Among the existing diseases of the human hearing system, doctors distinguish acute purulent otitis media of the middle ear. Inflammation spreads quite quickly from the eardrum through the auditory tube, affecting the mastoid process.
To provoke the development of a disorder, not completely cured colds, runny nose, SARS, rhinitis, penetration of infections into the ear, the causative agents of which are pathogenic bacteria and fungi, can be completely cured. It is very important to recognize the course of the disease in a timely manner and conduct treatment, since an ailment can provoke many complications.
Disease feature
In acute purulent otitis media, the code according to ICD-10 is H66.0. Medical workers attribute it to complex and dangerous diseases. Pathology can occur in completely different ways, and treatment is selected strictly separately, depending on the results of the study.
Sometimes patients still manage to effectively eliminate the disease at the initial stages of development, the most important thing is to timely pay attention to the presence of a problem. Otitis is often complicated by the appearance of adhesions, which lead to hearing loss and gradually turn into a chronic progressive form.
Mostly signs of acute suppurative otitis media are observed in children under 3 years of age. Relapses are sometimes recorded, and the disease is very difficult. A feature of a purulent form of pathology is an acute onset and a rather sluggish course.
Stages of the disease
Doctors distinguish three stages of acute purulent otitis media, characterized by certain signs. In particular, such stages are:
- preperforative;
- perforated;
- reparative.
The first of them is considered the initial form of the course of the disease. It is characterized by the absence of symptoms, or the symptoms are not too pronounced. The main symptoms are the presence of pain in the ear. Moreover, soreness can also occur in the temple, forehead, which provokes very strong discomfort.
Over time, the severity of symptoms intensifies, as the focus of inflammation expands, and tolerating them is simply unbearable. Even painkillers do not give the desired result. Along with quite severe pain, there is additional noise and ringing in the ears, constant congestion, which further aggravates a person’s well-being. The patient gradually begins to hear much worse, and it develops especially strongly if otitis media progresses against the course of the flu.
In addition to all these signs, a general deterioration in well-being is noted, the temperature rises, and it hurts the body. Pronounced intoxication symptoms appear, which you need to immediately fight, otherwise quite serious complications may arise.
The next stage of acute purulent otitis media is more complicated - perforated. It begins immediately after the rupture of the eardrum, from which pus begins to flow. In this case, the pain gradually subsides. A person begins to feel much better, the temperature drops or completely disappears. In the first days after the rupture of the membrane, pus secretions will be quite strong, and small disseminations of blood may appear. Patients note the presence of constant pulsation. Gradually, the amount of purulent discharge begins to decrease, and they become more thick and viscous. Acute perforated middle purulent otitis media requires urgent medical intervention, since this form is quite dangerous and provokes various kinds of complications.
The reparative stage of the disease is characterized by the cessation of pus, as well as the rapid healing of the wound. After this, the person begins to hear normally, the temperature returns to normal, and health improves. In some cases, the disease can be sluggish, there is no rupture of the eardrum and leakage of purulent contents. The temperature remains constantly elevated, the hearing does not return, and the pain does not go away. At the initial stage of the course of the disease, vomiting, headache, dizziness also join the remaining signs.
This occurs with prolonged maturation of pus and the formation of perforation. If this happens, then the infection can spread deep into the skull, which leads to irreparable consequences.
Causes of occurrence
According to statistics, mainly acute purulent otitis media of the middle ear develops due to the penetration of staphylococci. Sometimes the provocateurs of the disease are pneumococci. Protein inflammation, diphtheria bacillus, and otomycosis fungi are much less likely to provoke inflammation.
Often pathogens and infections enter the eardrum through the auditory tube. With normal functioning, it eliminates bacteria, protecting the ear canals from the development of pathological processes. During the course of the common cold and other infectious processes, the functionality of the Eustachian tube weakens and pathogens become activated. As a result of this, acute purulent otitis media begins to develop in a child and an adult.
Otolaryngologists distinguish several provoking factors, in particular such as:
- pharyngitis;
- rhinitis;
- tonsillitis;
- laryngitis;
- laryngotracheitis.
