Otitis media is an inflammation that develops in the cavity between the outer and inner ears. The pathological process occurs in the space that is behind the eardrum. Otherwise, this disease is called inflammation of the middle ear. Usually infections cause pathology. Inflammation affects both children and adults. However, in babies, the disease is much more common. This is due to the structural features of the hearing organ in children. The middle ear consists of auditory ossicles, which are responsible for conducting sound. Running such a disease is very dangerous, as it can lead to deafness.
Causes of the disease
The causes of otitis media are diverse. In most cases, they are associated with infection in the ear. Most often, coccal bacteria become the causative agents of the disease. The following pathologies can contribute to the occurrence of otitis media:
- Inflammation often develops as a complication after diseases of the nose and throat. The infection gets from the respiratory system into the ear. This happens especially often if a person blows his nose incorrectly. If the patient closes his mouth when removing secretions from the nose, then mucus can be thrown along with bacteria and viruses into the middle ear.
- Otitis media can be a consequence of any acute or chronic infectious disease. In this case, pathogens of inflammation enter the hearing organ with a blood stream.
- Inflammation of the middle ear is often noted with adenoids.
- A decrease in immunity can also lead to activation of microbes and the development of an inflammatory process in the ear.
- The disease often develops after damage to the eardrum. This organ protects the middle ear from infection. With membrane injuries, bacteria and viruses easily penetrate.
- Hypothermia can cause inflammation.
- The cause of the disease can be an allergic reaction. In this case, the pathology has a non-infectious origin.
People with congenital disorders in the structure of the ear and nose are also predisposed to the occurrence of otitis media.
Types of inflammation
The disease can occur in acute and chronic form. In the first case, the pathology begins suddenly. It lasts about 2 to 3 weeks and, with proper therapy, ends in recovery. If the treatment was insufficient, then chronic otitis media occurs. It is characterized by periodic exacerbations and remissions.
In addition, the disease is classified according to pathological manifestations. The following forms of inflammation are distinguished:
- catarrhal;
- exudative;
- adhesive;
- purulent;
- serous.
With pronounced manifestations, a purulent form of the disease occurs. She often gives serious complications.
Symptoms of acute and chronic form
Acute otitis media begins abruptly and suddenly. First, a person complains of a tingling sensation inside the ear. Then the unpleasant sensations intensify and develop into a sharp excruciating pain. It is pulsating in nature, can give to the jaw or to the head. In addition to pain, there are other signs of pathology:
- temperature rise (up to +39 degrees);
- worsening of general health (weakness, chills, pain in the head);
- feeling of stuffiness and noise in a sore ear;
- hearing loss.
The initial period of the disease lasts 5 to 7 days. Then the pus from the middle ear comes out through a tear in the eardrum. This stage of the pathology is called perforated. The patient's temperature decreases, his health improves slightly and pain decreases. This stage of the disease is noted not in all patients, but only with a purulent form of otitis media.
After this comes the recovery period (reparative stage). Heals the affected areas. Gradually, the patient's condition returns to normal, and hearing improves.
Otitis media in children in acute form begins with a high temperature (up to +39 - +39.5 degrees). Kids often cry, wake up at night, constantly touch the affected ear. Children who already know how to speak complain of severe pain. Inflammation may be accompanied by gastrointestinal upsets.
In the chronic form of otitis media, the symptoms of pathology are mild. Pain occurs only during exacerbations. A person's hearing is constantly reduced, tinnitus is noted. Periodically, purulent discharge leaves the ear canal. Patients complain of dizziness.
Catarrhal form
With catarrhal otitis media, the auditory tube and eardrum become inflamed. There is a sharp pain of a shooting character. It radiates to the temple and teeth. Isolation of pus from the ear is not noted.
This disease is easily detected by the patient's complaints. Treatment of this form of otitis media should be started immediately, since the pathology can go into an exudative or purulent form. The consequence of a neglected disease can be complete hearing loss.
Exudative form
The exudative form of otitis media is often very difficult to diagnose. This disease is not accompanied by severe pain. In the middle ear cavity, fluid accumulates (exudate). The patient has hearing impairment, a person constantly feels tinnitus.
