Treatment of acute or chronic inflammation of the ear labyrinth. Labyrinthitis or inflammation of the inner ear, how and how to treat it
Not everyone knows what otitis media is. This is a disease that affects the human ear. It consists of acute inflammation of the tissues that make up this important organ feelings. Thousands of people get sick with otitis media every year. different ages. And it is well known that otitis media cannot be called a harmless disease.
What is otitis media
To understand the principle of the occurrence of otitis, you need to remember what it is - the ear, what it is needed for and how it works. In fact, the ear is far from just the pinna, as some might think. The ear has a hidden inside complex system to convert sound waves into a form that is easy to perceive human brain. However, picking up sounds is not the only function of the ears. They also perform a vestibular function and serve as an organ that allows a person to maintain balance.
The three main sections of the ear are the middle, outer and inner. The outer ear is the pinna itself, as well as the auditory canal leading to the eardrum. Behind the eardrum is an air-filled tympanic cavity containing three auditory ossicles, the purpose of which is to transmit and amplify sound vibrations. This area makes up the middle ear. From the middle ear, vibrations enter a special area, which is located in temporal bone and it's called a labyrinth. It contains the organ of Corti - a cluster of nerve receptors that convert vibrations into nerve impulses. This area is called the inner ear. Also worth noting is the Eustachian tube, the entrance of which is located behind the palatine tonsils and which leads into the tympanic cavity. Its purpose is to ventilate the tympanic cavity, as well as to bring the pressure in the tympanic cavity into line with atmospheric pressure. The Eustachian tube is usually referred to as the middle ear.
It should be noted that otitis media can affect all three ear sections. Accordingly, if the disease affects the outer ear, then we talk about external otitis, if it is middle, then about otitis media, if the inner ear, then about internal. Usually, we're talking about only about unilateral lesions, however, with otitis media caused by infections of the upper respiratory sections, the disease can develop on both sides of the head.
Ear otitis is also divided into three types depending on the cause - viral, bacterial or traumatic. External otitis can also be fungal. Most common bacterial form diseases.
How does the ear work?
Otitis externa - symptoms, treatment
Otitis externa occurs as a result of infection of the surface of the skin of the ear with bacteria or fungi. According to statistics, approximately 10% of the world's population has suffered from external otitis at least once in their lives.
Factors contributing to otitis in adults are:
- hypothermia of the auricle, for example, during walks in the cold;
- mechanical damage to the auricle;
- removing sulfur from ear canal;
- entry of water, especially dirty water, into the ear canal.
Bacteria and fungi “love” the ear canal because it is damp, dark and quite humid. He is perfect place for their reproduction. And, probably, everyone would have otitis externa, if not for such a protective feature of the body as the formation of earwax. Yes, earwax- this is not at all a useless substance that clogs the ear canal, as many people think. It performs important bactericidal functions, and therefore its removal from the ear canal can lead to otitis media. The only exception is when too much sulfur is released and it affects the perception of sounds.
Inflammation of the external auditory canal usually refers to a type skin diseases– dermatitis, candidiasis, furunculosis. Accordingly, the disease is caused by bacteria, streptococci and staphylococci, and fungi of the genus Candida. In the case of furunculosis, inflammation occurs sebaceous glands. The main symptom of external otitis is, as a rule, pain, especially aggravated by pressure. Elevated temperature with external otitis it usually does not occur. Hearing loss rarely occurs with external otitis, except in cases where the process affects the eardrum or the ear canal is completely closed with pus. However, after recovery from otitis media, hearing is completely restored.
Diagnosis of external otitis in adults is quite simple. As a rule, a visual examination by a doctor is sufficient. A more detailed method of diagnosing otitis involves the use of an otoscope, a device that allows you to see the far end of the ear canal and the eardrum. Treatment of otitis media consists of eliminating the cause of ear inflammation. When treating otitis externa in adults, antibiotics or antifungal drugs are used. The type of antibacterial therapy should be determined by the doctor. Typically, ear drops are used for otitis externa rather than tablets. When external tissues of the auricle not located in the area of the auditory canal are affected, ointments are used. Frequent complication external otitis – transition inflammatory process to the middle ear through the eardrum.
Otitis media
Otitis media– inflammation of the middle part of the hearing organ. This kind of ear inflammation is one of the most common diseases on Earth. Hundreds of millions of people suffer from ear infections every year. According to various data, from 25% to 60% of people have suffered from otitis media at least once in their lives.
Causes
In most cases, the inflammatory process of the middle ear is not primary disease. As a rule, it is a complication of external otitis or infectious diseases of the upper respiratory tract - tonsillitis, rhinitis, sinusitis, as well as acute viral diseases - influenza, scarlet fever.
How does an infection from the respiratory tract get into the ear? The fact is that she has a direct path there - this is the Eustachian tube. With such respiratory symptoms Like a sneeze or cough, particles of mucus or phlegm can be thrown through the tube into the ear. In this case, it can occur as an inflammation of the eustachian tube(eustachitis) and inflammation of the middle ear. When the eustachian tube is blocked in the tympanic cavity, which is deprived of ventilation, stagnation processes can occur and fluid can accumulate, which leads to the proliferation of bacteria and the occurrence of disease.
The cause of otitis media can also be mastoiditis, allergic reactions that cause swelling of the mucous membranes.
Otitis ear has several varieties. First of all, a distinction is made between chronic and acute otitis. According to the degree of development, otitis of the middle ear is divided into exudative, purulent and catarrhal. Exudative otitis media of the ear is characterized by the accumulation of fluid in the tympanic cavity. With purulent otitis media of the middle ear, the appearance of pus and its accumulation are noted.
