External otitis media
Otitis externa is a diagnosis that is an inflammation of the outer ear that has a diffuse or limited character. Usually, otitis externa of a limited nature manifests itself as the formation of a boil. Such a boil is accompanied by sharp pain at the stage of infiltration. The latter can lead to the development of furunculosis if it is opened.
The content of the article:
Causes of otitis externa
Symptoms of limited otitis externa
Symptoms of diffuse otitis externa
Diagnosis of limited otitis externa
Diagnosis of diffuse otitis externa
Treatment of limited otitis externa
Treatment of diffuse otitis externa
Prevention of otitis externa
External otitis media
As for external otitis of a diffuse nature, it differs in the so-called diffuse inflammation of the auditory canal. The latter is characterized by pain and a feeling of bursting in the ear, subsequently purulent compartments appear. As a diagnosis of otitis externa, doctors perform an examination and palpation of the parotid region, as well as audiometry, otoscopy and bacposev from the contents secreted by the ear. Treatment of otitis externa consists in washing the auditory canal with the use of antiseptics. Also, turundum with certain medications is often placed in the ear, general antibiotic therapy is prescribed, as well as anti-inflammatory and immunostimulating treatment.
As you know, the outer ear is the peripheral part of the human hearing aid. The outer ear consists of the following compartments: the external auditory canal, represented by bone and cartilage tissue and the auricle. The outer and middle ear are separated by the eardrum. If the patient suffers from local inflammation of the external auditory canal, then we are talking about otitis externa of limited action. The latter is a purulent-inflammatory process localized in hair follicles or boils. If the inflammation is characterized by a general “spill” throughout the auditory canal, while covering bone and cartilage tissue, then they talk about diffuse otitis externa. The latter is characterized by various inflammatory changes occurring both in the skin and in the subcutaneous adipose tissue of the auditory canal itself. This inflammation can also lead to inflammation of the eardrum.
Causes of otitis externa
The main cause of otitis externa is considered to be an infection in the skin of the external auditory canal. Usually, the causative agent of otitis externa of a limited type is considered to be pyogenic staphylococcus. As for the diffuse type of otitis externa, the causative agents can be both staphylococci and hemophilic bacillus. Often the pathogens are pneumococci, Pseudomonas aeruginosa, Klebsiella, Moraxella, Candida fungi. Very often, the cause of otitis externa is suppuration from the eardrum cavity during purulent otitis media. The latter carries the infection to the outer ear.
Usually, the pathogen penetrates into the skin through the places of damage or microtrauma. In general, injury to the skin of the hearing aid can occur with ear injuries, in the presence of a foreign body in it, as well as in the case of ingestion of various chemicals of an aggressive nature. Improperly performed ear hygiene procedures, improper extraction of earwax or ordinary combing of the inner ear cavity can also be a possible cause of injury.
It should also be emphasized that the occurrence of otitis externa can also be caused by the constant moist environment of the auditory canal. Such a moist environment can be obtained by getting water into it, which leads to a decrease in the barrier function of the skin. Interestingly, with chronic infections (for example, tuberculosis, tonsillitis, syphilis), vitamin deficiency and severe fatigue, otitis externa can also develop.
Symptoms of limited otitis externa
Diffuse otitis externa usually begins with a persistent feeling of ear distension and characteristic itching. The patient is characterized by an increase in temperature in the auditory canal. The occurrence of pain syndrome with the irradiation of pain throughout the entire half of the head is a sure symptom that the patient develops diffuse otitis externa. The pain often increases during chewing. It is this pronounced pain syndrome that disrupts the patient’s sleep and can cause anorexia.
Another obvious symptom of diffuse otitis externa is to a large extent the swelling of the walls of the auditory canal, which are already inflamed. This swelling contributes to the narrowing of the lumen and is the cause of partial hearing loss. With diffuse external otitis media, a small amount of fluid is released. At first, such secretions are serous, and later — purulent. It should also be noted that regional lymph nodes are increasing. In the case of a severe course of the disease, the inflammatory process can spread to the soft tissues of the parotid region, as well as to the shell itself.
Usually, the acute period of diffuse otitis lasts for two or three weeks. In case of successful treatment, the symptoms of the disease may decrease during this time and the patient may recover completely. However, the diffuse type of otitis externa can also turn into a chronic form, then the treatment will be quite protracted. It is known that the chronic form of otitis after treatment will leave the patient with scars that will reduce the lumen in the ear canal, which will cause hearing loss.
Symptoms of diffuse otitis externa
Diffuse otitis externa usually begins with a persistent feeling of ear distension and characteristic itching. The patient is characterized by an increase in temperature in the auditory canal. The occurrence of pain syndrome with the irradiation of pain throughout the entire half of the head is a sure symptom that the patient develops diffuse otitis externa. The pain often increases during chewing. It is this pronounced pain syndrome that disrupts the patient’s sleep and can cause anorexia.
