Otitis media. Symptoms and treatment of children, adults. Antibiotics, folk remedies, propolis, warming up. Effects

Otitis media refers to common otorhinolaryngological diseases, second only to sinusitis. Since pathology is infectious in nature, incorrect or delayed treatment can lead to various complications, including hearing loss.

Not to notice symptoms of the disease it is difficult, because the main symptom of otitis media are acute pain, which intensified when panning or tilting the head.

Description and mechanism of development of otitis media

Otitis media - an inflammatory-infectious process, which is characterized by sharp signs and active dissemination in the area of ​​the mastoid process, the tympanum and auditory ear tube.

The basic mechanism of the disease includes the spread of pathogenic bacteria in the middle ear section, starting with the most important area for the ear drum. First of all, this is due to the anatomical structure of the ear: with the help of the eustachian tube cavity is always connected to the nose and throat through which penetrate the bacteria painful.

In addition, painful microbes can enter the ear with frequent sneezing, coughing or incorrect blowing nose.

Though the disease is equally manifested in individuals of any age and sex, the pathology is more common in children, because of some structural features of the ear cavity in children. Often, the disease manifests itself on the one hand, but babies may progress in both ears.

Causes and pathogens

In most clinical cases, otitis media appears with the development of SARS. Infection begins its propagation through the mouth and throat, ultimately infecting channel openings ear.

The second common cause is an infection of the auditory tract at the expense of penetration of streptococcal infections, pneumococcus and Staphylococcus aureus. Proceeding from the results of recent research, such ingress of bacteria into the human body to more than 60% of cases of otitis media calls.

Cause diseases can the following factors:

• inflammatory process within the nasopharynx;
• benign tumors: fibroma, neurinoma or angioma;
• a general decrease in the immune system;
• hypothermia;
• allergic diseases;
• incorrect removal of earwax;

In some cases, mechanical damage to the ear and surrounding regions may lead to the development of pathologic process, which is characterized by painful hit microorganism from the external environment. As a secondary phenomenon, otitis media often arises against meningitis, sinusitis, or tonsillitis.

The main pathogens are best studied in children. Thus, in newborns are most common Gram-negative bacteria, including Streptococcus agalactiae, Streptococcus pneumoniae or Haemophilus influenzae. In some cases, otitis media seen against the background of such a rare infection of the microorganism as Moraxella catarrhalis.

As for the adults, are the causative agents of bacteria Streptococcus pneumoniae and Haemophilus influenzae. In the case of the latter, launched a pathological process can lead to meningitis or bacteremia.

Common symptoms

Otitis media, symptoms and treatment depends on the severity of the flow often develops slowly, accompanied by various symptoms. The main characteristics of the disease, the same applies to any stage of strong lancinating pain and swelling.

In some cases there may be a rise in body temperature. At the same time there is a feeling of stuffiness in nose or ears, followed by hearing loss. Painful symptoms can be felt throughout the head, including the temporal and occipital regions. After some time, otitis media leads to a purulent discharge.

Stage of otitis media. Description and characteristic symptoms

In medical practice, there are several stages of otitis media, each of which has the characteristic manifestations. In this case, the disease is not always passes through all the stages.

Accepted provide initial, perforated and reparative phase. Timely and correctly chosen treatment can prevent further transition to the next stage of the disease, which makes it possible to avoid dangerous complications.

initial stage

Doperforativnaya or initial stage of otitis characterized by the presence of pronounced pain, congestion or excessive noise. The pain is felt as a stabbing, throbbing or shooting and usually increases at night.

Often there is a slight hearing loss due to absence of normal mobility bone auditory system and the presence of additional noise. The duration of this stage lasts from several hours to 2 days.

Otitis media, symptoms and treatment is better tolerated with timely treatment to the the skilled person, different type initial occurrence purulent fluid, but with isolation no.

Infectious area becomes swollen, redness appears. When attempting to lie or bend toward the affected ear pain intensifies. There may be some increase in temperature to a value 37,8-39,5 ℃.

perforated stage

The second stage of the disease is manifested by 3-5 hours after the start. A common feature of streaming is muco-purulent discharge. If mechanical damage is also possible presence of blood clots.

The presence of secretions is due to the breakthrough of the damaged membrane, which is accompanied by throbbing and tingling. Number mucopurulent liquid decreases with time.

As a result of perforation or leakage of the contents of the natural, the patient feels relief disease processes gradually weaken, the body temperature drops to normal values.

Perforated stage lasts 5-7 days. The size of the burst field admission purulent masses has no wide diameter that contributes to the normal leakage of fluid from the entire ear cavity.

If otitis manifested due to measles, tuberculosis or scarlet fever, perforation can reach a considerable size. In severe complications pus derived not from the outside of the ear and in the cranial cavity, which can lead to death.

