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Post-traumatic external otitis when it recovers. Traumatic otitis and mastoiditis

Andrey asks:

Hello! A week ago (after the injury), the ENT diagnosed p/traumatic perforated otitis. The audiologist noted hearing impairment at low frequencies. Prescribed: piracetam 20% - 10.0 IV No. 5; Actovigin 4.0 on physical therapy 200.0 IV drip. No. 5; combilipen 2.0 IM h/day. There is no pain in the damaged ear, but I periodically feel noise, stuffiness, squeaking at night, and itching in the ear.
Is this treatment enough in your opinion?
Due to the holidays, it is necessary to interrupt treatment. What happens if you miss two days of treatment?
I would also like to know whether the auditory ossicles are damaged or not, how to do this, no checks have been made.
Thanks in advance.

It is not recommended to interrupt treatment; the treatment was prescribed correctly and does not require adjustment. If the auditory ossicles were damaged, there would be a complete lack of hearing. After the course of treatment, it is necessary to conduct an additional examination by an ENT doctor.

Olesya asks:

Hello, yesterday my child (5.5 years old) and I were cleaning our ears with a cotton swab, he started playing around, wanted to grab the stick, but instead he hit himself on the ear, the stick was inside. We called an ambulance because the baby started crying and bleeding. At the hospital we were diagnosed with left-sided post-traumatic perforated otitis and wanted to admit us, but the place was only in the corridor. I refused, but now I think maybe I shouldn’t have. Prescribed: Otofa*3, Klacid*7.5 ml (125), Nazivin and Fenistil. Today we went to see our doctor at the clinic, she said that the prescription was correct, to take everything, but the broken membrane will never heal and the ear will remain chronic for life. Hearing loss is observed, but it is slight. Please tell me, when healing occurs, will the membrane remain thin for life? And how long will the bleeding last until complete healing? There is a little of it at the tip of the cotton wool.

If the comparison of the edges of the eardrum does not occur, then the restoration of this membrane will never occur. Bleeding usually stops within an hour of injury.

Olesya comments:

is surgery necessary

Only the attending ENT doctor can evaluate treatment tactics after performing an otoscopy. Unfortunately, we do not have such an opportunity within the framework of online consultation.

Alexandra asks:

please tell me. about surgical intervention for traumatic perforated otitis. how the operation is performed and what results it gives.

To restore the integrity of the eardrum after post-traumatic otitis media, tympanoplasty or myringoplasty is performed. That is, the operation is performed under general anesthesia, a flap is cut out of the skin above the ear, which is applied to the defect in the eardrum and plastic surgery is performed. This operation allows to improve the patient's hearing, reduces noise in the damaged ear, avoids water getting into the ear cavity and development chronic infection. Read more about otitis media in our series of articles by following the link: "

Not everyone knows what otitis media is. This is a disease that affects the human ear. It consists of acute inflammation of the tissues that make up this important sensory organ. Thousands of people get sick with otitis media every year. different ages. And it is well known that otitis media cannot be called a harmless disease.

What is otitis media

To understand the principle of the occurrence of otitis, you need to remember what it is - the ear, what it is needed for and how it works. In fact, the ear is far from just the pinna, as some might think. The ear has a complex system hidden inside for converting sound waves into a form suitable for perception by the human brain. However, picking up sounds is not the only function of the ears. They also perform a vestibular function and serve as an organ that allows a person to maintain balance.

The three main sections of the ear are the middle, outer and inner. The outer ear is the pinna itself, as well as ear canal, leading to the eardrum. Behind the eardrum is an air-filled tympanic cavity containing three auditory ossicles, the purpose of which is to transmit and amplify sound vibrations. This area makes up the middle ear. From the middle ear, vibrations enter a special area located in the temporal bone and called the labyrinth. It contains the organ of Corti - a cluster of nerve receptors that convert vibrations into nerve impulses. This area is called the inner ear. Also worth noting is the Eustachian tube, the entrance of which is located behind the palatine tonsils and which leads into the tympanic cavity. Its purpose is to ventilate the tympanic cavity, as well as to bring the pressure in the tympanic cavity into line with atmospheric pressure. The Eustachian tube is usually referred to as the middle ear.

It should be noted that otitis media can affect all three ear sections. Accordingly, if the disease affects the outer ear, then we talk about external otitis, if it is middle, then about otitis media, if the inner ear, then about internal. As a rule, we are talking only about one-sided lesions, however, with otitis media caused by infections of the upper respiratory tract, the disease can develop on both sides of the head.

Ear otitis is also divided into three types depending on the cause - viral, bacterial or traumatic. External otitis can also be fungal. The most common bacterial form of the disease occurs.

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How does the ear work?

Otitis externa - symptoms, treatment

Otitis externa occurs as a result of infection of the surface of the skin of the ear with bacteria or fungi. According to statistics, approximately 10% of the world's population has suffered from external otitis at least once in their lives.

Factors contributing to otitis in adults are:

hypothermia of the auricle, for example, during walks in the cold;
mechanical damage to the auricle;
removal of wax from the ear canal;
entry of water, especially dirty water, into the ear canal.

Bacteria and fungi “love” the ear canal because it is damp, dark and quite humid. He is perfect place for their reproduction. And, probably, everyone would have otitis externa, if not for such a protective feature of the body as the formation of earwax. Yes, earwax is not at all a useless substance that clogs the ear canal, as many people think. It performs important bactericidal functions, and therefore its removal from the ear canal can lead to otitis media. The only exception is when too much sulfur is released and it affects the perception of sounds.

Inflammation of the external auditory canal usually refers to a type skin diseases– dermatitis, candidiasis, furunculosis. Accordingly, the disease is caused by bacteria, streptococci and staphylococci, fungi of the genus Candida. In the case of furunculosis, inflammation occurs sebaceous glands. The main symptom of external otitis is, as a rule, pain, especially aggravated by pressure. There is usually no elevated temperature with external otitis media. Hearing loss rarely occurs with external otitis, except in cases where the process affects the eardrum or the ear canal is completely closed with pus. However, after recovery from otitis media, hearing is completely restored.

Diagnosis of external otitis in adults is quite simple. As a rule, a visual examination by a doctor is sufficient. A more detailed method of diagnosing otitis involves the use of an otoscope, a device that allows you to see the far end of the ear canal and the eardrum. Treatment of otitis media consists of eliminating the cause of ear inflammation. When treating otitis externa in adults, antibiotics or antifungal drugs are used. The type of antibacterial therapy should be determined by the doctor. As a rule, in the case of external otitis, they are used ear drops, not pills. When external tissues of the auricle not located in the area of the auditory canal are affected, ointments are used. A frequent complication of external otitis is the transition of the inflammatory process to the middle ear through the eardrum.

Otitis media

Otitis media is an inflammation of the middle part of the hearing organ. This kind of ear inflammation is one of the most common diseases on Earth. Hundreds of millions of people suffer from ear infections every year. According to various data, from 25% to 60% of people have suffered from otitis media at least once in their lives.

Causes

In most cases, the inflammatory process of the middle ear is not primary disease. As a rule, it is a complication of external otitis or infectious diseases of the upper respiratory tract - tonsillitis, rhinitis, sinusitis, as well as acute viral diseases- flu, scarlet fever.

How does an infection from the respiratory tract get into the ear? The fact is that she has a direct path there - this is the Eustachian tube. When you have respiratory symptoms such as sneezing or coughing, particles of mucus or phlegm may be pushed up the tube into your ear. In this case, both inflammation of the Eustachian tube itself (eustachitis) and inflammation of the middle ear can occur. When the Eustachian tube is blocked in the tympanic cavity, which is deprived of ventilation, stagnation processes can occur and fluid can accumulate, which leads to the proliferation of bacteria and the occurrence of disease.

The cause of otitis media can also be mastoiditis, allergic reactions that cause swelling of the mucous membranes.

Otitis ear has several varieties. First of all, a distinction is made between chronic and acute otitis media. According to the degree of development, otitis of the middle ear is divided into exudative, purulent and catarrhal. Exudative otitis media is characterized by the accumulation of fluid in the tympanic cavity. With purulent otitis media of the middle ear, the appearance of pus and its accumulation are noted.

Otitis media, symptoms in adults

Symptoms in adults primarily include ear pain. Pain with otitis media can be acute or shooting. Sometimes pain can be felt in the temple or crown area, it can pulsate, subside or intensify. With exudative otitis media, there may be a sensation of water splashing in the ear. Sometimes there is ear congestion, as well as a feeling of hearing one's own voice (autophony) or just a vague noise in the ear. Tissue swelling, hearing loss, fever, and headaches are often observed. However, an increase in temperature is often not a symptom of otitis media, but only a symptom of the infectious disease that caused it - acute respiratory infections, acute respiratory viral infections or influenza.

The most complex course is observed in the purulent form of otitis media. IN in this case The main symptom of otitis media is the discharge of pus. The tympanic cavity is filled with pus, and the body temperature rises to +38-39ºС. Pus can thin the surface of the eardrum and form a hole in it through which it leaks out. However, this process is generally beneficial, since the pressure in the cavity drops, and as a result the pain becomes less acute. The process of draining pus takes about a week. From this moment the temperature drops to subfebrile levels and wound healing begins. The total duration of the disease is 2-3 weeks with proper and timely treatment.

The chronic form of the disease is characterized by a sluggish infectious process, in which there are seasonal surges, during which the disease becomes acute.

Diagnostics

If you have suspicious symptoms, you should consult a doctor. Diagnosis is carried out by an otolaryngologist. The following can be used for this diagnostic sign. If an otolaryngologist's patient puffs out his cheeks, then the immobility of the membrane indicates that air does not enter the tympanic cavity from the nasopharynx and, therefore, the Eustachian tube is blocked. Inspection of the eardrum is carried out using an optical device - an otoscope, which also helps to identify some characteristic signs, for example, protrusion of the eardrum and its redness. A blood test can also be used for diagnosis, CT scan, radiography.

