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Causes and symptoms of otitis media how to treat it?

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What is otitis media?

Otitis media is an inflammation of the ear. The disease can be chronic or acute, suppurative or catarrhal. The severity of the pathological process depends entirely on the virulence of microorganisms and also plays an important role in the immune protection of the individual.

Statistics says that 30% of all ENT diseases is the acute form of otitis media. Children of preschool age get sick more often than adults. To three years 80% of children experience otitis media.

To hit the ear, causing otitis media, can:

Any inflammation of the ear is extremely dangerous, and to consult a doctor immediately after detecting symptoms described below.


The symptoms of otitis media

Symptoms of otitis media, which can be recognized average of acute otitis media are the following symptoms: severe pain in the ear (according to her patients describe as shooting), fever, and 1-3 days later – purulent discharge from the ear canal. After the appearance of pus usually, the condition of the patient improves, the temperature drops, the pain becomes less pronounced or disappears altogether.

The pus excreted from the break through the eardrum. The outcome of the disease is considered positive, with proper treatment, the hole in the eardrum slowly grows, without affecting hearing.

In case of unfavorable development of the disease the pus can not find an outlet, and this creates the risk that the infection can start to spread inside the skull. Otitis be able to go in meningitisand in abscess of the brain. In order to avoid such terrible consequences, when the first symptoms of otitis refer to otolaryngologist for advice and proper treatment.

Otitis media, depending on the localization of inflammation may be:

  • Outer;
  • Medium;
  • Internal.

External otitis often sick swimmers, so the disease is popularly called "swimmer's ear". The inflammation begins due to mechanical trauma to the Pinna or the external auditory canal. Damage to a protective cover leads to the introduction and proliferation of pathogens, then this place formed a furuncle.

If not immediately conduct the appropriate treatment, otitis externa becomes severe and spreads to the parotid cartilage and bone. In this disease the patient concerned about aching, throbbing pain, ear swelling and a moderate increase in temperature.

With an average otitis inflammatory process extends to the pneumatic middle ear cavity located behind the eardrum: the tympanic cavity, auditory tube and mastoid.

Form of otitis media often flows from catarrhal to purulent.

Acute catarrhal otitis media occurs in the form of complications of acute respiratory disease, or SARS, after penetration of the pathogen in the tympanic cavity. At the initial stage could decrease the hearing level, there was a noise in the ears, but the temperature is normal or slightly increased.

If these symptoms are ignored, the more catarrhal otitis media shows a sharp and strong increase of temperature and shooting pain in the ear, extending to eye, neck, throat or teeth. To cure a otitis can only get rid of the infection, which urgently need to see a doctor.

Acute purulent otitis media is neglected catarrhal form. The disease is manifested by a breakthrough of the tympanic membrane and discharge of pus with subsequent decrease in body temperature. Treatment except for infection control should include the permanent removal of pus from the ear that can only be done by the health care provider.

In addition, the pus may not always be able to get out myself. If the eardrum is very durable, need surgery for puncture of the eardrum. This procedure is called "paracentesis" and is performed using local anesthetic drugs: a special tool in the most favorable point made a puncture, and the pus goes.

After the pus is removed, the eardrum, scarring, and the quality of hearing in the future is not reduced.

If acute otitis media is not treated, the pus spread within the skull. In the end, developing internal otitis, which affects the vestibular apparatus, causing a brain abscess and lead at least to partial or complete loss of hearing. Therefore, when the first signs of otitis media should not try to dribble into the ears of anything, or lay the swab with alcohol or otherwith antiseptic, and an urgent need to go to the doctor!


Causes of otitis media

Each ENT disease accompanied by increased mucus production. Increasing its quantity at the unfortunate coincidence mucus gets into the Eustachian tube, and disturbing the ventilation of the tympanic cavity. Cells tympanic cavity secrete inflammatory fluid. In addition to clogging of the lumen of the Eustachian tube, exacerbate inflammation and contribute to the pathogenic microorganisms normally included in the composition of the local microflora.

