Acute otitis media
The content of the article:
- Causes and risk factors
- Forms of the disease
- Disease stages
- Symptoms of acute otitis media
- Diagnosis of acute otitis media
- Treatment of acute otitis media
- Possible complications and consequences
- Forecast
- Prevention
Acute otitis media is an acute inflammatory process that can develop in all parts of the ear, but in most cases this term refers to acute inflammation of the middle ear, i.e. acute otitis media.
Source: gorlonos.com
The ear is a complex organ that not only perceives sound vibrations, but is also responsible for the position of the body in space and the ability to maintain balance. The ear is divided into three sections - outer, middle and inner. The outer ear is formed by the auricle and the auditory canal, which ends with the eardrum. The function of the outer ear is to pick up sound signals and transmit them further to the structures of the middle ear. The middle ear consists of the tympanic cavity, located between the tympanic membrane and the opening of the temporal bone. In the tympanic cavity there are sound bones (hammer, incus and stapes). The function of this section of the ear is to conduct sound. The middle ear cavity is connected to the nasopharynx by the Eustachian tube,through which there is an equalization of pressure in the tympanic cavity and external atmospheric pressure.
The inner ear is formed by a system of canals (cochlea) located in the temporal bone. The cochlea is filled with fluid and lined with hair cells that convert mechanical vibrations of the fluid into nerve impulses that enter the corresponding parts of the brain through the auditory nerve. The function of the inner ear is to maintain balance. Inflammation of the inner ear (internal otitis media) is usually called labyrinthitis.
Acute otitis media can occur at any age, but children are more susceptible to it - they have this most common otorhinolaryngological disease. In the first years of life, about 80% of children suffer acute otitis media, and by 7 years - up to 95%. In about 30% of cases, otitis media transferred in childhood is the cause of hearing loss in adults.
Causes and risk factors
The causative agents of acute otitis media are most often staphylococci, pneumococci, Haemophilus influenzae, Klebsiella, Pseudomonas aeruginosa, Moraxella, microscopic yeast-like fungi of the genus Candida, influenza virus.
Risk factors include:
- infectious and inflammatory diseases of the ENT organs;
- mechanical or chemical ear injuries;
- the presence of a foreign body in the ear;
- water entering the ear;
- improper ear hygiene;
- hypothermia;
- operations on the nasal cavity and / or nasopharynx;
- allergies;
- immunodeficiency states;
- diabetes;
- children and old age.
Forms of the disease
Depending on the nature of the middle ear inflammation, acute catarrhal otitis media and acute purulent otitis media are distinguished.
By origin, acute otitis media is of the following forms:
- bacterial;
- viral;
- fungal (otomycosis).
Acute otitis externa can be limited and diffuse.
Disease stages
In the clinical picture of acute otitis media, the following stages are distinguished:
- Catarrh.
- Purulent inflammation, which, in turn, is subdivided into pre-perforated and perforated stages.
- Recovery or transition to a chronic form.
Source: okeydoc.ru
Symptoms of acute otitis media
Symptoms of acute otitis media depend on the form of the disease.
In acute otitis media, an intense shooting pain in the ear, a feeling of ear congestion, and hearing loss initially appear.
Local signs are accompanied by general malaise: weakness, lethargy, fever - usually to subfebrile, but sometimes to febrile values. In some cases, acute inflammation of the middle ear is accompanied by a sore throat, nasal congestion, and nasal discharge.
Children in the first years of life with acute otitis media refuse to eat, as when sucking and swallowing, pain in the ear increases. In addition, in children, acute otitis media is often accompanied by regurgitation, vomiting, and diarrhea.
A few days after the onset of the disease, the tympanic membrane perforates and the outflow of serous (catarrhal otitis media), and then purulent (in some cases, bloody) contents. At the same time, the general condition of the patient improves. The body temperature returns to normal, the ear pain subsides. Suppuration usually lasts no more than a week. After scarring perforation, hearing is usually restored. In the case of an unfavorable course of the disease, purulent exudate may not spill out, but spread into the cranial cavity with the subsequent development of meningitis or brain abscess. Acute otitis media lasts an average of 2-3 weeks.
For internal acute otitis media (labyrinthitis), severe attacks of dizziness are characteristic, which are accompanied by nausea, vomiting, tinnitus, and hearing impairment. Labyrinthitis in most cases is a complication of acute otitis media, so the appearance of vestibular disorders in acute otitis media should alert to the deepening of the inflammatory process.
