An inflammatory disease of a purulent nature, affecting the middle and lower parts of the tympanic membrane of the ear, is called chronic mesothympanitis. In this case, the integrity of the tympanic cavity may be impaired, and a mucopurulent secretion is secreted from it. The disease is often considered a complication of chronic otitis media, and it comes first in the list of causes of hearing loss. However, the inflammatory process with this pathology affects only the mucous membrane of the auditory analyzer, therefore, with timely treatment by a competent specialist, the prognosis is usually favorable. Adequate and modern therapy helps to avoid undesirable consequences.
Form of the disease
Patients have characteristic signs of chronic mesothympanitis, when purulent-mucous contents accumulate in the middle ear cavity. In this case, the tympanic membrane ruptures, and all the liquid rushes out. But even with a benign form of damage, targeted treatment is necessary, otherwise pathology can cause inflammation of the bone tissue and the formation of polyps inside it. The official name of the disease is tubotympanic purulent otitis media. Based on the classification, appropriate appointments are made, but it is important to establish the true diagnosis accurately, which will be confirmed by appropriate examinations and analyzes.
ICD code for chronic mesothympanitis
According to the classification of ICD-10 (International Classification of Diseases of the 10th revision), the disease has the corresponding marking H66.1. However, this category includes not only chronic tubotympanic disease (mesothympanitis), but also chronic otitis media of a purulent form of a benign course.
Causes of inflammation
The main reason for the development of the disease is infection in the ear. To microbes that can cause a pathological process, experts include:
- streptococci;
- fungi;
- staphylococci;
- pathogens of diphtheria;
- anaerobic bacteria.
Chronic purulent mesothympanitis is triggered by the action of several components and predisposing factors:
- accompanying illnesses;
- weakened immunity;
- frequent SARS with complications in the ears;
- hypothermia;
- swelling of the nasopharyngeal mucosa;
- deformation of the nasal septum.
In this case, experts distinguish between chronic left-sided mesotympanitis and right-sided. The diagnosis is made depending on the side of the development of the infectious process. Damage to two ears at once is possible, in this case the pathology is called bilateral, which is possible when the infection passes through the internal or external paths to the other ear.
How does the pathology develop?
Pathogens can enter the eardrum and provoke the disease as follows:
- The endogenous way. If the body has a focus of infection, such as caries, tonsillitis or sinusitis, then bacteria penetrate through the auditory tube into the middle ear and cause inflammation.
- Exogenous path. From the environment, microbes enter the auricle and under adverse conditions are able to penetrate inside. It is also possible with water ingress or hypothermia.
Often the cause is a clear decrease in the human immune forces when pathogenic microorganisms attack the body and they are not able to fight them.
What happens next?
Chronic purulent mesotympanitis is diagnosed with frequent relapses and the following factors are present:
- pathogenic microorganisms have high virulent properties;
- reduced overall resistance of the whole organism;
- acute otitis media often occur;
- in the nasopharynx multiple foci of infection are fixed that violate the functions of the auditory tube, so partial hearing loss is possible.
With this pathology, certain signs are characteristic. So, the walls of the eardrum are hyperemic, thickened and edematous. The mucous membranes are covered with purulent contents. If the disease progresses and develops into a chronic one, then scarring of the tissue and the formation of adhesions are possible. As a result, hearing loss is possible because the auditory ossicles are blocked by scar tissue.
Symptoms of treatment
The ICD-10 code for chronic mesothympanitis is H66.1. Often, the patient's clinical symptoms are rather scarce, but the doctor can focus on officially recognized:
- noise and throbbing in the ear;
- prolonged discharge of purulent contents from the ear cavity;
- partial hearing loss;
- a feeling of stuffiness in one or both ears;
- pain and pain in the ear canal;
- general intoxication and fever.
Usually there is no characteristic odor of purulent contents. But with the activation of bacteria and exfoliation inside the epithelium, a sharp putrefactive aroma arises. Moreover, when polyps have already appeared on the bone tissue, the discharge will be purulent with an admixture of blood.
Next, the following symptoms of chronic mesothympanitis join:
- overgrowth of granulation;
- an increase in polyps that limit the movement of the auditory ossicles;
- formation of adhesions.
It is these symptoms that lead to hearing loss. Moreover, the disease is characterized by malfunctions not only in the sound-conducting features, but also in the sound-absorbing properties of the inflamed ear.