This is the most insidious form of the disease. In the absence of pronounced symptoms, degenerative changes occur in the middle ear cavity. This can lead to serious and permanent hearing loss and even complete deafness.
Purulent inflammation
Otitis media in a purulent form most often has a bacterial rather than viral nature. This type of disease is most often noted. In the cavity of the middle ear, pus accumulates, which presses on the eardrum. Because of this, there is a sharp pain and a feeling of fullness.
The cause of this form of the disease, most often, is inflammation in the throat and nasopharynx. Sometimes the infection enters the ear with blood flow. Often neglected catarrhal or exudative otitis media flows into a purulent form of the disease.
In addition to a possible hearing loss, suppuration is dangerous and other serious complications. Pus can burst into the cranial cavity. This leads to meningitis, brain abscess, and blood poisoning.
Serous inflammation
Serous inflammation often occurs without pronounced symptoms. Pain is not noted. Serous fluid accumulates in the middle ear . The patient complains of a feeling of pressure, noise and stuffiness in the ear. Hearing is slightly impaired.
This disease is dangerous because it can go into a more severe form. Especially often this happens in young children who still cannot speak. They do not feel pain and cannot complain of congestion and noise in the ear. From the behavior of the kids it is very difficult to determine that they are sick.
Adhesive otitis media
Adhesive otitis media usually occurs in a chronic form. Severe pain is not observed. But at the same time, an adhesion process occurs in the cavity of the middle ear. This leads to tinnitus and a gradual decrease in hearing.
Diagnostics
This disease can be detected by the patient's characteristic complaints of pain and discharge from the ear. In order to clarify the diagnosis, the following examinations are prescribed:
- Otoscopy. Using a special device, the doctor examines the ear canal and eardrum.
- A swab of the ear. The doctor takes a purulent discharge for examination and sends it to the laboratory for bacterial sowing. This helps to identify the causative agent of inflammation.
- Audiometry. This examination is indicated for the adhesive form of the disease. It helps determine hearing acuity.
These diagnostic procedures distinguish middle ear inflammation from sulfur plugs, traumatic injuries of the eardrum and foreign bodies in the ear canal.
Local remedies
Treatment of otitis media is usually performed on an outpatient basis. Admission to the hospital is required only for complications. The choice of treatment method depends on the form and stage of the disease.
With otitis media, it is very important to remove the discomfort in the ear. For this, ear drops are prescribed with an anesthetic effect. Next, some preparations for instillation into the ear will be considered:
- Drops "Anauran". They contain antibiotics and anesthetic lidocaine. Drops are applied to cotton and inserted into the ear canal. They not only relieve pain, but also affect the pathogenic microflora. This remedy is contraindicated in pregnant women and nursing mothers, as well as children under 1 year old.
- The drug is Sofradex. The composition of these drops includes corticosteroid hormones and antibiotics. This helps relieve inflammation and swelling, as well as eliminate itching. They can be used not only for bacterial inflammation, but also in the treatment of otitis media in adults and children with allergic etiology. Drops can be used only for 10 days, since with prolonged use, microbes become resistant to their components.
- Otipaks ear drops. They contain the analgesic phenazone and the anesthetic lidocaine. They have a good analgesic effect. They can be used to treat otitis media in children, even in infancy. However, there are no antibiotics in their composition, therefore, such drops do not affect the cause of the disease, but only relieve symptoms.
- Means of Otinum. Drops contain non-steroidal anti-inflammatory and bactericidal substances. They effectively relieve inflammation, but less relieve pain than other drugs. These drops can also not be used for more than 10 days. Children can only be buried after the age of 1 year.
It is important to remember that ear drops cannot be used if the eardrum is damaged. This can lead to inflammation of the auditory nerve and serious hearing impairment. Therefore, these drugs alone can not be used. Before using them, you must go through an examination with an otolaryngologist.
Children with otitis media are prescribed vasoconstrictive nasal drops "Nazivin baby", "Ximelin", "Otrivin". The nasal and auditory passages are closely related. Therefore, the use of such drops helps relieve swelling and inflammation in the ear.