In addition, benign neoplasms of the larynx, nasal cavity, surgery, and therapeutic procedures can provoke the occurrence of a problem. The disease can develop with infection of the tympanic cavity, which occurs with injuries and penetration of a foreign body into the ear canal.
One of the most common causes of a purulent form of the disease is a weakened immune system. As a result, an inflammatory process proceeds with dangerous complications.
It was proved that purulent otitis media can occur against the background of an allergic ear reaction. It is considered the main manifestation of this kind of rhinitis, dermatitis, asthma, diathesis, bronchitis. Negative external conditions affect the etiology of hearing inflammation.
The main symptoms
Symptoms of acute purulent otitis media are quite characteristic, so confusing it with another disease is quite difficult. The main signs of the disease should include such as:
- pain localized in the ear;
- hearing impairment;
- temperature rise;
- purulent discharge.
When infected, first of all, a person begins to feel very severe pain, which sometimes becomes simply unbearable. Pain is exacerbated at the moment when the patient is trying to just touch his ear. At the same time, many say that the symptom is quite sharp and manifests itself at the moment of turning the head.
Against the background of severe inflammation, hearing loss is observed. The mucous membrane is quite fragile and thin, so absolutely any infection with a negative effect on auditory capabilities. In some cases, people say that they hear almost nothing and all sounds are deaf.
Inflammation in the ear is always accompanied by a rather sharp increase in body temperature, up to 39 degrees. In the first 2 days it is almost impossible to bring down it, as the process of suppuration continues.
Discharge of pus from the ear does not appear immediately, since in the first days of the inflammatory process it only accumulates. After the mucous can no longer withstand, it breaks through, and the contents flow out.
The hospital must be consulted at the first suspicion of otitis media. The acute and purulent form requires timely diagnosis and treatment. This will prevent complications.
Diagnostics
With the course of acute purulent otitis media, diagnosis is important. When contacting a doctor, he initially collects an anamnesis. The otolaryngologist makes a preliminary diagnosis based on the available symptoms.
Then a general blood test is prescribed. It shows the presence of bacterial inflammation. At the same time, leukocytosis is observed, as well as an increase in ESR.
In addition, for the study, exudate is taken directly from the focus of inflammation. It is being studied for the presence of pathogens and hypersensitivity to antibacterial agents. For the examination, such techniques are prescribed as:
- otoscopy;
- caperonal examination;
- radiography;
- paracentesis.
All these types of studies help determine the etiology of acute purulent otitis media. This, in turn, allows you to choose the methodology of therapy.
Treatment feature
During the treatment of acute purulent otitis media, special attention is paid to the stage of the course of the disease, since the use of medications will largely depend on this. In the very first days, when the general well-being of a person begins to deteriorate sharply, the use of antipyretic drugs is indicated.
Doctors recommend that all patients with otitis media observe strict bed rest, as the body experiences a very serious load. In addition, the general state of health does not make it possible to lead a normal lifestyle. If signs of mastoiditis occur, then the patient must be hospitalized.
To normalize the natural ventilation of the ear, a person must be prescribed vasoconstrictor drops in the nose. To reduce soreness, you need to use special medications that are injected directly into the ear canal. They are also available in the form of drops. Doctors also recommend using a solution of boric acid. It is worth noting that all funds must be warm.
Treatment of acute purulent otitis media is carried out using antibiotics for oral administration. The course of therapy takes 7-10 days, and it cannot be stopped even after improvement of well-being, as this can provoke a relapse.
During the removal of pus, the doctor can prescribe antihistamines, as well as microlytic agents that will help normalize the outflow of purulent contents.
Drug therapy
Diagnosis of the disease does not cause absolutely any difficulties, and after that patients are prescribed a set of therapeutic measures. Medication for acute purulent otitis media of the middle ear implies the use of such means as:
- drops;
- antibacterial medications;
- drugs that eliminate the accompanying symptoms.
