Due to the deep location in the temporal lobe of the head, the symptoms of an inner ear disease are difficult to recognize. Its infection most often occurs at the expense of other foci of inflammation.
Labyrinthitis (internal otitis media)
Labyrinthitis is an inflammatory type of inner ear disease that affects the vestibular and auditory receptors. Labyrinthitis makes up no more than 5% of the total number of diagnosed otitis media. The main pathogens are bacteria (staphylococci, streptococci, mycobacterium tuberculosis, meningococci, pneumococci, treponema pale). Mumps and influenza viruses can also activate the process.
According to the initial focus of the lesion and the pathway of the pathogen entering the cochlea, the following forms of labyrinthitis are distinguished:
- Tympanogenic. Infection spreads through the swollen membranes of the cochlear window or vestibule from the middle part of the auditory organ if there is an infection there. The outflow of pus is complicated, so the pressure inside the labyrinth increases.
- Meningogenic. Infection occurs from the meninges with various types of meningitis (tuberculous, influenza, measles, typhoid, scarlet fever). Two ears are often affected, which can lead to acquired deaf-dumbness.
- Hematogenous. It is carried by the flow of blood or lymph for such ailments as syphilis or mumps. Very rare.
- Traumatic. It develops as a result of damage to the tympanic membrane by a foreign body (needle, pin, match) as a result of improperly performed hygiene procedures. It can occur with craniocerebral trauma complicated by a fracture of the base of the skull.
Inflammatory disease of the inner ear, symptoms:
- noise and pain in the ears;
- dizziness (manifests itself after a week and a half after a person has suffered a bacterial infection and is regular, lasts from a few seconds to hours);
- hearing loss (especially high frequency sounds);
- imbalance;
- reflex frequent fluctuations of the eyeballs (starts from the side of the diseased organ);
- sometimes vomiting, nausea, pallor, sweating, discomfort in the heart area.
With sudden movements of the head, bending, procedures on the organs of hearing, the symptoms intensify.
From the labyrinth, the inflammatory process from the affected side can enter the trunk of the facial nerve and cause its paralysis. Signs of this are:
- fixed angle of the mouth;
- asymmetry of the tip of the nose;
- absence of wrinkles on the forehead when raising the eyebrows;
- inability to completely close the eye;
- increased salivation;
- dry eyeball;
- change in some taste sensations.
In the presence of symptoms of labyrinthitis, an in-depth examination is carried out to establish an accurate diagnosis: blood test, magnetic resonance therapy, audiometry, electronystagmography (study of reflexes of the eyeballs), bacteriological examination. An otolaryngologist or neurologist can diagnose diseases of the inner ear, the symptoms of which are not pronounced.
Labyrinthitis can be treated with conservative and surgical methods. Drug therapy is used in cases where there are no purulent formations, and the disease is uncommon.
Cephalosporin and penicillin antibiotics are prescribed.
For dehydration of the body, it is forbidden to take fluids (the daily rate is not more than 1 liter) and salt (up to 0.5 g). Glucocorticoids and diuretics are taken, and intravenous injections of magnesium sulfate and calcium chloride are given. Unpleasant symptoms are relieved with the help of antiemetic (cerucal), antihistamines (fenistil, suprastil) and sedatives (lorazepam, diazepam). Vitamins C, K, B, P, cocarboxylase, and intravenous atropine prevent the occurrence of trophic disorders.
With a complicated purulent form of internal otitis media, pus is removed by general cavity trepanation after conservative treatment. Labyrintectomy is rarely done. A timely surgical intervention can prevent the diffuse form of labyrinthitis and preserve the patient's hearing.
Meniere's disease
The etiology of this disease is unknown. The main symptoms of the disease are periodic attacks of dizziness, decreased perception of sounds and tinnitus. With each attack, hearing gradually deteriorates, although for a long period it can be in a state close to the normal limit.
The presumptive causes of the onset of the disease at different times were considered: a violation of the ionic balance of fluids, water and vitamin metabolism, vegetative-vascular dystonia, vasomotor disorders. Today, the most common variant is intralabyrinth edema due to an increase in the amount of endolymph.
Clinical picture:
- progressive hearing impairment in one or both ears;
- regular bouts of dizziness, accompanied by loss of balance, vomiting and nausea;
- tinnitus (one or two, usually at low frequencies)
- tachycardia.
The patient's head can be dizzy as often (1-2 times a week), and very rarely (1-2 times a year). As a result, the person is often unable to stay on his feet.
Temporary memory loss, drowsiness, forgetfulness, fatigue are possible.
According to these signs, the disease is diagnosed. For a more accurate diagnosis, audiometry, computed tomography or MRI, brain stem test response, and electronystagmography are used.
With conservative therapy, the following are used:
- antihistamines and antiemetic drugs;
- scolopamine in the form of a plaster for the auricle;
- diuretics and a low-salt diet to avoid fluid buildup in the snail;
- limiting stressful situations.
Surgical intervention has several methods:
- endolymphatic shunting (a tube is inserted to drain fluid into the endolymphatic sac);
- decompression of the endolymphatic sac (a piece of bone is removed to increase the volume of the sac);
- dissection of the vestibular nerve (the part of the nerve that is responsible for balance is dissected, hearing is not lost, but the operation is fraught with errors);
- labyrinthinectomy (the labyrinth is removed, while hearing is lost).
There are other methods of treatment, but they have a number of disadvantages, therefore, they are used only in certain clinics.
Otosclerosis
Otosclerosis is a dystrophic disease affecting the bone capsule of the labyrinth, in which bone neoplasms are localized. The causes of the disease are unclear, doctors believe that heredity plays an important role here, since the disease can be traced in several generations. About 85% of patients are women, their disease progresses during pregnancy and childbirth. The first manifestations are usually recorded at the age of 20-40.
The main symptoms are sound-conducting type hearing loss and tinnitus. Over time, neuritis may join.
Hearing loss begins with one ear, much later the other is connected. In this case, the enlarged cochlea interferes with the normal movement of the bones of the hearing aid.
Medication can only have a noise-reducing effect. Therefore, when hearing loss by 30 dB, the situation is corrected operatively, this helps more than 80% of patients. Surgical intervention consists in installing a stapes prosthesis alternately in each auditory organ at intervals of six months. In some cases, the only way out for the patient is a hearing aid.
Sensorineural hearing loss
Sensorineural hearing loss is damage to the organs responsible for the perception of sound. In this regard, the sound is received poorly and in a distorted form. The reasons may be:
- Meniere's disease;
- age-related changes;
- injuries to the temporal part of the head;
- neuritis of the auditory nerve.
If detected at an early stage, therapy with drugs, electrical stimulation, physiotherapy is carried out. In other cases, you have to resort to hearing aids.
