Otitis media is one of the most common otolaryngological diseases resulting from ear inflammation. Late diagnosis and therapy of ear pathology provokes complications. The most serious consequences of otitis media occur with the development of inflammatory processes in the middle ear and labyrinth.
The inner and middle ear cavities are separated from the environment by the eardrum, which prevents pathogenic flora from entering. Infection most often occurs by the tubular route, i.e. through the Eustachian tube, which connects the nasopharynx to the tympanic cavity in the middle ear. Rapidly developing catarrhal processes lead to the destruction of epithelial and bone tissue, which is fraught with complications.
Statistics
Why is otitis media dangerous? When analyzing more than a hundred cases of development of ear pathology requiring surgical intervention, specialists recorded the following frequency of serious complications:
- perforation (perforation) of the ear membrane - 47%;
- cholesteatoma (benign neoplasm) - 36%;
- mastoiditis (damage to the mastoid process) - 10%;
- meringitis (degenerative changes in the ear membrane) - 7%.
The most common consequence of an ENT disease is a violation of the integrity of the tympanic membrane. Membrane perforation is one of the simplest and most reversible complications, but only in the case of correct and timely treatment. In the chronic course of the inflammatory process, persistent perforation is observed, which is fraught with the occurrence of conductive hearing loss, i.e. hearing loss.
There are at least 10 more severe complications of otitis media, many of which lead not only to the development of auditory dysfunction, but also to disability or death. That is why, if alarming symptoms are detected, you should seek help from an otolaryngologist.
Cholesteatoma
Cholesteatoma is a cyst-like neoplasm in the ear cavity that occurs with otorrhea, i.e. discharge from the ear of hemorrhagic or purulent contents.
The tumor consists of epithelial cells, which over time begin to secrete a liquid secretion that destroys soft and bone tissues. The destruction of the auditory ossicles, which are responsible for conducting sound signals, causes hearing loss.
The growth of the tumor leads to damage to the ear labyrinth, as a result of which the semicircular canals, which are responsible for spatial orientation, are damaged. Spontaneous rupture of cystic neoplasms leads to the evacuation of pathogenic exudate, which is fraught with generalization of inflammatory processes. When a cholesteatoma ruptures, the following complications of otitis media occur in adults:
- meningitis;
- brain abscess;
- otogenic sepsis;
- paresis of the facial nerve;
- mastoiditis.
Important! Cholesteatomas practically do not respond to conservative treatment. If neoplasms are found in the ear, surgery is required.
Otogenic sepsis
Otogenic sepsis is the generalization of purulent-inflammatory processes, in which lesions are localized in the ear cavity. Pathology arises as a complication of labyrinthitis, external or middle purulent otitis media. Due to a decrease in the reactivity of the body, aggressive pathogenic flora prevails over the immune system, as a result of which there is an intensive spread of infection in the blood.
Often, the pathogenic flora spreads through the venous sinuses located inside the cranium. The sigmoid and stony sinuses are connected to the boundaries of the labyrinth and middle ear. In the presence of catarrhal or purulent processes, large veins are damaged, as a result of which phlebitis develops.
The development of phlebitis is fraught with the formation of blood clots in the vessels, which further leads to tissue necrosis and the development of gangrene.
The main symptom of sepsis is hyperthermia, characterized by a sharp rise in temperature. When the thermoregulatory mechanism is triggered, sweating is observed, which very quickly leads to dehydration. If characteristic signs occur, immediate hospitalization of the patient is required, followed by surgical and drug treatment.
Mastoiditis
Mastoiditis is an inflammation of the antrum and cellular structures that are located behind the auricle (mastoid). The penetration of infection into the porous structure of the bone leads to its softening and the development of osteomyelitis. As a rule, the provocateurs of pathological changes in bone tissue are Pseudomonas aeruginosa, anaerobic microbes, mycobacteria and aerobic bacilli.
The development of complications after otitis media in adults is most often evidenced by the following clinical manifestations:
- hyperthermia;
- swelling behind the auricle;
- shooting pains in the ear;
- hearing loss;
- noise in ears.
A serious illness requires immediate medical attention. In the early stages of the development of pathology, therapy is carried out with the help of antibiotics. However, the components of antibacterial drugs hardly penetrate into the cavernous structures of the mastoid process. To prevent Bezold's abscess, characterized by the formation of large abscesses under the cervical muscles, a sanitizing operation is performed. This allows you to clear the cells of the bone process from purulent foci.
Facial nerve paresis
Among the most formidable consequences of otitis media in adults are paresis of the facial nerve, in which there is a weakness of the facial muscles. The development of neuropathology is characterized by muscle tissue contractures. This manifests itself in the inability to close the right or left eye, smile or speak clearly.
Untimely therapy can cause muscle atrophy. In this case, even after the regeneration of the inflamed nerves, the absolute restoration of facial movements is impossible.
Inflammatory processes in the ear cavity lead to damage to the processes of the facial nerve, which are located in the pyramid of the temporal bone, stapes, mastoid, etc. The destruction of the protective sheath of the nerves provokes severe pain that radiates to the teeth, temple, back of the head, neck and other parts of the body.
Hearing loss
With the transition of otitis media into a chronic form, it is possible to develop persistent conductive hearing loss, which occurs as a result of a mechanical violation of the sound-conducting function of the auditory analyzer.
Tinnitus after otitis media is caused by the impossibility of unhindered passage of a sound signal through the ear canal, ear membrane and auditory ossicles.
Sound barriers most often appear at the level of the tympanic membrane, in which large perforations form. This contributes to a decrease in its working area and, accordingly, to a decrease in hearing acuity. Pathologies can also appear at the level of the ossicles. With purulent inflammation in the tympanic cavity, fibrin threads are formed, which, when hardened, limits the amplitude of oscillations of the auditory ossicles.
Conservative treatment of deafness after otitis media is ineffective. Complete immobilization of the stapes on the ear membrane can be eliminated only during stapedectomy.
Surgical intervention prevents further mineralization of the stapes, which leads to the regeneration of elastic tissues and the restoration of its sound-conducting function.
Prevention of complications
The first step towards preventing serious complications is an adequate and timely response to the appearance of anxiety symptoms. It should be understood that even acute respiratory viral infections and allergies can provoke edema of the Eustachian tube, which will lead to a violation of its drainage function. As a result, serous effusions will begin to accumulate in the ear cavity, which will lead to the development of ENT disease.
You cannot postpone a visit to the otolaryngologist if you have the following symptoms:
- ear congestion;
- shooting pains in the ear;
- hearing impairment;
- temperature increase;
- serous or purulent discharge from the ear canal.
If you start the course of treatment on time, you can stop local and general manifestations of otitis media within a week.
During acute inflammation, experts recommend refraining from smoking, since smoke provokes irritation of the mucous membrane and even greater swelling of the mouth of the Eustachian tube.
