How does otitis media ?The main symptoms , causes, diagnosis , treatment selection for acute otitis of the middle ear
Health / / August 12, 2017
Otitis media is a dangerous disease.
Besides severe pain, fever, hearing loss can develop serious complications.
tympanum is associated with the brain and its membranes, as the untimely or incorrect treatment can lead to encephalitis, meningitis, facial nerve lesion.
Otitis media is often found in childhood.
According to studies, almost 90% of children under the age of 2 years have suffered this disease.This pattern is easily explained.Blame has anatomical structure.The child auditory tube that connects the tympanic cavity and nasopharynx, wide and short, horizontal.Because the mucus, bacteria can easily get into the middle ear.
After the common cold, tonsillitis, sinusitis may experience symptoms of otitis.Local factors of immune protection is not fully formed, because the minimum number of microbes in a child causes inflammation.
Otitis media: the spread
infection Infection with otitis of the middle ear can get into the tympanic cavity in several ways:
• Tubogennym .The Eustachian tube opens into the nasopharynx, all the inflammatory processes that occur in the oral cavity, pharynx, larynx, sinuses, can cause otitis media.About 85% of infections is just such a pathway.
• Hematogenic .The middle ear is well supplied with blood, with blood flow often entered viruses, bacteria, such as influenza, rubella, scarlet fever.
• Through eardrum .When traumatic injury of all pathogens freely get into the middle ear, causing inflammation.
• retrograde path very rare.This term means that the infection with the cavity of the skull, brain, membranes down to the tympanic cavity.
reasons otitis media
directly etiological cause of the disease has microorganisms:
• Among the bacteria causing otitis pneumococcus (Streptococcus pneumoniae), Haemophilus influenzae (Haemophilus influenzae), Moraxella (Moraxella catarrhalis).In 95% of these bacteria are seeded in laboratory diagnosis.Very rarely have pyogenic pathogens Streptococcus, Staphylococcus aureus, mycoplasma, chlamydia.
• In 10% of cases the cause is, influenza viruses, parainfluenza, adenovirus, respiratory syncytial virus.
also provoking factors include:
• Allergic diseases.After contact with an allergen into the body occurs mucosal edema, narrowing the lumen of the Eustachian tube, the contents of the tympanic cavity is not displayed fully, due to stagnation of developing otitis media.For bronchial asthma, urticaria, food allergies require special attention.
• Sore throat, pharyngitis, laryngitis, dental disease, oral cavity, nasal sinuses, frequent runny nose increase the risk of inflammation.
• diseases that are accompanied by a decrease in immunity, adversely affect the middle ear protection factors.Because diabetes, kidney diseases, liver, virus infections, colds otitis media occurs more frequently.
• As a result of coughing, sneezing, blowing your nose increases the pressure in the nasopharynx, which is accompanied by reflux of infected mucus in the tube.
Development Mechanism In a healthy person in the tympanum is a small amount of mucus that flows seamlessly into the nasopharynx.
After contact with opportunistic germs, they do not cause changes, because the local immune cells destroy bacteria.If there is one with the above factors, the normal drainage of the middle ear is stopped.Pipe ceases swelling, lumen narrows or even closes.In the tympanic cavity accumulates fluid, after a while begin to multiply bacteria.The amount of mucus increases, it puts pressure on the membrane, causing soreness, pulsation.
process can turn into a festering.Then there is a breakthrough, and all the contents out through the dormer opening.
Otitis media.How to recognize the disease?
Most adults complain of pain in the ear.But as a suspect otitis a child under one year , when he can not speak and does not tell you where it hurts?It is necessary to pay attention to additional displays.
• Painful sensations are of different nature.Some people will celebrate a dull ache, others - urgent, pressing, throbbing.All depends on the stage of the process, the structure features.Amplifies it by night, in the morning.
• In acute otitis of the middle ear a little child restless, not sleeping, handles stretches to the ear.If you try to touch the painful area, he starts to cry, in every way prevents your efforts.
• On the affected side decreased hearing, an adult can own this notice.Mom grudnichka should pay attention if he hears the same on both sides.For this should call the child to his first right, then left.Perhaps, in some case, the baby will be a belated reaction, or it does not respond.
• Increased body temperature - a characteristic feature of otitis media.
• Draws attention intoxication syndrome: headache, weakness, loss of appetite, constant fatigue.The child is shown a waiver of the chest, the reluctance to play, lethargy, excessive sleepiness.
