen, etc. In case of an increase in body temperature and intense pain, antibiotic therapy is indicated. The drugs of choice are amoxicillin, cefuroxin, spiramycin. Having started taking an antibiotic, it is necessary to drink it for 7-10 days, since the early termination of antibiotic therapy can lead to relapses and complications, chronic otitis media, and the formation of adhesions inside the tympanic cavity.

A good effect in the pre-perforative stage of acute otitis media is provided by blowing the auditory tube according to Politzer and washing the middle ear with antibiotic solutions in combination with glucocorticosteroid drugs. The protrusion of the tympanic membrane against the background of the treatment suggests that, despite all the therapeutic measures, a large amount of pus accumulates in the tympanic cavity. This condition is fraught with the development of complications and requires paracentesis of the tympanic membrane.

In the perforated stage of acute otitis media, along with the use of antihistamines, vasoconstrictor and antibacterial agents, an external ear toilet and transtympanic administration of drugs are performed. Fenspiride is used to reduce edema and mucosal secretion, mucolytics (acetylcysteine, herbal preparations) are used to liquefy thick secretions. Physiotherapeutic treatment is prescribed: UFO, UHF and laser therapy.

Treatment in the reparative stage of acute otitis media is aimed at preventing the formation of adhesions, restoring the functions of the auditory tube, and increasing the body's defenses. Blowing through the auditory tube, introducing proteolytic enzymes into the tympanic cavity through it, pneumomassage of the tympanic membrane, phonophoresis with hyaluronidase, vitamin therapy, taking biostimulants (royal jelly, hemoderivative of calf blood) are used.

Acute otitis media prognosis

With timely and competent treatment, sufficient activity of the immune mechanisms, acute otitis media ends with complete recovery and 100% hearing recovery. However, a late visit to a doctor, poor immunity, adverse external influences and background diseases can cause a completely different outcome of the disease.

Acute otitis media can transform into chronic suppurative otitis media, which is accompanied by progressive hearing loss and recurrent suppuration. In some cases, the inflammatory process leads to pronounced cicatricial-adhesive changes in the tympanic cavity, impairing the mobility of the tympanic bones and causing the development of adhesive otitis media with persistent hearing loss.

In severe cases, acute otitis media is accompanied by the development of a number of complications: purulent labyrinthitis, mastoiditis, neuritis of the facial nerve, petrositis, meningitis, sigmoid sinus thrombosis, brain abscess, sepsis, some of which can be fatal.

Otitis media is an ENT disease characterized by the formation of foci of inflammation in the ear. The provocateurs of inflammation are infectious agents (bacteria, fungi, viruses), injury or an allergic reaction. More often, the disease occurs in children, which is associated with the peculiarities of the structure of the ear. Untimely treatment of pathology can lead to hearing loss or hearing loss.

What are the types of otitis media? There are many types of the disease, which is due not only to the cause of their occurrence and the peculiarities of the symptoms, but also to the place of localization. Inflammation can occur in one of three main areas of the ear, namely:

• external ear - represented by the auricle and the auditory canal. In the presence of foci of inflammation in these parts of the hearing aid, otitis externa develops;
• middle ear - consists of the tympanic cavity and three auditory ossicles, which are responsible for receiving sound signals from the outside;
• inner ear - includes semicircular canals, cochlea and vestibules. Inflammation in this section of the ear is most often called labyrinthitis.

Of all types of otitis media, middle occurs in 82% of cases.

Classification

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

• acute - characterized by a vivid manifestation of the symptoms of pathology, which last for 7 to 20 days;
• subacute - has less pronounced symptoms, the duration of inflammatory processes ranges from 3-4 weeks to 3 months;
• chronic - a sluggish ENT pathology with unexpressed clinical manifestations. They talk about the development of the disease if the duration of a 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, however, in the case of a diagnosis, the specialist indicates a more accurate cause of the disease, as evidenced by the name of a specific type of otitis media:

• bacterial - provoked by pathogenic microbes that cause inflammation;
• viral - caused by viral agents that enter the ear with 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 the body's allergic reaction to the penetration of allergic agents that provoke edema and irritation of tissues;
• traumatic - an 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 evidenced by suppuration, severe tissue edema and itching.

