Ear blowing is a medical procedure during which air is pumped into the tympanic cavity through the Eustachian tube. The physiotherapy method can be used to treat inflammation in the middle ear and auditory canals, as well as during the rehabilitation period after undergoing tympanoplasty to restore normal pressure in the ear cavity.
Blowing can be done for therapeutic or diagnostic purposes. Physiotherapy helps to restore the patency of the auditory canals, due to which their drainage function is normalized. This helps to eliminate exudate from the tympanic cavity, which leads to a regression of the inflammatory processes that occur during the development of catarrhal otitis media.
A little about physiology
The performance of the sound-conducting apparatus is largely determined by the equality of external (atmospheric) and internal pressure on the ear membrane. During swallowing, the mouth of the Eustachian tube expands, into which air enters from the nasopharynx. It penetrates into the tympanic cavity, where it is rapidly absorbed by the mucous epithelium. This results in negative (lowered) pressure inside the ear.
Hearing tubes, in particular the Eustachian tube, compensate for pressure differences so that the hearing aid functions properly. However, with the development of diseases or barotrauma, the conduction of the ear canals may be impaired. This leads to a narrowing of the lumen in the tube and, accordingly, a violation of its ventilation functions. To restore the patency of the canals and determine the cause of the edema in the tissues, the auditory tubes are blown.
Indications for the use of the procedure
The Eustachian tube connects the ear cavity and the nasopharynx to maintain normal pressure in the middle ear. Additionally, it performs a drainage and protective function, preventing the accumulation of serous effusions in the ear cavity and the penetration of pathogens from the nasopharynx into the middle ear. Barotrauma and infection of the nasopharyngeal mucosa lead to blockage of the mouth of the Eustachian tube.
A decrease in the patency of the auditory canal can be eliminated using the blowing procedure, which is used when:
- decrease in hearing acuity after otitis media;
- accumulation of exudate in the ear cavity;
- complications after rhinitis;
- deformation and protrusion of the ear membrane;
- sharp changes in external and internal pressure on the membrane.
Blowing out the ears with otitis media is indicated for congestion, autophony, conductive hearing loss and heaviness in the head.
The physiotherapy procedure contributes to the immediate relief of symptoms of septic and aseptic inflammation of the mucous membranes of the ear.
Politicalization
Blowing according to Politzer is a physiotherapeutic procedure, which consists in introducing air into the ear cavity through an otoscope and a balloon (pear) of Politzer. The special device is a rubber balloon with a metal tip in the shape of an olive. During the procedure, the tip is inserted into one of the nostrils, pressing the other nostril against the nasal cartilage, after which air is injected when the bulb is pressed.
How to blow out your ears? Before the procedure, it is necessary to clear the nasal passages from the accumulated mucus. To reduce swelling in the nasopharynx, vasoconstrictor nasal drops are instilled. The tip of the Politzer pear is inserted into one nostril, and the other is pressed tightly against the nasal septum to create an airtight environment. The external auditory canal of the patient is connected to the ear canal of the otolaryngologist using an otoscope.
After the preparatory stage, the patient must pronounce the word "steamer" by syllables. At this moment, the compression of the rubber bulb occurs, as a result of which air is forced into the nasopharynx. With normal patency of the Eustachian tube, the patient and the doctor hear a hiss.
If the mucous membrane of the auditory canal is inflamed, this will be signaled by a characteristic click resulting from the collision of the air flow with an obstacle.
Interpretation of results
The results of the diagnostic and treatment procedure are summed up solely on the basis of the auditory reactions of the otolaryngologist and the patient's subjective feelings. During the session and the patient speaks words
deviations in the soft palate are observed, due to which access to the mouth of the Eustachian tube opens. When air enters the auditory canal, the doctor and patient hear a characteristic noise.
Analysis results:
- a weak hissing sound indicates the absence of swelling in the mucous membrane of the ear canals;
- if clicks are heard in the otoscope, catarrhal processes in the mucous membranes are predicted in 90% of cases. The sound of bursting bubbles signals the accumulation of exudate in the ear cavity;
- the complete absence of any sounds indicates obstruction and swelling of the auditory canal.
According to the results of the examination, the specialist prescribes the appropriate course of treatment for the patient. To accelerate the processes of sputum discharge, mucolytic drugs are prescribed, and vasoconstrictors are prescribed to reduce puffiness.
Therapeutic effect
Politzer's method is used not only for diagnostic, but also for therapeutic purposes. Ear blowing helps to expand the inner diameter of the ear canal and restore normal pressure in the tympanic cavity. Physiotherapy manipulations are often used in the treatment of serous (exudative) otitis media and tubo otitis, i.e. inflammation of the mucous membrane of the Eustachian tube.
Forcing air into the ear cavity causes discomfort and pain.
Therefore, before the procedure, the mucous membranes in the nasal cavity are prudently treated with anesthetic solutions. In this case, the patient's head is slightly tilted to the side, so that during the expansion of the lumen in the auditory canal, unhindered evacuation of liquid exudate from the tympanic cavity occurs.
You cannot perform purging according to the Politzer method yourself. Excessive inflation of air can cause perforation of the ear membrane.
In most cases, up to 3-4 procedures are required to empty the middle ear from fluid. Complete evacuation of mucus leads to a decrease in tissue edema and elimination of pain. With persistent obstruction of the auditory canal, a specialist prescribes drug treatment, which helps to eliminate catarrhal processes and swelling of the mucous membranes.
Possible complications
Politicalization is contraindicated at the stage of acute infectious inflammation in the nasopharynx, provoked by microbial or viral pathogens. It is not recommended to resort to physiotherapy in the presence of neurological and mental disorders. If contraindications are ignored, the health condition may worsen.
If you blow your ears with otitis media without observing safety measures, the following complications may occur:
- nose bleed;
- periopharyngeal emphysema;
- barotrauma;
- perforation of the ear membrane;
- purulent otitis media.
Carrying out an invasive procedure only in 30-35% of cases contributes to the complete restoration of the patency of the ear canals. That is why the physiotherapy procedure is used only as an adjunct to pharmacotherapy, as one of the ways to relieve the symptoms of ear disease.
Catheterization
Ear catheterization is a physiotherapy procedure in which a Hartmann cannula is inserted into the Eustachian tube, forcing air into the tympanic cavity.The advantage of the method lies in the possibility of injecting the drug solution directly into the middle ear. The use of topical preparations contributes to the regression of catarrhal reactions, relief of pain and elimination of puffiness.
Catheterization should not be used if there are abnormalities in the nasal septum or cartilaginous ridges. This can cause tissue damage and the development of a bacterial infection.
How to blow out an ear after otitis media? Under the control of rhinoscopy, a thin metal catheter is inserted into the nasopharynx, the curved tip of which is directed downward. When the catheter reaches the posterior wall of the nasopharynx, the tip is turned so that it is located close to the median nasal septum (vomer). During the lateral rotation of the catheter, the tip enters the mouth of the Eustachian tube, after which air is pumped into the tympanic cavity.
The physiotherapy procedure is carried out after anemization of the nasopharynx, due to which the patient practically does not experience any discomfort. If necessary, a drug solution is injected into the middle ear through the distal part of the catheter. The injection of air and medicine is carried out using a Politzer balloon.
Before the procedure, the metal catheter must be sterilized to rule out the possibility of infection.