Most drops with rupture of the eardrum and purulent otitis media are strictly forbidden to use, as they can only aggravate the course of the disease. Despite good reviews, it is unacceptable to use the drug "Otipaks". For the treatment of purulent discharge, Otof drops are generally prescribed. It is a very good antimicrobial.
Another good painkiller and anti-inflammatory is Anauran. This drug is recommended for acute and chronic forms. Before instillation of the liquid, it is necessary to carefully treat the ear canal with hydrogen peroxide or any other antiseptic.
With left-sided or right-sided acute purulent otitis media, the doctor mainly prescribes antibacterial agents. The most popular drug is Amoxicillin, as it has antiseptic and antimicrobial effects. For topical use, aminoglycosides are also recommended. These funds are allowed to apply no more than 14 days. All drugs are prescribed in the form of capsules or tablets, and for severe illness, injections are used. If purulent otitis media develops after acute respiratory viral infections, then the doctor prescribes immunostimulating and antiviral drugs for faster recovery.
Folk techniques
Purulent otitis media is not recommended to be treated with folk remedies, since it is impossible to predict how each specific method will work. It is strictly forbidden to apply warming, as this only provokes an aggravation of the pathological process.
As a folk remedy, you can only use tea from chamomile and other anti-inflammatory plants. This tool is recommended to be used in combination with other methods to obtain a faster result.
Physiotherapy
Treatment of left-sided acute purulent otitis media, as well as right-sided, is carried out using physiotherapeutic techniques. A similar effect is prescribed to reduce the symptoms of the disease and restore hearing. Among the main techniques used such as:
- laser therapy;
- ultrasound exposure;
- UHF therapy.
If it is necessary to deliver antibacterial agents to the affected area, then electrophoresis is prescribed.
Surgical intervention
If conservative therapy did not bring the expected result, then surgery is indicated. With the course of inflammation, the outflow of purulent contents is very important. For this, the removal of polyps and granulations is prescribed.
In addition, shunting of the tympanic cavity may be indicated. For this, a small hole is made in the membrane, into which a small tube is then inserted. Through it, medications are introduced. It is also possible to perform surgery on the middle ear and the labyrinth.
What could be the consequences
Any disease with the wrong approach provokes the emergence of a number of dangerous complications, which are much more difficult to get rid of than the original disease. As a result, the functioning of the eardrum may be impaired, resulting in partial or complete hearing loss. The most dangerous complications are:
- inflammation of the temporal bone;
- damage to the inner ear;
- bone caries;
- meningitis.
With illiterate or untimely therapy, the acute form of the disease gradually turns into chronic purulent otitis media, which is quite difficult to treat. To eliminate the occurrence of dangerous pathologies, you need to immediately visit a doctor at the first sign of deterioration. Otolaryngologists recommend at least two times a year to conduct a preventive diagnosis of hearing.
Forecast
Given a competent approach, the prognosis of acute purulent otitis media is quite favorable. The disease ends with a complete recovery and restoration of hearing. If the disease was started, then it can become chronic with the formation of stable perforation of the eardrum. That is why it is very important to timely diagnose and treat existing disorders.
Preventive measures
Every adult knows that eliminating the disease and preventing its development in the body is much easier than treating an already advanced form of otitis media. Preventive measures are aimed at proper hearing care. It is strictly forbidden to clean the ear canals with ear sticks, as well as to instill drops without a doctor's prescription.
In the cold season, hats must be worn that protect the ears from blowing. It is important to minimize stay in damp rooms, in a draft. Treatment of colds and infectious diseases should be comprehensive and lead to a complete recovery. To consolidate the result after the treatment course, you must follow these rules throughout the year.
Strengthening health will help sports, hardening of the body, maintaining an active lifestyle. The immune system prevents infection from entering the ear canal. It is important to pay enough attention to a proper, balanced diet. The diet must be rich in minerals and vitamins.
During the period of activation of viral diseases, it is recommended for prevention to take appropriate medications, as well as vitamin complexes. Always remember that self-medication can cause irreparable harm to health.