Morphological classification

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

• exudative - accompanied by the evacuation of liquid exudate from the ear canals;
• 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 event of an infectious lesion of the body and is accompanied by the appearance of bubbles with bloody blotches on the surface of the tympanic membrane;
• adhesive - due to sluggish inflammation in the ear, adhesions may appear, as a result of which the patient develops hearing loss.

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

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

In the case of an infectious lesion of the hearing aid, bilateral otitis media often develops. To prevent damage to both ears, you should contact your ENT doctor at the first signs of illness.

Development stages

In the case of an acute course of the inflammatory process, several main stages of the development of the disease can be distinguished. As a rule, acute infectious pathologies do not lead to hearing loss. The only exception is purulent inflammation, as a result of which the morphological and functional structures of the auditory apparatus are destroyed. There are 5 main stages of otitis media of the middle ear, namely:

1. acute eustachitis - a constant feeling of stuffiness or hum in the ears; in the presence of an infectious agent, a slight increase in temperature is possible;
2. catarrhal inflammation - aseptic inflammation of the mucous membranes of the middle ear, which are accompanied by sharp pain and high temperature;
3. pre-perforative purulent inflammation - hearing impairment associated with pain radiating to the eyes, teeth, oropharynx, etc.;
4. post-perforated purulent inflammation - subsiding of the main symptoms of the disease with further suppuration, in which the hearing loss does not go away, but only intensifies;
5. reparative stage - pathological processes in the ear are stopped, and perforations present in the tissues are healed by scars.

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

Otitis externa

With the development of this type of ENT disease, pathological processes mainly affect the external auditory canal. It contains an acidic environment that prevents the development of pathogens inside the ear. But as a result of water entering the ear canal, the pH level can change. As a result, pathogens can easily penetrate tissues and provoke complications.

There are two main types of otitis media:

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 evacuating the pus;
2. diffuse - accompanied by damage to the tissues of the entire ear canal, which is due to the activity of the bacterial flora represented by streptococci. Diffuse ear damage most often occurs in allergic, bacterial and fungal types of ENT disease.

Labyrinthitis is an ENT disease characterized by the appearance of lesions in the inner ear. As a rule, the disease occurs as a result of inflammation of the outer or middle ear, as well as general damage to the body by an infection that reaches the semicircular canals of the inner ear by hematogenous route. The provocateurs of pathological changes in tissues can be meningitis, microbial and viral pathogens, cranial injuries, etc.

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

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

Otitis media

Inflammation that occurs in the tympanic cavity is often triggered by bacteria, viruses, or injury. The middle ear contains a complex bone mechanism that is responsible for the receptivity of sound waves. Therefore, damage to the hearing aid is fraught with hearing impairment and complete loss of hearing. The main types of otitis media in adults include:

• barotraumatic otitis media is a disease resulting from unilateral strong pressure on the walls of the tympanic membrane. A professional type of ENT disease that is most commonly seen in divers, swimmers and snorkelers. Often, with the progression of the disease, a secondary infection develops, provoking suppuration in the ear cavity;
• traumatic otitis media - a pathology in the hearing aid, provoked by trauma to the brain, cranium or spine. Fractures of the bones in the skull lead to deformation of the auditory ossicles and perforation of the membrane, as a result of which inflammation occurs and hearing deteriorates;
• post-traumatic otitis media is an infectious disease resulting from trauma to the organs of the hearing system. A decrease in the barrier function of tissues against the background of their damage creates conditions for the multiplication of bacteria or viruses that provoke purulent processes in the ear;
• hemorrhagic otitis media - a pathological change in the state 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, accordingly, to hearing impairment.

