Perforative otitis in people occurs in the process of complication of the acute purulent form of this disease. In this case, patients observe a violation of the integrity of the eardrums, which separate the middle and outer ear. As a result, people develop deafness along with hearing loss and impaired perception of sounds. This disease is dangerous. Against its background, a secondary infection may occur, which occurs due to perforation of the membrane.
Rupture of the membrane most often occurs in the lower quadrant. This is a triangular gap, its edges are uneven, pus can come out of it. If this happens, the doctor will take a small amount of fluid for bacteriological analysis in order to determine the causative agent of the disease and select antibiotic therapy. The larger the perforation, the more severely the hearing is impaired. A sharp pain in the ear may indicate a ruptured eardrum.
Otitis can be described as follows:
- Sudden onset of illness, rise in body temperature to 39 degrees.
- Pain in the ear radiating to the temple and teeth on the affected side.
- Hearing loss and tinnitus.
- General weakness and malaise.
Main causes of pathology
Factors that provoke perforated otitis may be as follows:
- Chronic inflammation in which a discharge accumulates in the ear cavity, which affects the eardrum, causing it to rapidly thin.
- Foreign objects that have a traumatic effect.
- Infectious migration from closely located organs: from the oropharynx, maxillary sinuses, nasal passages and so on.
- Incorrect execution of medical manipulations.
- Presence of traumatic injuries of the skull.
- Infection with blood flow in influenza, scarlet fever and more.
Now let's find out how modern clinics carry out the diagnosis of such a disease.
Diagnosis of disease
Diagnosis of perforated otitis is carried out using otoscopy, which is performed by a specialist. It is a painless simple procedure in which a plastic or metal funnel is inserted into the auditory external canal, and the auricle is pulled up to align the auditory canal and the eardrum is visually inspected.
Tearing it most often occurs in the lower quadrant. If available, the doctor takesfor bacteriological analysis, a small amount of liquid to determine the origin of the pathogen and the selection of antibacterial treatment. The larger the size of the perforation, the more severely the patient's hearing is impaired.
Now let's find out what signs indicate the appearance of this disease in the body.
Symptomatics
Perforative otitis is characterized by:
- Sudden onset of illness with body temperature rising to thirty-nine degrees.
- Pain in the ear that radiates to the temple and teeth, usually on the affected side.
- Hearing loss and noise.
- General weakness and malaise.
There are more serious forms of the disease.
Purulent otitis media and its symptoms
Purulent perforative otitis is characterized by:
- Sharp and very severe pain.
- Weakening or loss of hearing on the affected side.
- Outflow of pus with an unpleasant odor mixed with blood from the affected ear area.
- Ringing, noises and discomfort.
- Dizziness and nausea.
- Relief of pain as a result of the discharge of fluid from the ear.
The exit of air from the organ indicates a complete rupture of the membrane. After its perforation, with the successful discharge of fluid from the middle ear, a gradual restoration of auditory sensitivity occurs. A small size of acute suppurative perforated otitis media can heal on its own. In other cases, it is necessary to be treated, observing the degenerative change in the affectedeardrums.
Acute otitis media
This is a rather fast-flowing infectious lesion of the ear cavity. The clinical picture of the disease includes the presence of a pronounced pain syndrome along with sensations of congestion and noise, hearing loss, the appearance of a hole in the membrane with further suppuration.
As part of the diagnosis of acute perforated otitis media, otoscopy and blood tests are used. An x-ray of the skull and an examination of the auditory tube may be performed.
General treatment of the disease is carried out with antibiotics, anti-inflammatory and antihistamines. As for local therapy, it consists in blowing the auditory tube, and, in addition, instillation of drops, the introduction of proteolytic enzymes, and so on.
In children
Often children under three years of age suffer from acute perforated otitis media, this is facilitated by their anatomical features. In infants, the auditory tube is much shorter and more horizontal than in adults. Their tympanic cavity is filled with a peculiar connective tissue, which predisposes to the development of inflammation in this area.
Children have less resistance to infections, in addition, they have a weaker immune system. Diseases like adenoids, acute tonsillitis and adenoiditis only contribute to frequent relapses and the occurrence of otitis media.
It is extremely important to have time to pay attention to the symptoms of the disease. In the event that the baby is not yet two years old, then he will begin to indicate painrestlessness, denial of food and crying. As part of the pressure on the ear tragus, the crying of the crumbs will intensify, which will only confirm the diagnosis.
When confirming this disease in a baby, in no case should water be allowed to enter the ear canal. This can cause various complications, which is fraught with complete hearing loss. Now let's look at the methods of therapy.
Treatment
Treatment for an ailment such as perforated otitis media should be carried out in a hospital by an otolaryngologist and may include:
- The use of a special patch for the membrane, which helps to restore its integrity.
- Treatment with ear drops with anesthetic local and antibacterial effect (we are talking about Anauran, Otofe).
- Therapy with antihistamines ("Tavegil", "Cetrin", "Loratadine").
- Use of vasoconstrictor drops that facilitate nasal breathing and promote better fluid outflow from the ear (for example, Otrivin or Naphthyzin).
- Carrying out systemic antibiotic therapy (prescribed after a doctor's examination).
- Applying a warm half-alcohol compress to the ear.
- Surgical intervention may be appropriate in case of large perforations or as a result of the failure of the previously described treatment methods.
Surgical treatment of perforated otitis media is the application of bone patches to the perforation site. A skin flap is taken from the area above the ear, then it is sutured with absorbable thin material alongthe perimeter of the rupture of the membrane. Subsequently, the transplanted area reliably takes root, and hearing, in turn, will be restored.
If you have symptoms characteristic of acute or perforated otitis media, you should immediately contact an otolaryngologist.
Prevention
Such measures play an important role, especially in children, since this disease, unfortunately, is prone to relapse. So, you need:
- Properly and timely treat any infection along with diseases of the throat, ears and nose.
- Don't use sharp objects to clear your ear canals.
- Excessive noise exposure should not be allowed.
- Immunity support needed.
- It is important to teach your baby how to sneeze and blow your nose.
- You need to protect the external auditory meatus from the effects of noise, for example, wearing ear protectors in an airplane, sucking on a lollipop during takeoff, and so on.
Inflammatory process of the middle ear will require a correct approach, and at the same time, immediate treatment. This condition does not pose a threat to the patient's life, but it is important to follow all preventive measures in order to avoid the occurrence of relapses and complications of the disease.
