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Average otitis is an inflammatory process which develops on average to fish soup. A middle ear is called the small space which is located between an inner ear and a tympanic membrane. As a rule, pain arises in an ear at the person owing to development of average otitis or outside otitis (that is, inflammations of an outside ear). But specialists advise at emergence of pain in an ear nevertheless to address specialists and to pass inspection as can provoke such pain also other, more serious diseases, and also development of tumors in different departments of an acoustic organ.
Otitis mainly develops at children preschool children. Average otitis at children is shown more often because a structure of a middle ear at the child contribute to development of infectious process. According to medical statistics, about 90% of preschool children by seven years already had average otitis. It is extremely important to treat average otitis correctly that as a result at the child more serious complications did not develop.
Reasons of average otitis
In most cases average otitis develops in combination with viral respiratory diseases. Development of an infection in a nasal cavity can take after a while acoustical pipes as their openings open on a back wall of a nasopharynx in a nose. The inflammation provokes edematization in a gleam of acoustical pipes that, in turn, becomes a cause of infringement in them the leveling pressure. Thereof the person constantly feels a certain congestion in ears.
The infection can appear in a drum cavity, having got in other ways there: owing to an injury, and also a meningogenny way, extending in a middle ear through all system of an ear labyrinth. Most less often the infection gets into a middle ear in the hematogenous way, that is through blood.
Types of average otitis
Different degrees of manifestation of average otitis are allocated. At acute average otitis inflammatory process develops owing to impact on an organism of a viral infection. In most cases at the person the upper respiratory tract infection is in parallel observed. At this condition of the patient constantly feels a certain discomfort in an ear and its congestion.
If bacteria get into a middle ear which at a normality is always sterile, then gradually in it pus which presses on walls of a middle ear begins to collect. In this case it is already about purulent (bacterial) average otitis. Very often viral average otitis gradually passes into a purulent form. The last is most often observed at children. It is important to differentiate these states as at bacterial otitis treatment of this illness assumes reception of antibiotics. At the same time at a virus form of otitis antibiotics will not give to the patient relief. Therapy by antibiotics at purulent bacterial otitis is important for the prevention of emergence of various complications. In the absence of adequate therapy pus through a tympanic membrane can get to outside acoustical pass of the patient and provoke development of a purulent mastoiditis. One more very dangerous disease which can develop as an effect of the wrong treatment of purulent otitis is otogenic meningitis at which there is a development of inflammatory process of a cover of a brain.
One more type of otitis — exudative average otitis is allocated. This form of a disease is serous or sector average otitis. The disease is shown as an effect of obstruction of a gleam of an acoustical pipe and the subsequent pressure decline in a drum cavity. The viral infection or a bacterial infection is the reason of development of this form of an illness.
In certain cases in a drum cavity liquid and thereof the conductive type of relative deafness develops collects. Throughout some time (there pass several weeks or months) density of liquid on average to fish soup increases, therefore, the conductive type of relative deafness is aggravated. At such state the patient needs to perform special operation — a myringotomy at which are made a section of a tympanic membrane and the small tubule is entered into a middle ear.
If at the patient chronic purulent otitis develops, then in a tympanic membrane there is an opening, and there is an active infectious process. It proceeds several weeks. Throughout all this time at the patient the otorrhea – emergence of purulent discharges from an ear takes place. Not enough pus is in certain cases emitted, respectively, it can be considered only under a microscope. At this form of a disease the hearing at the patient strongly worsens.
Symptoms of average otitis
Average otitis at the patient develops gradually, at the same time different symptoms are observed. Initially at the patient acute catarral otitis at which the symptoms arising as an effect of accumulation of liquid in a tympanic cavity gradually accrue develops.
The subsequent symptoms of otitis of a middle ear are caused by emergence and accumulation of pus in a tympanic cavity. After that the tympanic membrane is broken off and there is a pus effluence.