Treatment

How to treat the disease? Treatment of otitis media is quite complex compared to treatment of external otitis. However, in most cases conservative treatment is used. First of all, in case of acute otitis media, it makes no sense to instill ear drops with antibacterial drugs, since they will not reach the site of inflammation. However, for inflammation of the middle ear, the focus of which is directly adjacent to the eardrum, anti-inflammatory and analgesic drops can be instilled into the ear. They can be absorbed by the eardrum, and the substance will enter the region of the middle part of the hearing organ, into the tympanic cavity.

Antibiotics are the main method of treating otitis media in adults and children. Typically, medications are taken in tablet form. However, if the eardrum has ruptured, antibiotic ear drops can also be used. A course of antibiotics must be prescribed by a doctor. He also chooses the type of antibiotics, since many of them have an ototoxic effect. Their use can cause irreversible hearing loss.

The greatest effectiveness for otitis media of the middle ear was demonstrated by a course of treatment with penicillin antibiotics, amoxicillin, as well as cephalosporins or macrolides. However, cephalosporin has an ototoxic effect, so it is not recommended to inject it directly into the ear through a catheter or instill it into the ear canal in case of damage to the eardrum. Antiseptic agents, such as miramistin, can also be used for therapy.

When treating otitis media, it is often necessary to use painkillers. To relieve pain in diseases of the middle part of the hearing organ, drops with painkillers, for example, lidocaine, are used.

In case of membrane perforation, scar stimulants are used to speed up its healing. These include ordinary iodine solution and silver nitrate 40%.

Glucocorticoids (prednisolone, dexomethasone), as well as non-steroidal anti-inflammatory drugs, can be used as anti-inflammatory drugs and agents that can relieve swelling. In the presence of allergic processes or with exudative otitis, they are used antihistamines, for example, suparastin or tavegil.

Also, for exudative otitis media, medications are taken to thin the exudate, for example, carbocisteine. There are also complex drugs that have several types of action, for example, Otipax, Otinum, Otofa, Sofradex. In case of purulent discharge, you should regularly clean the ear canal of pus and rinse it with a weak stream of water.

Is it possible to warm your ear? It depends on the type of disease. In some cases, heat can speed up healing, while in others, on the contrary, it can aggravate the disease. In the purulent form of middle ear disease, heat is contraindicated, and in the catarrhal stage, heat promotes blood flow to the affected area and speeds up the patient's recovery. Heat is also one of the effective ways to reduce pain during otitis media. However, only a doctor can give permission to use heat; self-medication is unacceptable. If heat is contraindicated, it can be replaced with physiotherapeutic procedures (UHF, electrophoresis).

They often resort to surgical treatment of the middle ear, especially in the case of a purulent version of the disease and its rapid development, which threatens severe complications. This operation is called paracentesis and is aimed at removing pus from the tympanic cavity. For mastoiditis, surgery can also be performed to drain the internal areas of the mastoid process.

Special catheters are also used to blow and clean the Eustachian tube. Through them can also be introduced medications.

Folk remedies when treating inflammation of the middle ear in adults, they can be used only for relatively mild forms of the disease and with the permission of the attending physician. Here are some recipes suitable for treating otitis media.

Cotton wool is moistened with propolis infusion and inserted into the area of the external auditory canal. This composition has wound healing and antimicrobial properties. The tampon must be changed several times a day. Plantain juice, instilled into the ear in the amount of 2-3 drops per day, has a similar effect. To get rid of infections of the nasopharynx and larynx, which provoke middle ear infections, you can use rinses based on chamomile, sage, and St. John's wort.

Complications

With proper therapy, otitis media can go away without leaving any long-term consequences. However, inflammation of the middle ear can cause several types of complications. First of all, the infection can spread to the inner ear and cause internal otitis media - labyrinthitis. It can also cause permanent or transient hearing loss or complete deafness in one ear.

Perforation of the eardrum also leads to hearing loss. Although, contrary to popular belief, the membrane can become overgrown, even after it is overgrown, hearing sensitivity will be permanently reduced.

Mastoiditis is accompanied by acute pain in the parotid space. It is also dangerous for its complications - the breakthrough of pus on the membranes of the brain with the appearance of meningitis or in the neck area.

Labyrinthitis

Labyrinthitis is an inflammation of the inner ear. Labyrinthitis is the most dangerous of all types of otitis. For inflammation of the inner ear typical symptoms include hearing loss, vestibular disorders and pain. Treatment of internal otitis is carried out only with the help of antibiotics; no folk remedies will help in this case.

Labyrinthitis is dangerous due to hearing loss as a result of the death of the auditory nerve. Also, with internal otitis, complications such as brain abscess are possible, which can lead to death.

Otitis ear in children

Otitis media in adults is much less common than this disease in children. This is due, firstly, to more weak immunity child's body. Therefore, infectious diseases of the upper respiratory tract are more common in children. In addition, the structural features auditory tube in children they contribute to stagnant processes in it. It has a straight profile, and the expanded lumen at its entrance facilitates the entry of mucus and even pieces of food or vomit (in infants).

Careful treatment of otitis media in childhood is very important. If carried out incorrect treatment, then the disease can become chronic and make itself felt already in adulthood with chronic outbreaks. In addition, if otitis media is not cured in infancy, this may result in partial hearing loss, and this, in turn, leads to a delay mental development child.

Prevention of otitis media

Prevention includes preventing situations such as hypothermia of the body, primarily the ear area, and dirty water getting into the ear canal area. It is necessary to promptly treat inflammatory diseases of the upper respiratory tract, such as sinusitis, sinusitis, and pharyngitis. It is recommended to use a cap while swimming, and after being in the water, you should completely clear the ear canal of water. During the cold and damp seasons, it is recommended to wear a hat when going outside.

Otitis media occurs not only as a complication after viral infections. Various types of injuries can serve as a harbinger and provocateur of the disease. Which are accompanied by damage to the outer and inner parts of the ear cavity. Traumatic otitis media is considered in terms of the formation of a focus of inflammation, hearing impairment, and additional penetration of bacteria. This form of the disease may be associated with changes in the functioning of nerve fibers, parotid glands and joints.

Traumatic otitis media, caused by damage to the ear cavity during cleaning, blow, bruise, fall, industrial injury, with the ingress of foreign small objects or substances.

Typically, this form of the disease provokes an acute inflammatory process, accompanied by infection, damage to the eardrum, hearing loss or deafness.

The consequences resulting from damage to the external ear cavity and inner ear are identified by specialists as post-traumatic otitis media.

External injuries usually occur in adults. Children love to insert foreign objects into their own and each other's ear canals.

First signs

After an injury, the first sign of the disease is an outside sign. The following is a set of key symptoms characterizing traumatic otitis media:

dizziness accompanied by nausea,
acute headache,
increase in body temperature,
imbalance.

In this state, appetite disappears, hearing deteriorates and constant weakness in the body prevails. The extreme symptomatology of the disease is bloody and mucous discharge from the ear.

One of the types of traumatic otitis is. It occurs when diving under water and surfacing (important for divers), during takeoff and landing of an airplane. This injury occurs due to changes in external pressure. Characteristic symptoms:

feeling of increasing pressure inside,
pain varies in scale from slightly noticeable to acute,
itching in the ear canal.

Dizziness, disorientation, and even loss of consciousness are also possible.

Whatever the injury that foreshadows post-traumatic otitis media, without waiting for the above symptoms, you should seek medical attention.

How to treat the disease

After the examination and depending on the severity of the disease, the doctor selects a treatment option. With a mild form of post-traumatic otitis, you can get by with less aggressive intervention than with visible complications.

In any case, the external auditory canal must be disinfected and closed to prevent infections using a sterile cotton-gauze swab.

To prevent the formation of massive purulent accumulations, warming procedures are performed in the form of compresses. When you need to remove the already accumulated pus, you should rinse the ear canal and insert a flagellum moistened with a solution of boric alcohol into the cavity. Swelling of the nasopharynx is relieved by vasoconstrictor drops in the nose. And in order to prevent the pus from spreading further and reaching the brain, the doctor decides to puncture the eardrum and thereby free the ear canal from fluid. The patient loses his hearing, but it will recover after a while.

To remove the source of inflammation and reduce pain, the doctor prescribes antibacterial drugs. Can be used antihistamines.

Surgical intervention is applicable in urgent cases, when urgent need. When a patient needs hearing restoration both after the injury itself and as a result of the consequences of disease progression.

Folk remedies act only as an auxiliary element. Rinsing the ear canals and warming the cavities is performed only with the permission of a specialist, so as not to aggravate the current situation.

The progressive purulent form of traumatic otitis requires the intervention of antibiotics.

Consequences and complications

When untimely or unskilled assistance was provided for post-traumatic otitis media, or when the patient himself did not properly follow all instructions, a number of protracted processes may occur that worsen the state of health.

Traumatic otitis can easily turn into acute or catarrhal. Acute - occurs when the ear canal is completely blocked by fluid. Accompanied by hearing loss, a feeling of fluid moving from side to side, and general congestion. with inflammation of the eardrum, appears due to the presence of pathogens streptococci, staphylococci.

The occurrence of mastoiditis is characterized by purulent infection of the mucous membrane and bone tissue temporal bone. Otogenic sepsis, with the same purulent formations that can spread through the veins, leads to damage to the blood vessels of the brain, joints, and kidneys.

Meningitis is a common problem. The disease is an inflammation of the membranes of the brain and spinal cord.

Prevention

The main rule of prevention is to avoid and prevent any injuries. If such a situation could not be avoided, you should immediately contact medical care, determine the severity of the damage, learn about the possible consequences and begin treatment. To avoid post-traumatic otitis media, you should show your ear canal during examination to a specialist and pay attention to your sensations.

Any hypothermia, viral infections, vitamin deficiencies, kidney problems, and a number of serious diseases such as diabetes are provocateurs. It is worth avoiding crowds of people so as not to become infected with ARVI, and to monitor the current condition and stage of existing diseases. Support immunity with a standard and basic complex: balanced nutrition, physical activity, healthy sleep and less stressful situations.

