Otitis is any inflammation of the ear. In pediatric practice most often this term is inflammation of the middle ear, although there is still a otitis externa involving the ear and external auditory canal, and inner ear infection (labyrinthitis). The nature of inflammation distinguish serous (catarrhal) and purulent otitis media. The process may be distributed within a single ear or be bilateral.
Causes and pathogenesis of otitis media
Ear infections are caused by bacteria, rarely by viruses or fungi. In otitis externa the bacteria embedded in the deeper layers of the skin of the auricle or external auditory canal with the formation of boils. Fungal infections manifest themselves in the form of adhesive inflammation of the ear canal.
Otitis media the basis of their pathogenesis has easy penetration in childhood infections from the nose to the ear via shorter and wider than in adults, the Eustachian tube. Inefficient, with frequent copious lavage of the nose, or delayed treatment of rhinitis in pediatric practice, leads to a rapid involvement in the inflammation of the middle ear. Also contribute to the common cold, children stay in the draft (especially infants) remaining in the ears of water after swimming, rapidly cooling tissue. These moments, combined with shorter and less convoluted compared to adults, outer ear canal, through which cold air or liquid easier to penetrate the eardrum, reduce the local immunity of the ear.
Further due to impaired local immune response to infectious agents it is easier to multiply and trigger an inflammatory process. It should be noted the role of chronic foci of infection in the naso – and oropharynx (tonsillitis, sinusitis).
The transition when catarrhal inflammation purulent bacterial flora becomes overly aggressive and causes the fusion of fabrics, promotes both the reduction of local and General immunity, and especially childhood infections, in which this form of the disease found: scarlet fever, tetanus, measles.
Labyrinthitis is the most severe and rare form of otitis media. Develop with the penetration of antibiotic-resistant infectious agents in the deep regions of an ear on the background of anemia, diabetes, tuberculosis, protein starvation, and other conditions leading to immunodeficiency. Often the cause of labyrinthitis is getting mumps, wherein the infection is transferred by blood flow.
The symptoms of otitis media
The main manifestation of external otitis, the pain becomes localized in the region of purulent lesions of the hair follicles of the external auditory canal or itching in case of fungal infection.
When otitis media with serous inflammation the pain will be sharp, shooting, radiating to the head. Possible malaise, fatigue, headaches
For purulent otitis media also characterized by a sharp pain to the point of melting of tissue of the tympanic membrane, after which come first fluid discharge from the ear, persistent hearing loss up to deafness.
Labyrinthitis manifested by a sudden loss of hearing, dizziness, nauseam, loss of balance, which are called the labyrinth attack.
Diagnosis of otitis media
The diagnosis of otitis media is quite simple to put in children who may already own to complain of pain and to indicate the place that’s bothering them. When pressing on the tragus, the pain increases.
ENT doctor during examination of the ear using a special mirror or Otoscope sees the changes of the tympanic membrane in the form of a truncated light cone, serous or purulent effusion, perforation of the eardrum. When external otitis inflammatory changes visible in the form of boils, areas of redness of the skin or fungal infections.
Some difficulties on the first stage is diagnosis of otitis media in infantswho are not able to complain. The baby cries and turns his head, after 3 months grabs the handles over the sore ear may refuse to suck or spit up. If you press on the tragus to the affected ear, the screaming intensified.
Treatment of otitis media
Any experienced audiologist will say that for the successful treatment of otitis media the child’s need to engage not only with your ears but also the nose. In the case, even if the child complains of one ear, necessary to carry out the local procedures of the two parties, as the process quickly becomes bilateral.
The main groups of drugs used for the treatment of otitis media: antibiotics (semisynthetic penicillins or macrolides), antifungals, antigistaminnye, antipyretic.
Antibiotics applied locally in the form of drops (mefenamic acid) if you saved the eardrum (no hearing loss and does not flow from the ear) or systemically (tablets or suspension) in cases of advanced or bilateral process with fever and General intoxication, in the treatment of labyrinthitis.
Popular antiseptics for infants – sulfacetamide. Topical drops (combination of anti-inflammatory and analgesic) in the form of ear drops, suitable for children of different ages.
In order to treat concomitant rhinitis in children, preferable not a vasoconstrictor, and the combined anti-inflammatory drugs (rinofluimucil, sinupret), and, in infants a drug of choice remains at all, combining an antihistamine and a vasoconstrictor component.
Labyrinthitis treated only in a specialized hospital with the use of antimicrobial, anti-inflammatory and dehydration therapy. If necessary, execute operational benefits.
If there are signs of violation of the integrity of the tympanic membrane from drops have to give. In the case of large scars after healing of the defect in the membrane or in the case of chronic purulent it melting, accompanied by a persistent reduction in hearing is, you may need tympanoplasty operation.
Timely and rational treatment of ear infections in the early stages of inflammation with a high probability prevents the transition of catarrhal inflammation of the purulent, acute and chronic.