Causes of otitis media are:

  • The penetration of infection from other ENT-organs – as a complication of concomitant infectious-viral diseases;

  • Various diseases of the nose, sinuses and nasopharynx. These include all types of rhinitis, a deviated septum, in children, the adenoids (adenoid vegetation);

  • Injuries of the auricle;
  • Hypothermia and weakened immune system.

Complications and consequences of otitis media

Although sick with a cold only the ears, complications from inadequate treatment or its absence can affect many organs. Incomplete treatment of otitis media leads to very terrible consequences – suppuration goes on the lower jaw, touching the salivary gland and often leading to disability.

But even more dangerous otitis media does what the disease is not always easy to identify. For example, in some cases, the disease is not accompanied by acute pain in the ears. Often due to otitis media, gastro-intestinal tract. This is because our abdominal area and the ear are connected to one nerve. Therefore, during ear infections, especially a child, can swell the intestine, to appear vomiting, constipation. That is, you might suspect appendicitis, in this case, you will be directed to the surgeon. But the diagnosis of inflammatory diseases in young children must be performed with a ENT doctor.

If the mother thinks that her child has a disorder of the gastrointestinal tract, and will undertake self-treatment, otitis media, meanwhile, can develop into more serious disease – tantric. This is a situation in which pus enters the ear region and joins another inflammation, resulting in externally, ears are bulged, there is swelling again and the temperature rises. The complication may come in the next few days and in a month, that is, to predict it it is impossible. If these symptoms of otitis media will not be noticed, after a couple of months, we will develop meningitis, so be careful with otitis.

Othercommon complications of otitis media include the transition to the chronic stage, the lesion of the vestibular apparatus and hearing loss.

In addition, a complication of otitis media may be:

  • Meningitis and other intracranial complications (brain abscess, encephalitis, hydrocephalus) follows otoantritis stage, if measures are not taken on time;

  • Paresis of the facial nerve;

  • Perforation of the eardrum and filling the ear cavity with pus;
  • Cholesteatoma – overlapping auditory canal tumor cyst-like formation in the form of a capsule with necrotic epithelium and keratin;
  • Mastoiditis – inflammation of mastoid, causing destruction of the ossicles in the middle ear;

  • The disorder of the functioning of the digestive tract – bloating, vomiting, diarrhea;

  • Permanent childhood hearing impairment, hearing loss (up to complete deafness).

Chronic otitis media is extremely difficult to be treated and greatly decreases quality of life – impaired hearing in the ears is a constant inflammatory process and suppuration occurs. Often for getting rid of chronic otitis media in adults, conservative treatment is not enough and have to resort to surgery.


Diagnosis of otitis media

Competent doctor diagnose acute otitis without special tools and innovative technologies. A simple inspection of the ear and auditory canal with the help of the headlamp reflector (mirror with hole in center), or of an Otoscope to diagnose otitis media.

How to diagnose otitis externa?

In otitis externa the doctor pays attention to the skin in the ear, the size of the auditory canal and separating it from the. If hearing the lumen is greatly narrowed, especially when not even visible to the eardrum, the skin is red, and the inside of the ear visible liquid highlighter, it allows the doctor to diagnose "otitis externa".

How to diagnose otitis media?

Acute otitis media is diagnosed also to a greater extent by visual examination. The doctor is guided by some characteristic features of this disease: normal tympanic membrane, limiting its mobility and the presence of perforation.

All of these symptoms it is easy to check – the patient is sufficient to lighten up, not opening his mouth. "Blowing off the ears" – a technique called the Valsalva maneuver is continuously used by divers and diverswhen the deep descent to equalize pressure in the ear. As the ingress of air into the tympanum membrane is markedly curved, but if the cavity is filled with liquid, then bending will not.

Perforation in the eardrum with otitis visible to the naked eye after the overflow the ear cavity pus and leakage at the break.

Clarification of the diagnosis of "labyrinthitis": audiometry

The study of hearing in a special apparatus – audiometry, and measurement of pressure inside the ear – the timpanometry – used for diagnosis in cases of suspected chronic otitis media.

If the hearing acuity occurring with otitis media drops sharply, and begin attacks of vertigo, there is a reasonable suspicion of internal otitis (inflammation of the ear labyrinth). In this case, use audiometry, seek help from an audiologist and a neurological examination.