Signs of illness

Acute otitis media

Acute otitis media- rapidly occurring infectious and inflammatory lesion of the middle ear cavity. Clinical picture The disease includes severe pain, general symptoms, sensations of congestion and noise in the ear, decreased hearing, and the appearance of a perforation in the eardrum followed by suppuration. The diagnosis of acute otitis media is based on data from a clinical blood test, otoscopy, various studies hearing, skull radiography, rhino- and pharyngoscopy, examination of the auditory tube. General treatment diseases are treated with antibiotics, antihistamines and anti-inflammatory drugs, local therapy consists of blowing out the auditory tube, instilling ear drops, washing the tympanic cavity, introducing proteolytic enzymes into it, etc.

Acute otitis media

Acute otitis media is a widespread pathology in both pediatric and adult otolaryngology. Acute otitis media is the most common form of otitis. It is observed with equal frequency in women and men. IN Lately There is a tendency of acute otitis media to have a more sluggish course in adults and frequent recurrence in children. In young children, due to the structural features of the ear in acute otitis media, the antrum - the mastoid cave - is immediately involved in the inflammatory process and the disease has the character of otoanthritis. Acute otitis media can occur as a complication of eustachitis, exudative otitis media, aerootitis, ear trauma, and inflammatory diseases of the nasopharynx.

Causes of acute otitis media

Up to 65% of acute otitis media are caused by streptococcal infection. In second place in terms of frequency of occurrence are pneumococcus and staphylococcus. In rare cases, acute otitis media is caused by diphtheria bacillus, Proteus, or fungi (otomycosis).

Most often, the penetration of infectious agents into the tympanic cavity occurs through tubogenic means - through the auditory (Eustachian) tube. Normally, the auditory tube serves as a barrier that protects the middle ear from microorganisms in the nasopharynx entering it. However, with various general and local diseases, its function may be impaired, which leads to infection of the tympanic cavity with the development of acute otitis media. Factors that provoke dysfunction of the auditory tube are: inflammatory processes of the upper respiratory tract (rhinitis, ozena, pharyngitis, laryngitis, laryngotracheitis, tonsillitis, adenoids, chronic tonsillitis); benign tumors of the pharynx (angioma, fibroma, neuroma, etc.), tumors of the nasal cavity; surgical interventions in the nasal cavity and pharynx; diagnostic and therapeutic procedures (Politzer blowing, catheterization of the auditory tube, tamponade for nosebleeds).

The development of acute otitis media can occur when the tympanic cavity is infected transtympanically - through a damaged eardrum, which happens with injuries and foreign bodies oh wow. The hematogenous route of infection of the middle ear cavity with the occurrence of acute otitis media can be observed in common infections (measles, influenza, scarlet fever, rubella, diphtheria, syphilis, tuberculosis). A casuistic case is the appearance of acute otitis media due to the penetration of infection from the cranial cavity or inner ear.

In the occurrence of acute otitis media, the state of general and local immunity is important. When it decreases, even saprophytic flora entering the tympanic cavity from the nasopharynx can cause inflammation. Relatively recently, it was proven that the so-called ear allergy, which is one of the manifestations of systemic allergy along with allergic rhinitis, exudative diathesis, allergic dermatitis, asthmatic bronchitis and bronchial asthma. Unfavorable factors play an important role in the development of acute otitis media external environment: hypothermia, dampness, sudden changes atmospheric pressure.

Symptoms of acute otitis media

Acute otitis media lasts on average about 2-3 weeks. During a typical acute otitis media, 3 successive stages are distinguished: pre-perforation (initial), perforation and reparative. Each of these stages has its own clinical manifestations. With timely treatment or high immunological resistance of the body, acute otitis media can take an abortive course at any of the indicated stages.

Pre-perforation stage Acute otitis media may take only a few hours or last 4-6 days. It is characterized by a sudden onset of intense ear pain and severe general symptoms. Ear pain is caused by rapidly increasing inflammatory infiltration of the mucous membrane lining the tympanic cavity, resulting in irritation of the nerve endings of the glossopharyngeal and trigeminal nerves. Ear pain in acute otitis media is sharply painful and sometimes unbearable, leading to sleep disturbances and decreased appetite. It radiates to the temporal and parietal regions. Pain syndrome in patients with acute otitis media is accompanied by noise and congestion in the ear, and hearing loss. These symptoms are due to the fact that due to inflammatory changes, the mobility of the auditory ossicles located in the tympanic cavity, which are responsible for sound conduction, decreases.

General manifestations of acute otitis media are an increase in body temperature to 39°C, general weakness, chills, fatigue and weakness. Influenza, scarlet fever and measles acute otitis media often occur with simultaneous involvement of the inner ear in the inflammatory process with the development of labyrinthitis and decreased hearing due to sound perception disorders.

Perforated stage Acute otitis media occurs when, as a result of the accumulation of too much purulent contents in the tympanic cavity, the eardrum ruptures. Through the resulting hole, mucopurulent, then purulent, and sometimes bloody discharge begins to emerge. At the same time, the health of the patient with acute otitis media improves noticeably, the pain in the ear subsides, and the body temperature improves. Suppuration usually lasts no more than a week, after which the disease progresses to the next stage.

Reparative stage Acute otitis media is characterized by a sharp decrease and cessation of suppuration from the ear. In most patients at this stage, spontaneous scarring of the perforation in the eardrum occurs and complete restoration of hearing occurs. If the perforation size is more than 1 mm, the fibrous layer of the eardrum is not restored. If healing of the hole does occur, then the perforation site remains atrophic and thin, since it is formed only by the epithelial and mucous layers without a fibrous component. Large perforations of the tympanic membrane do not close; along their edge, the outer epidermal layer of the membrane fuses with the internal mucous membrane, forming calloused edges of the residual perforation.

Acute otitis media does not always occur with a typical clinical picture. In some cases, there is an initially prolonged and mild nature of the symptoms, and the absence of spontaneous rupture of the eardrum. On the other hand, an extremely severe course of acute otitis media with severe symptoms, temperature up to 40°C, headache, nausea and dizziness is possible. Delayed formation of perforation of the tympanic membrane in such cases leads to rapid spread infections in the cranial cavity with the development of intracranial complications. In cases where, after perforation of the eardrum, there is no improvement in the condition, there is a worsening of symptoms after some improvement, or prolonged (more than a month) suppuration is observed, one should think about the development of mastoiditis.

Diagnosis of acute otitis media

The diagnosis of acute otitis media is established by an otolaryngologist based on the patient’s complaints, the characteristic sudden onset of the disease, the results of otoscopy and microotoscopy, and hearing tests. A clinical blood test in patients with a typical course of acute otitis media reveals moderate leukocytosis and a mild acceleration of ESR. Severe forms The diseases are accompanied by pronounced leukocytosis with a shift to the left and a significant acceleration of ESR. An unfavorable sign indicating the development of mastoiditis is the absence of eosinophils.

The otoscopic picture of acute otitis media depends on the stage of the disease. In the initial period, injection of the radial vessels of the tympanic membrane is detected. Then the hyperemia becomes diffuse, infiltration and protrusion of the membrane towards the ear canal are noted, and sometimes a whitish coating is present. In the perforated stage, otoscopy reveals a slit-like or round perforation of the eardrum, and a pulsating light reflex is observed - pulsation of pus synchronous with the pulse, visible through the perforation. In some cases, prolapse of the mucous membrane of the tympanic cavity, resembling granulation tissue, is observed through the perforated hole. In the reparative stage of acute otitis media, otoscopy may indicate fusion of the perforation or its organization in the form of compaction and callus of the edge.

Audiometry, threshold audiometry and tuning fork testing detect conductive hearing loss. Acoustic impedance measurements indicate reduced mobility of the auditory ossicles. If mastoiditis and petrositis are suspected, an X-ray of the skull in the area of the mastoid process is performed to exclude intracranial complications MRI and CT scan of the brain. Identification of diseases of the nasopharynx, which could be the cause of acute otitis media, is carried out using rhinoscopy, pharyngoscopy, laryngoscopy, determining the patency of the Eustachian tube, and radiography of the paranasal sinuses.

Treatment of acute otitis media

Acute otitis media is treated depending on the stage and, as a rule, on an outpatient basis. If complications develop, hospitalization of the patient is indicated. To relieve pain in the pre-perforation stage of acute otitis media, ear drops containing anesthetics are used. It is effective to instill drops heated to 38-39 °C, followed by closing the ear canal with cotton wool and Vaseline, which is removed after a few hours. Turundas moistened with an alcoholic solution of boric acid are also used. To relieve swelling and improve the drainage function of the auditory tube, antihistamines and nasal vasoconstrictor drops are prescribed: oxymetazoline, xylometazoline, naphazoline, tetrizoline, xylometazoline.

General therapy for patients with acute otitis media is carried out with anti-inflammatory drugs: diclofenac, ibufen, etc. In case of increased body temperature and intense pain, antibiotic therapy is indicated. The drugs of choice are amoxicillin, cefuroxin, spiramycin. Once you start taking an antibiotic, you need to drink it for 7-10 days, since early cessation of antibiotic therapy can lead to relapses and complications, chronic otitis media, and the formation of adhesions inside the tympanic cavity.

A good effect in the pre-perforation stage of acute otitis media is obtained by blowing the auditory tube according to Politzer and washing the middle ear with antibiotic solutions in combination with glucocorticosteroid drugs. Protrusion of the eardrum during treatment indicates that despite all therapeutic measures, a large amount of pus accumulates in the tympanic cavity. This condition is fraught with the development of complications and requires paracentesis of the eardrum.

In the perforated stage of acute otitis media, along with the use of antihistamines, vasoconstrictors and antibacterial agents, toilet of the external ear and transtympanic administration of drugs are carried out. To reduce swelling and secretion of the mucous membrane, fenspiride is used, and mucolytics (acetylcysteine, herbal preparations) are used to thin out thick secretions. Physiotherapeutic treatment is prescribed: ultraviolet irradiation, UHF and laser therapy.

