Chronic tubo-otitis is an inflammation of the auditory canals, which entails disorders of the ventilation and drainage functions. This pathology develops rather slowly. With its progression, an inflammatory process of the mucous membrane of the tympanic cavity is observed, which is explained by the ingress of exudate into the middle ear zone. The code of chronic tubo-otitis according to ICD-10 is N 66.2.
Causes of the disease
The main condition for the formation of chronic tubootitis is inflammation in the nose and nasopharynx. They provoke a violation of the normal activity of the auditory tubes, performing a drainage and ventilation function.
In addition, several more conditions for the development of chronic tubootitis should be highlighted:
- scarring;
- polyps in the nasal cavity;
- adenoids;
- shell hypertrophy;
- tumors.
With such pathologies, the deformation of the tympanic membrane occurs, which takes an abnormally elongated shape against the background of a decrease in pressure inside the cavity. In addition, transudate formation is observed in the middle ear region, which consists of inflammatory cells. It is this substance that involves the tympanic cavity in the pathological process. Doctors call this disease exudative otitis media. Gradually, this pathology goes into a severe stage and entails the emergence of chronic tubootitis.
Pathogenesis
Perhaps there are other reasons for the development of this disease, but they are still not fully understood. However, it is reliably known that tubootitis is provoked by viruses and hypovirulent microorganisms. It is extremely important to consider the predisposition of the mucous membranes to allergic manifestations and inflammatory processes at the genetic level.
All the described conditions can arise in various combinations, which, in turn, determine the course of the pathology.
Symptoms of chronic tubo-otitis
The main sign of the disease is considered dysfunction of the auditory canal.
In addition, the symptoms of this pathology should include:
- hearing impairment;
- scarring;
- thinning of the eardrum;
- the formation of calcareous plaques;
- cords;
- compaction of the mucous membrane;
- stiffness of the auditory ossicles;
- salt deposition in the tympanic membrane;
- narrowing of the mucous membrane.
The main difference between acute and chronic tubootitis is the nature of the course and symptoms. So, in the first form, the patient complains of other signs: tinnitus, a sensation of the presence of a foreign body, decreased hearing acuity, impaired perception.
Varieties
Among other things, the course of the disease can be divided into several stages. Each of them has a certain histological picture and characteristic of the state of the mucous membrane.
The first stage is characterized by the formation of transudate in the region of the tympanic membrane with slight dissemination of mucus. In addition, there is an increase in integumentary epithelium. In this case, the number of mucous glands increases significantly.
At the second stage, the clinical picture changes slightly and looks as follows: most of the mucous membranes in the tympanic cavity produce specific mucus. In relation to other products at the cellular level, the formation of the so-called sticky ear occurs.
The third stage of chronic tubootitis (according to ICD-10 - H 66.2) is characterized by a decrease in the amount of exudate, but the mucus that has already accumulated by that time acquires a higher viscosity. Against the background of this phenomenon, the adhesion process begins. It is he who becomes the prerequisite for the closure of the tympanic cavity.
Against the background of thinning of the membrane, its strong stretching occurs. As a result, it becomes even thinner, more flabby and almost imperceptible, atrophy gradually develops. To return the membrane into the lumen of the auditory canal at this stage is possible only by blowing.
With a prolonged violation of patency, an adhesive process forms in the tympanic cavity.
Etiology
It is worth saying that many patients suffering from a chronic form of tubo-otitis almost do not experience pain. Often, they only complain of discomfort, a feeling of congestion, noise and fluid flow inside the ear. Video microscopy and otoscopy demonstrate a cloudy hue of the membrane and its abnormally inverted shape.
As a rule, such examinations make it possible to detect calcareous plaques that are visible through the epidermal layers. In addition, conductive hearing loss is observed. This is due to obstruction of the auditory canals. It is noteworthy that for all the problems described, the patient does not form disorders in the functioning of the vestibular apparatus.
Diagnostics
Chronic tubo-otitis is characterized by many specific symptoms that can be detected by otoscopy:
- elongated eardrum;
- lack of a cone of light;
- accumulation of exudate behind a translucent stretched membrane.
Accumulated liquid may include air bubbles, and its hue ranges from yellowish to blue.
An audiogram may show conductive hearing loss.
Treatment of chronic tubootitis
Therapy for patients with such a diagnosis should include several main components:
- elimination of the initial causes against which the auditory canal function was impaired;
- normalization of hearing;
- performing certain procedures to prevent sustained hearing loss;
- surgical intervention in the form of shunting of the tympanic membrane in the absence of a positive effect from conservative techniques.
Treatment of chronic tubootitis involves the use of:
- antibiotics;
- laser therapy;
- vasoconstrictor drugs;
- hyposensitizing medications;
- pneumatic massage of the eardrum;
- endaural iontophoresis;
- UHF;
- blowing off according to the Valsalva or Politzer scheme.
If all the described conservative methods have not yielded a positive result and could not cope with the elimination of inflammatory exudate, the patient is prescribed more complex procedures: paracentesis or drainage of the eardrum, if two-sided chronic tubo-otitis and severe pathologies are detected, a more serious intervention is shunting. In this case, a special shunt is installed inside the cavity, through which washing and processing of the affected area with a medical solution is carried out.
Folk therapy
Both acute and bilateral tubo-otitis can be treated with effective recipes. The most effective among such remedies is ordinary onion. For its use, thoroughly clean the affected ear from all kinds of secretions using hydrogen peroxide. Then inside it is necessary to drip warm onion juice. For maximum effect, it is recommended to drip and nose.
There is another way to use this vegetable. A piece of onion needs to be heated and sent to the ear canal. Such procedures should be carried out within two weeks.
Onions can be replaced with spicy healing herbs. Here is another popular recipe that helps get rid of chronic tubootitis: steam baths of chamomile, nettle, yarrow, or a combination thereof. For their preparation, it is necessary to fill the pan half with water, bring it to a boil, and then send a handful of dried plant to it. Cook the mixture should be just a few minutes. Then you need to remove the pan from the stove and lean over it with a sore ear. For more effect, cover your head with a towel. Such an event resembles "potato inhalations" well known to everyone since childhood. The procedure is recommended daily for a week.
Prevention
To prevent the development of tubo-otitis or reduce the regularity of its exacerbations, several rules should be followed.
For example, it is very important to learn how to properly bow out, closing the second nostril well. In the case of diagnosing rhinitis, it is necessary to prevent nasal congestion, systematically rinse it, and make sure that inflammatory mucus does not accumulate in the tonsil area.
To eliminate exudate, you need to gargle regularly. If you ignore this procedure, then a beneficial microflora will form in the tonsils for the development of harmful microorganisms, which will begin to multiply intensively, provoking the appearance of tubootitis, first in acute and then in chronic form.
In case of stuffy ears and discomfort in the auditory canal, especially if a child complains, you should immediately contact a specialist.