Preparations for oral administration and physiotherapy
To relieve pain and inflammation, adult patients are shown oral administration of drugs: "Diclofenac", "Ketorolac", "Nurofen", "Ibuprofen". When treating a disease in a child, medications are prescribed in children's forms and dosages.
In the treatment of otitis media, antibiotics are also used for oral administration. If the disease proceeds in an acute form, it is recommended to use penicillin preparations: Amoxicillin and Ampicillin. They have a wide spectrum of action and affect many types of microorganisms.
If the disease has become chronic, then antibiotics from the group of aminoglycosides and fluoroquinolones are prescribed. These are the tablets "Ciprofloxacin" and "Vero-Netilmicin" in ampoules. It should be remembered that during pregnancy and lactation they can not be taken. During the course of treatment with antibacterial drugs, probiotics are prescribed to maintain normal microflora.
In childhood, antibiotics are required only with a purulent form of the disease. They are prescribed by the doctor after determining the sensitivity of microflora in appropriate dosages. If otitis media proceeds in a mild catarrhal form, then you can do only by using drops.
In the early stages of the disease, ear washing with bactericidal solutions helps. If pus has accumulated in the hearing organ and does not erupt for a long time, then oral mucus thinners are used orally: “ACC”, “Fluimucil” and other mucolytics.
Assign sessions of physiotherapy. Apply exposure to ultraviolet rays and a magnetic field on the area of the diseased ear.
During the disease it is very important to strengthen the body's defenses. For this purpose, immunostimulants are prescribed: Actovegin, Apilak and multivitamin complexes.
Features of the treatment of various forms of otitis media
The general principles for the treatment of otitis media have been described above. However, the treatment of various forms of this disease has its own characteristics.
With a serous form, it is sometimes necessary to make an artificial hole in the eardrum. Through it, drugs are injected directly into the middle ear cavity. This method is used for a disease duration of at least 3 months.
Adhesive otitis media is often caused by impaired nasal breathing. In the treatment of this form of the disease, blowing of the ear canal and pneumatic massage of the tympanic membrane are used. However, in advanced cases of the adhesive process, conservative treatment is not always effective, and an operation has to be done. The eardrum is opened and adhesions removed surgically. In more complex cases, the auditory ossicles are prosthetized.
Folk remedies
The treatment of otitis media at home should be coordinated with your doctor. It cannot completely replace the use of ear drops and antibiotics. However, folk remedies can complement medicines.
The following recipes can be recommended:
- Propolis product with sunflower oil. At the pharmacy you need to buy propolis tincture. For 1 part of the drug should be 4 parts of oil. All ingredients must be mixed well. Then, turunda is made from gauze, moistened in the composition, inserted into the ear and held for 8 to 10 hours. The procedure needs to be done 7 to 10 days.
- Calamus root. From this tool make a healing broth. A tablespoon of the plant root is placed in water and boiled for half an hour. Then boiled water is added, so that the volume of the composition is about 200 ml. This remedy has anti-inflammatory properties. It should be drunk 1 tablespoon before meals. The course of treatment is 2 to 3 weeks.
- Camphor oil. This drug can be purchased at pharmacy chains. It is instilled in a sore ear in the amount of 3 drops several times a day. You can also take a cotton swab and moisten in oil. It is placed in the ear for 4 hours. In this case, you need to tie a warm scarf on top.
Treatment of otitis media at home should be carried out carefully. Some patients may be allergic to propolis, calamus, or camphor. In this case, therapy should be discontinued.
Prevention
To prevent the disease, it is necessary to treat diseases of the nose and throat in time. It is also important to maintain immunity at a high level and to avoid hypothermia. Equally important is oral hygiene and dental health. Often the cause of the disease becomes caries.
Otitis is often found in children suffering from adenoids. It is very important to timely treat and, if necessary, remove overgrown nasopharyngeal tonsils. Simple surgical intervention will help to avoid inflammation in the middle ear.
At the first signs of otitis media, you need to urgently visit a doctor. At the initial stage, inflammation is easily cured by local means. A timely visit to the otolaryngologist will help prevent complications and hearing loss.