Mesotympanitis: symptoms and treatment


Mesotympanitis is a chronic inflammatory disease of the mucous membrane of the tympanic cavity, most pronounced in its middle and lower parts, in which there are abundant purulent discharge from the ear canal, edema and necrotic changes in the mucosa of the inner ear. In most cases, chronic purulent mesotympanitis has a one-sided nature, but in some cases, the bilateral development of the pathological process is possible. Self-medication is unacceptable, since it can lead to complete loss of hearing.

Nosology code for ICD-10 (International Classification of Diseases) — H66.1.

Etiology

The causative agents of this disease are often:


  • Pseudomonas aeruginosa
  • fungal organisms
  • Staphylococci
  • Streptococcus.

Predisposing factors that can trigger the development of this disease include:


  1. frequent, chronic diseases of the nasopharynx;
  2. Acute and chronic otitis media
  3. Pathology in the Eustachian tube area
  4. damage to the tympanic membrane due to improper hygiene procedures or as a result of medical measures
  5. facial and skull injuries;
  6. infectious diseases
  7. lymphadenitis
  8. frequent and prolonged hypothermia
  9. non-observance of the elementary rules for the hygiene of the ear;
  10. mechanical damage to the ear;
  11. Diseases of the bone system
  12. hypersensitivity to bacteria.

It should be noted that the development of chronic mesotympanitis is more likely in the case of a weakened immune system.

Symptomatics

The clinical picture of mesotympanitis manifests itself as follows:


  • hearing impairment
  • sharp and intense pain during an exacerbation, aching and short-lived in nature during remission;
  • sensation of pulsation in the area of ​​the patient’s ear
  • tinnitus
  • secretion of purulent exudate
  • increased body temperature, which is caused by the inflammatory process
  • inflammation of the submaxillary, cervical lymph nodes
  • signs of general body intoxication
  • sleep disturbance due to pain syndrome in the affected ear
  • irritability, sudden mood swings.

At a physical examination of the patient, the presence of this disease can indicate the following:


  1. The external passage in the ear is filled with purulent exudate, sometimes with blood impurities
  2. Perforation is observed at the edge or center of the tympanic membrane
  3. hyperemia and mucosal edema;
  4. fine-grained granulation

It should be noted that hearing loss is a symptom that does not manifest itself immediately. Deterioration of auditory perception is observed when impregnated with pus of auditory ossicles.

With such a clinical picture, you should urgently go to the otolaryngologist, and not attempt to eliminate the disease yourself. In this case, you can avoid the development of serious complications.

Diagnostics

First of all, the otolaryngologist conducts a thorough physical examination of the patient’s ear. To establish an accurate diagnosis, laboratory-instrumental examination methods are conducted:


  • examining the ear with a special reflector, often with microscopy
  • A swab from the ear canal to determine the presence of bacteria, as well as their sensitivity to antibiotics
  • CT and X-ray of the temporal region
  • a general and biochemical blood test.

The list of diagnostic studies can be supplemented by other methods, depending on the history of the disease and the clinical manifestations of the disease.

Treatment of the disease otolaryngologist appoints based on the results of the analysis and the established etiological factor.





Treatment

Treatment of mesotympanitis is aimed, first of all, at eliminating pathological flora, reducing the inflammatory process and keeping the patient’s hearing.

Medication therapy includes the use of such medications:


  1. antibiotics of the penicillin and cephalosporin series
  2. at elevated temperature — antipyretic
  3. antihistamines
  4. decongestants
  5. non-steroidal anti-inflammatory;
  6. vitamin and mineral complex

In addition to taking systemic medications, the doctor prescribes topical preparations for washing the ear canal. In this case, antiseptic and astringent agents are used. Also can be prescribed powder on the mucosa of the inner ear on the basis of furatsilina.

During a persistent remission, physiotherapy procedures can be performed:


  • phonophoresis
  • Electrophoresis;
  • ultrasound procedures.

Surgical intervention occurs in cases where conservative treatment does not produce the proper result or there is a periodic or persistent purulent discharge from the ear cavity. In such cases, small granulomas, polyps and scars are removed.

Timely treatment started allows avoiding the development of serious complications and keeps the patient’s hearing. In the event that medical measures are not initiated in time, the inflammatory process may spread to the temporal region, deterioration or complete loss of hearing.

Complications

In cases of untimely begun or incorrect treatment of chronic mesotympanitis, it is possible to form:


  1. paresis or paralysis of the facial nerve
  2. otogenic sepsis
  3. brain abscess;
  4. meningitis
  5. Arachnoiditis.

Prevention

To prevent the development of mesotympanitis, the following preventive measures should be applied in practice:


  • timely treatment of inflammatory diseases of the nasopharynx;
  • correct, regular hygiene of the ears
  • correct, nutritious meals
  • Maintaining a healthy lifestyle
  • correction of anatomical disorders of the ear canals, if any,
  • strengthening the immune system.

If you get into the ear of foreign objects or in the presence of the above symptoms, you need to contact the otolaryngologist, and not to treat at your discretion. In addition, you need to systematically undergo a prophylactic examination with an otolaryngologist. Preventing the disease is much easier than treating it and eliminating complications.