Treatment in the reparative stage of acute otitis media is aimed at preventing the formation of adhesions, restoring the functions of the auditory tube, and increasing the body's defenses. They use blowing of the auditory tube, introducing proteolytic enzymes into the tympanic cavity through it, pneumomassage of the eardrum, ultraphonophoresis with hyaluronidase, vitamin therapy, and taking biostimulants (royal jelly, calf blood hemoderivat).

Prognosis of acute otitis media

With timely and competent treatment, and sufficient activity of immune mechanisms, acute otitis media ends with complete recovery and 100% restoration of hearing. However, late visit to the doctor, poor immune system, unfavorable external influences and underlying diseases can cause a completely different outcome of the disease.

Acute otitis media can transform into chronic suppurative otitis media, which is accompanied by progressive hearing loss and relapses of suppuration. In some cases, the inflammatory process leads to pronounced cicatricial and adhesive changes in the tympanic cavity, disrupting the mobility of the tympanic ossicles and causing the development of adhesive otitis media with persistent hearing loss.

In severe cases, acute otitis media is accompanied by the development of a number of complications: purulent labyrinthitis, mastoiditis, neuritis of the facial nerve, petrositis, meningitis, sigmoid sinus thrombosis, brain abscess, sepsis, some of which can be fatal.

What is barotraumatic otitis media?

Barotraumatic otitis is a complex of symptoms that arise in response to changes in environmental pressure, surrounding a person. Classic situations leading to ear barotrauma are:

Diving/ascent
Airplane ascent/landing

Barotraumatic otitis media is related to the middle ear. It includes the Eustachian tube and the tympanic cavity, which is normally filled with air. The middle ear is separated from the outer ear by an impenetrable flexible eardrum. On the other hand, the exit of the Eustachian tube into the nasopharynx is also closed most of the time, which protects the tympanic cavity from the penetration of excess bacteria into it. Thus, the middle ear is a relatively isolated part of the ear system.

However, it cannot be completely isolated, because metabolic processes in the mucous membrane of the tympanic cavity lead to a rarefaction of the air present and a decrease in its pressure. As a result, the eardrum changes its curvature and loses sensitivity when perceiving external sound waves. To prevent this from happening, the mouth of the Eustachian tube sometimes opens slightly (when swallowing or artificially increasing the pressure in the nasopharynx), due to which a portion of air enters the tympanic cavity and equalizes the pressure.

Thus, matching the pressure in the middle ear cavity to the ambient pressure is a fundamental condition for proper functioning. auditory system human being, which is one of the most perfect among living beings.

Symptoms

Man and the species immediately preceding him evolved on land with a predominant sedentary nature of life. Therefore, our ears can distinguish hundreds of tones, but are absolutely not adapted to immersion in water and flying in the air.

When immersed in water, a person is exposed to increased pressure from a medium denser than air. Water pours into the ear and puts pressure on the eardrum from the outside. The eardrum is an elastic membrane. The degree of its elasticity varies among people: for some it is thin, for others it is quite dense. The elasticity parameter changes with age: for example, in young children the membrane is very thick. In addition, it may have defects and thinning resulting from previous otitis media. In the presence of predisposing factors, force on the membrane with increased pressure in some cases can lead to its perforation and the flow of water into the middle ear cavity.

The symptoms that a person feels during barotraumatic stress develop in the following sequence:

Increasing sensation of pressure in the ear.
Ear congestion.
At first, a mild, ongoing pain, then a sharp one.
Coldness in the depths of the ear is the result of water penetrating into the tympanic cavity.
Severe itching, urge to sneeze, ear irritation.

The described scenario may threaten the general condition of the diver. There is a possibility of disorientation, vomiting, dizziness, and loss of consciousness.

Post-traumatic symptoms of water flowing into the tympanic cavity manifest themselves in the development of otitis media in a purulent form. It is characterized by:

It should be noted that membrane rupture during immersion is a rare occurrence. More often, barotraumatic otitis develops according to the second scenario.

As is known, in order to avoid traumatic otitis when immersed in water, they resort to equalizing the pressure in the tympanic cavity in the following ways:

You can yawn or swallow saliva.
It is possible to create an area of increased pressure in the nasopharynx with the nose closed, due to which the passage into the Eustachian tube will open and air will penetrate into the tympanic cavity (the so-called “blowing”).

The second option is the most effective, but in some cases it carries danger. If a person is sick with a respiratory disease and has pathogenic environment in the nasopharynx, by purging, he risks throwing infectious agents into the Eustachian tube, which will cause at least otitis in the catarrhal stage with a transition to an exudative form or, in the future, purulent otitis media.

Traumatic symptoms at the initial stage:

Ear congestion
Creaking, wet sounds in the ear when swallowing
Hearing loss
No pain

Over time, symptoms will intensify and change. Depending on the course of the disease, they can take the following form:

Severe pain
Temperature increase
Feeling of pressure in the ear
Feeling of fluid in the ear
Ear discharge (usually purulent)
Significant hearing loss

All of the above about barotraumatic otitis media is true not only for diving situations, but also applies to airplane flights.

Treatment

The term “barotraumatic” indicates the cause that influenced the occurrence of otitis media. In terms of its content, post-traumatic otitis due to pressure drop is a standard otitis media of the middle ear with its characteristic treatment methods.

For the treatment of catarrhal stage use:

drugs that relieve swelling of the mucous membrane of the Eustachian tube (for example, Tavegil),
anti-inflammatory drugs (eg Erespal),
agents that increase the secretion of mucous membranes (eg, Sinupret).
vasoconstrictors (eg Nazivin).

Physiotherapeutic heating and blowing are of great importance for healing. To prevent further spread of the infectious environment from the nasopharynx, treatment of barotraumatic otitis should involve treatment of primary inflammation of the upper respiratory tract.

For the purulent form of traumatic otitis, the first-line drugs are antibiotics: local (Otipax drops, Tsipromed, etc.) and systemic (tablets Amoxicillin, Ketocef, Clarithromycin, etc.). For purulent discharge, collateral successful treatment is to thoroughly clean the ear.

Prevention

The following recommendations should be considered preventative:

Visit an otolaryngologist before diving.
Do not dive under water or fly in an airplane if you have respiratory problems.
Learn to equalize the pressure in the middle ear using “blowing” and use this method when immersed in water and when landing an airplane (but not during ascent and takeoff).
Do not use earplugs when scuba diving: they may worsen pressure imbalances.

By following these rules, you don’t have to worry about barotraumatic otitis media.

External post-traumatic otitis

Post-traumatic otitis is a type of disease that can be a consequence of an injury or bruise to the ear. An ENT doctor can help relieve suffering and cure the disease.

The Capital Clinic employs qualified specialists - otolaryngologists. Each patient will receive all necessary services. Reception is by appointment only.

Children at any age are most affected by otitis media. As for the post-traumatic form, it cannot be protected or prevented. Before the age of 3, almost 80% of children were diagnosed with this disease. Statistics show that post-traumatic otitis media is on par with such dangerous diseases, like sore throat, scarlet fever and influenza.

Types of post-traumatic otitis

This type of disease has one form. This is internal otitis, when inflammatory processes occur in the labyrinth of the auricle. Occurs as a complication after an injury. With internal otitis, pus may appear due to bruises in the middle ear. Then the infection enters through a punctured hole in the eardrum. Post-traumatic otitis media can become chronic if you do not consult a specialist in time.

Signs of illness

The onset of post-traumatic otitis media is often accompanied by tinnitus. Severe pain is felt, which increases in the evening. Dizziness and nausea appear. Lost appetite. The temperature rises. Vomiting may begin. The person complains of general weakness and loses his sense of balance. The quality of hearing decreases. If the disease is treated in time, the fluid accumulated in the ear tube can resolve on its own. Otherwise, it will accumulate in the area of the inner ear. The person may lose their hearing.

Otitis media is easy to recognize. However, for this you should consult an ENT doctor. Specialists at the Stolichnaya Clinic deal with the problems of post-traumatic otitis media. They can conduct a qualified differential diagnosis of diseases that are similar in symptoms to the post-traumatic form of otitis.

Treatment methods for post-traumatic otitis media at the Stolichnaya Clinic

Treatment should only be carried out by a qualified otolaryngologist. You can find one in the “Capital Clinic” in Kyiv. The specialist will offer the following treatment options:

Warming procedures. Compresses will help avoid large purulent discharge;

Flushing toilets of the ear canal, to remove pus;

Use of vasoconstrictor drops in the nose. The goal is to relieve swelling of the nasopharynx;

Turundas moistened with solutions of boric alcohol. This promotes the rapid release of pus and rapid healing of the wound;

Eardrum puncture. This is done to prevent pus from entering the brain.

Before you begin treatment at the Capital Clinic, you should undergo a general examination. Nowadays there are many allergy sufferers. Perhaps taking blood tests will help determine the optimal method of recovery.

The ENT doctor at the Capital Clinic will provide a full and qualified consultation. It will help you decide on the type of detailed examination of the auricle. The diagnosis will be made as soon as possible. The clinic has the highest level of provision with the latest equipment.

Post-traumatic otitis is a type of disease that can be a consequence of an injury or bruise to the ear. An ENT doctor can help relieve suffering and cure the disease.

The Capital Clinic employs qualified specialists - otolaryngologists. Each patient will receive all necessary services. Reception is by appointment only.

Types of post-traumatic otitis

Start post-traumatic otitis often accompanied by tinnitus. There is severe pain that increases in the evening. Dizziness and nausea appear. Lost appetite. The temperature rises. Vomiting may begin. The person complains of general weakness and loses his sense of balance. The quality of hearing decreases. If the disease is treated in time, the fluid accumulated in the ear tube can resolve on its own. Otherwise, it will accumulate in the area of the inner ear. The person may lose their hearing.

Otitis media is easy to recognize. However, for this you should consult an ENT doctor. Specialists at the Stolichnaya Clinic deal with problems post-traumatic otitis. They can conduct a qualified differential diagnosis of diseases that are similar in symptoms to the post-traumatic form of otitis.

