Very often, inflammatory processes of varying severity develop in the body. Adhesive otitis media, whose symptoms begin to manifest with impaired auditory activity, is not uncommon. Such a disease is accompanied by inflammation in the middle ear. As a result, adhesions with strands are formed, and the mobility of the auditory ossicles is impaired. Why does this disease occur? What treatments do doctors offer?
Features of adhesive otitis media
The middle ear is represented by two components: a cavity with auditory ossicles and an Eustachian tube. They are separated by an eardrum, which is also responsible for the transmission of sound vibrations. They pass through the bones to the structures of the inner ear. Here the subsequent transmission and perception of signals along the auditory nerves occurs. After that, the sound takes on the corresponding part of the brain. Adhesive otitis media appears due to decreased mobility of the tympanic membrane and ossicles. The disease is accompanied by a partial or complete violation of sound perception.
Causes of occurrence
Most often, the cause of the pathology is inflammation in the middle ear - acute otitis media and its various forms. Illiterate use of antibiotics in the treatment process can also provoke the disease. The drugs successfully fight inflammation in the ear cavity, but at the same time dilute the exudate accumulated in it. As a result, scar cords and adhesions from connective tissue are formed. They braid the bones, blocking the mobility of the structures and disrupting the patency of the auditory tube.
In otolaryngology, there are cases when adhesive otitis media develops as an independent disease. It is preceded by a variety of pathological processes that significantly impede the patency of the auditory tube and prevent full ventilation of the tympanic cavity. These violations include:
- protracted tonsillitis;
- adenoids;
- damage to the nasal septum;
- neoplasms in the pharynx;
- diseases affecting the upper respiratory tract (laryngitis, acute respiratory viral infections);
- chronic inflammation in the nasal cavity (sinusitis, sinusitis).
Regardless of the cause of the disease, having noticed its first signs, it is necessary to consult a doctor. Timely prescribed treatment can prevent the development of serious complications, avoid surgery.
Clinical manifestations of the disease
The development of the pathological process begins gradually. The first symptom that patients pay attention to is noise in the ear. Adhesive otitis media is characterized by conductive hearing impairment, when there is a persistent deterioration in the mechanical conduct of sound vibrations. The clinical symptoms of the disease are largely similar to the picture of other ailments. Therefore, many diagnostic measures are used to determine the cause of hearing changes. They make it possible to exclude other pathological processes that can lead to conductive hearing loss (accumulation of sulfur secretion, tubootitis, otosclerosis, etc.).
Establishing diagnosis
What principles does a doctor follow when choosing treatment tactics? Adhesive otitis media is a serious diagnosis, which requires a complete examination of the patient to confirm. Usually it includes:
- visual inspection;
- otoscopy (examination of the ear cavity using a light source and a reflector);
- catheterization (examination of the auditory tube that connects the ear to the nasopharynx);
- audiometry (test for hearing acuity);
- impedanometry (detection of changes in the structure of the Eustachian tube, eardrum).
The fundamental manipulations in the diagnosis of the disease are audiometry and subsequent catheterization. Impedansometry allows you to check the motility of the bones and identify adhesions. Due to the latter, the eardrum gradually loses its functions, which provokes a sharp hearing loss in the patient.
Given the results of the examination, the doctor prescribes the appropriate treatment. Adhesive otitis media, detected in the early stages, lends itself well to drug therapy and does not require surgical intervention. With the advanced form of the disease, an operation is prescribed. In especially serious cases, the patient is shown to use a hearing aid. What other methods of treating pathology exist?
Drug therapy
At the very initial stage of the pathological process, the patient is prescribed injections of B vitamins, aloe, and vitreous. To improve the elasticity of adhesions and prevent their further spread to the Eustachian tube, Lidase, Fluimucil, and Chymotrypsin are prescribed.
Physiotherapy
Conservative treatment with medications is usually supplemented with physiotherapy. The most effective are the following procedures:
- ultrasound massage;
- microwave therapy ;
- UHF;
- mud therapy.
To prevent relapse of the disease, it is recommended to repeat treatment courses 2-3 times a year.
Politzer Method and Adhesive Otitis
Treatment by blowing the Eustachian tube according to the Politzer method gives a positive effect. The procedure involves constant monitoring with the help of an otoscope. One olive is introduced into the patient’s ear, the other - a doctor. A catheter is also attached to the patient’s nostril, from which the balloon leaves. The second nostril is clamped with a finger, after which the patient is asked to slowly pronounce the word "steamboat". With each pronunciation of stressed syllable, the pear is squeezed. If there are no adhesions in the Eustachian tube, air passes unhindered.
This procedure is often combined with pneumatic massage of the tympanic membrane. Using a special apparatus, the membrane is exposed to a jet of air, the strength of which is controlled. This procedure positively affects the mobility of the tympanic membrane, prevents the formation of adhesions.
Surgical intervention
Not always with the help of drugs and physiotherapy is able to defeat the adhesive otitis media. Does conservative treatment fail? In such situations, when the disease is bilateral in nature, the patient is prescribed an operation - tympanotomy. During surgery, the doctor opens the eardrum, thereby providing access to the auditory ossicles. Tympanotomy allows you to get rid of accumulated exudate, eliminate adhesions.
Even the operation does not give a 100% guarantee of a positive result. Often against the background of a large area of lesions by adhesions, adhesive otitis media develops repeatedly. Symptoms of the disease after surgery do not differ from those before starting a course of treatment. Patients are diagnosed with scars that gradually deform the eardrum, which affects the quality of hearing. It is impossible to stop the pathological process and improve the patency of the Eustachian tube. In such situations, they resort to replacing the bones with artificial polymer prostheses, and ventilation is carried out through the auditory canal.
Danger of relapse
Patients who have experienced adhesive otitis media should be monitored by an otorhinolaryngologist for six months after treatment. After this period, it is recommended to undergo a second examination to make sure that there are no pathological changes in the ear cavity. If abnormalities are detected, the course of treatment is repeated. In the future, the disease can provoke fibrinous-cicatricial changes in the structure of the middle ear. Unfortunately, such violations are irreversible. In the absence of adequate treatment, pathology can cause ankylosis of the joints of the auditory ossicles, which leads to total deafness.
Preventive measures
An acute inflammatory process in the middle ear often ends with a diagnosis of adhesive otitis media. Treatment with folk remedies or drugs does not always bring a positive result. Surgical intervention is very time-consuming and does not allow to prevent relapse of the disease. Therefore, it is necessary to deal with the prevention of the disease. It is recommended to start from the first days of a child’s life. Breastfeeding provides the full formation of the muscles of the ear, resulting in reduced susceptibility to the effects of pathological agents. Moreover, it strengthens the body's immune system and reduces the risk of developing respiratory diseases.
Modern pharmacology offers a number of drugs to increase resistance to viral pathologies and quick recovery from colds. They are also an excellent prevention of adhesive otitis media. Among these medications should be highlighted "Influvak", "Imudon", "Bronchomunal." Before using the drugs, it is recommended to consult with a specialist on the dosage and duration of the course of prevention. If inflammation could not be avoided, it is necessary to follow the treatment regimen that the doctor suggests. Any deviations from the recommendations of a specialist are dangerous relapse of the disease.