Otitis – symptoms, treatment

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Most of us have experienced the unpleasant phenomenon of earache in our lives. Very often, this symptom is synonymous with an ongoing inflammatory process in the ear. Otitis is mainly a childhood problem, but depending on the type of inflammation and the place of development of the infectious process, this disease can affect anyone, regardless of age.

The organ of hearing consists of three basic elements:

1. outer ear – includes the auricle and the external auditory canal
2. middle ear – consists of the tympanic cavity containing a set of ossicles; it is separated from the outer ear by the eardrum and connected with the pharynx through the Eustachian tube – this pathway is the main cause of otitis media
3. the inner ear – the basic element is the labyrinth, consisting of: the cochlea, three semicircular canals and the inner auditory canal

The inflammatory process can affect any element of the hearing organ and the basic division includes:

1. otitis externa
2. otitis media
3. inflammation of the inner ear

Inflammation of the outer ear

This disease can affect any of us, regardless of age, and is observed quite often. The inflammatory process mainly affects the external auditory canal and is believed to be the result of the destruction of the sebaceous glands, which results in a lack of production of protective earwax. The contributing factors include: damage to the epithelium, excessive humidity, and a change in the pH of the ear canal.

Otitis externa is more common in people who:

– have diabetes

– have a problem with allergies

– they often use swimming pools

– to clean the ear canals, use inappropriate tools such as matches, hairpins, etc. Contrary to popular belief, you should not use cotton buds for this purpose. Special earwax-dissolving liquids are recommended for self-cleaning of the ear.

Ear spray facilitating the removal of earwax – check the offer

Given the microbes that can cause inflammation, the infection may be:

1. a bacterial infection – most often caused by staphylococcus aureus (Staphylococcus aureus) in the form of a boil or a purulent lesion and by sticks of blue oil (Pseudomonas aeruginosa)
2. fungal infection – most often caused by fungi of the genus Candida or mold fungi
3. viral infection – the culprit is mainly herpes viruses or varicella-zoster viruses

The main symptoms are: ear pain – intensifying with the movements of the lower jaw and the pressure of the section of the ear, leakage of serous or purulent discharge, ear itching, sometimes hearing loss.

Untreated otitis externa can lead to such complications as: involvement of the middle ear with inflammation, mastoiditis, turbinitis, hearing loss.

The diagnosis of otitis externa is based mainly on an ENT examination and the identification of typical lesions. Ear swabbing for microbiological tests or x-rays of the temporal bone to exclude mastoiditis may also be helpful.

Treatment should be carried out by an otolaryngologist and it consists of:

– systematic cleaning of the ear canal by a doctor

– use of antibiotics or antifungal drugs in the form of ointments or suspensions, and in severe cases, use of drugs by mouth

An important element limiting the risk of otitis externa is limiting unnecessary manipulations within the ear canal, and in the case of earwax retention, its removal by a doctor. It is not worth waiting for a visit, so it is worth taking advantage of private otolaryngologist services offered by POLMED.

Inflammation of the middle ear

Almost 90% of children have suffered from otitis media at least once, and about 60% have had it multiple times. The disease is most often observed in infants and preschool children, and more often in the fall and winter months. Such a high incidence in childhood is due to the specific anatomical structure of the Eustachian tube – it is wider, shorter and more horizontal, which makes it easier for the infection to pass from the nasopharynx to the middle ear. In most cases, otitis media is closely associated with an upper respiratory tract infection.

The basic causes of impaired patency of the Eustachian tube include: inflammatory edema within the mouth of the proboscis, allergies, adenoid hypertrophy, polyps and neoplastic infiltration. The factors increasing the risk of otitis media include: immunological disorders, exposure to tobacco smoke, artificial feeding, gastroesophageal reflex or congenital craniofacial defects.

