Reasons | Symptoms of Chronic Suppurative Otitis Media | Diagnostics | Treatment of Chronic Suppurative Otitis Media | Prevention of chronic suppurative inflammation in the middle ear
Disease of the middle ear, in which a sluggish inflammatory process is detected in conjunction with periodic suppuration from the outer ear, is called chronic suppurative otitis media (CHOS). In this case, damage to the tympanic membrane, a violation of the transmission of a sound wave through the auditory ossicles, and progressive hearing loss are noted.
You can diagnose and treat chronic suppurative otitis media in the Department of Otorhinolaryngology K + 31.
The middle ear is a complex anatomical structure, consisting of three parts: the tympanic cavity, the auditory (Eustachian) tube and the airway bone cells of the mastoid process of the skull. The tympanic cavity is located just behind the eardrum and contains a chain of tiny ossicles that amplify and conduct sound towards the inner ear.
The auditory tube is the link between the nasopharyngeal cavity and the tympanic cavity, which is necessary to create the same air pressure on both sides of the eardrum. At the same time, in the presence of chronic purulent inflammation in the tympanic cavity, there is an outflow of pathological contents from the middle ear through the Eustachian tube into the nasopharyngeal cavity. This phenomenon has important diagnostic value.
The cells of the mastoid process also communicate with the tympanic cavity. When filling them with pus, there are pronounced pain behind the ear, redness of the skin, headaches.
Causes
The most common causative agents of otitis media are staphylococci, streptococci, haemophilus influenzae; other bacteria, as well as viruses and fungi, are somewhat less common.
The emergence of CHSO occurs, as a rule, after insufficient therapy for acute otitis media of any localization . In most cases, this is facilitated by an injury or rupture of the tympanic membrane, which leads to a massive drift of infection from the outer ear. Chronization of the inflammatory process is often observed in immunodeficiency states, in the presence of pathology of the nasal mucosa, paranasal sinuses and nasopharynx, in the case of long-term treatment that suppresses immunity (large doses of glucocorticosteroids, antiallergic, cytostatic therapy).
Symptoms of chronic suppurative otitis media
Mesotympanitis and epitympanitis are the two main types of HGSO. They are distinguished by external manifestations, they are also accompanied by complications of varying severity.
In the case of mesotympanitis , the structures of the auditory tube and the middle ear cavity are involved in the inflammatory process. The bone tissue remains intact. Mesotympanitis is characterized by the presence of perforation in the stretched part of the tympanic membrane, periodic or constant discharge of mucopurulent masses from the external auditory canal, hearing impairment, and the presence of extraneous noises of varying intensity in the ears. Pain, as a rule, is not pronounced and has a local character. The general condition practically does not suffer (low-grade fever, weakness).
Epitympanitis is characterized by the presence of a small, often subtle perforation in the unstressed part of the membrane, the spread of inflammation to the cells of the mastoid process, as well as to the bony frame of the middle ear. The main difference from mesotympanitis is the growth of cholesteatoma and the localization of perforation. This is what indicates the destruction of bone tissue under the influence of an aggressive inflammatory process. Epitympanitis is accompanied by severe pain in the ear, general symptoms in the form of headache, weakness, fever. Also characterized by an increase in the lymph nodes of the neck, redness of the skin behind the ear, tinnitus, hearing loss.
Diagnostics
Diagnosis of HCVO begins with the collection of anamnesis. The doctor should ask, and the patient should tell about the infectious diseases of the ear or other localizations suffered in the near future, the tendency to such a pathology, about the time and circumstances that led to the onset of symptoms of this disease.
After examining the patient's complaints, an otoscopy is performed - an examination of the tympanic membrane . It defines a defect (in the central or marginal part), redness and thickening. With large defects, you can consider the tympanic cavity itself, where there is an edematous, full-blooded mucous membrane, pus, damage to bone tissue (with epitympanitis). For a more detailed examination, microscopic and endoscopic techniques are used.
Bone-destructive changes are better visualized using computed tomography.
We keep the health of patients in focus and evaluate the functions of the inner ear without fail: we perform audiometry, tuning fork and vestibular tests.
Treatment of ronic purulent otitis media
Treatment of chronic suppurative otitis media begins with conservative therapy . The main goal of this stage is to completely suppress the inflammatory process in the tympanic cavity, for which regular washing of the tympanic cavity by an otorhinolaryngologist, antibacterial ear drops, and anti-inflammatory therapy are prescribed.
After elimination of the inflammation, a surgical intervention is planned, aimed at plastic surgery of the tympanic membrane.
Prevention of chronic suppurative inflammation in the middle ear
Otorhinolaryngologists of the K + 31 Clinic recommend promptly seeking medical help from specialists when the first signs of otitis media appear. In this case, correct and complete treatment allows you to maintain health for you and is the best method for preventing HCV.