Another obvious symptom of diffuse otitis externa is to a large extent the swelling of the walls of the auditory canal, which are already inflamed. This swelling contributes to the narrowing of the lumen and is the cause of partial hearing loss. With diffuse external otitis media, a small amount of fluid is released. At first, such secretions are serous, and later — purulent. It should also be noted that regional lymph nodes are increasing. In the case of a severe course of the disease, the inflammatory process can spread to the soft tissues of the parotid region, as well as to the shell itself.
Usually, the acute period of diffuse otitis lasts for two or three weeks. In case of successful treatment, the symptoms of the disease may decrease during this time and the patient may recover completely. However, the diffuse type of otitis externa can also turn into a chronic form, then the treatment will be quite protracted. It is known that the chronic form of otitis after treatment will leave the patient with scars that will reduce the lumen in the ear canal, which will cause hearing loss.
Diagnosis of limited otitis externa
First of all, an otolaryngologist conducts an examination of the ear, followed by an otoscopy. During the examination, the doctor pulls back the auricle. If the patient really suffers from otitis externa, then when pulling the auricle, he will feel a sharp earache. If pain occurs when pressing on the tragus of the ear, then this is a clear sign of a limited type of otitis, which is localized on the anterior wall of the auditory canal. The occurrence of sharp pain during palpation behind the ear indicates the presence of a boil located in the posterior-upper part of the wall of the auditory canal itself. In the area of the lower wall with external otitis, there is always a sharp palpation in the area above the lower jaw.
Diagnosis in the form of otoscopy helps to identify a boil in the auditory canal. If this is the initial stage of otitis externa, then the boil will have a swollen red appearance. In the subsequent stages of the development of otitis externa, the auditory canal will be blocked by a ripe boil. After opening such a boil with the help of otoscopy, its content will be revealed, which may be pus or a crater-like hole present.
Another type of diagnosis is audiometry, as well as the study of hearing by means of a tuning fork. The latter is able to determine the conductive type of hearing loss, as well as to lateralize sound transmission in the direction of the auditory canal of the diseased ear. In order to determine the pathogen with 100% accuracy, doctors perform back-seeding of pus taken from the boil. Differentiated external otitis should always be distinguished from all other types of otitis, as well as from eczema and mastoiditis.
Diagnosis of diffuse otitis externa
Diagnosis of diffuse external otitis involves, first of all, the use of otoscopy. This procedure is able to detect severe redness and swelling on the skin, as well as the presence of erosion and serous discharge. The use of audiometry will help to identify the degree of hearing loss, and the lateralization of sound moves to the diseased ear. With the help of bacteriological studies, it is possible to detect the pathogen and determine which antibacterial drugs are most suitable for the patient.
Treatment of limited otitis externa
Treatment of otitis externa involves, first of all, the toilet of the outer ear, as well as the treatment of the affected area of the ear with a solution of silver nitrate. To do this, turunda is usually injected into the ear canal with a certain antibacterial ointment, which can be a flucinar, celestoderm or triderm. Then ear drops drip into the ear, which must contain an antibiotic. Analgesics are prescribed to relieve pain. The doctor may also prescribe an anti-inflammatory drug. The use of UHF therapy is also not excluded. If the patient suffers from a ripe boil, then it must be opened by applying an incision. After opening the boil, it is necessary to rinse the ear canal using solutions based on antibiotics or antiseptics.
Also, in the case of external otitis media with a large number of boils, antibiotic therapy is prescribed. If the staphylococcal nature of otitis is confirmed, then the doctor prescribes antistaphylococcal anatoskin. Vitamin therapy, VLOK, UFOK or autohemotherapy procedures are used to increase immunity.
Treatment of diffuse otitis externa
Usually, a number of antibiotics, antihistamines and multivitamins are prescribed for the treatment of diffuse otitis externa. If necessary, immunocorrective treatment is carried out. If we talk about the local treatment of diffuse otitis externa, then it consists in the use of turundum lubricated with mercury ointment in the auditory canal. Burov’s liquid, hormonal ointments and antibacterial gels are also used. Doctors often prescribe various ear drops in combination with antibiotics. In order to wash the auditory canal from pus, solutions of antibiotics are used. If the patient suffers from external otitis of a fungal nature, then an antifungal drug is prescribed for treatment, which is used both systemically and topically.
Prevention of otitis externa
The best prevention of otitis externa is to prevent injury to the ear and the ingress of various foreign bodies into it. Also, a person should not comb the auricle when feeling itchy. During bathing, you need to protect your ear from getting water into it. In case of contact with a foreign body in the ear, in no case should you try to eliminate the object yourself, so as not to injure the auditory canal. It is also not necessary to clean the ear of sulfur with those objects that are not intended for this. Ear cleaning should be carried out with a special ear stick at a depth of no more than 0.5 cm.
