Chronic tubo-otitis - inflammation of the ear canals, which entails disorders of the ventilation and drainage functions. This pathology develops rather slowly. With its progression, an inflammatory process of the mucous membrane of the tympanic cavity is observed, which is explained by the ingress of exudate into the zone of the middle ear. ICD-10 chronic tubootitis code - H 66.2.
Causes of disease
The main condition for the formation of chronic tubootitis are foci of inflammation in the area of the nose and nasopharynx. It is they who provoke a violation of the normal activity of the auditory tubes, which perform a drainage and ventilation function.
In addition, there are a few more conditions for the development of chronic tubo-otitis:
- scars;
- polyps in the nasal cavity;
- adenoids;
- shell hypertrophy;
- tumors.
With such pathologies, the tympanic membrane is deformed, which takes an abnormal elongated shape against the background of a decrease in pressure inside the cavity. In addition, there is the formation of transudate in the middle ear,which is made up of inflammatory cells. It is this substance that involves the tympanic cavity in the pathological process. Doctors call this disease exudative otitis media. Gradually, this pathology enters a severe stage and entails the onset of chronic tubo-otitis.
Pathogenesis
Perhaps there are other reasons for the development of this disease, but they have not yet been fully studied. However, it is reliably known that tubootitis is provoked by viruses and hypovirulent microorganisms. It is extremely important to take into account the predisposition of the mucous membranes to allergic manifestations and inflammatory processes at the genetic level.
All the described conditions can arise in different combinations, which, in turn, predetermine the course of the pathology.
Symptoms of chronic tubootitis
The main symptom of the disease is dysfunction of the auditory canal.
In addition, the symptoms of this pathology should include:
- hearing loss;
- scarring;
- thinning of the eardrum;
- formation of calcareous plaques;
- strings;
- tightening of the mucous membrane;
- immobility of the auditory ossicles;
- deposition of s alts in the tympanic membrane;
- narrowing of the mucous membrane.
The main difference between acute and chronic tubo-otitis is the nature of the course and symptoms. So, in the first form, the patient complains of other signs: tinnitus, a feeling of the presence of a foreignbody, hearing loss, impaired perception.
Varieties
Among other things, the course of the disease can be conditionally divided into several stages. Each of them has a certain histological picture and characteristics of the state of the mucous membrane.
The first stage is characterized by the formation of a transudate in the eardrum with a slight patch of mucus. In addition, there is an increase in the integumentary epithelium. At the same time, the number of mucous glands increases significantly.
At the second stage, the clinical picture changes slightly and looks like this: most of the mucosal integument in the tympanic cavity produces specific mucus. In relation to other products at the cellular level, the so-called sticky ear is formed.
The third stage of chronic tubootitis (according to ICD-10 - H 66.2) is characterized by a decrease in the amount of exudate, but the mucus that has already accumulated by that time becomes more viscous. Against the background of this phenomenon, the adhesive process begins. It is he who becomes a prerequisite for the closure of the tympanic cavity.
Against the background of the thinning of the membrane, its strong stretching occurs. As a result, it becomes even thinner, more flabby and almost imperceptible, atrophy gradually develops. To return the membrane to the lumen of the auditory canal at this stage is possible only with the help of blowing.
With prolonged obstruction, an adhesive process is formed in the tympanic cavity.
Etiology
Worth itto say that many patients suffering from the chronic form of tubo-otitis experience almost no pain. Often they only complain of discomfort, a feeling of congestion, noise and fluid flow inside the ear. Video microscopy and otoscopy demonstrate the cloudy appearance of the membrane and its abnormally retracted shape.
As a rule, such examinations make it possible to detect calcareous plaques that are visible through the epidermal layers. In addition, there is a conductive hearing loss. This is due to the obstruction of the auditory canals. It is noteworthy that with all the problems described, the patient does not develop disorders in the functioning of the vestibular apparatus.
Diagnosis
Chronic tubo-otitis is characterized by many specific symptoms that can be detected by otoscopy:
- stretched eardrum;
- no cone of light;
- accumulation of exudate behind a translucent stretched membrane.
Accumulated fluid may include air bubbles and range from yellowish to blue in color.
Audiogram may show conductive hearing loss.
Treatment of chronic tubootitis
Therapy for patients with this diagnosis should include several main components:
- elimination of the initial causes, against which the functions of the auditory canal were impaired;
- normalization of hearing;
- execution of certainprocedures to prevent permanent hearing loss;
- surgical intervention in the form of a bypass of the eardrum in the absence of a positive effect from conservative methods.
Treatment of chronic tubootitis involves the use of:
- antibiotics;
- laser therapy;
- vasoconstrictor drugs;
- hyposensitizing drugs;
- pneumomassage of eardrums;
- endaural iontophoresis;
- UHF;
- blowing according to the Valsalva or Politzer scheme.
If all the described conservative methods did not bring a positive result and could not cope with the elimination of inflammatory exudate, the patient is prescribed more complex procedures: paracentesis or drainage of the eardrum, if bilateral chronic tubo-otitis and severe forms of pathology are detected, a more serious intervention is shunting. At the same time, a special shunt is installed inside the cavity, through which the affected area is washed and treated with a medical solution.
Folk Therapy
Treatment for both acute and bilateral tubootitis can be achieved with effective prescriptions. The most effective among such means is an ordinary onion. To use it, you should carefully clean the affected ear from all kinds of secretions using hydrogen peroxide. Then inside it is necessary to drip warm onion juice. ForFor maximum effect, it is recommended to drip and nose.
There is another way to use this vegetable. A piece of onion needs to be warmed up and sent to the auditory canal. Such procedures should be carried out within two weeks.
Onions can be replaced with spicy medicinal herbs. Here is another folk recipe that helps get rid of chronic tubootitis: steam baths of chamomile, nettle, yarrow, or a combination of them. To prepare them, it is necessary to fill the pan halfway with water, bring it to a boil, and then send a handful of the dried plant into it. The mixture only takes a few minutes to cook. Then the pan must be removed from the stove and lean over it with a sore ear. For best results, cover your head with a towel. Such an event resembles "potato inhalations" well known to everyone since childhood. It is recommended to carry out the procedure daily for a week.
Prevention
To prevent the development of tubo-otitis or to reduce the regularity of its exacerbations, you should follow a few rules.
For example, it is very important to learn how to blow your nose correctly, closing the other nostril well. In the case of diagnosing rhinitis, nasal congestion should be prevented, it should be washed systematically, and inflammatory mucus should not accumulate in the tonsil area.
To eliminate exudate, you need to gargle regularly. If you ignore this procedure, then a beneficial microflora will form in the tonsils for the development of harmful microorganisms, which will begin intensively.multiply, provoking the appearance of tubo-otitis, first in an acute form, and then in a chronic form.
When stuffy ears and discomfort occur in the auditory canal, especially if a child complains, you should immediately contact a specialist.
