Causes
Symptoms of adhesive (adhesive) otitis media
Diagnostics
Treatment of adhesive (adhesive) otitis media
Prevention of adhesive (adhesive) otitis media
In a healthy person, the tympanic cavity is lined with a mucous membrane, and inside this cavity there are three auditory ossicles: the malleus, the incus and the stapes. Mobility between them is a prerequisite for the normal conduction of sound waves and the implementation of the function of hearing. In ensuring the ideal mobility of the auditory ossicles, an important role is played by the fluid produced by the mucous membrane of the tympanic cavity and the micro-joints located between the malleus, incus and stapes.
You can diagnose and treat adhesive otitis media in the Department of Otorhinolaryngology K + 31.
In the case of the development of adhesive otitis media, the volume of secreted fluid decreases sharply. Instead, a layer of fibrin is deposited on the walls of the tympanic cavity, the inner side of the tympanic membrane and the auditory ossicles, which over time turns into fibrous scar tissue. Such changes lead to the formation of adhesions and adhesions on the mucous membranes, a decrease in the drainage function of the auditory tube and a limitation of the mobility of the auditory ossicle chain, which inevitably leads to a deterioration in hearing or its complete loss.
Causes
An adhesive process in the middle ear develops, as a rule, after a postponed and poorly treated acute or chronic otitis media , which is accompanied by edema of the mucous membrane of the tympanic cavity and the accumulation of fluid in it, different in volume and composition. However, in all cases, the exudate is inflammatory and includes a large amount of fibrin.
In the process of resolving the inflammatory reaction, the liquid is partly absorbed back, partly leaves the tympanic cavity through the auditory tube, and partly is evacuated during the provision of medical care. In the presence of a large amount of exudate, the first two mechanisms do not work effectively enough, therefore, the lack of timely treatment leads to the deposition of insoluble fibrin on the walls of the tympanic cavity and other structures of the middle ear. The process of converting fibrin into fibrous-scar tissue does not occur simultaneously and takes up to several years.
Symptoms of adhesive (adhesive) otitis media
Adhesive otitis media does not have a pronounced clinical picture of inflammation, so the patient rarely complains of pain in the ear, any discharge from the external auditory canal, or deterioration of the general condition.
The main manifestation of adhesive otitis media is progressive hearing loss, impaired perception of sounds of a certain wavelength, and the appearance of tinnitus. These symptoms bother a person constantly, and the tinnitus becomes so intolerable that it makes them seek medical help.
Diagnostics
In the diagnosis of adhesive otitis media, it is very important to clarify the previously transferred acute or chronic forms of otitis media. If possible, a thorough study of the patient's medical records (analyzes, diagnostic and treatment protocols). If this is not possible, then a detailed questioning is carried out.
The next stage of diagnosis is otoscopy . When examining the tympanic membrane, its retraction, cicatricial changes, and deformation are determined. The preservation of the mobility of the tympanic membrane can be judged by the results of tympanometry, as well as the Valsalva test and Siegle's funnel. With a pronounced adhesive process, the membrane remains motionless.
Tympanometry examines the function of the joints between the ossicles. In the case of adhesive otitis media, ankylosis is noted in these joints - a lack of mobility. Such changes in the structures of the middle ear are the main cause of hearing loss.
The degree of hearing impairment is measured using auditory tests: test with a tuning fork, audiometry.
The presence of an adhesive process in the tympanic cavity and, especially, at the inner opening of the auditory tube can be determined after blowing the latter. The absence of air entering the tympanic cavity indicates a complete fusion of the auditory tube.
To reveal the degree of adhesions and the severity of adhesive otitis media allows CT or MRI of the temporal bone . These studies allow visualizing the most inaccessible structures of the middle ear for a simple examination.
Treatment of adhesive (adhesive) otitis media
We keep the health of our patients in focus and prescribe comprehensive treatment for adhesive otitis media. This is a very difficult, painstaking and lengthy process that includes:
- Regular blowing of the auditory tube in order to restore its patency;
- Pneumatic massage of the tympanic membrane;
- Introduction of proteolytic enzyme preparations into the tympanic cavity;
- Intravenous use of biostimulants, vitamin therapy, physiotherapy;
- With persistent tinnitus, sedatives and psychotherapy are prescribed to protect the nervous system from exhaustion;
The lack of effect of conservative treatment is an indication for surgical intervention in the volume of plastic surgery of the tympanic membrane and auditory ossicles.
Prevention of adhesive (adhesive) otitis media
The most important principle of prevention of an adhesive process in the middle ear is timely treatment of acute and chronic forms of otitis media. In order to maintain health for you, we recommend that you exclude any attempts to self-medicate, and if symptoms of inflammation in the ear appear, seek medical help from an ENT doctor.