Treatment methods for post-traumatic otitis media at the Stolichnaya Clinic

Treatment should only be carried out by a qualified otolaryngologist. You can find one in the “Capital Clinic” in Kyiv. The specialist will offer the following treatment options:

Warming procedures. Compresses will help avoid large purulent discharge;

Flushing toilets of the ear canal, to remove pus;

Use of vasoconstrictor drops in the nose. The goal is to relieve swelling of the nasopharynx;

Turundas moistened with solutions of boric alcohol. This promotes the rapid release of pus and rapid healing of the wound;

Eardrum puncture. This is done to prevent pus from entering the brain.

Barotraumatic otitis is a complex of symptoms that arise in response to changes in the pressure of the environment surrounding a person. Classic situations leading to ear barotrauma are:

Diving/ascent
Airplane ascent/landing

Thus, the correspondence of the pressure in the middle ear cavity to the environmental pressure is a fundamental condition for the proper functioning of the human auditory system, which is one of the most advanced among living beings.

The symptoms that a person feels during barotraumatic stress develop in the following sequence:

Increasing sensation of pressure in the ear.
Ear congestion.
At first, a mild, ongoing pain, then a sharp one.
Coldness in the depths of the ear is the result of water penetrating into the tympanic cavity.
Severe itching, urge to sneeze, ear irritation.

The described scenario may threaten the general condition of the diver. There is a possibility of disorientation, vomiting, and dizziness. loss of consciousness.

Post-traumatic symptoms of water flowing into the tympanic cavity manifest themselves in the development of otitis media in a purulent form. It is characterized by:

It should be noted that membrane rupture during immersion is a rare occurrence. More often, barotraumatic otitis develops according to the second scenario.

As is known, in order to avoid traumatic otitis when immersed in water, they resort to equalizing the pressure in the tympanic cavity in the following ways:

You can yawn or swallow saliva.
It is possible to create an area of increased pressure in the nasopharynx with the nose closed, due to which the passage into the Eustachian tube will open and air will penetrate into the tympanic cavity (the so-called “blowing”).

The second option is the most effective, but in some cases it carries danger. If a person is sick with a respiratory disease and has a pathogenic environment in the nasopharynx, by blowing, he risks throwing infectious agents into the Eustachian tube, which will cause at least otitis in the catarrhal stage with a transition to an exudative form or, in the long term, purulent otitis media.

Traumatic symptoms at the initial stage:

Ear congestion
Creaking, wet sounds in the ear when swallowing
Hearing loss
No pain

Over time, symptoms will intensify and change. Depending on the course of the disease, they can take the following form:

Severe pain
Temperature increase
Feeling of pressure in the ear
Feeling of fluid in the ear
Ear discharge (usually purulent)
Significant hearing loss

All of the above about barotraumatic otitis media is true not only for diving situations, but also applies to airplane flights.

For the treatment of catarrhal stage use:

drugs that relieve swelling of the mucous membrane of the Eustachian tube (for example, Tavegil),
anti-inflammatory drugs (eg Erespal),
agents that increase the secretion of mucous membranes (eg Sinupret).
vasoconstrictors (eg Nazivin).

For the purulent form of traumatic otitis, the first-line drugs are antibiotics. local (Otipax drops, Tsipromed, etc.) and systemic (tablets Amoxicillin, Ketocef, Clarithromycin, etc.). For purulent discharge, the key to successful treatment is thorough cleaning of the ear.

The following recommendations should be considered preventative:

Visit an otolaryngologist before diving.
Do not dive under water or fly in an airplane if you have respiratory problems.
Learn to equalize the pressure in the middle ear using “blowing” and use this method when immersed in water and when landing an airplane (but not during ascent and takeoff).
Do not use earplugs when scuba diving: they may worsen pressure imbalances.

By following these rules, you don’t have to worry about barotraumatic otitis media.

Leave your comment

Chronic diseases: not specified

Good day! Please tell me about this question: a month ago I was robbed and beaten, there was a strong blow to my ear, after which there was a hum in my ear and I began to have trouble hearing it (it didn’t hurt and there was no discharge). I went to the doctor, he said that the eardrum was cherry, there was hearing loss, he prescribed treatment: Sofradex, Compress with Dimexide, Farmazolin, Loratodin, Augmentin. I was treated. But the hum remained, only a little bit better to hear. Will the hearing return? What to do?

Tags: eardrum injury, post-traumatic otitis, post-traumatic otitis, post-traumatic otitis media, post-traumatic otitis treatment

Otitis media of the ear I visited a doctor, he diagnosed me with acute otitis of the ear and prescribed me.

Hearing loss Today I saw an ENT doctor with a complaint of hearing loss in my right ear and had her examined.

Ears are clogged, otitis of the middle ear Otitis of the middle ear / treatment - 4 days amoxicillin tablets.

Otitis media Six years ago I went to the operating table due to severe ear pain.

Acute otitis media The child first developed a severe cough, the cough was treated for a week.

Acute exudative otitis media My daughter is 8 months old. 24 were admitted to the hospital.

Acute catarrhal otitis of the middle ear Me and all mine big family We've been planning our vacation for a long time.

Acute otitis media Three days ago I was diagnosed with an ENT diagnosis - Acute medium double sided.

Don't forget to rate the doctors' answers, help us improve them by asking additional questions on the subject of this question .
Also, don’t forget to thank your doctors.

Hello! It is possible that a hematoma has formed on the eardrum as a result of injury. When the hematoma resolves, hearing resumes. For now, lidase electrophoresis will be helpful. perforation of the auditory tubes.
p. S. Be healthy!

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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.

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 consists of three sections - outer, middle and inner. The outer ear is formed by the pinna and the auditory canal, which ends at the eardrum. The function of the outer ear is to capture sound signals and transmit them further to the structures of the middle ear. The middle ear consists of the tympanic cavity located between the eardrum and the opening of the temporal bone. The tympanic cavity contains the ossicles (hammer, incus and stapes). The function of this part of the ear is to conduct sound. The middle ear cavity is connected to the nasopharynx by the Eustachian tube, through which the pressure in the tympanic cavity and external atmospheric pressure are equalized.

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, which convert mechanical vibrations of the fluid into nerve impulses that enter the corresponding parts of the brain along the auditory nerve. The function of the inner ear is to provide balance. Inflammation of the inner ear (otitis media) is usually called labyrinthitis.

A differential diagnosis of acute internal otitis with brain pathologies that can cause dizziness, including neoplasms, is required.

Acute otitis media can occur at any age, but children are more susceptible to it - in them it is the most common otorhinolaryngological disease. In the first years of life, about 80% of children experience acute otitis media, and by the age of 7 – up to 95%. In approximately 30% of cases, otitis media suffered in childhood is the cause of hearing loss in adults.

The causative agents of acute otitis are most often staphylococci, pneumococci, Haemophilus influenzae, Klebsiella, Pseudomonas aeruginosa, Moraxella, microscopic yeast-like fungi of the genus Candida, and influenza virus.

Risk factors include:

infectious and inflammatory diseases of the ENT organs;
mechanical or chemical injuries to the ear;
presence of a foreign body in the ear;
water getting into the ear;
improper ear hygiene;
hypothermia;
operations on the nasal cavity and/or nasopharynx;
allergies;
immunodeficiency states;
diabetes;
childhood and old age.

Depending on the nature of the inflammation of the middle ear, acute catarrhal otitis and acute purulent otitis are distinguished.

By origin, acute otitis occurs in the following forms:

bacterial;
viral;
fungal (otomycosis).

Acute external otitis may be limited and diffuse.

Limited external otitis manifests itself in the form of inflammation of the hair follicle or the development of a boil in the external auditory canal.

The clinical picture of acute otitis includes the following stages:

Catarrh.
Purulent inflammation, which, in turn, is divided into pre-perforation and perforation stages.
Recovery or transition to a chronic form.

Symptoms of acute otitis depend on the form of the disease.

In acute otitis media, intense shooting pain in the ear, a feeling of ear fullness, and hearing loss first appear.

Local symptoms are accompanied by general malaise: weakness, lethargy, increased body temperature - usually to subfebrile, but sometimes to febrile levels. 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 pain in the ear intensifies when sucking and swallowing. 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 eardrum perforates and the serous (catarrhal otitis) and then purulent (in some cases bloody) contents leak out. At the same time, the patient's general condition improves. Body temperature returns to normal, ear pain subsides. Suppuration usually lasts no more than a week. After scarring of the perforation, hearing is usually restored. In the case of an unfavorable course of the disease, purulent exudate may not pour out, but spread into the cranial cavity with the subsequent development of meningitis or brain abscess. Acute otitis media lasts on average 2-3 weeks.

Acute internal otitis (labyrinthitis) is characterized by severe attacks of dizziness, 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 us to the deepening of the inflammatory process.

The manifestation of acute limited external otitis is first itching, and then pain in the ear canal, which can radiate to the upper and lower jaw, temple, and back of the head. The pain intensifies when chewing, as well as at night. Limited external otitis manifests itself in the form of inflammation of the hair follicle or the development of a boil in the external auditory canal. A boil can completely block the lumen of the ear canal, which causes hearing loss. When the boil is opened and its contents drain, the pain subsides and the patient's condition improves.

In acute diffuse external otitis, patients complain of a feeling of fullness, itching, and then severe pain in the ear, which intensifies during conversation, when chewing food, and palpation of the ear. There is hyperemia of the ear canal, its swelling and slit-like narrowing, and enlargement of regional lymph nodes. Discharge from the ear in acute diffuse external otitis is usually scanty, initially serous, and then purulent. The inflammatory process may spread to the soft tissues of the parotid region and auricle.

To determine acute otitis, a history and complaints are collected, an objective examination is carried out, and, if necessary, instrumental and laboratory diagnostic methods are used.

If acute otitis is suspected, otoscopy is usually performed, which makes it possible to examine the eardrum, 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 auditory ossicles to conduct auditory pressure waves. Audiometry is indicated to identify hearing impairment.

In order to identify the pathogen and determine its sensitivity to anti-infective drugs, a bacteriological study is carried out.

Children in the first years of life with acute otitis media refuse to eat, as pain in the ear intensifies when sucking and swallowing.