X-ray and computed tomography

Radiography in acute otitis media is used to confirm its complications – severe intracranial infections, or mastoiditis. These cases are rare, but if there is suspicion of these dangerous complications, the required CT scan brain and temporal bones of the skull.

Determination of bacterial flora in otitis media

Bacterial seeding for otitis media, at first glance, seems pointless study. After all, for the cultivation of bacteria need time and the final result is visible only on a 6-7 day, and if there is timely treatment of otitis media, the disease is to be held at this time. But not all cases of otitis media help the usual antibiotics and if the doctor knows the results of the smear, what microorganisms caused otitis media, it obviously will prescribe any drug.

What to do with otitis media?

As soon as discomfort in the ears, whether periodic nasal or aching pain, you should immediately consult a doctor for competent treatment. Otherwise, acute otitis media, most likely, will pass in the chronic, leaving behind on eardrum scarring, thinning, or vtjazhenija the gap, and then patient waiting for frequent infections and hearing loss.

If you go to the doctor on the same day, when the pain is impossible, then the only thing you can do is use inside antihistamines (due to the reduction of pressure in the ear the pain subsides), and in severe pain – analgesic drugs.

Note: camphor oil, infusionchamomile, boric alcohol, the juice of onions and garlic or vitovice – any of these "medicinal" drugs for the treatment of otitis media can lead to deafness for life. The same applies to the warm sand, salt or hot water bottle. The inflammatory process in the ear are amplified several times, because these folk remedies give the bacteria food and speed up their reproduction, causing the accumulation of pus and severe swelling. Antiseptic also alcohol-based are especially dangerous for children, having a gentle, sensitive mucous membranes.

But worst of all – getting pus in the brain, leading to irreversible consequences – a person can remain permanently disabled!


How to treat otitis media?

Regardless of the form of otitis, the patient requires pain medication, so as to endure the ear pain is unbearable.

Than cure otitis externa?

If otitis externa discovered in adults, the main treatment will be with the help of ear drops. In a healthy person with a normal immune system external otitis will be using only drops, antibiotic injections or tablets is not required. Droplets can only consist of an antibacterial drug, and can combine an antibiotic and anti-inflammatory. Otitis externa drops are treated in an average over weeks.

Mainly for the treatment of external otitis is prescribed:

  • Antibiotics – norfloxacin (Normaks), ciprofloxacin hydrochloride (Tsiprolet), rifamycin (mefenamic acid);
  • Antibiotics with corticosteroids – Kandibiotik (beclomethasone, lidocaine, clotrimazole, chloramphenicol), Sofradeks (dexamethasone, framizetin, gramicidin);
  • Antiseptics (Miramistin);
  • Antifungal ointments – clotrimazole (candid), natamycin (Pimafucin, Pimafucort) – appoint if otitis externa is fungal in origin.

Of the newly-established funds use the ointment with the active substance "mupirocin" which has no pathological actions on the normal microflora of the skin, but is active against fungi.

How do we treat acute otitis media and auditory labyrinth in adults?

Antibiotics

Otitis media is commonly treated with antibacterial drugs. But the treatment of otitis media in adults is slightly different from the therapy of children's diseases, frequency of self-recovery from otitis media in an adult, more than 90 percent, which almost stops the need for antibiotics. But the remaining 10percent come with very severe consequences, so if after the first two days of the disease no improvement occurs, then prescribe antibiotics.

Antibiotics should appoint a qualified doctor, as this class of drugs is extremely dangerous due to side effects. However, deaths from complications of otitis media reaches 28,000 per year, therefore, as a rule, treatment is justified. Usually antibiotics are prescribed in pill form, but if the patient cannot take a pill, used injection.

To treat otitis media in adults, use:

  • Amoxicillin (flemoksin soljutab, Ecobol, Ospamox or Amosin);
  • The combination of amoxicillin with klavulanova acid (Flemoklav, Augmentin, Amoclav);
  • Cefuroxime (Zephyrus, Axetil, Zinnat, Zinacef).

