Adhesive (adhesive) otitis media is a disease characterized by inflammation of the mucous epithelium of the tympanic cavity, as a result of which the mobility of the auditory ossicles is impaired. Fibrous processes in the middle ear lead to a narrowing of the diameter of the auditory tube, which affects the auditory function. ENT disease develops mainly after inadequate treatment of acute or chronic inflammation in the middle ear.
The tympanic cavity, inside which the auditory ossicles are located, is covered with mucous epithelium. The normal conduction of sound signals entering the ear is due to the mobility of these bones, which largely depends on the amount of fluid that lubricates the micro-joints. With the development of pathological processes in the ear, the volume of secreted fluid decreases sharply, as a result of which adhesive otitis media develops.
Due to insufficient production of liquid secretion, fibrin is deposited on the bones and tympanic membrane. Within a short time, this substance hardens, as a result of which fibrous-cicatricial tissue is formed. Adhesions develop in the tympanic cavity, which interfere with the normal drainage of the auditory tube. Pathological changes lead to a decrease in the amplitude of oscillations of the auditory ossicles, as a result of which hearing deteriorates.
The formation of cicatricial adhesions leads to the development of sound-perceiving dysfunction, which is caused by conductive hearing impairment.
Causes
The precursors of adhesive disease of the middle ear in 75% of cases are chronic turbo otitis or healed non-perforated acute otitis media. As a result of the elimination of inflammatory processes, fibrin threads remain inside the tympanic cavity, the hardening of which inevitably leads to the formation of adhesive cords from the connective tissue. Cords envelop the auditory ossicles, as a result of which their mobility decreases.
In clinical otolaryngology, many cases of the development of the disease without previous destructive processes occurring in the ear have been recorded. In such cases, the main cause of ENT disease is infectious lesions of the upper respiratory tract. Experts include among the main provocateurs of pathology:
- laryngitis;
- chronic rhinitis;
- tonsillitis;
- deformation of the nasal septum;
- pharyngitis;
- sinusitis;
- adenoids.
Important! Untimely relief of inflammatory processes in the hearing aid leads to hearing loss, which practically cannot be restored even after outpatient treatment.
Clinical picture
The main symptoms of the development of adhesive middle ear disease are pain and auditory dysfunction, the manifestation of which is hearing loss. In the case of excessive proliferation of connective tissue, deformation of the tympanic membrane occurs, as a result of which the patient feels "lumbago" in the ear. A gradual increase in the number of scars at the mouth of the ear canal leads to a violation of its conduction and, as a result, even greater hearing impairment.
Further ankylosis of the micro-joints in the ossicles causes the development of hearing loss. However, to a greater extent, the violation of sound conduction is associated with the formation of a shutter from scar tissue inside the ear canals. A few clinical manifestations of the disease are similar to those of otosclerosis, traumatic otitis media, etc. Therefore, when characteristic signs of the disease appear, it is necessary to be examined by an otolaryngologist.
Types of ENT diseases
There are several types of pathology, which are determined by the severity of the symptomatic picture. The scheme and duration of the course of treatment of the disease largely depends on the accuracy of the diagnosis. In clinical otolaryngology, there are three main forms of adhesive otitis media:
- light - accompanied by the formation of a small number of adhesions, as a result of which there is a slight decrease in hearing;
- middle - characterized by a curvature of the tympanic membrane, in which fibrin threads appear. Their hardening leads to a decrease in tissue elasticity and, accordingly, hearing impairment;
- severe - accompanied by the proliferation of fibrous tissues, which inevitably leads to the appearance of atrophic scars that deform the auditory ossicles and membrane.
Fibrous-cicatricial neoplasms in the hearing aid are almost impossible to eliminate. Thanks to hardware and drug treatment, it is only possible to stop the formation of adhesions.
Diagnostics
For adequate treatment of adhesive otitis media, it is necessary to undergo a complete diagnostic examination. The key point in diagnosis is the determination of the otoscopic picture of pathology. This allows you to find out the degree of deformation of the tympanic membrane, the number of adhesions in the tympanic cavity and the level of obliteration of the lumen of the ear canal.
When examining a patient, the following types of activities are carried out:
- audiometry - allows you to accurately determine the degree of decrease in auditory activity. For these purposes, the ear canal is blown through the Politzer. In the event of the development of the disease, the procedure does not contribute to the aggravation of hearing. However, to accurately determine the type of pathology, catheterization of the ear canal is additionally carried out;
- acoustic impedance measurement - helps to determine the degree of elasticity of the tympanic membrane and the amplitude of oscillations of the auditory ossicles. If, when air is pumped into the tympanic cavity, the membrane does not vibrate, this signals its damage by adhesions;
- otoscopy is an effective method for determining the degree of deformation of the auditory ossicles and membrane by the presence of darkening on their surface.
In case of irreversible deformation of the auditory ossicles, prosthetics are performed, the effectiveness of which largely depends on the stage of development of the disease.
Treatment principles
At the initial stage of treatment of ENT disease, it is necessary to eliminate the factors that provoke a narrowing of the diameter of the ear canal. For these purposes, the nasal cavity and paranasal sinuses are sanitized by transtubar administration of Fluimucil, Hydrocortisone and other drugs. Parenteral use of vitamins, FiBS and ATP increases the reactivity of the immune system, thereby reducing the risk of developing infectious complications.
How to get rid of the noise of adhesive otitis media? To relieve the main symptoms of pathology, the following therapeutic measures are used:
- pneumatic membrane massage;
- electrophoresis;
- adenotomy;
- microwave physics;
- ultraphonophoresis.
With the progression of ENT disease, complications may occur, such as meningoencephalitis, phlegmon of the neck or paresis of the auditory nerve.
In most cases, conservative treatment does not give the desired therapeutic results. For this reason, the further development of hearing loss can be prevented through surgery. Tympanotomy, i.e. dissection of adhesive cords and outgrowths of connective tissue helps to restore normal mobility of both the tympanic membrane and the auditory ossicles.
It should be noted that surgery provides only temporary relief of symptoms. After the procedure, the process of adhesion formation is resumed in 90%. Hearing aids will be a more effective treatment for otitis media.Replacing the auditory ossicles with artificial prostheses guarantees the absence of scars, which prevents the development of auditory dysfunction.
Alternative treatment
Natural preparations can be used to prevent trophic changes in the mucous epithelium, tympanic membrane and auditory ossicles. However, the treatment of adhesive otitis media with folk remedies will give positive results in the initial stages of the development of the disease. With the permission of the attending physician, the following types of funds can be included in the complex therapy of ENT diseases:
- mixture of butter and mummy: 1 tsp. Mix the mummy with 250 g of melted butter. Bury the prepared solution in the ears twice a day, 2-3 drops;
- propolis tincture: mix water with propolis tincture in equal proportions. In the prepared solution, moisten a cotton turunda and insert them into the ear canal for 40-60 minutes. Perform the procedure twice a day;
- saline solution with onion juice: Mix onion juice with saline solution (proportion 1 to 1). Pour the warmed liquid into the ear and cover with a cotton swab for 20 minutes. The procedure should be performed 2-3 times a day;
- infusion of garlic and vegetable oil: chop a clove of garlic and pour 2 tbsp. vegetable oil. Insist the remedy for three days, then add 3 drops of eucalyptus oil to it. Instill 3 drops of the strained emulsion in each of the auditory canals twice a day;
Self-medication is fraught with the progression of pathology and the development of deafness. For this reason, an otolaryngologist should be consulted before using alternative medicine.