Otitis media can run as:

1. acute otitis media – this form shows inflammation in the tympanic cavity with the continuity of the tympanic membrane and is accompanied by an infection of the upper respiratory tract; inflammation can be caused by viruses (influenza, parainfluenza, RSV, rhinoviruses or adenoviruses) or bacteria (pneumococci, bacilli Haemophilus influenzae, Moraxella catarrhalis)
2. exudative otitis media – fluid retention in the spaces of the middle ear is characteristic, with the eardrum preserved and without significant signs of inflammation; if left untreated, it leads to irreversible changes in the middle ear and permanent hearing damage; it can be the result of both bacterial and viral infection
3. chronic otitis media – characterized by a chronic inflammatory process, with a loss of the eardrum, leakage from the ear and hearing loss; is the result of infection with bacteria, which, according to some theories, form a biofilm in the middle ear, i.e. a structure composed of bacteria and integrating substances that is resistant to the action of antibiotics
4. The symptoms of otitis media depend on the type of otitis and are best expressed in the acute form of the inflammation. Common symptoms include:

Severe, throbbing pain in your ear

– deterioration of hearing – is often the only symptom of the exudative form – e.g. the child’s lack of response to a call, changing the telephone receiver or turning up the radio or television

– a feeling of distraction

– fever

– malaise, anxiety, lack of appetite, vomiting

– serous or purulent discharge from the ear – a characteristic symptom associated with perforation of the tympanic membrane and typical in chronic form

Untreated otitis media can lead to numerous complications, including: perforation of the eardrum, destruction of the ossicles, tympanosclerosis (conductive hearing loss associated with the accumulation of collagen-calcium deposits in the tympanic cavity), facial nerve paralysis, inflammation of the inner ear, intracranial complications (brain abscesses, meningitis), inflammation of the temporal bone. The end result of most complications may be permanent deafness and, consequently, impaired psychophysical development of the child.

The basic method of diagnosing otitis media and differentiating between different forms is an ENT examination, in particular an otoscopic examination to assess the condition of the tympanic membrane. Hearing tests (audiogram), computed tomography and bacteriological tests of discharge from the ear and nasopharynx are also helpful.

At Medonet Market, you can purchase the Child health check – diagnostic tests, thanks to which you can check the basic and most common parameters determining the child’s health.

Treatment of acute otitis media is limited to the use of antibiotics and supportive measures, i.e. the use of drugs that reduce fever, painkillers and reduce swelling at the mouth of the Eustachian tube. In most cases, the antibiotic is used for about 10 days, and the extension of antibiotic therapy is recommended in children under 2 years of age, with perforation of the tympanic membrane and in people with reduced immunity. With exudative otitis media, it is often necessary to incision the eardrum, the so-called paracentesis and placement of drains to drain excess secretions. Additionally, in the case of adenoid hypertrophy, it is removed to clear the opening of the Eustachian tube. In chronic otitis media, therapy is reduced to surgery.

In order to reduce the risk of otitis media, you should lead a healthy lifestyle, treat upper respiratory tract infections as quickly as possible, avoid supine feeding of infants, prevent and treat allergies, do not expose children to tobacco smoke, correct mechanical causes blocking the mouth of the ear tubes (hypertrophic tonsils, polyps).

Inflammation of the inner ear = labyrinthitis

Due to unusual symptoms and insidious course, the disease is dangerous, because if left untreated, it leads to serious complications, including permanent hearing loss. Most often, inflammation of the inner ear is the result of the passage of the inflammatory process from the middle ear as a complication of chronic inflammation. Less commonly, inflammation is the result of the passage of microorganisms or their toxins from the meninges or through the blood (blood-borne route). Labyrinthitis may be the result of infection:

– bacteria – meningococci, pneumococci, bacilli Haemophilus influenzae, mycobacteria tuberculosis

– viruses – rubella, measles, mumps, cytomegaly or chicken pox – shingles

– protozoa – Toxoplasma gondii

Inflammation can also be the result of trauma or autoimmune diseases.

Inflammation of the inner ear can be acute or chronic.

Symptoms that should alarm and raise suspicion of labyrinthitis, especially when we previously had otitis media, are:

1. general malaise, fatigue
2. balance disorders
3. dizziness
4. deterioration of hearing or deafness
5. nystagmus
6. feeling tinnitus
7. nausea and / or vomiting

Lack of or late treatment may lead to complications such as: complete hearing loss, permanent damage to the balance organ, meningitis, abscesses of the brain or cerebellum, temporal osteitis.

The diagnosis of labyrinthitis is based on ENT and neurological examinations as well as imaging tests, such as magnetic resonance imaging or x-ray of the temporal bone.

Inflammation of the inner ear requires hospitalization and intensive treatment, primarily intravenous antibiotic therapy and surgical treatment – middle ear drainage or removal of the labyrinth.

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