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

It should be noted that 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 reactivity of the body. Infectious diseases, injuries, poor hygiene, allergic reactions, vitamin deficiency, hypothermia or internal boils can provoke the development of pathology.

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

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

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

Otitis media is a condition in which the middle ear, the space behind the tympanic membrane made up of small ossicles, becomes inflamed.

Most often, the disease manifests itself in children, as well as in people with weakened immunity.

Otitis media is accompanied by pain (usually in one ear canal, but bilateral pain also happens), fever, poor health, sleep disturbance. If the disease is not treated, then otitis media can develop into hearing loss, move to neighboring organs and cause a number of other complications.

Schematic representation of the inflammation process in the middle ear.

Types of otitis media

Acute infectious purulent otitis media

Most often it occurs as a result of various diseases of the upper respiratory tract.

Symptoms:

• congestion and discomfort in the ear canal;
• temperature increase;
• painful sensations;
• discharge of pus;
• noise in the ear.

Acute infectious exudative otitis media

If an infection enters the ear canal, the formation of pus may begin, which leads to purulent otitis media. Also, the disease occurs due to a decrease in pressure in the tympanic cavity and due to the plug of the auditory tube. The disease can manifest itself due to a violation of the outflow of fluid (exudate) from the auditory tube.

Symptoms of acute infectious exudative otitis media:

• you may feel like the ear is blocked or has fluid in it;
• the accumulation of fluid may cause ear pain;
• if left untreated, hearing loss may develop;
• during a medical examination, it is found that the eardrum has become gray and the vascular network has increased.

Acute hemorrhagic otitis media

Hemorrhagic otitis media - inflammation of the mucous membrane of the middle ear and, as a result, accumulates bloody fluid (hemorrhagic exudate) and significantly increases the permeability of the vessels of the tympanic membrane.

Signs of the disease with acute hemorrhagic otitis media:

• physical examination reveals blueness of the tympanic membrane;
• there is progressive hearing loss;
• ear congestion is felt;
• slight pain is observed during palpation;
• a reddish (bloody) inflammatory fluid is visible in the tympanic cavity.

Acute traumatic otitis media

The cause of traumatic otitis media is various minor injuries, including thermal effects (burns, frostbite), chemical, mechanical. Through a damaged eardrum or through a crack in the temporal bone, the infection reaches the middle ear. Sometimes, in the event of an injury, blood enters the middle ear cavity, forming suppuration.

The disease can be recognized by the following signs:

• hemorrhages are noticeable on the eardrum, the hole has torn edges;
• hearing loss;
• bloody or purulent discharge comes out of the ear.

Chronic allergic exudative otitis media

The disease occurs as a result of a violation of the flow of fluid from the middle ear during respiratory and allergic diseases, as well as when the ear is not properly treated with antibiotics. The longer the purulent exudate is in the tympanic cavity, the thicker it becomes, making it difficult and increasing its duration of treatment.

Symptoms:

• feeling of ear congestion;
• a feeling of "overflow" of fluid in the ear cavity;
• hearing loss;
• the eardrum looks cloudy and retracted.

Chronic infectious purulent otitis media

The infection progresses for a long time, which is why the inflammation can last for several weeks or even months.

Chronic infectious purulent otitis media is characterized by:

• purulent discharge with an unpleasant odor from the ear canal;
• significant hearing loss.

In some cases, the disease can go unnoticed and, as a result, a scar forms on the eardrum or adhesions occur, leading to hearing impairment.

Chronic adhesive otitis media

The disease develops during the long presence of fluid in the middle ear cavity, impairing the patency of the auditory tubes, which leads to the formation of connective tissue, from which adhesions are formed that impede the mobility of the auditory ossicles. As a result, sound conduction and hearing are impaired.

The main signs of the disease:

• rapid hearing loss;
• noise in ears;
• feeling of ear congestion.