Source: okeydoc.ru
The manifestation of acute limited external otitis media is at first itching, and then pain in the ear canal, which can radiate to the upper and lower jaw, temple, occiput. Painful sensations intensify when chewing, as well as at night. Limited otitis externa manifests itself in the form of inflammation of the hair follicle or the development of a furuncle in the external auditory canal. The furuncle can completely block the lumen of the ear canal, which causes hearing loss. When the boil is opened and its contents expire, the pain subsides, the patient's condition improves.
In acute diffuse otitis externa, patients complain of a feeling of fullness, itching, and then severe pain in the ear, which increases during a conversation, when chewing food, and palpation of the ear. There is hyperemia of the ear canal, its edema and slit-like narrowing, an increase in regional lymph nodes. Discharge from the ear in acute diffuse otitis externa is usually scanty, at first serous, and then purulent. The spread of the inflammatory process to the soft tissues of the parotid region and the auricle is possible.
Diagnosis of acute otitis media
To determine acute otitis media, anamnesis and complaints are collected, an objective examination, and, if necessary, instrumental and laboratory diagnostic methods are used.
If acute otitis media is suspected, an otoscopy is usually performed, which makes it possible to examine the tympanic membrane, to detect its thickening, hyperemia, injection, protrusion or perforation. X-ray examination of the temporal bones reveals a decrease in pneumatization of the middle ear cavities. Tympanometry is used to determine the ability of the eardrum and the ossicles to conduct a wave of auditory pressure. Audiometry is indicated to detect hearing impairment.
Source: likar.info
In order to identify the pathogen and determine its sensitivity to anti-infectious drugs, a bacteriological study is carried out.
Differential diagnosis of acute internal otitis media with brain pathologies that can cause dizziness, including neoplasms, is required. Acute otitis media is differentiated from histiocytosis, a tumor of the tympanic cavity. Acute otitis externa should be differentiated from mumps, other types of otitis media, eczema of the external auditory canal, mastoiditis, furuncle of the ear canal. For the purpose of differential diagnosis of acute otitis media with other diseases, a computer or magnetic resonance imaging of the brain may be prescribed.
Treatment of acute otitis media
Treatment of acute otitis externa is local, in most cases it consists in washing the external auditory canal with antiseptic solutions.
Source: lorlen.ru
With pronounced pain syndrome, an increase in temperature, pain relievers of the group of non-steroidal anti-inflammatory drugs are prescribed. If necessary, the ripe boils are opened, after which the ear canal is washed with antiseptic solutions.
Treatment of acute otitis media is carried out with anti-infectious (in most cases antibacterial) drugs, non-steroidal anti-inflammatory drugs. Local use of vasoconstrictor drugs that eliminate swelling of the nasal cavity and nasopharynx in order to drain the tympanic cavity. If the tympanic cavity is not drained on its own within a few days from the onset of the disease, the tympanic membrane is dissected (paracentesis). If, after scarring the eardrum, the patient's hearing is not restored, blowing and pneumatic massage are indicated.
Conservative treatment of acute internal otitis media is mainly symptomatic. To eliminate nausea and vomiting, antiemetic drugs, antihistamines are used. In case of ineffectiveness of conservative therapy, surgical intervention is indicated. According to the testimony, a labyrinthotomy is performed, an opening of the temporal bone pyramid.
Possible complications and consequences
In the absence of timely adequate treatment, acute otitis media can become chronic, which is associated with a high risk of hearing loss.
In addition, the disease can be complicated by the development of sepsis, inflammation of the mastoid process of the temporal bone, encephalitis, meningitis, brain abscess, cerebral sinus thrombosis, and facial nerve paralysis. The occurrence of intracranial complications can be fatal.
Forecast
With timely and adequate treatment of acute otitis media, the prognosis is favorable. In the presence of background diseases, immunodeficiency states, late seeking medical help, self-medication and the appearance of complications, the prognosis worsens.
Prevention
In order to prevent the development of acute otitis media, it is recommended:
- timely treatment of infectious diseases, especially diseases of the ENT organs;
- strengthening the body's defenses;
- avoiding hypothermia;
- avoidance of ear injury (including refusal from attempts to independently remove foreign bodies from the ear and use objects that are not intended for this purpose to clean the ears);
- compliance with the rules of personal hygiene.
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Anna Aksenova Medical journalist About the author
Education: 2004-2007 "First Kiev Medical College" specialty "Laboratory Diagnostics".
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
