Otitis media is an inflammatory ear disease.
The terms “ear otitis”, “middle ear otitis”, etc. are incorrect, because the word “otitis” comes from the word “ōtos” – “ear” (Greek) and obviously means ear inflammation.
In anatomy, the outer, middle and inner ear are distinguished, this is the basis for the classification of otitis according to the localization of the inflammatory process: external, middle and internal otitis.
Depending on the course, acute otitis and chronic otitis are isolated.
By the type of exudate, serous (exudate, in which there are practically no blood cells and contains up to 3% protein), catarrhal (mucous exudate) and purulent (neutrophil predominance) otitis media are isolated.
OTITIS EXTERNA
N.O. is an inflammatory disease of the outer ear. The skin and its appendages (hair follicles, sebaceous glands) are affected, with further development, subcutaneous fat is involved in the process.
Symptoms of otitis externa
The main symptom is pain in the outer ear, which can radiate (radiate) into the eye, neck or teeth, increase with chewing movements, conversation.
The pain may be accompanied by a feeling of stuffiness of the ear, itching (especially pronounced in fungal infection), an increase in the parotid lymph node on the affected side. At later stages, purulent discharge from the outer ear may appear.
Causes of otitis externa
The main cause of otitis externa is infection (bacterial, viral or fungal), the development of which can be caused by a decrease in the immune status, dystrophic processes in the skin (for example, with hypoproteinemia, liver failure, lack of vitamins A, C, E), traumatization of the skin of the external auditory canal (for example, when cleaning the ears).
Diagnostics
Otoscopy; bacteriological examination.
Outpatient treatment.
Antibiotics or antifungal drugs (depending on the pathogen), immunomodulators, with severe pain syndrome – analgesics. With a small amount of inflammatory process – local treatment (turunda with alcohol solutions of antiseptics).
OTITIS MEDIA
Otitis media is an inflammation of the middle ear caused by the development of infection in the mucous membranes of the air cavities. As a rule, it is accompanied by the formation of exudate (inflammatory fluid) in the middle ear cavity.
In clinical practice, otorhinolaryngologists most often encounter acute otitis media.
OTITIS MEDIA MEDIUM ACUTE
It is characterized by progressive development, stages of the course, general symptoms of intoxication.
ACUTE OTITIS MEDIA IN ADULTS
SYMPTOMS OF ACUTE OTITIS MEDIA
There are 3 stages in the development of the disease, successively replacing each other.
1.Nonperforative stage
It is characterized by an increase in the inflammatory reaction, the accumulation of effusion in the middle ear and the entry into the blood of toxins produced by pathogens.
There is a sharp throbbing, bursting or shooting pain in the ear, which increases in the supine position, “giving” in the teeth or half of the head. Congestion and noise in the ear, hearing loss are also characteristic.
There are common symptoms characteristic of an inflammatory reaction: fever up to 38-39 ° C and above, increased heart rate and respiration, weakness, decreased appetite.
2. Perforating stage
At a certain moment, the proteolytic enzymes of the microorganisms that caused the inflammation corrode the eardrum, its perforation (perforation) occurs and the inflammatory exudate (pus) comes out (otorrhea is the outflow of fluid from the external auditory canal).
The intensity of most symptoms decreases. Hearing loss and noise in the ear are preserved.
3. The stage of reparation
The inflammatory process stops, the perforation closes.
The patient’s well-being and all clinical indicators are gradually normalizing.
reasons
The cause of the development of inflammation in the middle ear is a bacterial infection (the main pathogens are streptococci, staphylococci, E. coli).
Most often, the pathogen penetrates into the middle ear from the nasopharynx through the auditory tube. It is also possible to transfer pathogens from the primary focus with blood flow; through the outer ear with injuries of the eardrum.
DIAGNOSIS OF ACUTE OTITIS MEDIA
Otoscopy; general blood test – characteristic signs of inflammation: an increase in the number of leukocytes (up to 15 * 109 / l in adults, in children it may be higher), an increase in ESR, etc.
TREATMENT OF ACUTE OTITIS MEDIA
Treatment tactics are aimed at destroying the causative agent of the disease and depends on the stage of the process.
Since the duration of each stage is individual, the decision on changes in therapy should be made by an ENT doctor based on an examination (otoscopy). It is necessary to visit an ENT doctor at least once every 5 days, and in the early stages of the disease – more often (1 time every 2-3 days). In case of severe course of the disease, hospitalization is necessary.
At the nonperforative stage – antibiotic therapy, NSAIDs, vitamins, ear drops with antibiotics, antiseptics and anti-inflammatory drugs. Local thermal procedures are contraindicated.
At the second stage – continuation of general and local antibiotic therapy; removal of exudate from the external auditory canal with cotton swabs; turunda with warm alcohol solutions of antiseptics.
At the reparative stage – completion of a course of antibiotics, biostimulants, vitamins; blowing of the Eustachian tubes, pneumatic or manual massage of the eardrum.
ACUTE OTITIS MEDIA IN CHILDREN
Develops as a result of acute respiratory viral infections, childhood infections. Children are more susceptible to the disease due to the lack of acquired immunity and features of the anatomy of the ear. In children, the symptoms of intoxication prevail over local symptoms, secretory, or exudative, otitis media occurs more often.
COMPLICATIONS
With otitis media, it is necessary to start therapy in a timely manner in order to avoid the development of complications: mastoiditis, labyrinthitis, meningitis, brain abscess, sepsis.