At a recovery stage of a disease there is a gradual reduction of an inflammation, suppuration stops, there is an union of edges of a tympanic membrane.
At the first stage of an illness of people the feeling of a congestion and strong noise generally complains of severe pain in an ear. Pain in an ear can be very different, but generally pain is felt in the depth of an ear. It can be pricking, pulsing, drilling, periodically shooting. Pain brings to the patient very strong tortures, completely depriving of him rest. As a rule, pain becomes intensive at night. Respectively, to sleep the person having acute otitis practically cannot. Pain can give to the head, teeth, it becomes stronger when swallowing or when the person sneezes or coughs. At otitis at the patient owing to inflammatory process the hearing considerably decreases. Besides, the general weakness is observed, appetite disappears, and body temperature sometimes increases up to 39 degrees.
Examining the patient, the doctor pays attention to puffiness and reddening of a tympanic membrane. Morbidity in the course of palpation of area of a mastoid is possible.
The second stage of an illness of which the current of pus and a rupture of a tympanic membrane and suppuration is characteristic begins approximately for the third day after an onset of the illness. At this time the person notes that pain becomes much less intensive, the general state improves, indicators of body temperature come to norm. If at this time there is no perforation of a tympanic membrane, then the doctor makes a small puncture for its opening. At timely work of such puncture which is called a paracentesis the person recovers quicker, at the same time there is a recovery of hearing and complications of an illness are not noted.
If otitis of a middle ear proceeds normally, then recovery at which subsiding of an inflammation and obsolescence of a rupture of a tympanic membrane is noted follows after that. As a rule, the disease completely recovers approximately in two-three weeks. By this time at the person the hearing completely returns to normal.
Complications of average otitis
If treatment of average otitis is not made in general or the wrong therapy is appointed, the disease can lead to manifestation of a purulent form of otitis in several days. In turn, the rupture of a tympanic membrane, the pathological process affecting an acoustical nerve happens an effect of purulent otitis often. As a result, there is a noticeable hearing impairment. It is necessary to distinguish a mastoiditis from the most serious complications of average otitis. At this disease there is an inflammatory process in a mucous membrane of cells of a mastoid. At development of such complication the patient needs to carry out an urgent operative measure. If the pus which collected in the course of progressing of otitis gets into a head cavity, then such state is life-threatening the person. At a disease of purulent meningoentsefalita the high level of a lethality is noted. Therefore, for the prevention of the complications described above it is necessary to treat carefully otitis, being guided by appointments of the specialist. If the campaign to therapy is wrong, then the similar situation is fraught with transition of otitis to a chronic form. Chronic otitis is much more difficult to treat, at the same time the patient as a result can lose hearing. If the patient wishes to cure completely chronic otitis, he most often needs to perform a difficult surgery.
Besides, the labyrinthitis, brain abscess, sepsis can become complications of otitis of a middle ear.
Diagnosis of average otitis
If suspicions on development of a disease of an ear take place, it is necessary to visit at once the doctor of LOR-specialization or to call the doctor on the house if the concern is shown by the small child and at the same time he complains of ear pain.
Initially the doctor finds out what general symptoms are shown at the person. After that the specialist examines, an otoskopiya and a palpation. In the course of survey he surely notes existence or lack of some characteristics (existence of paresis of a facial nerve, temperature and a condition of area of a mastoid, a cutaneous dropsy over it, a condition of lymph nodes which are located near ears, etc.).
Carrying out an otoskopiya at children babies and newborns becomes complicated the fact that outside acoustical pass very narrow, and the tympanic membrane has almost horizontal position. Therefore, the doctor surely considers these and other features at survey and can estimate a condition only of upper parts of a tympanic membrane of the child.
Whenever possible in the course of establishment of the diagnosis research of acoustical function of the patient is also conducted. It is also important to define mobility of a tympanic membrane surely.