Reparative stage

Within the reparative stage, regenerative scarring previously formed hole by means of connective tissue. Purulent fluid ceases to stand out, the patient's hearing returns to normal. Reduced swelling of the entire internal cavity of the ear and the tympanic membrane.

If the perforation is a slight degree that does not exceed 1-2 mm, healing occurs without scarring. However, if a breakthrough was significant, the site of outflow of purulent secretions formed fibrous connective tissue type.

Often the background of this can form salt deposits. Also a possible situation where the adhesive surface of fibrous tissue reaches the middle ear cavity, due to hearing impairment that occurs even after closure of otitis. In this case, it is considered a full-fledged recovery is possible only after the return of the hearing.

If caught in the final stage to the interior of the skull is not pus flowed out, the patient has mastoiditis - a dangerous inflammation. When the refilling ear purulent fluid, the doctor diagnosed an empyema of the temporal bone.

The features based on the type of otitis

In addition to clinical stages of otitis media, in practice, there are different types, which differ based on the causes, the rate of development of various symptoms and duration.

The main types are acute and chronic otitis media. Of the secondary often isolated pericardial, catarrhal or serous. It is also possible manifestation of a rare species of adhesive.

acute otitis media

Acute otitis media type is characterized by sudden onset, severity of symptoms while rapidly increasing. First, the patient feels a sharp tingling, noting a significant increase in pain intensity.

Painful sensations may from time to time to subside, but the improvement of short duration and pain again catches up with the patient. In this case, treatment should be taken as quickly as possible.

During the break the ear drum with simultaneous outflow of purulent secretions, painful symptoms subside, the general state of the patient is stabilized. The result is a complete obliteration erupted channel connective tissue with subsequent scarring.

The mean duration of the acute type is 3-4 weeks, which may vary depending on the complexity of the disease and timely adoption of the necessary measures. In the absence of proper treatment, possible complications such as inflammation of the temporal bone or facial nerve.

chronic otitis

A distinctive feature of the chronic form of acute symptoms is sluggish. Often this type is formed as a consequence of purulent otitis, which is accompanied by inflammation of the mucous-tissue envelope, Eustachian tube connects the ear drum with the department.

Chronic type is shown on the basis of the characteristic symptoms, including total hearing loss and episodic leakage purulent secretions.

In rare cases, dizziness, noise or squeak in his ears. Soreness at the same patient do not disturb.

For this form is the most favorable pathology occasionally lead to serious complications for the health.

Hearing ability is reduced from the value of the auditory damage bone.

In addition to the most successful current, chronic type has different form - purulent epitimpantit.

In this case, an infectious lesion reaches the area above the eardrum. Based on this particular location for perforation is situated at the top, because of which pus separated only partially.

It also relates to chronic type evstahiit which develops due to inflammation of the mouth the nose or mouth, including mucosal surface auditory tube in diseases such as rhinitis, angina or pharyngitis.

glue ear

Exudative otitis characterized by the accumulation of fluid - fluid from blood vesselsWhich is released in the tissues or specific organs in the presence of an inflammatory process.

A characteristic feature of this species is the almost complete absence of any symptoms. Development of fluid occurs on the background of the previously transferred infectious respiratory diseases.

The secondary causes include smoking, poor environment or presence of allergic reactions. Also, this type manifests itself due to the curvature of the nasal septum, reducing the immune system, as well as in the elderly.

Lack of timely treatment of glue ear is fraught with consequences such as the formation of purulent abscess of the middle ear, loss of mobility of the auditory ossicles, as well as total loss of hearing. Often may develop a perforation of the tympanic membrane stretching area.

serous otitis

Serous otitis media is the weakest type of subtype of acute, symptoms of which usually does not cause any discomfort to the patient. It is characterized by an accumulation of sulfur in the pinna, which is why the patient feels a slight pressure, noting the congestion in the ears with minimal hearing loss.

Otitis media (symptoms and treatment should always be seen by the doctor) serous type is not dangerous, but the lack of proper care can lead to frequent relapses and the transition to more serious forms of otitis.

If after 2 months, the patient did not improve, the doctor made a hole in the drum area, through which we introduce the necessary medication drugs.

Diagnosis of the disease in children and adults

If you suspect any pathological processes of the ear, you must immediately consult an audiologist who will put the correct diagnosis. Timely referral to help avoid complications and cure the disease in the fastest possible time.

Diagnosis of the inflammatory process primarily involves examination of the patient by the method otoscopy and aural reflector. Such visual symptoms such as redness or tissue in the presence of perforation of the tympanic area indicate the appearance of disease.

For more accurate initial diagnosis the doctor can connect audiometry and tympanometry, which will measure the severity of hearing loss and the pressure inside the ear. These research methods are optional, but in some cases their conduct is necessary.

In case of suspicion of serious complications of otitis media, which can act meningitis, brain abscess or mastoiditis, an expert appointed by the CT, MRI and X-rays, including referral to an optometrist and neurologist.