A differential diagnosis of acute internal otitis 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 external otitis should be differentiated from mumps, other types of otitis media, eczema of the external auditory canal, mastoiditis, furuncle of the auditory canal. For the purpose of differential diagnosis of acute otitis with other diseases, computer or magnetic resonance imaging brain.

Treatment of acute external otitis is local, in most cases it consists of washing the external auditory canal with antiseptic solutions.

In cases of severe pain and fever, painkillers from the group of non-steroidal anti-inflammatory drugs are prescribed. If necessary, mature boils are opened, after which the ear canal is washed antiseptic solutions.

Treatment of acute otitis media is carried out with anti-infective (in most cases antibacterial) drugs, non-steroidal anti-inflammatory drugs. Vasoconstrictor drugs are used locally to eliminate swelling of the nasal cavity and nasopharynx in order to drain the tympanic cavity. If the tympanic cavity does not drain on its own within several days from the onset of the disease, the tympanic membrane is dissected (paracentesis). If, after scarring of the eardrum, the patient’s hearing is not restored, blowing and pneumatic massage are indicated.

Conservative treatment of acute internal otitis is mainly symptomatic. To eliminate nausea and vomiting, antiemetic drugs and antihistamines are used. If conservative therapy is ineffective, surgical intervention is indicated. According to indications, a labyrinthotomy is performed, opening the pyramid of the temporal bone.

In the absence of timely adequate treatment, acute otitis may become chronic, which is associated with high risk the appearance of hearing loss.

In approximately 30% of cases, otitis media suffered in childhood is the cause of hearing loss in adults.

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, thrombosis of the cerebral sinuses, and facial nerve paralysis. The occurrence of intracranial complications can lead to death.

With timely and adequate treatment of acute otitis, the prognosis is favorable. In the presence of underlying diseases, immunodeficiency conditions, late application For medical help, self-medication and the emergence of complications, the prognosis worsens.

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;
avoiding injury to the ear (including refusal to attempt to independently remove foreign bodies from the ear and use objects not intended for this purpose to clean the ears);
compliance with personal hygiene rules.

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Traumatic otitis media, caused by damage to the ear cavity during cleaning, blow, bruise, fall, industrial injury, with the ingress of foreign small objects or substances.

Typically, this form of the disease provokes an acute inflammatory process, accompanied by infection, damage to the eardrum, hearing loss or deafness.

The consequences resulting from damage to the external ear cavity and inner ear are identified by specialists as post-traumatic otitis media.

External injuries usually occur in adults. Children love to insert foreign objects into their own and each other's ear canals.

After an injury, the first sign of the disease is extraneous noise in the ears. The following is a set of key symptoms characterizing traumatic otitis media:

dizziness accompanied by nausea,
acute headache,
increase in body temperature,
imbalance.

In this state, appetite disappears, hearing deteriorates and constant weakness in the body prevails. The extreme symptomatology of the disease is bloody and mucous discharge from the ear.

One type of traumatic otitis is baratraumatic otitis. It occurs when diving under water and surfacing (important for divers), during takeoff and landing of an airplane. This injury occurs due to changes in external pressure. Characteristic symptoms:

ear congestion,
feeling of increasing pressure inside,
pain varies in scale from slightly noticeable to acute,
itching in the ear canal.

Dizziness, disorientation, and even loss of consciousness are also possible.

Whatever the injury that foreshadows post-traumatic otitis media, without waiting for the above symptoms, you should seek medical attention.

In any case, the external auditory canal must be disinfected and closed to prevent infections using a sterile cotton-gauze swab.

To remove the source of inflammation and reduce pain, the doctor prescribes antibacterial drugs. It is possible to use antihistamines.

Surgical intervention is applicable in urgent cases, if there is an urgent need. When a patient needs hearing restoration both after the injury itself and as a result of the consequences of disease progression.

Folk remedies act only as an auxiliary element. Rinsing the ear canals and warming the cavities is performed only with the permission of a specialist, so as not to aggravate the current situation.

The progressive purulent form of traumatic otitis requires the intervention of antibiotics.

Traumatic otitis can easily turn into acute or catarrhal. Acute - occurs when the ear canal is completely blocked by fluid. Accompanied by hearing loss, a feeling of fluid moving from side to side, and general congestion. Catarrhal otitis with inflammation of the eardrum appears due to the presence of pathogens streptococci and staphylococci.

The occurrence of mastoiditis is characterized by purulent infection of the mucous membrane and bone tissue of the temporal bone. Otogenic sepsis, with the same purulent formations that can spread through the veins, leads to damage to the blood vessels of the brain, joints, and kidneys.

Meningitis is a common problem. The disease is an inflammation of the membranes of the brain and spinal cord.

The main rule of prevention is to avoid and prevent any injuries. If such a situation could not be avoided, you should immediately seek medical help, determine the severity of the injury, learn about the possible consequences and begin treatment. To avoid post-traumatic otitis media, you should show your ear canal during examination to a specialist and pay attention to your sensations.

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Otitis media is an infectious inflammatory process characterized by rapid development and localized in the middle ear cavity. The ear cavity is located inside the temporal bone and is covered from the outside by the eardrum. This membrane separates the middle ear from the ear canal. When an infectious process begins to develop, it involves not only the ear cavity itself, but also nearby structures. We are talking about the air cells of the mastoid process, extending from the temporal bone, and eustachian tube.

This pathology is extremely common in otolaryngology and accounts for up to 30% of cases of all diseases of the ENT organs. In addition, otitis media is often a concomitant disease and is associated with other ear pathologies - as a rule, this occurs in 30% of cases.

Both children and adults are susceptible to the disease, but children suffer from otitis media more often, which is due to the structural features of the middle ear in childhood. As for men and women, they suffer from otitis media with the same frequency. Recent statistics indicate that cases of slowly progressing otitis media among the adult population and relapses in children have become more frequent. Up to 62% of babies suffer from acute otitis media during the first year of life.

The average duration of the disease is 3 weeks. During this time, otitis media goes through all stages of its development.

Symptoms of the disease manifest themselves clearly, among them the following can be distinguished:

The very first symptom characterizing the onset of the disease is the occurrence of pain. Moreover, it can manifest itself in different ways: it can be pulsating and incessant, it can be pulling and shooting, with short-term breaks. Sometimes the pain is localized not only in the ear, but also radiates to the temporal region or the back of the head. With otitis media, teeth may begin to hurt;

The disease manifests itself in a person's hearing loss. This symptom can appear both at the initial stage of otitis media and at all subsequent stages. The feeling of ear fullness may disappear after swallowing saliva or deep yawning;

The patient often suffers from autophony, which manifests itself in the resonance of his own voice during speech;

A person experiences congestion in the ear, sometimes there is a feeling of a foreign object inside or pressing sensation;

Sometimes extraneous noise appears;

Purulent or serous contents begin to separate from the ear. Although sometimes discharge is not observed or is present, but very insignificant;

At the same time, adjacent areas increase in size and become painful. The lymph nodes;

The area behind the ear of a person suffering from otitis media begins to hurt, turn red and swell. The pain is aching;

The inflammatory process can involve either one or both ears. In the latter case, it is advisable to talk about bilateral otitis media;

Body temperature almost always rises. It can reach high values, up to 39 °C and above. At very high temperatures, vomiting may occur;

A person suffers from general intoxication of the body: sleep is disturbed, appetite decreases, fatigue increases, a feeling of general weakness and malaise appears;

Often nearby ENT organs are involved in the process, the patient suffers from rhinitis, and may experience pain and dryness in the throat.

Symptoms of the disease can be either bright or blurred. The clinical picture varies, the disease can be very severe, with a temperature of up to 40 ° C and purulent-bloody discharge from the ear canal. In some cases, on the contrary, the symptoms are mild, for example, with the exudative form of the disease.

The causes of otitis media are diverse, among them the following can be distinguished:

The first cause of the development of the disease, which is the leading among other factors, is human infection with streptococcal infection. The next most common microbes that cause otitis media are pneumococci and staphylococci. It is the entry of streptococcus into the tympanic cavity that in 65% of cases causes the development of an acute infectious process in the middle ear. This is facilitated by diseases of the nasopharynx, nose, paranasal sinuses, and throat;

Improper nose blowing often causes a person to develop otitis media. If a person tries to remove mucus from the nose and closes his mouth, then under the influence of the resulting pressure, some of it can penetrate into the middle ear;

Adenoids are another reason leading to the development of otitis media;

Enlargement of the posterior ends of the nasal concha, making it difficult to open the auditory tube;

Deviation of the nasal septum;

Acute otitis media can develop against the background of multiple infectious diseases, since pathological microorganisms also enter the middle ear cavity through the blood;

Trauma to the eardrum is another factor predisposing to the development of the disease. In this case, pathological bacteria and viruses can enter the body tubogenically, that is, from the external environment into the ear cavity;

Benign tumors pharynx, such as fibroma, angioma, neuroma - all these are potential factors that can lead to the development of otitis media;

A decrease in general immunity also leads to the fact that an inflammatory process may occur in the middle ear;

General hypothermia of the body, prolonged stay in a damp climate with sudden changes in pressure can trigger the onset of the disease;

Recent data indicate that allergies may be the trigger for the development of otitis media;

As a secondary pathology, otitis media can occur against the background of many diseases, in particular, meningitis, tonsillitis, scarlet fever, influenza, measles and other diseases lead to it.

There are several stages of acute otitis media. They follow each other and have characteristic clinical manifestations. However, it is not necessary that the disease must go through all stages of development. With timely and adequate treatment, otitis media is a reversible process.

initial stage a disease called pre-perforation, characterized by the presence of severe pain and general symptoms. Its duration can vary from several hours to several days. Painful sensations arise against the background of the fact that irritation of the ternary and glossopharyngeal nerve occurs. The pain radiates to both the temporal and parietal regions. A person's hearing decreases due to the fact that the auditory ossicles in the tympanic region become less mobile.

At this stage, pus accumulates, but has not yet ruptured the eardrum. She herself becomes swollen and turns red. Painful sensations intensify when a person lies down or leans towards the damaged ear. During otoscopy, the doctor observes a thickening of the eardrum, through which purulent contents are visible. Sometimes it may become coated white.