Features of the development of the disease
If you start treatment on time, it is possible to eradicate the infection at the very beginning and get rid of complications. The disease develops according to the following scheme:
- At first, the pathology practically does not make itself felt, but the patient feels fatigue, constant fatigue and some noise in the ears. It is important at this stage to appear to the doctor.
- If a provoking factor has arisen (ARVI, hypothermia, water has got), then the eardrum bursts and pus is secreted. The picture of the disease is already quite pronounced, the patient's condition is serious. After the course of treatment, complete scarring of the tympanic cavity occurs, purulent discharge disappears and hearing is gradually restored.
However, chronic mesotympanitis is usually treated for a rather long period of time. At the same time, the period of remission can alternate with the stage of exacerbation, so it is so important to find a competent doctor and follow all his instructions. Therapy can take more than one year. But do not be scared if you have this diagnosis. Usually, with qualified treatment, the outcome is positive, and complications appear only in the absence of the necessary therapy.
How is the treatment?
If you are diagnosed with chronic mesothympanitis, your medical history may include information about the following treatments:
- therapeutic, aimed at immunomodulatory, hyposensitizing and etiotropic effects;
- physiotherapy;
- surgical procedures;
- recommendations for using folk methods.
Antibiotics are always indicated for prescription. In this case, drugs of a wide spectrum of exposure from the category of cephalosporins, macrolides and fluoroquinolones are prescribed. It is also necessary to use not only pills (injections), but also antibacterial ear drops. Well proven such as:
However, uncontrolled and too long antibiotic therapy will lead to a complete suppression of their own immunity and the appearance of a fungal variety of otitis media. Therefore, it is important to undergo examinations and use only prescribed medications.
Recommended Drug List
To effectively treat a disease, it is important to establish its cause. So, with a fungal breed of pathology, it is necessary to use the local preparation "Candibiotic", which is instilled into the ear. It is also necessary to take "Fluconazole" and "Nystatin."
Nonsteroidal anti-inflammatory drugs are prescribed to reduce swelling, relieve inflammation and eliminate pain. These include Diclofenac, Ortofen and Ibuprofen.
To increase the body's overall resistance and increase the chances of an early recovery, the doctor may recommend immunomodulators. Among the drugs showed themselves well: "Polyoxidonium", Immunal "and" Bronchomunal ".
Vitamin complexes and antihistamines will be prescribed. You can use the most familiar in each specific situation. To modern medicines include: "Zirtek" and "Zodak", however, and "Suprastin" shows itself well.
If the patient has foci of infection, it is important to eliminate them. So, growing adenoids must be removed, carious teeth treated. With a curved nasal septum, surgery may be indicated.
Possible physiotherapy
If chronic mesothympanitis occurs, treatment involves the appointment of physiotherapy. But such methods only supplement the main therapy and are carried out in remission to consolidate the achieved therapeutic result. Among the main recommended procedures are the following:
- Ural federal district;
- electrophoresis;
- phonophoresis;
- aeroinotherapy;
- microwave exposure;
- UHF
It is also good to use paraffin therapy and mud therapy. To improve metabolism and achieve a bactericidal effect, a low-energy laser is often used.
The validity of surgery
Surgically treat this disease only after unsuccessful attempts to cure the patient with therapeutic methods. At the same time, doctors remove granulations and overgrown polyps. Usually the operation is performed under general anesthesia, because it is quite extensive. Affected tissue must be cauterized using a solution of silver nitrate. But the surgeon must be extremely careful in order to avoid damage to healthy tissues.
To restore the affected eardrum, myringoplasty is used. However, such an intervention is indicated only in case of complications.
How will traditional medicine help?
If the attending physician is not opposed, then the patient can use methods from traditional medicine to accelerate the healing process:
- Heat the butter to a comfortable temperature, add the mummy and bury in the ear.
- Inside, it is useful to consume a drink consisting of warm milk, a teaspoon of honey and a mummy.
- A cake made of water, flour, linseed oil and camphor alcohol can be applied to a sick ear.
- In propolis tincture, moisten a cotton swab and lay in a sore ear.
- It does not harm, but improves immunity, taking infusion of raspberry roots in a glass a day (drink for a month).
- Natural antiseptics are bay leaf infusion, elderberry and onion juice.
However, it is strictly forbidden to use any means without the approval of a specialist. Before you self-medicate, think about the consequences.
Finally
The article provided information about a disease such as chronic mesothympanitis. The disease is provoked by pathogens, causes ear pain and hearing loss. Treatment is prescribed strictly individually, depending on the causes of the appearance.