• In infants can be vomiting, diarrhea.
• A break of the eardrum to the ear follows pus.This is an important symptom suggesting acute otitis media.
Otitis media.Methods of diagnosis
clinically difficult to diagnose as similar symptoms occur in other diseases.Contact with foreign body in the ear canal is accompanied by pain, hearing loss, but body temperature within normal limits.When bathing the ear can lay as there is water.Hearing loss is the main symptom, pain, anxiety, intoxication syndrome absent.
After collecting complaints, general evaluation of the doctor conducting the following manipulations:
• Otoscopy.With the help of a special device the doctor examines the eardrum.There are indications, based on which, you can make a diagnosis of otitis media.If the disease is mild, there is a slight retraction of the membrane and redness.In severe redness, smoothing its edges, through the membrane itself visible liquid level, which has an arc shape.Sometimes you can determine the color of the exudate.
• But not always unambiguous data otoscopy to confirm otitis media using tympanometry - definition of mobility of the tympanic membrane.When the inflammatory process is stressful, inactive.
• If there are marked hearing loss, audiometry carried out.
• severe general condition, high temperature can touch up the doctor on the possibility of complications.In this case, computer or magnetic resonance imaging can help rule out encephalitis, meningitis.
• Very rarely spend a puncture of the tympanic cavity to obtain exudate for research, determining the causative agent, the sensitivity to antibiotics.This is a serious procedure, it is indicated for severe, treatment failure, children with immunodeficiency.
Common complications of otitis media
Untimely treatment in hospital can lead to complications.Most of them are dangerous to health, because when the first symptoms of otitis need to consult a doctor.
• The tympanic cavity pus accumulates, thinner membrane will melt, eventually going on her break.In this case the symptoms are reduced, there is a positive dynamics of the general condition.
• The gap is accompanied by a temporary hearing loss.Fortunately, the defect heals quickly, the recovery process takes a few days to a week.
• In the propagation of inflammation in the brain there are serious diseases: brain abscess, meningitis, encephalitis.
Otitis media.Features of treatment
Patients with uncomplicated treated at home, admission to hospital is indicated for severe, suspected meningitis, encephalitis.
Treatment of acute otitis media can be:
medikamentozno , which includes:
• Fever-reducing agent.
• vasoconstrictor drugs into the nose.
• Treatment of comorbidity.
Surgical , which implies:
Antibiotics .Drugs in this group are assigned when severe forms of otitis media.In less severe possible expectant management.First, the patient is using antipyretics, analgesics, if after 2 days no improvement, or vice versa, ceases worse, antibiotics are used.
In some cases, they are administered at once, without waiting for a few days.These situations include:
• Child first two years should take antibiotics.
• Pain syndrome, intoxication, temperature greatly worsen the condition.
• Both ears are involved in the pathological process.
drugs of choice have protected penicillins (Amoxiclav, Augmentin), and cephalosporins.The method of application may be different.Adults appoint tablets, syrups for children is recommended.To achieve high efficiency, quick recovery, use the injectable form.
If the patient has an allergy to penicillin series tsefalopsoriny, or they are not effective, the doctor come to the aid of macrolides (clarithromycin, azithromycin), levofloxacin.After applying the drug side effects may occur: diarrhea, nausea, headache, allergic vysypka.
Antipyretic .These funds are still there and painkillers.Currently, treatment of otitis media recommended two groups of drugs: paracetamol and ibuprofen.They allowed the children.
vasoconstrictive .This is not the main direction in the treatment of otitis media.Often, chronic rhinitis provokes an inflammatory reaction in the ear.After treatment of rhinitis risk of disease is reduced significantly.
Particular attention should be paid to chronic infection foci.Tonsillitis, pharyngitis, sinusitis is the cause of otitis media. Early treatment of this pathology has a positive effect on the course of the disease.
myringotomy .This surgery is necessary in severe condition of the patient, with the ineffectiveness of conservative therapy, to relieve symptoms.After anesthesia in the eardrum incision, through which flows pus.As a result, pain, intoxication subsides.Also, the liquid is taken for further study, the definition of agent, antibiotic susceptibility.
auripuncture performed both for diagnosis and treatment.After infiltration anesthesia using a special needle into the low back box of the eardrum is punctured.Through this opening, the contents are pumped with suction.