Effective treatments

Depending on the type and stage, the treatment of inflammation may be conservative or operative. The use of any therapeutic methods should be held strictly under the supervision of a specialist.

Acute type is treated on an outpatient basis is not more than 1 week. If there are symptoms such as malaise or a sharp rise in temperature, the doctor prescribes strict bed rest.

Main therapeutic methods for the treatment of any type of inflammation include the use of the following methods:

• medicated preparations;
• physiotherapy (UHF therapy or electrophoresis);
• warm compresses.

Surgical treatments are applied only when the disease has no effect conservative therapy, as well as the progression of severe complications.

Surgery is the use of two ways - paracentesis and antrotomiya. Often carried out the first type of surgical intervention, by means of which opened the area of ​​the tympanic membrane with a further pumping out purulent fluid. Antrotomiya used in the case of complicated mastoiditis, suggesting intraosseous cavity opening protrusion.

Contrary to popular belief, traditional treatments of otitis not proved its effectiveness, and any improvements are being relatively normal tissue regeneration process and release infectious liquid. Moreover, about half of the inflammation of the ear are by themselves, but this does not negate the importance of referral to a specialist.

medication

Drug treatment primarily involves the use of antibiotics, which are among the most effective drugs for the treatment of otitis media. Can become complementary means glyukokortiokidov group, ear drops, and the use of antihistamine drugs.

A more detailed list of medications used is described in the following table:

Therapeutic	name	Description and methods of influence
antibiotics	Amoxicillin, Ciprofloxacin, Augmentin, Rulid, Spiramycin, Ampicillin trihydrate, netilmicin	It has antibacterial effects, allowing to destroy pathogens. It is produced in the form of tablets or capsules. The most frequently used is not more than 1 week.
Ear drops	Otinum, Otofa, Sofradeks, Normaks, Kandibiotik, Otipaks, Anauran, Miramidez, Neladex	Help reduce the painful symptoms due to anesthetic action. They can be used for 2-3 weeks. Application: heat drops to room temperature and drip as written in the instructions; then put into the ear cavity of a cotton ball, which will need to be removed after 2-3 hours.
Antihistamine and vasoconstrictor drugs	Tizin, Rinazolin, Otrivin, Noksprey, ebastine, Suprastin	Help reduce redness and swelling and improve the condition of the patient. In some cases, can lower body temperature. Applied no more than 4-7 days.
anti-inflammatory drugs	Ibuprofen, Analgin, piroxicam, Nimesulide, Ketoprofen, Nurofen, diclofenac	Lower inflammation within the middle ear, enhance tissue regenerative properties. Not suitable for the relief of infections. Apply as long as the inflammation disappears
Vitamin complexes and biostimulants	Aktovegin, Vitrus, peaks Multiabs, Alphabet, apilak	Improve the general condition of the patient, improving the immune system and internal processes to fight against harmful bacteria. You should be applied only in conjunction with the major groups of drugs. Duration of 1-2 months, depending on the individual characteristics

Medications of any pharmacological group should be chosen specialist. Improper use of certain medications can seriously harm. Effective drug therapy is only possible with the complex application and must always be carried out under the supervision of a physician.

Physiotherapy

Otitis media (symptoms and treatment of each individual patsiena) for physiotherapeutic treatment It stops further development, reduces the risk of inflammation, painful destroyed microorganisms pain passes.

The most common methods of physiotherapy:

• UFO. Carried out with special equipment, which emits low intensity ultraviolet ray acts on the affected area. Produces a general strengthening of the immune system, it eliminates the bacterial reproduction and helps relieve inflammation.
• UHF. Exposure to high frequency electromagnetic radiation with a frequency previously exposed under certain particular patient. In addition to the positive qualities must be remembered that promotes the use of UHF formation of purulent fluid in the middle ear, due to which method should hold proceed with caution.
• Electrophoresis. Suitable for administration desired drug through the skin or mucosa of a patient by means of the low-frequency envelope of the electric current. The antibiotics most often used as a drug. It allows you to have the most rapid pharmacological effect.

Some methods of physical therapy, in particular the use of phototherapy are contraindicated in the presence of purulent fluid. In all other respects, the impact of physical therapy is one of the safest ways to treat otitis media starting to moderate.

When substantial hearing loss, the patient may be given a lavage auricle or pneumatic massage drum region of the auditory meatus. It is also often used method for pipe flushing evstahievoy Politzer.

Forecast

Otitis media of any type well treatable provided timely treatment of a specialist. Correct these therapies can reduce the negative symptoms and minimize the risk of dangerous complications. It is important not to self-medicate, and trust in the good doctor, and modern methods of treatment.

Registration of the article: Mila Friedan

Video of otitis

Elena Malysheva tell about otitis media: