Labyrinthitis (otitis media). Causes, symptoms, signs, diagnosis and treatment of pathology

Otitis in adults is a disease that must be taken seriously, to know its symptoms, consequences and treatment. In this article, the reader will receive all the necessary information, learn medication and folk ways treatment, preventive measures.

Characteristics of the disease

The human ear has a complex structure and consists of the outer, middle and inner parts. Depending on this, otitis media can be localized in different tissues of the ear.

Inflammation of the ear threatens with serious consequences for a person

Outer ear - directly ear canal in the form of an auricle.

Distinguish the following inflammation of the outer ear.

• perichondritis - infection of the cartilage with a subsequent inflammatory process;
• diseases of the skin (eczema, herpes) provoke otitis media;
• diffuse otitis media occurs if there is a skin injury with infection;
• mycosis - the development of a fungus on the skin of the ear;
• with furunculosis, the sebaceous glands become inflamed. Inflammation occurs due to pathogenic microbes in the roots of miniature hairs;
• otohematoma - hemorrhage in the organ, accompanied by the development of pathogens and inflammation.

The middle ear is formed by the tympanic cavity, which includes the membrane, and the auditory tube, which balances the pressure inside the organ.

May cause the following diseases:

• inflammation tympanic cavity and, as a result, membranes;
• inflammatory process in the auditory tube;
• infection of the skull bone as the next stage in the development of otitis media.

Infections of this part of the ear with otitis are divided into acute and chronic.

Acute otitis media is characterized by inflammation of the middle ear mucosa and discharge of pus. Purulent otitis in adults is provoked by the penetration of infection through the connecting channels (through the auditory, Eustachian tube) from the nasopharynx; this often occurs with the development of SARS, but can be caused by more specific reasons:

• strong pressure drops when washing the nose or blowing your nose;
• the development of various infections: measles, typhoid, tuberculosis. The disease is transmitted through the blood;
• reduced immunity, including HIV, syphilis, or diabetes.

Chronic otitis also affects the mucous membrane and forms purulent inflammation.

Otitis occurs due to:

• untreated acute otitis in the presence of other infectious diseases;
• violations of normal nasal breathing (in the event of an allergy or nasal injury);
• suppressed immune system;
• use of drugs that depress protective function organism.

The inner ear consists of a labyrinth organ.

An infection can get into this part of the ear with chronic otitis media, as well as in the case of:

• the occurrence of severe injury;
• the development of meningitis (inflammation of the brain);
• progression of syphilis.

Symptoms and consequences

Attention! Signs of otitis in adults differ depending on the location of the inflammation and the nature of its course.

With external otitis media, the auricle is affected, the symptoms can be seen with your own eyes:

• Perichondritis is characterized by swelling in the form of tuberosity and pain in the auricle;
• with infectious skin lesions, redness, crust, weeping of the skin occur;
• diffuse otitis media causes bright itching and pus from the ear, painful sensations if you touch or pull the ear;
• with the progression of mycosis appear characteristics: feeling of congestion and noise, deterioration in the ability to hear, itching, unpleasant odor;
• furunculosis is strong painful sensations in the ear, which are given to the face, neck and teeth. A tubercle with yellowish pus appears on the ear, painful when pressed. Pain interferes with speaking and chewing food;
• with otohematoma, a tumor-like formation occurs bright color(blue and purple), does not cause pain.

The defeat of the middle ear carries a greater risk to human health.

It is characterized by the following symptoms:

• pronounced congestion and noise;
• a clear echo (resonance) from your own voice in an inflamed ear;
• shooting pain in an abscess of the tympanic cavity. The development of infection leads to a breakthrough of the membrane and hearing loss;
• in some cases, there is an increase in body temperature (not higher than 40 degrees Celsius);
• general weakness in the body;
• throbbing pain;

With the transition of otitis media to chronic stage there is a constant discharge of pus, hearing worsens, it may be accompanied by regular pain in the head and ear.

Internal otitis affects the patient's vestibular apparatus and manifests itself:

• severe dizziness, impaired coordination;
• vomiting;
• increased heart rate;
• pallor of the skin;
• significant hearing loss.

A frivolous attitude to the symptoms of otitis media, insufficient treatment can cause complications. Progressive ear inflammation can cause:

1. Epitympanitis - inflammation of the temporal bone.
2. Paralysis of the facial nerve.
3. Hernia of the skull.
4. brain abscess.
5. meningitis.
6. Complete hearing loss.

Attention! These consequences require urgent medical, including surgical, intervention!

Diagnosis and treatment

Before you start treating otitis, you should visit a doctor for an examination. The ENT specialist makes a diagnosis on the basis of the survey, the signs identified during the examination of the ear (otoscopy). The doctor also checks the acuity of hearing, analyzes the results of a bacteriological blood test. If necessary, x-rays and tomography of the skull are done.

Before you start treating otitis, you should visit a doctor for an examination.

Treatment of otitis in adults depends on the characteristics of the disease. The patient uses drops and takes medications, but in severe cases surgical intervention in stationary conditions.

Attention! If timely measures are taken, all treatment can be carried out at home.

Treatment for otitis externa includes:

• the use of antibacterial, regenerating ointments;
• cold and compresses;
• extraction of fluid, opening of abscesses surgically;
• taking antibiotics;
• lubrication of bumps and boils with iodine, wetting tampons with boric alcohol and laying in the auricles;

For improvement general well-being and lowering the temperature prescribed aspirin, paracetamol. Physiotherapy can be prescribed in the clinic: UHF and UVI, especially in chronic otitis media.

Acute otitis media should be treated promptly, because the risk of complications in this case is high.

• A catheter is inserted into the auditory tube to inject antibacterial substances that eliminate inflammation. This must be done daily to eliminate pathogenic bacteria.
• The eardrum is massaged with a narrowly directed air stream.
• Reception of an imuprofen and paracetam is shown.
• Drops for otitis media are used.
• Are made daily warm compresses: cotton wool soaked in petroleum jelly and soaked in alcohol with glycerin is inserted into the ear canal. Such a compress relieves swelling and warms well.

In some cases (with severe pus), the surgeon makes a puncture of the eardrum. Hormones and antibiotics for otitis in adults in this case are administered through a catheter.

Attention! After a puncture, drops from otitis media are contraindicated.

If there is no improvement in this case, trepanation of the mastoid process of the middle ear is performed.

Chronic otitis is treated with a slightly different program, since the efficiency factor is secondary here. In this case, therapy with antibacterial drugs, washing and infusion of drugs, as well as physiotherapeutic measures are indicated:

• wash the sore ear with warm solutions of boric acid, furacillin, hydrogen peroxide;
• wash with antibiotics (with the addition of hormones);
• antibiotics and furacillin (along with other drugs: chinosol, dimexide, etc.) pour into the ear canal;
• UFO and UHF.

If a complication occurs, the treatment takes a serious turn, takes place with the use of surgical means.

Inflammation of internal otitis is eliminated with the help of enhanced antibiotic and vitamin therapy. In this case, surgical treatment is required (to avoid hearing loss): a cleansing operation is performed in the second week of taking the medication.

Folk recipes for the treatment of otitis media

Over the centuries and millennia, people have developed natural ways to eliminate inflammation in the ear. Treatment of otitis media at home involves the use of the following recipes.

For external otitis in adults, two-hour compresses from a warm alcohol solution are used (the ratio of water and alcohol: one to one).

A decoction of bay leaves is also effective: put 5 medium leaves in a glass of water, bring to a boil and let it brew. Use 2 tbsp 3 times a day, and also instill 10 drops of decoction into the sore ear.

For many centuries and millennia, people have developed natural ways to eliminate inflammation in the ear.

Otitis media can be cured with garlic, onions and infusion of birch buds:

• insist crushed garlic with vegetable oil within 10 days. Keep in the sun. Add glycerin to the resulting solution and instill a few drops into the ear. Before this, the solution should be warmed;
• cut off the top of the bulb, make a recess in it and pour cumin into it. Close the top, bake in the oven for half an hour. Then squeeze; instill the resulting juice before going to bed for a week, 3 drops in the ear;
• 10% tincture of birch buds relieves inflammation well and restores hearing. After moistening a cotton swab, insert into the ear for a minute. Repeat 3-4 times a day.

cure otitis media poppy and decoctions of herbs will help:

• boil 7 unripe poppy seeds in 150 ml of milk for 30 minutes. Wash the sore ear with the resulting decoction;
• pour 200 ml of boiling water with 1 tablespoon of eucalyptus, yarrow, calendula and string mixed in equal parts. After insisting for half an hour, drink the infusion throughout the day.

The above prescriptions act as additional and do not replace medical treatment.

Prevention and restoration of hearing after otitis media

How can infection be minimized? Prevention of otitis in adults involves the observance of simple rules.

1. Refrain from swimming in polluted waters.
2. Thoroughly clean ears after any contact with water.
3. Responsibly treat any diseases of the ears and nose.

Advice! Swimming in rivers and open water is recommended using ear plugs.

Often, people treat otitis media unreasonably lightly, not realizing that complications from this infection can lead to the most unfortunate consequences. The information in this article will help you to reasonably assess the dangers and risks of the disease, learn how to avoid it, and, if necessary, cure it.

Otitis - what is it, types, symptoms in adults, treatment of otitis media

Otitis is an ENT disease, which is an inflammatory process in the ear. Manifested by pain in the ear (throbbing, shooting, aching), elevated temperature body, hearing impairment, tinnitus, mucopurulent discharge from the external auditory canal. The severity of the pathological process depends entirely on the virulence of microorganisms, and the state of human immune defense also plays an important role.

What is it, what are the first signs and symptoms of otitis media, and how to treat in adults without consequences for the ear, we will consider later in the article.

What is otitis?

Otitis media is inflammatory lesion the inner, middle or outer part of the human ear, occurring in a chronic or acute form. The disease is characterized by damage to the structures of the outer, middle or inner ear, while patients present specific complaints. Symptoms in adults depend on the area of ​​inflammation, the addition of local or systemic complications.

Pathology can develop at any time of the year, but the peak of visits to the hospital occurs in autumn and winter, when people do not have time to change from warm to cold.

The reasons

The causes and symptoms of otitis media depend on the type of disease, immune status, and environmental factors. The fundamental elements in the formation of the disease are the influence of air temperature, the purity of the water used for hygiene, the season.

The causes of otitis media are:

• Penetration of infection from other ENT organs - as a complication of a concomitant infectious viral disease;
• Various diseases of the nose, its sinuses and nasopharynx. This includes all types of rhinitis, deviated septum, adenoids (adenoid vegetations);
• Injuries of the auricle;
• Hypothermia and weakened immunity.

Conditions that significantly increase the risk of developing the disease include:

• allergy;
• inflammation of the ENT organs;
• immunodeficiency states;
• performing surgical operations in the area of ​​the nasopharynx or nasal cavity;
• infancy, childhood.

Otitis in adults is a disease that must be taken seriously, to know its symptoms, consequences and treatment.

Types of otitis media

The structure of the human ear is divided into three interconnected parts, which bear the following names:

Depending on in which specific part of the organ the inflammatory process occurs, in medicine it is customary to distinguish three types of otitis media:

Otitis externa

Otitis externa can be limited or diffuse, in some cases it extends to the eardrum, it is more common in elderly patients. Occurs as a result of mechanical or chemical injury ear. A patient with otitis externa complains of throbbing pain in the ear, which radiates to the neck, teeth and eyes, and is aggravated by talking and chewing.

Development is facilitated by two factors:

• Infection drift sharp object(hairpin, toothpick);
• Ingress and accumulation of moisture in the external auditory canal.

It often occurs if the ear is constantly in contact with water, such as when swimming, which is why it is called "swimmer's ear".

Otitis media

With otitis media, the inflammatory process occurs in the tympanic cavity. There are many forms and variants of the course of this disease. It can be catarrhal and purulent, perforative and non-perforative, acute and chronic. Otitis media can develop complications.

otitis media

This type is also called labyrinthitis, its symptoms can vary in severity (from mild to pronounced).

The symptoms of otitis are similar in all forms of the disease, but their intensity and some features depend on the type.

• Acute. Occurs suddenly, has severe symptoms.

The otolaryngologist determines how and how to treat otitis media by establishing the type and degree of the disease.

Symptoms of otitis media in adults

The clinical picture of otitis media directly depends on the location of the pathological process.

• earache. This symptom is constantly disturbing and is the main one that brings the greatest discomfort. Sometimes the pain shoots in the teeth, temple, lower jaw. The cause of the development of this condition with otitis media is considered to be increased pressure in the ear cavity;
• redness of the ear canal, discoloration of the auricle;
• gradual deterioration of hearing due to the opening of abscesses and the filling of the auditory canal with purulent masses;
• fever - most often there is an increase in body temperature, however, this is also an optional sign;
• discharge from the ear with otitis externa is almost always. After all, nothing prevents the inflammatory fluid from standing out.

Symptoms of otitis are often accompanied by a runny nose, which leads to swelling of the nasal mucosa and congestion of the auditory tube.

• In the case of the development of acute purulent local external otitis (furuncle in the ear canal), the patient complains of pain in the ear, which is aggravated by pressure or pulling on it.
• There is also pain when opening the mouth and pain when the ear funnel is inserted to examine the external auditory canal.
• Externally, the auricle is edematous and reddened.
• Acute infectious purulent diffuse otitis media develops as a result of inflammation of the middle ear and suppuration from it.

• heat;
• ear pain (throbbing or aching);
• decline auditory function, which, as a rule, recovers a few days after the first manifestations of symptoms;
• nausea, general malaise, vomiting;
• purulent discharge from the ears.

• The main symptom of the acute form is severe ear pain, which patients describe as twitching or shooting.
• The pain can be very intense, worse in the evening.
• One of the signs of otitis is the so-called autophony - the presence of constant noise in the ear, not associated with sounds from the outside, ear congestion appears.

Acute otitis should always be treated to the end, as the pus will begin to spread inside the skull.

• Hearing loss.
• Pain appears only during periods of exacerbation.

If you have symptoms of otitis, you need to urgently consult a doctor who will correctly diagnose and tell you how to treat inflammation.

Complications

Do not think that otitis media is a harmless catarrhal disease. In addition to the fact that it knocks a person out of the rut for a long time, reducing his ability to work for at least 10 days, it is possible to develop irreversible changes with persistent deterioration or complete loss of hearing.

When the disease is allowed to take its course, the following complications may occur:

• rupture of the eardrum (as a rule, it takes 2 weeks for the hole to heal);
• choleostomy (growth of tissue behind the eardrum, hearing loss);
• destruction of the auditory ossicles of the middle ear (incus, malleus, stirrup);
• mastoiditis (inflammatory lesion of the mastoid process of the temporal bone).

Diagnostics

A competent doctor diagnoses acute otitis without special devices and innovative technologies. A simple examination of the auricle and auditory canal with a head reflector (a mirror with a hole in the center) or an otoscope is enough to diagnose otitis media.

As methods confirming and clarifying the diagnosis, it can be prescribed general analysis blood, in which signs of inflammation are detected (increased ESR, an increase in the number of leukocytes, and others).

Of the instrumental methods, radiography, computed tomography of the temporal regions are used.

How to treat otitis media in adults?

Antibacterial drugs (antibiotics, sulfonamides, etc.) play a special role in the treatment of otitis media. Their use has a number of features - the medicine should not only act on the bacteria that caused otitis media, but also penetrate well into the tympanic cavity.

Treatment of inflammatory changes in the auricle begins with bed rest. Antibiotics, anti-inflammatory drugs, antipyretic drugs are prescribed simultaneously. The combination of drugs allows you to effectively treat the pathology.

Comprehensive treatment of otitis media

It's no secret how acute otitis in adults is treated - drops in the ears. This is the most common remedy for otitis media. Depending on the type of disease, different drugs are used. Ear drops can contain only an antibacterial drug or be combined - contain an antibiotic and an anti-inflammatory substance.

There are the following types of drops:

• glucocorticosteroid (Garazon, Sofradex, Dexon, Anauran);
• containing anti-inflammatory nonsteroidal drugs(Otinum, Otipaks);
• antibacterial (Otofa, Tsipromed, Normax, Fugentin).

The course of treatment takes 5-7 days.

1. In combination with ear drops for otitis, otolaryngologists often prescribe vasoconstrictor drops in the nose (Naphthyzin, Nazol, Galazolin, Otrivin, etc.), thanks to which it is possible to remove the swelling of the mucous membrane eustachian tube and thereby reduce the load on the eardrum.
2. In addition to drops in the complex, antihistamine (antiallergic) agents may also be prescribed, pursuing the same goal - removing mucosal edema. These can be tablets of Loratadine, Suprastin, Diazolin, etc.
3. To reduce temperature and reduce pain in the ear, non-steroidal anti-inflammatory drugs based on paracetamol (panadol), ibuprofen (nurofen), nise are prescribed.
4. Antibiotics for otitis media in adults are added to the treatment of acute moderate form with the development of purulent inflammation. The use of Augmentin has proven itself well. Rulid, Amoxiclav, Cefazolin are also effective.

In addition to the above measures, physiotherapy procedures are used:

• UHF for the nose area;
• laser therapy for the mouth of the auditory tube;
• pneumomassage focused on the eardrum area.

If all the above actions did not lead to a regression of the process, or treatment was started at the stage of perforation of the tympanic membrane, then first of all it is necessary to ensure a good outflow of pus from the middle ear cavity. To do this, carry out regular cleansing of the external auditory canal from secretions.

• You can not independently prescribe medicines for yourself, choose a dosage, interrupt the medication when the symptoms of otitis media disappear.
• Wrong actions performed at one's own discretion can cause harm to health.
• Before going to the doctor, you can only take a paracetamol tablet to reduce pain. This drug is effective and has few contraindications. At correct use paracetamol rarely causes side effects.

Prevention

The main goal of preventing otitis media in adults is to keep the Eustachian tube from becoming blocked. thick mucus. This is not such an easy task. As a rule, acute rhinitis is accompanied by liquid secretions, but in the process of treatment, mucus often becomes much thicker, stagnation in the nasopharynx.

1. Foci of chronic infection - tonsillitis, pharyngitis increase the risk of otitis media.
2. After swimming, especially in open water, it is necessary to dry the ears thoroughly to prevent water from getting inside along with bacteria. Especially for people prone to otitis, antiseptic drops have been developed that are instilled into the ears after each bath.
3. Regularly clean your ears from dirt and sulfur, maintain hygiene. But it is better to leave a minimum of sulfur, since it protects the ear canal from pathogenic microbes.

In conclusion, it should be noted that otitis media is a very unpleasant disease. Do not think that all symptoms will go away on their own. Be sure to consult a doctor at the first signs. Often, people treat otitis media unreasonably lightly, not realizing that complications from this infection can lead to the most unfortunate consequences.

Discussion: 4 comments

How to treat otitis media if there is no desire to take antibiotics? Or without them?

If a purulent form, then antibiotics are indispensable. I had ordinary otitis media, I did not treat it, and it turned into a more complex form. As a result, I spent a lot of time, health and money on medicines. Therefore, it is imperative that when initial form consult a doctor and even if antibiotics are prescribed, do not take them. It is clear that these are not vitamins, but if there is already pus, then very serious complications. And next to the ear is the brain, so be a reasonable person and listen to the doctor

Thanks a lot for the article. I'll keep it on mind.

Even untreated caries can cause otitis media.

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Symptoms of otitis media and treatment of various forms of inflammation in adults

Otitis media inflammation of the ear in adults is classified into three types of otitis media, external, middle and internal, the form of otitis is determined by the doctor

Seasonal diseases ARI, SARS, influenza can cause various complications. One form of the consequences is otitis media, inflammation in the ears. The condition is unpleasant and requires treatment. But are the symptoms of otitis media in adults always the result of a cold, and what treatment is required in each case? Details in the article.

A different approach to disease

Inflammation of the ear in adults is classified into three types of otitis media:

• External - the focus of the disease is located in the outer part of the ear, the skin is affected by bacteria, fungi penetrating from the outside.
• Medium - the inflammatory process is localized in the middle part of the ear, behind the eardrum. Occurs due to diseases in the nasal and oral cavity with improper treatment or cleansing of mucus channels.
• Internal (labyrinthitis) - the focus of the disease is located in the inner part of the ear, develops as a complication of otitis media and is one of the most serious inflammation requiring special treatment. There is a threat of purulent damage to the meninges of the brain.

According to the symptoms of otitis, which the patient complains about during the appointment, the doctor determines the localization of the disease.

Otitis externa

Signs may be the following:

• Itching in the ear canal, which becomes more intrusive and painful.
• Pain when pressing on the outer part of the organ (pulling the ear, palpation in the itch or on the external protrusion).
• Swelling of the auditory canal.
• Redness of the skin.
• On examination, you can see a tubercle, which confirms the development of a boil. When the head ripens, a mucous discharge may appear.
• Wet skin in the ear canal due to the development of bacteria.
• Congestion, noise.

These are the main symptoms of otitis externa, which can occur singly or in combination, it all depends on the causative agent of inflammation. The most painful is furunculosis during maturation.

Otitis media

Evidence of inflammation developing behind the eardrum is the following symptoms:

• Various pains in the ear (aching, shooting, throbbing). Increases during swallowing, sneezing, coughing.
• Decreased hearing acuity.
• He gives his voice inside, patients emphasize that they clearly hear themselves, but the surrounding sounds are muffled.
• Noise in ears.
• Discomfort, lethargy.
• Hyperthermia up to 39 degrees.
• Discharge of pus after rupture of the membrane.

These symptoms of otitis media in adults appear gradually and cause serious inconvenience.

Labyrinthitis or otitis media

The disease is less common, but requires immediate treatment to eliminate negative consequences. Appears due to late treatment of people in the hospital with otitis media or improper treatment. Serious viral diseases can also go to the stage of labyrinthitis, as a complication factor. The main symptoms for an emergency call to the lore are:

The danger of otitis media in adults is that purulent inflammation can affect the brain, temporal bone, circulatory system and lead to lethal outcome for a short period.

The right approach to disease

Regardless of the location of the inflammation, otitis media in adults requires treatment that only a doctor can prescribe. The specifics of therapy are varied and can only be medicinal or require surgical intervention. Treatment of otitis in adults is determined by the diagnosis and symptoms of the disease.

Until the membrane is perforated, antibiotics, vasoconstrictor drops, analgesics, antipyretics, alcohol compress, physiotherapy.

After a breakthrough in the membrane, pus begins to flow out, the cavity is vulnerable to the penetration of liquids and dirt. Do not use ear drops or any liquid preparations through the auditory canal.

Ear inflammation in adults is never asymptomatic. But sometimes these signs do not indicate an ENT disease, but about age-related changes or the consequences of head injuries, cervical region or other violations. Therefore, you should not wait for deterioration in well-being and engage in self-medication. How to treat otitis media in an adult, only an otorhinolaryngologist will answer. It is possible that ear pain is caused by improper care of the organ or signals other diseases.

Comprehensive treatment of otitis media in adults

Otitis media is an inflammation of one of the parts of the ear that affects hearing and many life processes. According to statistics, in adulthood, the disease occurs much less frequently than in children.

But if signs of the disease are found in anyone in any age group, it is urgent to start therapy in order to avoid dangerous consequences and a significant reduction in the patient's quality of life.

Otitis classification

According to the nature of the course of the disease, forms are distinguished:

• Acute. The disease occurs suddenly, has severe symptoms.
• Chronic. The inflammatory process continues for a long time, has periods of exacerbation.

There are three types of localization:

• Outer. Damage to the external auditory canals. The causative agents of this form of otitis are Pseudomonas aeruginosa and staphylococcus aureus. For fungi of the genus Candida and Aspergillus, the external auditory meatus is a great place to breed - it's dark and damp after swimming.
• Average. The Eustachian tube and tympanic cavity are affected. The causative agents of otitis media and internal are usually pathogenic bacteria (Hemophilus influenzae, pneumococci, moraxella) and viruses.
• Interior. Most dangerous form. The inflammatory process develops in the labyrinth located in the temporal bone. It contains special receptor cells that transmit sounds to the corresponding part of the brain.

According to the ways of manifestation of otitis media, the following forms are distinguished:

• Purulent. There is an accumulation of pus behind the eardrum.
• Catarrhal. There is swelling and redness of the tissues, there is no liquid or purulent discharge.
• Exudative. In the middle ear, fluid (blood or lymph) accumulates, which is an excellent breeding ground for microorganisms.

A photo different types otitis media

Causes

Otolaryngologists identify the following factors that can lead to the development of otitis media:

• Ingress of contaminated water. In the presence of microtraumas and cracks in the outer ear, inflammation may develop upon contact with infectious agents in water.
• Complicated sinusitis, SARS. In this case, the pathogen enters the middle ear through the rinotuber route, that is, through the Eustachian tube, which connects the ear and the nasal cavity. If inflammation of the middle ear is not stopped in time, then the infection penetrates into the inner ear.
• kidney disease, diabetes, infectious diseases, hypothermia against the background of reduced reactivity of the immune system can increase the risk of developing otitis media.
• Improper nasal cleansing (blowing your nose through both nostrils at the same time), severe coughing and sneezing lead to increased pressure in the nasopharynx. This, in turn, can cause infected mucus to enter the middle ear.
• Mechanical removal of sulfur from the outer ear, which protects the hearing organ from infection and damage.
• Foreign bodies in the ear.
• Immunodeficiency state, including HIV infection.

The picture shows the area of ​​​​the focus of inflammation of otitis media.

Symptoms in adults

Clinical manifestations of the disease are associated with the localization of the inflammatory process. You can suspect the presence of otitis media in adulthood by classic symptoms:

• Shooting pain.
• Feeling of congestion.
• Discomfort.
• Temperature rise.
• There may be a slight hearing loss.
• Sleep disturbance.
• With the development of otitis media, perforation of the tympanic membrane is possible, the occurrence of purulent discharge mixed with blood.

• Hearing loss.
• Periodic purulent discharge from the ear.
• Dizziness or tinnitus.
• Pain appears only during periods of exacerbation of the disease.
• Temperature rise is possible.

Signs of inflammation of the inner ear:

• Frequent dizziness.
• Nausea and vomiting are possible.
• Hearing loss.
• Noise in ears.

How to treat

The basis of the treatment of the external ear in adults is ear drops. If the patient does not have immunodeficiency states (HIV infection, diabetes), antibacterial drugs not needed. The course of therapy usually does not exceed 5-7 days.

Often used to treat inflammation of the external ear:

• Antibiotics (ciprofloxacin hydrochloride, norfloxacin, rifamycin).
• Corticosteroids and antibiotics (sofradex, candibiotic).
• Antiseptics - Miramistin with a spray, which also has an antifungal effect.
• Antifungal ointments (clotrimazole, natamycin) if the causative agent of otitis media is a fungus. Mupirocin ointment is also widely prescribed, which normalizes the microflora in the outer ear.

During the treatment of inflammation of the middle and inner ear, antibacterial drugs are the main ones. The drugs are prescribed 2-3 days after the first signs of otitis media appear.

Therapy should be carried out under the supervision of a physician. It should not be forgotten that about 28 thousand patients die annually in the world due to improper treatment otitis.

The main antibiotics for therapy:

• Amoxicillin (Flemoxin, Ospamox, Amosin).
• Cefuroxime (Cefurus, Zinnat).
• Amoxicillin with clavulanic acid (Flemoklav, Augmentin).

Reception of antibacterial drugs should be at least 7 days.

Ear drops are also widely used to treat otitis media. In the absence of perforation, drugs are used that anesthetize: Otinum, Otipax. The use of drops with antibiotics at this stage is impractical, because the inflammatory process occurs behind the eardrum.

In this case, antibiotics are used. However, ototoxic drugs (gentamicin, framycetin, neomycin) that can lead to hearing loss, drugs with phenazone, alcohol are contraindicated. At this stage, such drops are widely prescribed: Normax, Ciprofarm, Miramistin.

In some cases, minor surgery is required during treatment. This operation is called paracentesis of the tympanic membrane. It is carried out in the absence of improvement against the background of taking antibiotics.

During manipulation, use local anesthesia. A puncture is made in the eardrum with a special needle, through which pus is removed. The incision heals on its own after the discharge of pus stops.

Therapy of inflammation of the inner ear is carried out only in a hospital under the constant supervision of an otolaryngologist. It includes the use of antibiotics, agents to improve microcirculation inside the labyrinth, as well as neuroprotective drugs to protect nerve cells from damage.

Physiotherapy

Quite often, drug therapy is combined with physiotherapy:

• UHF. Treatment consists in exposing the body to a high-frequency electromagnetic field with a certain frequency. It must be administered with caution, because it can lead to the formation of fluid in the middle ear.
• Electrophoresis. The method allows you to inject drugs through the skin using an electric current.
• Ultraviolet radiation. The procedure allows you to effectively relieve inflammation. The tympanic membrane and the external auditory canal are exposed to irradiation. The duration should not exceed minutes.

Folk remedies

If you are a follower traditional medicine, then the following recipes are widely used for the treatment of otitis media:

• Dry heat. For acute inflammation, it is enough to cover the ear with a dry towel and attach a bottle of hot water or salt heated in a pan, wrapped in a bag.
• Using onion juice Cut off the top of the onion and sprinkle 1 tablespoon of cumin inside. Cover the onion “pot” with a cut “lid” and bake in the oven for 30 minutes. After that, squeeze the juice and drip 3-4 drops overnight.
• Use of tincture of birch buds. The tool has anti-inflammatory and analgesic effect. Birch buds and vodka are mixed in a ratio of 1:10, insist 2 weeks. The resulting tincture must be heated, dripped onto a cotton wool and put in the ear in the form of a turunda. It is necessary to repeat the procedure 14 times.
• Application of 10% tincture of calendula. 2 tablespoons of the collection pour 200 ml of vodka, leave for 7 days. Strain the mixture and instill 3-4 drops into the affected ear up to 8 times a day.

How to treat otitis in adults, see our video:

Complications

In the absence of effective therapy, ear inflammation can lead to serious consequences:

• The infection spreads to the lower jaw, salivary glands. Often in such cases, patients become disabled.
• Violation of the gastrointestinal tract. Ears and organs abdominal cavity connected by one nerve. As a result, with inflammation of the ear, bloating, vomiting, and constipation are possible.
• Paresis of the facial nerve.
• Otoanthritis - the penetration of infection into the behind-the-ear region. Outwardly, the ears protrude, swelling occurs, the temperature rises.
• Meningitis and other intracranial complications (encephalitis, hydrocephalus).
• Cholesteastomy is the formation of a cyst in the ear canal, which is filled with keratin and dead cells.
• Mastoiditis - inflammation in the middle ear, causing the destruction of the auditory ossicles.
• Complete hearing loss.

Patients in adulthood may not pay attention to ear inflammation for a long time. That is why in some cases conservative therapy does not give the desired result and inevitably surgical intervention.

Inflammation of the inner ear, or labyrinthitis, is a rare but dangerous form of otitis media. It develops due to the ingress of harmful microorganisms into the hearing organs. In some cases, it develops due to trauma. When the first symptoms of the disease appear, you should immediately visit a doctor. In case of ignoring the disease, you can completely lose your hearing.

Inflammation of the inner ear, although rare, is severe. The course of the disease can be compared with acute otitis media. The disease spreads to the labyrinth, consisting of three semicircular canals and the cochlea. The channels are responsible for the sense of balance, and the cochlea for hearing. Since the inner ear is located quite deeply, the infection can get inside through other sources of infection.

The disease develops against the background of otitis media. The middle and inner ear are separated by a membrane and through it the infection enters the inner ear. There, pus forms and pressure increases.

The infection can get into the labyrinth not only through the ear, but also through the membrane of the brain, due to meningitis. In this case, the infection affects both ears and causes complete deafness, especially in children. Injury to the ear with a needle or other foreign body increases the risk of inflammation. In some cases, labyrinthitis develops as a result of a blow to the temple or back of the head.

Inflammatory disease is also one of the complications:

• syphilis;
• flu;
• tuberculosis;
• epidemic parotitis.

Other causes of the disease:

• cold;
• alcoholism,
• neoplasms in the middle ear;
• drug overdose.

Depending on the localization of the inflammatory process, there are:

• purulent labyrinthitis;
• limited labyrinth.

Harmful bacteria and all their metabolic products enter the labyrinth during the course of the disease. Treatment of inflammation of the inner ear should be started when the first signs appear in adults and children.

Symptoms of inflammation of the inner ear

Symptoms of the disease develop depending on the stage and course of inflammation. Main features:

• Hearing loss. Occurs suddenly. Sometimes hearing is completely lost.
• Pain and tinnitus.
• Dizziness.
• Uncontrolled eye movements.
• Disturbance of balance and balance.
• Increased sweating;
• Tachycardia.

The patient's condition worsens with head movements. And dizziness worries regularly and can even last for several hours. In this case, the patient feels as if objects around him are rotating. This symptom is systemic. To alleviate his condition, the patient lies motionless on his side, with the diseased ear up. In the case of chronic labyrinthitis, the head may begin to spin suddenly and not stop for several days. Sometimes vomiting and nausea may occur. Non-systemic dizziness characterized by:

• lack of coordination;
• unsteadiness when walking.

What else is dangerous inflammation of the inner ear? Symptoms of the disease should be treated at the first sign of them. The disease can cause paralysis of the facial nerve. The main signs of paralysis:

• increased secretion of saliva;
• taste change;
• there are no wrinkles on the forehead when lifting the eyebrows;
• complete immobility of the eyelids;
• it is impossible to smile or frown;
• dry eyes.

These symptoms require immediate treatment.

On the part of the auditory analyzer, patients complain of ringing in the auricle with inflammation of the ear and high-frequency noise. Hearing loss is observed within a few days. Purulent labyrinthitis leads to complete deafness.

Diagnosis of otitis media

Inflammation inside the ear requires immediate medical attention. After talking with the patient and examining him, the otolaryngologist should make a diagnosis. What is included in the general inspection:

• examination of the tympanic membrane;
• an overview of the auricle and behind the ear;

It is also desirable for the patient to take a general blood test. For a more accurate diagnosis, which will show a holistic picture of the disease, the following methods are used:

1. Audimetry. This is a study of auditory sensitivity to sounds of different frequencies. It is carried out by a specialist using an audiometer or a tuning fork. All hidden hearing impairments and ear diseases are shown by an audiogram. This method has no contraindications and side effects. It is suitable for both adults and children.
2. CT scan. Sequential transillumination of human organs by X-rays. Gives clearer and more detailed images than conventional x-rays. Contraindications: pregnancy and body weight over 180 kg.
3. MRI. Gives a more contrast image than CT and at the same time the body does not experience ionizing radiation. Contraindications: pacemaker and middle ear implants.
4. Electronystagmography - a study of mobility eyeballs.
5. Vestibulometry is a group of studies that gives full information about the state of the vestibular apparatus.

To identify the causative agent of the disease, infected tissues are given for bacteriological analysis.

If it turned out that the inner ear was inflamed with otitis media, the doctor should choose a treatment regimen and monitor the patient's condition until he is completely cured.

Therapeutic treatment

After the diagnosis of labyrinthitis, the otolaryngologist prescribes the appropriate treatment regimen. In severe cases, the patient is hospitalized and treated in a hospital. If the disease is localized in one area and is not complicated by purulent masses, drug therapy is performed. In addition, the patient needs rest and bed rest. The following procedures will be helpful:

• diet - consumption of 1 liter pure water per day and reducing salt intake (½ gr);
• taking diuretics and hormones that increase blood glucose levels - glucocorticoids;
• internal injections of glucose, calcium chloride and magnesium sulfate;
• vitamin therapy: B, K, C, P;
• intake of carboxylase.

If the labyrinth is filled with purulent masses and the entire inner ear is affected, surgical intervention is performed. This happens when medications do not bring any effect. The main task of the operation is to remove purulent masses from the inner ear. After all, the inflammatory process is located dangerously close to the brain and poses a threat not only to health, but also to the life of the patient. The type of operation depends on the course of the disease and the condition of the patient:

1. Labyrinthotomy. Opening of the semicircular canal of the labyrinth. Provides an outflow of pus from the inner ear.
2. Antomatoidotomy - trepanation of the mastoid process and removal of pus from there. Held under local anesthesia. Rehabilitation after surgery can take several months.
3. Labyrinthectomy - surgical removal of the labyrinth. Used on rare occasions.

If the labyrinthitis has led to deafness, hearing aids or hearing replacement surgery are prescribed.

Medical treatment

The treatment regimen is prescribed by the doctor depending on individual features organism. If the disease is caused by a bacteriological infection, antibiotics are prescribed:

• II generation cephalosporins: Cefuroxime, Ceftin, Kefurox;
• III generation: Ceftriaxone, Tercef;
• IV generation: Maxim.

From the group of penicillins appoint:

• Oxacillin;
• Piperacillin.

For severe forms:

• Cifroploxacin;
• Tsiprinol;
• Digital.

To relieve inflammation in the inner ear, use:

• Diclofenac;
• Dicloran;
• Naklofen.

To eliminate nausea, vomiting and dizziness, take antihistamines:

• Tavegil;
• Diazolin;

For comfort nervous system:

• diazepam;
• Lorazepam.

To improve blood circulation in the inner ear:

• Alfaserk;
• Betahistine;
• Betaserc.

If treatment is started on time, all the functions of the inner ear will return to normal, and hearing will be restored. In order to prevent a relapse, at the first manifestations of the disease of the ENT organs, it is necessary to consult a doctor.

Physiotherapy

Physiotherapy is used to eliminate inflammation in the inner ear and improve blood circulation. What methods are used:

1. Laser therapy. For treatment, low-intensity radiation is used. The laser penetrates deep into tissues and reduces signs of inflammation and pain, enhances immune processes and restores the normal functioning of the diseased organ.
2. Short-wave ultraviolet radiation (UV). Short rays have antiviral and bactericidal action. It also destroys toxins and other harmful microorganisms. After a few hours, redness appears at the site of irradiation, which disappears in 1-2 days.
3. Transcranial electroanalgesia. The method of physiotherapy, which consists in the impact of a pulsed electric current on a sore spot. Effects: analgesic, sedative, regenerative.
4. Galvinization or galvinic collar according to Shcherbak is the effect on the body of a low voltage electric current. The method is contraindicated in malignant tumors, skin diseases, cardiovascular diseases.

With labyrinthitis, UHF therapy and magnetotherapy cannot be used.

Folk remedies to help

It is impossible to cure labyrinthitis with the help of folk recipes. Alternative medicine can only enhance the effect of the main drugs. Also, "grandmother's" methods are used to relieve the symptoms of the disease:

1. Dilute honey or propolis tincture in proportions 1: 1 with filtered warm water. Bury 2 drops in the ear.
2. Mix freshly squeezed onion juice with vegetable oil in equal proportions. Soak a swab in the resulting mixture and insert it into the affected ear. You can leave it all night.
3. Medical burnet (2 tablespoons) pour two cups of boiling water. Insist for half an hour. Take orally three times a day for a tablespoon.

You can use these folk recipes only under the supervision of a doctor. Herbal teas and herbal teas from echinacea, rose hips, lemon balm and chamomile will be useful. In no case should warming procedures be carried out. This can lead to the spread of pus to healthy tissue.

Prognosis and possible consequences of the disease

Inflammation of the inner ear often occurs as a complication of colds and infectious diseases, such as:

• pneumonia;
• measles;
• flu;
• tuberculosis;
• scarlet fever.

If the inflammation is detected on time and the necessary medicinal help, all auditory functions and functions of the vestibular apparatus will be restored. But if you ignore the signs of the disease, the consequences of otitis media are quite severe:

• inflammation of the facial nerve;
• mastoiditis - inflammation of the mastoid process near the temporal bone;
• osteomyelitis of the apex of the pyramid of the temporal bone;
• meningitis;
• encephalitis;
• sepsis;
• cerebral thrombosis;
• hearing loss;
• intracranial abscesses.

If you start treatment at an early stage, all symptoms and disorders will disappear. Otherwise, the patient may lose his hearing and health.

Prevention of inflammation

To protect yourself from labyrinthitis, you need to treat all infectious diseases in time and prevent them from becoming chronic. Basically, it concerns otitis media. Injury to the temporal region should also be avoided and the eardrum should be checked regularly for damage. Since inflammation of the inner ear is almost asymptomatic, in order to prevent it is necessary to regularly visit an otolaryngologist. For a general improvement in the condition of the body and strengthening the immune system, simple well-known rules will help:

• consumption of foods rich in vitamins and minerals;
• sports and regular physical activity;
• daily walks in the fresh air;
• maintaining cleanliness and microclimate in the room;
• timely treatment of respiratory infections;
• at chronic diseases- annual visits to medical sanatoriums.

If the labyrinthitis was caused by a traumatic brain injury, then the symptoms may be different. With damage to the inner and middle ear, an accumulation of inflammatory fluid with an admixture of blood is often observed ( hemorrhagic exudate), which is visible through the eardrum. Also, damage to the temporal bone can lead to paresis of the facial nerve. This complication is manifested by the inability to voluntarily control the muscles of the face ( half of the face on the side of the lesion remains motionless). Paresis of the facial nerve occurs in case of damage to the canal of the facial nerve, located in the temporal bone.

Symptoms of labyrinthitis

Symptom	Origin mechanism	External manifestation
Involuntary oscillatory eye movements (nystagmus)	Occur due to dysfunction of one of the labyrinths. The subcortical and cortical regions of the brain that process signals from the semicircular canals lead to nystagmus in response to dysfunction of the labyrinth. At the beginning of the disease, nystagmus is directed towards the affected ear, and then changes its direction in the opposite direction within a few hours. In the context of damage to the cavity of the inner ear this symptom is the most important.
Nausea and vomiting	Appear due to the transition of nerve impulses from the vestibular nerve to nearby nerve fibers of the vagus nerve. In turn, this nerve is able to irritate the upper gastrointestinal tract, which leads to nausea, and with excessive stimulation of the soft muscles of these departments, vomiting.
Excessive sweating (hyperhidrosis)	Appears on initial stage lesions of the labyrinth or exacerbation of chronic labyrinthitis. Excessive sweating occurs due to excessive stimulation of the vagus nerve.
Dizziness	Caused by damage to the semicircular canals. Information about the position of the head and torso reaches the brain only from a healthy labyrinth. As a result, the vestibular center is not able to assess the current position, which leads to a violation in spatial orientation. Dizziness can subjectively manifest itself as a sensation of rotation of surrounding objects, a feeling of uncertainty in determining one's current position in space, or as the ground moving from under one's feet. The vertigo attacks may be short-lived ( 3 - 5 minutes) or last for several hours.
Hearing loss up to deafness	Hearing loss occurs when the cochlea of ​​the inner ear and/or the auditory nerve is damaged. Deafness, as a rule, occurs due to a purulent lesion of the inner ear cavity or after an acute acoustic ear injury. It should be noted that hearing loss is more pronounced in the high frequency range.
Movement coordination disorders	It is observed with pathological changes in the semicircular canals and in the vestibulocochlear nerve. These disorders lead to a change in gait ( unsure and shaky), as well as to the deviation of the trunk and head in a healthy direction.
Noise in the ears (tinnitus)	Occurs when the auditory nerve is damaged. Noise in the ears in the vast majority of cases appears along with hearing loss. Subjectively, tinnitus is perceived as a hum, buzz, hiss, ringing or squeak.
Change in heart rate	With labyrinthitis, a decrease in heart rate is most often observed. This is due to excessive activation of the vagus nerve, which also supplies nerve fibers and heart. Nervus vagus can change the conduction of the heart and lead to a slowing of the rhythm.

Diagnosis of labyrinthitis

• otoscopy;
• vestibulometry;
• fistula test;
• audiometry;
• electronystagmography.

Otoscopy

The examination always starts with a healthy ear. For a more convenient examination of the external auditory canal, the doctor pulls the auricle back and up. With the help of a special instrument of the otoscope, defects in the eardrum can be visually detected. If the tympanic membrane is partially or completely destroyed, using this method, you can examine the middle ear cavity. Otoscopy is used if the labyrinthitis was caused by acute acoustic trauma of the inner ear or if the inflammatory process spreads from the middle ear cavity to the inner ear.

Vestibulometry

Vestibulometry involves the use of the following functional tests:

• caloric test;
• rotational test;
• pressor test;
• otolith reaction;
• finger-nose test;
• index test.

Caloric test implies a slow infusion of water into the external auditory meatus, which may be warm ( 39 - 40ºС) or cold ( 17 - 18ºС). If water at room temperature is used, then the resulting involuntary eye movements are directed towards the ear being examined, and if cold water is poured in, in the opposite direction. This nystagmus occurs normally, but is absent when the inner ear is affected. It is worth noting that the caloric test is carried out only with an intact eardrum, so as not to lead to the ingress of a large amount of water into the middle ear cavity.

Rotational test produced on a special chair with a rotating seat. For this, the subject is asked to sit in a chair, keep his head straight, and completely close his eyes. Then 10 rotations to the right side are carried out, and then another 10 rotations to the left. In this case, the rotation speed should be 1 revolution in 2 seconds. After this test is over, the doctor monitors the appearance of nystagmus. Normally, nystagmus lasts about half a minute. The shortening of the duration of nystagmus speaks in favor of the defeat of the labyrinthitis.

Pressor test carried out using a special Politzer balloon. Air is injected into the external auditory canal through this balloon. If nystagmus occurs, then this speaks in favor of a fistula ( pathological canal) in the lateral semicircular canal.

Wojacek's otolith reaction just like the rotational test, it is performed on a special rotating chair. The examined patient closes his eyes and lowers his head down so that his chin touches the sternum. The chair is rotated 5 times within 10 seconds. Then wait 5 seconds, after which the subject must raise his head and open his eyes. The function of the vestibular apparatus is assessed by various symptoms ( nausea, vomiting, cold sweat, blanching of the face, faintness).

Finger-nose test is a simple test to detect violations in the coordination of movements. The patient is asked to close their eyes and withdraw one of the hands, and then slowly touch the tip of the nose with the index finger of that hand. With labyrinthitis, this test helps to identify vestibular ataxia. Ataxia is a violation of gait and coordination of movements and may occur due to damage to the vestibular apparatus. Most often, vestibular ataxia is unilateral.

Barany index test carried out in a sitting position. The patient is asked to put the index finger of the hand into the finger of the doctor's outstretched hand alternately with open eyes and then closed. With labyrinthitis, the person under study closed eyes misses with both hands.

Audiometry

There are the following types of audiometry:

• tone audiometry;
• speech audiometry;
• audiometry using a tuning fork.

Speech audiometry necessary to determine the quality of word recognition at different sound levels. Through air telephones, the person under study is asked to listen to a recording of 25 or 50 words spoken with varying intensity. At the end of the speech audiometry, the number of words that were heard is counted. Any word change ( using the singular instead of the plural and vice versa) is considered an incorrect answer.

Audiometry using a tuning fork used in the absence of pure tone audiometry. As a rule, the Weber or Rinne test is used. To do this, the leg of the sounding tuning fork is applied to the crown ( weber test). With an unaffected auditory analyzer, the sound is felt in both ears with the same intensity. With a one-sided labyrinthitis, the patient will hear better with the affected ear. For the Rinne test, the stem of a sounding tuning fork is applied to the mastoid process of the temporal bone. After the subject says that the sound of the tuning fork has ceased to be felt, it is removed and brought to the auricle. With labyrinthitis, the sound of a tuning fork is not felt while approaching the ear, while normally a person begins to hear the sound of a tuning fork again.

Electronystagmography

In addition to the above methods, other highly informative diagnostic methods can be used that can detect damage to the inner ear.

There are the following instrumental methods diagnosis of labyrinthitis:

• radiography;

Computed tomography of the temporal bone is one of the preferred methods in the diagnosis of labyrinthitis. This method allows to visualize not only the bony structures of the temporal bone, but also various soft tissue structures in their natural location. Computed tomography allows not only to identify the nature and degree of damage, but also allows you to visualize the state of blood vessels and nerve tissues in this segment. As with radiography, the only contraindication for this method is the presence of pregnancy.

Magnetic resonance imaging is the "gold standard" in the diagnosis of various lesions of the inner ear. Magnetic resonance imaging is the most informative diagnostic method and allows you to study in detail the structures of the bone and membranous labyrinth. The only drawback of this method is the inability to obtain information about the middle ear cavity.

If labyrinthitis is the result of a viral or bacterial infection, then it is necessary to perform a complete blood count. If labyrinthitis is caused by a bacterial infection entering the cavity of the inner ear, then an increased number of leukocytes will be found in the blood ( white blood cells that protect the body from pathogenic bacteria), and with a viral disease - an increased number of lymphocytes ( immune system cells). Also, the infectious process leads to an increase in ESR ( erythrocyte sedimentation rate).

If labyrinthitis is caused by otitis media, then in this case it is necessary to conduct a bacteriological examination of discharge from the ear ( method to identify the type of pathogen).

Treatment of labyrinthitis with medicines

Medical treatment includes the use medicines different groups. To treat a bacterial infection, antibiotics are prescribed, taking into account the sensitivity of microorganisms ( antibiogram). They also prescribe medications that have an anti-inflammatory effect, as well as normalize metabolic processes in the inner ear cavity and brain.

Antibiotics for the treatment of labyrinthitis

Medical treatment of labyrinthitis

Surgery for labyrinthitis

The following important points regarding the operation for labyrinthitis should be mentioned:

• indications;
• methodology;
• anesthesia;
• hearing forecast;
• rehabilitation.

Indications

The following indications for the operation are distinguished:

• irreversible hearing loss;
• purulent labyrinthitis;
• a combination of labyrinthitis with inflammation of other bone structures of the temporal bone;
• penetration of infection from the cavity of the inner ear into the brain.

Purulent labyrinthitis caused by ingestion of staphylococci or streptococci into the cavity of the inner ear. This form labyrinthitis leads to complete damage to the organ of Corti. In the future, purulent inflammation of the inner ear can lead to necrotic labyrinthitis, which is manifested by the alternation of dead ( necrotic) plots soft tissue and the bone part of the labyrinth along with foci of purulent inflammation.

The combination of labyrinthitis with inflammation of other bone structures of the temporal bone. In some cases, the inflammatory process, in addition to the labyrinth, can affect adjacent bone segments of the temporal bone. Inflammation of the mastoid process ( mastoiditis) or the apex of the pyramidal bone ( petrosite), usually treated with surgery ( surgery to remove pus).

Penetration of infection from the cavity of the inner ear into the brain. One of the complications of labyrinthitis is the spread of the inflammatory process along the course of the auditory nerve to the brain. In this case, meningitis, meningoencephalitis ( inflammation of the substance of the brain and membranes) or brain abscess ( accumulation of pus in the brain).

Methodology

To access the labyrinth, you can use the following techniques:

• Ginsberg method;
• Neumann's method.

Ginsberg method. The labyrinth is opened in the region of the cochlea and the vestibule from the lateral ( horizontal) semicircular canal. An autopsy is performed with a special surgical chisel in a place that corresponds to the main curl of the cochlea. It is necessary to accurately perform surgical manipulations, since if the chisel under the blow of a hammer jumps to oval window, then this will lead to damage to the facial nerve. Also nearby is a branch of the internal carotid artery, which can also be easily damaged. At the second stage, the horizontal semicircular canal is opened. Further, through this channel, scraping is performed with a special spoon ( destruction) vestibule and passages of the cochlea.

Neumann's method. This method is more radical, since not one, but two semicircular canals are opened at once ( top and side). After these channels have been opened, the cochlea is scraped. This type of operation is very harder way Ginsberg, but allows better drainage of the labyrinth ( outflow of pathological secretions from the cavity of the inner ear).

Anesthesia

Hearing prediction

Hearing prosthesis surgery needs special consideration. This method is effective in case of damage to the cochlea of ​​the inner ear and is based on the installation in the human body of a special device that can convert sound signals into nerve signals. A cochlear implant is used as a prosthesis ( an implant that functions as a cochlea), which consists of several parts. In the temporal bone, an implant body is implanted under the skin, which is able to perceive sound signals. A special electrode array is inserted into the ladder of the cochlea. Having received sound signals, a special processor in the body of the implant processes them and transmits them to the cochlea and further to the electrode array, in which the sound is transformed into electrical impulses that are recognized by the auditory area of ​​the brain.

Rehabilitation

Rehabilitation after hearing aids can take quite a long time. a long period time. This is due to the fact that the process of adaptation takes place over several months, and the patient is taught to hear again through this cochlear implant.

Prevention of labyrinthitis

Sanitation is a technique for improving the body. During the rehabilitation of ENT organs ( nasal cavities, sinuses, pharynx, larynx, ears) there is an destruction of microorganisms that live there and are capable of leading to various diseases with a decrease in immunity.

There are the following indications for the rehabilitation of ENT organs:

• an increase in body temperature above 37ºС;
• the appearance of pain in the nose or in the sinuses;
• difficulty breathing through the nose;
• deterioration of the sense of smell;
• pain, soreness or burning in the throat;
• an increase in the size of the tonsils ( tonsils) and the presence of films on them.

For rehabilitation, the following medicinal substances are used:

• furatsilin;
• chlorhexidine;
• chlorophyllipt;
• tomicid.

Chlorhexidine is an antiseptic substance that neutralizes not only various bacteria but also viruses and microscopic fungi. Chlorhexidine can be used in various dilutions ( 0.05 and 0.2% solution) for rinsing the mouth.

Chlorophyllipt is an oil or alcohol solution that is effective against staphylococcus aureus. In diseases of the nasal sinuses ( sinusitis, frontitis) the drug is instilled 5-10 drops 3 times a day for a week.

Tomicide is a drug that inhibits the growth of gram-positive microorganisms ( staphylococci, streptococci). For rinsing, it is necessary to use 10-15 ml of a heated tomicid solution 4-6 times a day. When gargling, contact with this drug should not exceed 5 minutes.

It should be noted that sanitation should be used together with other methods of treatment of diseases of the upper respiratory tract ( antibiotic therapy). Surgical debridement is resorted to only in the case when drug therapy has no effect.

One of the most dangerous pathologies are diseases of the inner ear. Their symptoms are generally similar, but the causes and characteristics of the course may be different. Prevention will help to avoid such diseases. There is no way to protect against congenital problems, but some of them are treatable. All these issues should be considered in more detail.

Types of diseases and their consequences

First you need to find out the main diseases of the inner ear. There are such pathologies as:

• Labyrinthitis. This is the most famous and widespread disease. We are talking about the inflammatory process, that is, internal otitis media. There are two main types: limited and spilled. In the first case, the infection does not go beyond the affected sector and only partially damages the ear, and in the second case, it covers the entire cavity of the inner ear and often leads to persistent deafness, including bilateral. Serous and purulent inflammation are also distinguished. Serous is characterized by the accumulation of fluid, which is provoked by exposure to toxins and does not bear any special negative consequences. With purulent labyrinthitis, especially diffuse, bacteria multiply in the cavity of the inner ear, suppuration and destruction of the receptors and curls of the cochlea occur. The organ of Corti suffers the most, causing deafness.
• Traumatic injuries. Various deformations of the labyrinth and cochlea, internal breaks, fractures, displacements, hemorrhages in the ear, etc.
• Organ underdevelopment. This type of anomaly is congenital. Depending on the degree and localization of disorders, in some cases it is possible to partially restore the ability to hear due to surgical intervention. If the ear is completely devoid of the cochlea or the organ of Corti, the problem cannot be solved.
• Tumors and other neoplasms. Epithelial growths, cysts and tumors, including oncological ones, can form in one of the areas of the inner ear.
• . This is sensorineural hearing loss, which is mainly the result of one of the primary diseases of the inner ear. The most important receptors in the auditory system, as well as the auditory nerve, are affected. As a result, there is a dysfunction of the conductive analyzer, that is, sound signals cannot be processed and transformed into nerve impulse, which is then transmitted to the brain.
• Otosclerosis. overgrowth bone tissue in the cavity of the labyrinth, which blocks the ear, its functions and leads to deafness.
• Pathology of the vestibular apparatus. When the infection enters the vestibular apparatus, problems with coordination begin. There may also be diseases associated with, which are caused by malfunctions or damage to them. One of the most well-known problems is, which is associated with an increase in the amount of endolymph in the inner ear.

The consequences of these diseases are hearing impairment at the neurosensory level. There is a destruction of hair receptors that are not able to recover. When inflammation occurs serous type manages to preserve the islets of receptors. If you use modern methods of hearing restoration, a person can retain the ability to hear.

Purulent diseases are dangerous for the inner ear in that necrotic processes and tissue decomposition enter into the process. As a result, the cochlea and the organ of Corti suffer. Sensory hairs die and deafness develops without the possibility of its cure.

Symptoms and causes

With the development of inflammation of the inner ear, the patient has the following symptoms:

• pain in the ear and temporal bone, may radiate to the back of the head or to the entire half of the head;
• malaise and weakness;
• dizziness, problems with coordination;
• nausea and vomiting;
• elevated temperature;
• noise in ears;
• tachycardia;
• hearing loss.

When an organ is damaged, severe pain, hearing is noticeably reduced, symptoms of intoxication and disorientation are observed.

provoke various violations in the work and condition of the inner ear can be such reasons as:

• Congenital anomalies of development. Underdevelopment of the fetus, the influence of heredity, bad habits mother, toxins and infections in the prenatal period.
• Birth trauma. Difficult childbirth, use of forceps, deformation of the skull when passing through the birth canal.
• Traumatic brain injury. Any type of damage, especially when strong blows or falls from a height, skull fractures and gunshot wounds affecting the ear.
• Internal damage to the ear. When foreign objects get through the middle ear, during the surgical procedures, barotrauma.
• Infectious inflammation and viruses. Otitis media, mastoiditis, meningitis, as well as typhoid, tuberculosis and other diseases.
• acoustic impact. Deterioration of receptors due to prolonged noise and harsh sounds.
• Intoxication. The impact on the ear of the waste products of bacteria, alcohol, drugs, certain medicines and other toxic substances, including the environmental situation.

Also affect systemic pathologies, neurological and vascular, cervical osteochondrosis, stress.

There are three main routes of infection of the inner ear:

• Otogenic. Through the organs of hearing, mainly from the middle ear.
• Meningogenic. From the brain, meninges and intracranial space to the ear.
• Hematogenous. Through the bloodstream when infection enters the bloodstream.

It is possible to establish the place of development of the pathology, its causes and the degree of violations that have occurred through special examinations. Diagnostics includes the following activities:

• otoscopy;
• blood and urine analysis;
• audiometry;
• samples with tuning forks;
• radiography;
• CT and MRI.

When discharge from the ear appears, samples of secretion are taken for analysis to determine the type of bacteria involved in pathological process, as well as the selection of the most effective drugs.

Treatment and prevention

Not all inner ear problems can be cured. With the death of receptors or scarring of the organ of Corti, it is not possible to restore hearing. In some cases, cochlear hearing aids may help.

In general, the treatment of diseases of the inner ear is as follows:

• Medical therapy. It is used to eliminate inflammation and symptoms of intoxication. Drugs are used to stimulate neurological processes and the vascular system. It all depends on the specific diagnosis and the cause of the problem.
• Surgery. It is possible to eliminate the symptoms of suppuration and its consequences by opening the labyrinth and sanitizing it. Also held recovery operations and implantation.
• Physiotherapy. Some types of procedures speed up tissue repair and improve organ function. Often physiotherapy is combined with the introduction of drugs directly into the ear.

Help to cope with problems helps proper nutrition and healthy lifestyle. Avoid vitamin deficiencies and weakening of the immune system.

To restore hearing and balance function, special exercises and breathing techniques are used.

To prevent the development of these diseases, it is necessary to observe, that is, to avoid negative influences, loud sounds and injuries. In a timely manner, consult a doctor for the treatment of otitis media and other infectious diseases. If you notice symptoms that point to one of the diseases mentioned, contact your doctor immediately.

A person's inner ear can become inflamed, and this inflammation of the inner ear is called labyrinthitis. The labyrinthite includes 3 semicircular canals that help people control their balance. A similar disease in advanced form can cause partial hearing loss.

Causes of the disease

Otitis media can be viral or bacterial in origin. The main symptoms of this ear disease:

• nausea;
• vomit;
• dizziness;
• loss of balance.

Also, patients may experience headache, which may be accompanied by the appearance of ringing in the ears (tinnitus) and partial hearing loss. If inflammation of the inner ear is caused bacterial infections, then the impairment of auditory function will be permanent.

Dizziness occurs suddenly, approximately 10-14 days after a viral / infectious disease. If the attack is strong, it will be accompanied by nausea and vomiting. A few days after the onset of the disease, dizziness may disappear, but with careless movements, seizures will occur, leading to a loss of orientation in space.

The reasons for the origin of labyrinthitis are not clear enough. The most common provoking causes of the disease, especially in adults, may be a cold of the upper respiratory tract, influenza or SARS. In addition, labyrinthitis is diagnosed after meningitis. Sometimes the provoking cause may be an inflammatory process occurring in the middle ear.

Diagnosis of the disease

If the patient has symptoms that are characteristic of the ongoing inflammatory process in the middle ear, he should immediately seek help from the hospital. After passing a visual examination of a doctor, hardware testing of a sick person is prescribed.

Among these methods, electronistamography can be noted, which will help to identify the cause of the origin of dizziness. A similar diagnostic method allows you to fix the movement of the eyeballs. To do this, special electrodes are attached to them, which quite accurately record the movement of the eyes. Based on this information, it is possible to understand which part of the central nervous system (CNS) has been damaged.

Then a test of the person's hearing abilities is carried out, which will help to understand the degree of their impairment. To do this, a check is made of the part of the brain that is responsible for recognizing sound vibrations. Similar procedure will help determine how well something is functioning. nerve ending, which connects inner part ear with brain.

Treatment process

Treatment of inflammation of the inner ear is carried out with conservative medications.

aim conservative methods is the prevention of complications that can transfer the inflammatory process to the purulent stage. For this, antibiotic treatment is used.

Antibiotics are prescribed a wide range actions, since it is initially quite difficult to identify the pathogen. Most often, penicillin and cevalosporin antibiotics are used for this. It is forbidden to use ototoxic antibacterial drugs.

Such treatment is recommended to be combined with dehydration therapy. It includes a whole range of measures, the main of which is the restriction of fluid and salt intake. The volume of water consumed by a person per day should not exceed 1-1.1 liters, and the amount of salt cannot be more than 1 g. In addition, diuretics are recommended to help remove excess fluid from the body. Hypertonic injections and glucose should also be administered intravenously.

To prevent trophic disorders in the ear tissues, vitamins C, B, P and K, Preductal or Cocarboxylase are used. Moreover, the effectiveness of treatment can be increased by intramuscular injections with Atropine and Scopolamine.

If purulent or diffuse-serous forms of labyrinthitis occur, the patient is prescribed surgery. A similar form of the disease can occur against the background of acute otitis media or exacerbations after purulent diseases of the ear.

Currently, doctors perform 2 types of operations - antromastoidotomy or general cavitary sanitizing operation. With the help of such methods, purulent inclusions are removed (elimination) from the inner ear. But before carrying out such an surgical intervention, you must first undergo a course of drug treatment.

If a fistula is found in patients, they are also prescribed surgery. With the help of such an intervention, the inflamed area is removed from the tympanic membrane. If the patient has complications of an intracranial nature, then the operation should be performed in the shortest possible time. This will help avoid complications.

Complications of the disease

To prevent the occurrence of complications, prophylaxis of internal otitis media is carried out. Its purpose is the timely detection of the disease and the prevention of exacerbations. In addition, similar preventive actions help the doctor prescribe proper treatment, which will help to avoid further hearing loss and the occurrence of side ailments. Most effective method prevention is a regular examination by the attending physician, who, at the slightest suspicion of the onset of the disease, will prescribe a course of maintenance therapy.

The main complications of internal otitis media are inflammatory processes in nearby organs. Among them, mastoiditis can be noted - this is an infectious inflammation mastoid processes at the temporal bones. Arises high risk the appearance of encephalitis, meningitis or brain abscess, since purulent discharge can penetrate into the cavity of the cranium.

In addition, during the prevention of inflammatory processes of the inner ear, differential diagnosis patient. This will allow you to distinguish the disease from other ailments similar in symptoms. Among them, special attention should be paid to the abscess of the cerebellum or otogenic arachnoiditis, in which the inflammatory process of the meninges occurs.