Otitis: Symptoms and Treatment
Otitis is a general type of definition, implying an ear inflammatory disease. Otitis, the symptoms of which, respectively, are associated with inflammation, is for the most part a disease noted in children, it often occurs against the background of the infection in the middle ear, a little less often to provoke otitis may have an ear trauma or an allergy.
The ears are actually fragile enough, their work is directly determined by the smallest movements of each of the elements that make up them. Nature reliably provided the protection required by the ears. So, most of these organs are located in the temporal bone, communication with the outside world is provided by a pair of channels in the form of an external auditory canal and Eustachian tube.
The auditory canal (external) ends blindly, the eardrum acts as a barrier to it and the middle ear cavity. The auditory tube acts as an element providing the communication of the nose with the cavity of the middle ear. In addition to ventilation as one of the functions, this pipe is responsible for the distribution of pressure in such a way that it is equal for both sides of the eardrum. This is an extremely important function, because it provides the required sound performance.
As we have already noted, most often, otitis is noted in children, despite the fact that the disease as a whole is also relevant for other age groups.
As to the reasons for the greater susceptibility of this disease to children, they consist of age-related anatomical features, which are in particular in the structure of the middle ear. Thus, in children the auditory tube is somewhat shorter than in adults. In addition, it is practically straight, without bends, which significantly facilitates the way of getting into the middle ear of the infection. It is noteworthy that during the first three years since the birth of the order in 80% of children, a diagnosis of otitis is observed, this occurs at least once.
Causes of otitis
As the main reasons provoking otitis, we can distinguish the following:
- ARI, which causes damage to the nasal mucosa, against which the occlusion of the outlet area in the auditory tube occurs. For this reason, in turn, the ventilation and cleaning processes required for the drum cavity are disrupted.
- The urgency of chronic diseases of the nasopharyngeal region (tonsillitis, rhinosinusitis, etc.), tumors of the nasopharynx, adenoid vegetations.
- Development of otitis caused by diving and surfacing by divers, divers (or mareotitis)
- The development of otitis against the background of sudden changes in atmospheric pressure, which are relevant for ascents / descents of airplanes (which is defined as aeroatitis).
- Low immunity as a result of changes in the season, stresses of various types and scales.
Based on anatomical features, otitis can manifest itself in accordance with the classification of its species as otitis externa, otitis media and otitis media. Based on this classification, respectively, and violations of the functions of a particular department are determined.
External otitis media. In this form, the disease is an inflammatory change affecting the skin in combination with the subcutaneous tissue in the area of the auditory (external) passage. The course of external otitis, in turn, is possible both as an inflammation of a local scale (in the form of a furuncle), and as an inflammation of a diffuse distribution of nature.
The formation of the furuncle occurs when the infection enters the hair or sebaceous sacs in the ear canal. As the main manifestation of the symptomatology, pain can be isolated in this case, centered within the area of the auditory canal, and this pain is increased as a result of movements produced by the lower jaw (during a conversation, chewing food, etc.).
The increase of pain sensations is explained by the pressure exerted by the joint of the lower jaw. In general, the condition of patients varies insignificantly, in some cases, subfebrile temperature is possible. As a rule, the dissection of the boil occurs spontaneously, after it ripens completely. Such an outcome provides an improvement in well-being. By the way, for this disease, the hearing of patients is not affected by negative influences.
Read more: otitis externa.
External (diffuse) otitis media. Predominantly this form of otitis begins to develop as complications against the background of purulent chronic otitis media. Their cause is the constant formation of purulent discharge in the affected eardrum, as well as infection of tissues in the area of the auditory canal. The manifestations of this form of otitis are the reddening of the ear canal and the appearance of pain in this area. In some cases, diffuse otitis (otitis diffuse) is provoked by skin irritation arising in the area of the auditory canal under the influence of chemicals or under the influence of mechanical trauma accompanied by infection.
Often, the middle section of the ear is exposed to inflammation, which is defined as tubo-otitis (or eustachiitis). More in detail with this disease you can familiarize in section «Otolaryngology» on our site in article Tubootit (eustachiitis), now we will briefly stop on the basic positions of a symptomatology.
Tuboitic as a disease consists in inflammation of the auditory tube, and this tube reacts first of all to the process of infection, which manifests itself in the form of redness and swelling. As a rule, this is accompanied by the closure of the lumen on the background of the effect of edema, as a result of which the pressure in the middle ear decreases. In turn, directly for the patient, a number of these processes will manifest themselves in the reduction of hearing in combination with stiffness. Besides this, this state is accompanied by a sensation in the region of the big ear of his own voice.
As a rule, chewing and swallowing of saliva slightly reduces these manifestations, which is explained by the brief opening of the lumen of the auditory tube at these moments.
Without providing the appropriate response from the immune system or the doctor, the inflammation of the middle ear cavity occurs in the complex. This, in turn, leads to the appearance in the ear of pain, having shooting character and giving to the area of the lower jaw, neck and temple. The temperature rises seriously, the hearing falls, which occurs as a result of the formation of exudate in the cavity of the middle ear, then it becomes purulent.
By 3-4 days the course of the disease begins the development of the next stage in the inflammatory process, in which, as a result of the action of pus in the tympanic membrane, an aperture appears (which is defined as a perforation) and through this hole the exudate enters the external auditory canal. In other words, at this stage, the patient will notice that liquid passes through the auditory canal on the side of the lesion. As a rule, perforation is accompanied by a certain improvement in the general condition, the pain gradually decreases, the temperature drops.
In the absence of the required treatment, the fluid acquires a certain density of consistency with the simultaneous formation of fibrin threads in it, spikes with scars begin to form. Because of the scarring in this case, there is a difficulty in the normal functioning of the auditory ossicles, which in turn can lead to permanent hearing impairment.
Internal otitis media (labyrinthite) . The disease in this form is accompanied by the appearance of complaints of dizziness, accompanied by pronounced noise in the ears and a stable hearing impairment. Actually, dizziness can manifest itself in a variety of diseases, however, when it suddenly appears after a previous cold with a patient in combination with nausea and vomiting, there is every reason to consult a specialist for advice on the relevance of the ear disease.
Diagnosis of otitis media is based on the patient’s complaints, but a significant obstacle in carrying it out for young children is the limited oral contact due to the age of the children with the doctor. The detection of the disease is performed using methods such as:
- X-ray of the skull;
- blood test (general)
- auditory hearing (audiometry, tuning forks).
Treatment of otitis
Treatment of otitis media can be medicinal or surgical, which is determined in particular by the peculiarities of its course, shape, manifestation of symptoms and diseases accompanying it. In either case, the effectiveness of the treatment depends on how early the treatment started.
Treatment of otitis corresponds to certain rules, oriented to the following:
- reduction of pain;
- reduction in puffiness
- measures to improve outflow from the middle ear of pus;
- Measures to reduce swelling in the mucosa of the auditory tube
- use of antibiotics as an overwhelming measure aimed at combating an infection localized in the middle ear area
- local treatment using compresses and certain hygiene measures
- surgical intervention (the method of shunting the tympanum, in the absence of efficacy — the eardrum is cut, which is defined as a paracentesis).
In addition to the above measures, physiotherapy procedures are used:
- UHF for the nose area
- laser therapy for the mouth of the auditory tube
- A pneumomassage that targets the eardrum.
For the diagnosis of otitis, it is necessary to contact the attending pediatrician (therapist), then consultation and treatment with an otolaryngologist (LOR) will be required.