You can assign other drugs, but it is important to observe the basic requirement of antibiotics, finish the course of treatment, which lasts at least a week. If the microorganisms are not extinct in connection with the termination of reception of antibiotics, the bacteria produced a resistance to this group of drugs, and the antibiotics stop working.

Ear drops for otitis media

A comprehensive treatment of otitis media often includes the use of drops. It is extremely important to know that not all ear drops are the same and if it hurts the ear, not any drops will be fine. The difference is that damage to the tympanic membrane and the perforation of the active substance for the treatment of otitis media are totally different.

If the eardrum is intact, then use painkillers drops – Drops, Otinum or Otizol – lidocaine, benzocaine or choline salicylate. In the catarrhal form of otitis media in adults does not help drops with the antibiotic, since the substance does not fall within a source of inflammation behind the eardrum.

When the pus burst forth, and the tympanum is open, on the contrary, the drops are contraindicated with the anesthetic effect, as they can lead to undesirable consequences. Especially with the discharge of pus the pain subsides.

To avoid repeated sepsis or pus getting into the inner ear, the tympanic cavity open drip prescribed antibiotics is "Normaks", "Tsiprofarm", "Miramistin" and the other, they should appoint only a doctor. Categorically prohibited the use of ototoxic antibiotics, drugs, alcohol, phenazone or choline salicylate.

On topic: Antibiotics and drops into the ears for otitis media

Paracentesis of the tympanic membrane is an extreme measure

When the therapeutic treatment of otitis media with medication has no effect behind the eardrumaccumulate a large amount of pus. This causes a very severe pain and increased absorption of products of vital activity of bacteria in the blood. There is a General intoxication of the organism. As soon as these symptoms, doctors prescribe urgent paracentesis operation, preventing the serious complications of otitis media.

The operation is performed under local anesthesia. In the process of paracentesis of eardrum incision with a special needle at the thinnest point to minimally traumatize the tissue, and through the resulting hole is leaking pus. And neatly incised wound heals much faster than with a natural hole of perforation, and after a paracentesis is formed minimal scar.

The next day there is dramatic improvement of health and accelerates the recovery of the patient. This is especially true of paracentesis in the treatment of otitis media in children.

Urgent conducting of paracentesis is indicated for:

  • Inflammation of the inner ear;

  • The defeat of the meninges, which is manifested in the form of headaches and nausea;

  • The defeat of the facial nerve.
  • If within three days after beginning antibiotic therapy the pain does not subside and the abscess subsides.

Unlike external or otitis media of varying severity, inflammation of the auditory labyrinth is treated comprehensively, and only under medical care under the constant supervision of a neurologist and an otolaryngologist. For the treatment of the maze requires not only antibiotics, but also a neuroprotectant and drugs to improve blood microcirculation in the inner ear.

Topic: Treatment of otitis media in the home


Prevention of otitis media

The main objective of the prevention of otitis media in adults is that the Eustachian tube was not blocked with mucus. This is not an easy task. As a rule, acute rhinitis accompanied by fluid discharge, but in the process of treatment, the mucus often becomes much thicker, zastaivayas in the nasopharynx.

To prevent the development of otitis media caused by congestive purulent processes, it is necessary to promptly cure the relevant ENT diseases – a banal rhinitis, sinusitis, or remove the adenoids from the throat.

What to do to prevent complications of ENT diseases in the form of otitis media:

  • Usevasoconstrictors in the nose to reduce swelling of the mucous;
  • To maintain fluid balance in the body, drinking more water;
  • To take timely antipyretic drugs at a very high temperature, preventing its retention;
  • Keep the temperature of the air in a residential area in the range of 18 to 20 degrees Celsius;
  • To maintain the humidity in the room ventilate and to make regular wet cleaning;
  • Be careful in blowing the nose – in any case not to overdo it, as it causes the blocking of the auditory tube and the stagnation of the infected mucus, and vyskakovaci each nostril by pinching them individually.

But the most important prevention at the first symptoms will be timely access to a doctor. It will examine the eardrum and determine which part of the ear otitis media, would the purulent exudate in the tympanic cavity. You may need a blood test, or other examination, the results of which the doctor will choose the right treatment and protect the patient from the terrible complications of otitis media.