The eardrum ruptures under the influence of accumulated pus, and the contents come out. The discharge is mucopurulent in nature, at first there is a lot of it. Sometimes blood can be found in the contents discharged from the ear. The pain subsides and the person feels significant relief. Body temperature drops, symptoms of intoxication weaken.

At this stage, otoscopy gives the following picture: discharge flows through the damaged membrane in portions, and the membrane itself pulsates synchronously. Over time, there are fewer and fewer of them, the amount of mucus decreases, and purulent masses become the main content.

This stage can last up to one week. As for the size of the perforation, with purulent otitis media they are small. Extensive perforation is observed when the disease occurs against the background of scarlet fever, tuberculosis or measles. Sometimes the perforated stage can be characterized by the fact that purulent masses do not break out, but into the cranial cavity. This poses a serious threat not only to the health, but also to the life of the patient.

The final (reparative stage) is the one at which scarring of the perforation occurs. In this case, the pus ceases to be released, and the patient’s hearing begins to recover. The infiltration of the eardrum is reduced, and its swelling is reduced. During otoscopy, the doctor observes its shine and more or less defined contours. If the perforation was minor and did not exceed 1 mm, then it is completely healed without leaving a scar.

If the breakthrough was significant, then in its place fibrous tissue is formed that does not have the ability to regenerate. Often salt deposits form in this place. Often, fibrous adhesions can be observed in the middle ear cavity, which contributes to a decrease in the mobility of the auditory ossicles and, as a result, hearing impairment.

If otitis is uncomplicated, then a general blood test reveals a slight increase in ESR and a slight shift in the leukocyte count to the left. Sometimes it happens that at the perforated stage, pus breaks out, but the patient’s condition remains consistently severe. This in most cases indicates the development of mastoiditis. If pus is released for a month and begins to fill the ear again after cleansing, then this condition is called mastoid empyema.

Otitis media can be either acute or chronic. Each of these forms has its own characteristics, differs in course and recommended methods of treatment. The main difference between otitis media is the speed of development and duration of the disease.

Acute otitis media begins suddenly and its symptoms increase rapidly. First, the patient complains of tingling in the ear, then the pain becomes more and more intense. If acute otitis media develops in childhood, then those children who cannot speak burst into continuous crying. The pain may subside, but the period of time is very short.

After the eardrum ruptures and the purulent contents come out, the pain stops and the person’s condition returns to normal. Then scarring of the eardrum occurs and hearing is restored. Acute otitis media lasts up to 3 weeks on average. However, it is fraught with complications, such as inflammation of the process of the temporal bone - mastoiditis, temporary paralysis of the facial nerve - paresis, as well as inflammation of the inner ear, meningitis, brain abscess and other intracranial diseases. Therefore, it is so important to consult a doctor in time and begin timely therapy.

As for chronic otitis media, it is a disease characterized by a sluggish course. Most often, the chronic form of the disease is a consequence of acute purulent otitis media. Mesotympanitis, in the form of which chronic otitis occurs, accounts for up to 55% of cases of this type of disease. In this case, the mucous membrane lining the auditory tube, the middle and the section of the tympanic cavity located underneath become inflamed. It is there that the eardrum is perforated, but the main one often remains intact and stretched.

The chronic form of otitis is characterized by the following complaints presented by the patient: hearing loss, constant or periodic appearance of purulent discharge from the auditory canal, in rare cases, dizziness and tinnitus. Pain can only bother a person when otitis media enters the acute phase.

The course of mesotympanitis is favorable, the disease rarely leads to serious consequences. Hearing will be reduced depending on how damaged the auditory ossicles are at the time of treatment. Diagnosis of acute otitis is based on the patient's complaints and culture of the microflora of the discharged contents.

The second form in which chronic otitis media can occur is purulent epitympantitis. In this case, the supratympanic space is damaged. The rupture site is localized in the upper part, so the purulent contents are not completely separated from the ear cavity. This form of chronic otitis is more often fraught with complications than mesotympanitis.

In order to adequately assess the condition of bone structures, standard studies are often not enough and an X-ray examination is required.

There are other forms of otitis media, which include exudative, catarrhal, purulent, serous and adhesive otitis media. Each of them has its own characteristic signs that make it possible to diagnose the disease and prescribe adequate treatment.

Exudative otitis media differs in that exudate accumulates in the middle ear cavity, but there is no pain. More to characteristic features This type of otitis includes decreased hearing in the patient and preservation of the eardrum. It is the absence of pronounced symptoms that makes diagnosing this type of otitis difficult. Most often, it develops against the background of previous pathologies of the upper respiratory tract, causing infectious nature. It is especially difficult to identify this type of disease in children who do not complain of hearing loss. Among other reasons leading to the development of exudative otitis media, one can highlight smoking, unfavorable environmental conditions, allergic reactions, deviated nasal septum, autonomic dysfunction, acute otitis media, old age, decreased immunity, nasal tamponade, etc.

As for the pathogenesis of the disease, it begins with the fact that a vacuum is formed inside the tympanic cavity, and the function of the auditory tube is disrupted. Against this background, oxygen is absorbed, pressure drops and transudate appears. Over time, the mucous glands are activated and the volume of secreted secretions increases. It becomes denser and its viscosity increases. Against this background, degenerative processes begin to progress, which subsequently cause hearing loss. Depending on the duration of exudative otitis, there are several of its forms: chronic, which lasts more than 2 months, subacute, which lasts up to 2 months, and acute, which lasts less than 3 weeks.

This type of otitis is fraught with complications such as the development of purulent otitis of the middle ear, immobility of the auditory ossicles and hearing loss, the formation of perforation or cholesteatoma, and persistent elongation of the eardrum.

Catarrhal otitis media is another type of disease, characterized by an acute course and inflammation of the auditory tube, tympanic membrane and mastoid process. This form of otitis is dangerous due to serious complications and, if not treated promptly, can lead to complete hearing loss.

Among the reasons causing the development of catarrhal otitis are frequent infections, chronic diseases ENT organs, proliferation of adenoids, lack of vitamins, decreased immune strength, coughing and sneezing, leading to increased pressure in the nasopharynx.

The symptoms of catarrhal otitis are vivid; the disease manifests itself with acute pain, most often shooting. It radiates to both the temple and the teeth. Therefore, it is not difficult to recognize this form of otitis media. If treatment is not started in time, catarrhal otitis often turns into a purulent or exudative form.

Purulent otitis media is characterized by the fact that inflammation of the mucous membrane of the middle ear occurs with the appearance of purulent contents. All parts of the middle ear are involved in the pathological process, and not just the tympanic cavity. Acute purulent otitis occurs most often among other types of otitis and can lead to hearing loss, which cannot be restored.

Another danger of the purulent form of otitis is that it can cause intracranial complications, such as meningitis, brain abscess, and otogenic sepsis.

Viruses rarely cause the development of purulent otitis media, in only 4% of cases. Most often, inflammation is caused by bacteria.

The infection enters the ear through the auditory tube; this process occurs especially easily against the background of diseases of the nose and nasopharynx. But bacteria can also enter the middle ear cavity through the blood, which most often occurs during the flu. In childhood, purulent otitis media occurs much more often than in adults.

After an infection enters the mucous membrane of the middle ear, processes begin causing congestion exudate, which after a short time transforms from serous to purulent. Its volume gradually increases, which leads to increased pressure on the eardrum and its subsequent breakthrough. The danger is that the purulent contents may not come out, but may enter the cranial cavity. Treatment is based on washing the ear cavity with a special solution, antibiotics and disinfectants.

Serous otitis media is an inflammation of the middle ear, which has mild symptoms and is characterized by the accumulation of non-purulent exudate. Fluid begins to accumulate in the tympanic cavity, and the person feels some pressure, congestion in the ears and an unexpressed hearing loss.

To diagnose serous otitis, a standard examination of the eardrum and listening to the patient’s complaints is most often sufficient. The danger of serous otitis is that it can transform into a more serious form of the disease and cause complications. This happens especially often when a person ignores hearing loss and discomfort in the ear for a long time, and when the disease develops in young children.

Depending on what caused the development of otitis media, appropriate treatment will be prescribed. If serous otitis does not go away within 3 months, then the patient is shown myringometry, that is, artificial creation of a hole in the eardrum through which the necessary medications are administered.

If serous otitis often recurs, then it is necessary to look for and eliminate the cause that causes it. Recently, cases of the development of serous otitis media against the background of severe allergic reactions have become more frequent.

Adhesive otitis media, like other types of this disease, is determined by the presence of inflammation in the middle ear cavity, however, the process is chronic and leads to the formation of adhesions and cords, which significantly reduces a person’s hearing.

Symptoms of this type of otitis are expressed in the fact that the patient complains of noise in the ear.

If the doctor suspects the person seeking help adhesive otitis media, then in addition to otoscopy, he is prescribed audiometry, impedance measurement and a study of the patency of the auditory tube.

In most cases, catarrhal or exudative otitis leads to the formation of adhesive otitis. Incorrect and irrational antibiotic therapy also often serves as a trigger mechanism for triggering the disease. The disease can be triggered by acute infectious processes in the body, as well as chronic, sluggish infections and a deviated nasal septum.

Therapy is primarily aimed at eliminating the cause of the disease. It is necessary to normalize nasal breathing as quickly as possible. A course of special blowing and pneumomassage of the membrane is used. Antihistamines are indicated, as well as the introduction of chymotrypsin, lidase, and hydrocortisone into the middle ear cavity. Often conservative treatment alone is not enough, and if the hearing loss continues to progress, surgical intervention is necessary. It is important to understand that formed scars do not tend to disappear. Therefore, the sooner a person seeks help from a doctor, the more optimistic the prognosis will be. full recovery.

Treatment of otitis media depends on what form of the disease the patient has. Therapy also depends on the stage of the inflammatory process and the presence of complications. As for acute otitis media, it is treated in most cases in an outpatient setting. If the disease causes complications, then hospitalization of the patient is indicated.

