Disease sexually transmitted:

Late congenital syphilis

Diseases of the ear and mastoid process

  • What is Adhesive otitis media
  • What triggers / Causes of Adhesive otitis media
  • Pathogenesis (what is happening) during Adhesive otitis media
  • Symptoms of Adhesive otitis media
  • Diagnosis of Adhesive otitis media
  • Treatment of Adhesive otitis media
  • Which doctors should be consulted if You Adhesive otitis media

What is Adhesive otitis media -

Adhesive otitis media is middle ear infection with the formation of adhesions in the tympanic cavity and scarring of the eardrum.

What triggers / Causes of Adhesive otitis media:

The disease is the result of errors in diagnosis and treatment of acute otitis media. There are a number of objective reasons that lead to the development of adhesive otitis media. These include:

  • violation of the ventilation and drainage functions of the auditory tube-
  • the exudate containing a large amount of fibrin
  • allergic interstitial inflammation, accompanied by swelling of the mucous membrane of the tympanic cavity-
  • small leukocyte activity and enzymatic reactions of the exudate-
  • the development of granulation tissue
  • the remains of myxoid tissue, serving as a plastic material for the formation of adhesions-
  • getting food and stomach contents into the tympanic cavity with sry givani-
  • atmospheric pressure with hemorrhages in the mucous membrane-
  • trauma-
  • irrational antibiotic treatment, etc.

Pathogenesis (what is happening) during Adhesive otitis media:

When poor drainage function of the auditory tube, the absence of perforation of the eardrum or not timely performed paracentesis in the treatment of antibiotics, and have only bakteriostaticheskie action, the fluid is sterilized, the symptoms of intoxication (fever, pain) disappear, there is a visible recovery.
If this situation is not detected in a timely manner, in subsequent exudate begins to organize and fibrinous threads turn into spikes. Their location varies: Windows osseous labyrinth, the ossicular chain or the eardrum. As a result, the performance of sound is broken, there is a persistent conductive hearing loss.

Symptoms of Adhesive otitis media:

General condition of the child is not suffering, otoscopy picture without changes, possible hearing loss and ringing in the ear. This requires active timely audiological diagnostics, as children, as a rule, the hearing loss is not MS/Gouda. Every case of acute otitis media in a child requires confirmation normalization of auditory function in specialized institutions.

Diagnosis of Adhesive otitis media:

History. Important information about previous acute otitis media with discharge from the ear or without used treatment, use of antibiotics, the hearing at the end of the disease. You must also find out information about previous disease of the pharynx, nose and paranasal sinuses, surgical interventions in the area of the nasopharynx, the migrated barotrauma, etc.
Otoscopy. Typically, there is retraction of the eardrum, light reflex is shortened dramatically issued a short process of Malleus, anterior and posterior folds. Sometimes the eardrum visible whitish blotches - petrificada, plots thickening alternating with as parussini scars, places connected with the labyrinth wall.
At otoscopy as a rule, are determined by the described changes of the tympanic membrane, but her normal appearance does not exclude adhesive otitis media, if the stiffness of the ossicular chain was the result of otitis media and mastoiditis treated with antibiotics.
Study of the mobility of the eardrum by means of a pneumatic funnel has a relative value. The eardrum can maintain mobility when ankylosis of ear ossicles, but the restriction of her movements is usually a sign of adhesions in the tympanic cavity.
The study of the function of the Eustachian tube absolutely necessarily.
Studies of hearing. Audiological study testifies to the defeat of conduction. The most characteristic features of adhesive process in the ossicular chain are high threshold for air conduction, the parallelism of the curves of bone and air conduction, a significant air-bone interval.
It should be borne in mind that the obliteration of the Windows osseous labyrinth scars gives hearing loss, due to a decrease in not only air and bone conduction, especially poorly perceived high tones.
Radiography in projections Schüller (cave) and Mayer (Attica) detects some changes in the tympanic cavity and the mastoid process, evidence of previous disease of the ear, in the lower pneumatization mastoid or sclerosis, Cicatrical changes in atticoantral region and the extension of the mastoid cave.
Computed tomography greatly expands the capabilities of research, it can help determine the condition of the ossicular chain and even scarring in the area of the Windows of the bony labyrinth.

Treatment of Adhesive otitis media:

Treatment of adhesive otitis media can be conservative and surgical.
In the initial stages of the disease the positive effect can give a systematic blowing ears for Catheterization, the introduction of drugs into the tympanic cavity through the catheter, probing the auditory tube, vibration and pneumomassage eardrum, electrotherapy (galvanization and paradisal, pulsed magnetic therapy, designed for vasomotor, trophic and electrolytic action).
These methods are combined with parenteral administration of aloe, hormonal preparations, enzymes.
Good effect is observed with the introduction of the tympanic cavity hyaluronidase with tympanometry. Occasionally, with persistent perforation of the tympanic membrane, transtemporal pump chymotrypsin, hyaluronidase. In children these drugs is best administered via electrophoresis. This treatment is aimed at the resorption of scar tissue and fill it more loose connective. Naturally, severe scarring is poorly amenable to such therapy.
Surgeonwith on-demand treatment of adhesive otitis media is very complicated. It is performed using an operating microscope and special tools. The opening of the tympanic cavity is often accompanied by injury of the tympanic membrane due to scarring. Then use optics to find out the mechanism of conduction disturbances. Often exhibit the scars in the ossicular chain, which is relatively easy to remove. More complex operations are performed when the defect of any bones or parts of it. In most cases exposed to the destruction of the long process of the incus, then perform her prosthetics. In children surgery for adhesive otitis media unpromising because of the increased propensity to the development of granulation tissue and re-scarring, which negates the results of even a well-executed operation.

Which doctors should be consulted if You Adhesive otitis media:

ENT

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