To the patient for establishment of the diagnosis blood test is carried out: at otitis the raised SOE, a leukocytosis with shift takes place to the left. Carrying out X-ray inspection is appointed only if at the patient manifestation of complications is suspected.
The most indicative in the course of establishment of the diagnosis release of pus at a rupture of a tympanic membrane is considered. Sometimes for release of pus carry out a special puncture. But in the absence of pus development of otitis cannot also be excluded as it is quite possible that he did not manage to appear yet.
Treatment of average otitis
Acute otitis of a middle ear of a virus origin is treated about one week, at a disease of purulent otitis the illness recovers approximately for two weeks. If acute otitis of a middle ear is diagnosed for the patient, then to it appoint conservative therapy. It is very important to define what otitis – purulent or virus – takes place as prescription of antibiotics is made only at development of purulent average otitis. In that case the course of reception of antibiotics proceeds about one week.
If acute catarral otitis is diagnosed for the patient, then after consultation with the doctor sometimes for two days of a course of a disease waiting tactics is applied. It is important to watch a condition of the sick child or adult. If necessary to the patient reception of medicines with febrifugal properties is appointed. Besides, when progressing acute otitis to the patient surely appoint local drugs. These are drops in a nose with vasoconstrictive influence which promote improvement of passability of an acoustical pipe.
At catarral otitis the quite good effect is shown after carrying out dry thermal procedures in an ear. They allow to make more active the address of a lymph and blood in the place where the inflammation develops, stimulate a producing protective blood cells. For this purpose use warming up by a blue lamp, compresses from vodka, turundas with ear drops.
If at the patient purulent otitis developed, then the special attention should be paid to clarification from pus by means of wadded turundas. This procedure needs to be made during an illness regularly. For improvement of effect it is possible to wash out an ear disinfecting solutions. 3% solution of peroxide of hydrogen is suitable for this purpose, for example. Except the described treatment methods often at otitis the doctor appoints a course of physioprocedures with thermal influence. It can be UVCh-therapy, ultra-violet radiation, treatment dirt or therapy, it is carried out with use of the laser.
To prepare a compress from vodka or the diluted alcohol, it is necessary to prepare the gauze napkin put four times. It has to cover completely a sink of an ear and have still a stock, going beyond an ear approximately on 2 cm. The napkin in the middle is cut, doing the special place for an ear. After that the napkin is moistened in vodka or divorced alcohol. After the ear will be implanted into a cut, it is necessary to impose the wax paper which is completely covering a compress. From above it is reasonable to put a big piece of a vyta. Hold such compress for several hours.
Use of drops for ears is possible only after appointment of the doctor as it is important to define features of inflammatory process. Hit of drops in a middle ear at a rupture of a tympanic membrane is fraught with injury of an acoustical nerve or acoustical stones. As a result at the patient relative deafness can develop. The most sparing method is the instillation of drops a turunda which is done of dry cotton wool. It is very accurately placed in acoustical pass outside, the field of what on it drip the medicine which is in advance warmed up to normal body temperature. It is the simplest to warm up a pipette with medicine in hot water.
That it was easier for child to have average otitis, it is important to provide it an opportunity to breathe freely a nose. The child needs to clean the nasal courses periodically. For this purpose it is possible to use Q-tips, a little sochenny in vegetable oil. Ears at the sick person always have to stay in heat therefore it is important to watch that the child wore a cap even in warm time. Sometimes at the complicated otitises to the patient surgical treatment is carried out.
Prevention of average otitis
Development of average otitis becomes especially frequent an effect of usual cold. Therefore any display of a catarrhal disease it is necessary to treat correctly. To prevent transition of otitis to a purulent form, it is important to treat quickly all diseases which are connected with purulent processes — antritis, cold. Sometimes for the prevention of aggravation of process there is a need to delete adenoides which expand in a drink. It is necessary to teach the child to blow nose correctly, in turn closing nostrils. However, it is the most important to address at once in the presence of certain symptoms the specialist.
Section: Diseases of an ear throat-nose