For elimination pain symptom Drops that have an anesthetic effect are instilled into the ears. This could be Otipax, Otinum, Anauran and others. Before carrying out the procedure, it is advisable to warm the medicine 2 degrees above the normal temperature of the human body. After instillation, you need to insert a cotton swab into the ear and remove it after a few hours. If the doctor has not carried out a preliminary examination and the risk of perforation of the membrane cannot be ruled out, then you can use a cotton swab dipped in a solution of boric acid.

Antihistamines, as well as vasoconstrictor nasal drops, help relieve swelling. Among them are Tizin, Otrivin, Nazivin and others.

In order to relieve inflammation, the patient is prescribed drugs such as Nurofen, Ibuprofen, Diclofenac. When the pain is not relieved by the above remedies, and the temperature continues to rise, bacterial infection It is better to stop with antibiotics.

When the disease is at the pre-perforation stage, a highly effective treatment method is Politzer blowing of the auditory tube. Therapy is supplemented by rinsing the ear with antibiotic solutions, which are combined with glucocorticosteroids. If the purulent contents do not decrease, and the eardrum continues to bulge, then artificial perforation is necessary. This is done in order to prevent the breakthrough of purulent masses into the cranial cavity.

When the disease has reached the perforated stage, the patient is shown toileting the ear and administering agents to reduce swelling and liquefy secretions, for example, ACC, Fluimucil and others.

Don't forget about physical therapy. Ultraviolet irradiation, laser therapy, and UHF are effective.

It is important to prevent the formation of adhesions and prevent hearing loss. To do this, you need to increase your immunity using vitamin therapy and taking biostimulants - Actovegin and Apilac.

If the disease requires the prescription of antibiotics, then it is worth understanding that they alone will not be enough. oral administration. Local administration of antibacterial agents is also necessary. Doctors recommend taking ampicillin, amoxicillin, azithromycin, ciprofloxacin and others orally. Netilmicin and cefazolin are used as injection solutions. Locally prescribed drugs are Tsipromed, Otofa, Normax, Fugentin and others.

You should not prescribe antibiotics yourself. They are prescribed only by the attending physician, since the illiterate use of these medications can not only help get rid of otitis media, but, on the contrary, aggravate the course of the disease.

Education: In 2009, he received a diploma in the specialty “General Medicine” in Petrozavodsk state university. After completing an internship in the Murmansk regional clinical hospital received a diploma in the specialty “Otorhinolaryngology” (2010)

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Post-traumatic otitis media is a pathological process that results from injury or bruise. Until the age of 3, almost 80% of children suffered from a similar disease. However, this disease can also occur in adults due to injuries at work or accidents in everyday life. According to statistics, traumatic otitis media is on par with sore throat, scarlet fever and influenza. Therefore, if unpleasant symptoms appear, you should immediately seek help from a doctor.

Post-traumatic otitis has different origins:

due to cleaning the ear with various objects;
blows to the ear;
contusions;
penetration of hot scale or shavings into the ear canal;
an attempt to remove a foreign body.

In combination with the usual picture of the inflammatory process, the disease has features that need to be taken into account during examination and therapy: it is combined with cranial and spinal injuries. In such a situation, diagnosis and treatment are determined by a neurologist and neurosurgeon. The presence of symptoms of a fracture of the base of the skull or spine indicates the need to fix the patient’s head and torso. Ear trauma in some cases is associated with rupture of the membrane, which leads to re-infection of the tympanic cavity and the formation of an acute form of otitis media. If the integrity of the membrane is not broken, the infection penetrates into the middle ear through the ear canal. Deterioration of tissue reactivity after injury may be a provoking factor for mastoiditis. An open wound of the mastoid process becomes infected in all cases, which is why the tympanic cavity is likely to become infected with the formation of an acute inflammatory process.

Trauma to the middle ear may result in damage to the auditory ossicles, fracture of the malleus, incus, or dislocation. Similar changes are observed with traumatic brain injuries. Damage can be detected using otoscopy and otomicroscopy, and if the integrity of the membrane is not compromised, using impedancemetry. But often the nature of the lesion is diagnosed during the process of tympanotomy and tympanoplasty.

Post-traumatic otitis media manifests itself in one form. An internal disease when inflammation occurs in the labyrinth of the ear canal. Formed as a consequence of trauma. With this disease, purulent contents appear due to bruises in the middle ear. In such a situation, infection occurs through a hole in the membrane. Traumatic otitis media can transform into a chronic form when untimely application to the doctor.

In the presence of the disease, inflammatory phenomena are observed in the mucosa and periosteum. Serous and purulent inflammatory fluid is released. The mucous membrane will thicken, ulcers and erosions will form. At the peak of the pathology, the tympanic cavity will be filled with inflammatory exudate and thickened mucous membrane. Since the drainage of the pipe will be disrupted, this will cause the membrane to bulge outward. If the patient is provided with inadequate care at this stage, part of the membrane will melt and the contents of the cavity will leak out (otorrhea).

Traumatic otitis media has characteristic symptoms. At the initial stage, intense pain occurs inside the ear. They can be unbearable, and therefore become a provoking factor for insomnia and loss of appetite. Radiates to the temple. Temperature indicators rise to 38-39 degrees, chills and poisoning occur. The symptoms felt by the patient during the pathological process are formed in the following sequence:

Increasing discomfort in the ear.
Congestion.
Initially, the pain is short-lived, then sharp.
Intense itching, irritation.

Post-traumatic symptoms manifest themselves in the formation of purulent otitis media. The pathology is characterized by:

When a patient has respiratory pathology and pathogenic microflora in the nasopharynx, the risk of viral agents being thrown into the ear canal increases. This is fraught with the appearance of traumatic otitis media. Over time, symptoms increase and change. Taking into account the course of the disease, it takes the following form:

Intense pain.
Hyperthermia.
Pressure inside the ear.
Purulent discharge.
Significant hearing loss.

Based on the patient's complaints, the specialist suggests inflammation in the middle ear. Tuning fork diagnostics are carried out. It makes it possible to determine the quality of hearing. In some cases, the doctor sends the patient for testing general analyzes, bacterioscopic examination. Then he prescribes therapy. Main methods of treatment:

Often used during the treatment of traumatic otitis media. Most patients use them without prior consultation with a specialist, which can cause harm to health. They contain anti-inflammatory and anesthetic substances. They are used only when the membrane is intact, since their penetration through the hole into the cavity negatively affects the patient’s hearing. To accurately insert the drops, you need to pull the ear up and back with the hand opposite the injured ear. This method will help to align the passage and the product will be able to get into the source of inflammation. After instillation, you should close your ear with cotton wool moistened with Vaseline. Most of the drops eliminate discomfort and help restore appetite. The most effective are:

They are not used for all forms of acute otitis media, but therapy with this group of drugs reduces the likelihood of adverse consequences. If missing danger signs poisoning (gag reflex, intense pain in the head), the use of an antimicrobial drug can be postponed for 2-3 days. Antimicrobial drugs are prescribed directly by the doctor, since some of the drugs may not be suitable. If there is no effect, after 3 days the product should be replaced with another. The most effective antimicrobials:

The use of compresses makes it possible to prevent the release of pus. Must be carried out carefully. It is necessary to agree in advance with your doctor regarding possible contraindications and side effects.

Rinsing the ear canal to remove purulent contents. Held in inpatient conditions under the supervision of a doctor. To avoid penetration of pus into the brain and subsequent infection, it is necessary to carry out such manipulations. Contributes to a significant improvement in general condition. The procedure uses solutions of antibacterial agents in combination with glucocorticosteroids.

Use of vasoconstrictor nasal drops. Helps eliminate swelling in the nasopharynx. Use must be carried out with the permission of a physician, taking into account individual characteristics the patient's body. The most common means:

Turundas, which are soaked in boric alcohol. They help remove purulent contents in the shortest possible time and restore the wound.

This is done to prevent purulent contents from penetrating into the brain. It is carried out in a hospital setting by a qualified specialist.

With proper therapy, otitis media goes away without leaving any complications. However, they cause several types of consequences. Infection can spread to the inner ear and cause labyrinthitis. In addition, the disease provokes persistent or transient hearing impairment or permanent deafness. This effect occurs not only in a situation of damage to the nerve receptors that are located in the inner ear, but also when the auditory ossicles located in the ear cavity are damaged.

Perforation of the membrane also leads to hearing loss. Although the membrane can become overgrown, the sensitivity of the ear will be permanently impaired. Traumatic otitis media can provoke mastoiditis, an inflammatory process of the mastoid process of the temporal bone, which is adjacent to the ear on the back side.

Mastoiditis is associated with acute pain in the parotid space. It is fraught with such consequences as the opening of purulent contents into the brain with the formation of meningitis or into the area cervical region.

If therapy is not started in a timely manner, purulent otitis media and membrane rupture quickly appear. In some cases, purulent meningoencephalitis leads to death. To prevent the occurrence of hearing loss, it is necessary to contact a specialist at the initial symptoms.

Any disease, including traumatic otitis media, is easier to prevent than to treat later. Therefore, it is necessary to carefully monitor the condition of the ENT organs and exclude all kinds of injuries. It is necessary to adhere to the following preventive measures for post-traumatic otitis:

Careful handling of sharp, cutting objects at home. If this is a child, avoid contact with objects that could cause injury to the ENT organs.
Implementation of hygiene measures (exclusion of contact with infected acute respiratory infections, hypothermia, etc.).
Compliance with occupational safety regulations at work. This will make it possible to eliminate injuries and avoid accidents.
Preventing foreign objects from entering the ear canal that could damage its anatomical integrity.
Therapy of chronic pathologies.
Elimination of self-removal of foreign bodies from the ear cavity.

By following these simple instructions, it is possible to prevent the occurrence of unpleasant symptoms.

Post-traumatic otitis media is an acute inflammatory process in various parts of the tympanic cavity, which is caused by trauma. In such a case, it is necessary to immediately contact a specialist, since untimely or inappropriate therapy may lead to irreversible consequences. The prognosis will depend on the severity of the injury and the timing of seeking help.

Post-traumatic otitis - what the disease represents is shown in the video.