Otitis media, symptoms in adults
Symptoms in adults primarily include ear pain. Pain with otitis media can be acute or shooting. Sometimes pain can be felt in the temple or crown area, it can pulsate, subside or intensify. With exudative otitis media, there may be a sensation of water splashing in the ear. Sometimes there is ear congestion, as well as a feeling of hearing one's own voice (autophony) or just a vague noise in the ear. Tissue swelling, hearing loss, fever, and headaches are often observed. However, an increase in temperature is often not a symptom of otitis media, but only a symptom of the infectious disease that caused it - acute respiratory infections, acute respiratory viral infections or influenza.
The most complex course is observed with purulent form otitis media. In this case, the main symptom of otitis media is the discharge of pus. The tympanic cavity is filled with pus, and the body temperature rises to +38-39ºС. Pus can thin the surface of the eardrum and form a hole in it through which it leaks out. However, this process is generally beneficial, since the pressure in the cavity drops, and as a result the pain becomes less acute. The process of draining pus takes about a week. From this moment, the temperature drops to subfebrile levels and wound healing begins. The total duration of the disease is 2-3 weeks with proper and timely treatment.
The chronic form of the disease is characterized by a sluggish infectious process, in which there are seasonal surges, during which the disease becomes acute.
Diagnostics
If you have suspicious symptoms, you should consult a doctor. Diagnosis is carried out by an otolaryngologist. The following can be used for this diagnostic sign. If an otolaryngologist’s patient puffs out his cheeks, then the immobility of the membrane indicates that air does not enter the tympanic cavity from the nasopharynx and, therefore, the Eustachian tube is blocked. Inspection of the eardrum is carried out using an optical device - an otoscope. It also helps to identify some characteristic signs, for example, protrusion of the eardrum and its redness. Blood tests, computed tomography, and radiography can also be used for diagnosis.
Treatment
How to treat the disease? Treatment of otitis media is quite complex compared to treatment of external otitis. However, in most cases conservative treatment is used. First of all, in case of acute otitis media, it makes no sense to instill ear drops with antibacterial drugs, since they will not reach the site of inflammation. However, for inflammation of the middle ear, the focus of which is directly adjacent to the eardrum, anti-inflammatory and analgesic drops can be instilled into the ear. They can be absorbed by the eardrum, and the substance will enter the region of the middle part of the organ of hearing, into the tympanic cavity.
Antibiotics are the main method of treating otitis media in adults and children. Typically, medications are taken in tablet form. However, if the eardrum has ruptured, antibiotic ear drops can also be used. A course of antibiotics must be prescribed by a doctor. He also chooses the type of antibiotics, since many of them have an ototoxic effect. Their use can cause irreversible hearing loss.
The greatest effectiveness for otitis media of the middle ear was demonstrated by a course of treatment with penicillin antibiotics, amoxicillin, as well as cephalosporins or macrolides. However, cephalosporin has an ototoxic effect, so it is not recommended to inject it directly into the ear through a catheter or instill it into the ear canal in case of damage to the eardrum. Can be used for therapy antiseptics, such as miramistin.
When treating otitis media, it is often necessary to use painkillers. To relieve pain in diseases of the middle part of the hearing organ, drops with painkillers, for example, lidocaine, are used.
In case of membrane perforation, scar stimulants are used to speed up its healing. These include ordinary iodine solution and silver nitrate 40%.
Glucocorticoids (prednisolone, dexomethasone), as well as non-steroidal anti-inflammatory drugs, can be used as anti-inflammatory drugs and agents that can relieve swelling. In the presence of allergic processes or with exudative otitis, antihistamines are used, for example, suparastin or tavegil.
Also, for exudative otitis media, medications are taken to thin the exudate, for example, carbocisteine. There are also complex drugs that have several types of action, for example, Otipax, Otinum, Otofa, Sofradex. In case of purulent discharge, you should regularly clean the ear canal of pus and rinse it with a weak stream of water.
Is it possible to warm your ear? It depends on the type of disease. In some cases, heat can speed up healing, while in others, on the contrary, it can aggravate the disease. In the purulent form of middle ear disease, heat is contraindicated, and in the catarrhal stage, heat promotes blood flow to the affected area and speeds up the patient’s recovery. Heat is also one of the effective ways to reduce pain during otitis media. However, only a doctor can give permission to use heat; self-medication is unacceptable. If heat is contraindicated, it can be replaced with physiotherapeutic procedures (UHF, electrophoresis).
They often resort to surgical treatment of the middle ear, especially in the case of a purulent version of the disease and its rapid development, which threatens severe complications. This operation is called paracentesis and is aimed at removing pus from the tympanic cavity. For mastoiditis, surgery can also be performed to drain the internal areas of the mastoid process.
Special catheters are also used to blow and clean the Eustachian tube. Medicines can also be administered through them.
Folk remedies when treating inflammation of the middle ear in adults, they can be used only for relatively mild forms of the disease and with the permission of the attending physician. Here are some recipes suitable for treating otitis media.
Cotton wool is moistened with propolis infusion and inserted into the area of the external auditory canal. This composition has wound healing and antimicrobial properties. The tampon must be changed several times a day. Plantain juice, instilled into the ear in the amount of 2-3 drops per day, has a similar effect. To get rid of infections of the nasopharynx and larynx, which provoke middle ear infections, you can use rinses based on chamomile, sage, and St. John's wort.
Complications
With proper therapy, otitis media can go away without leaving any long-term consequences. However, inflammation of the middle ear can cause several types of complications. First of all, the infection can spread to the inner ear and cause internal otitis– labyrinthitis. It can also cause permanent or transient hearing loss or complete deafness in one ear.
Perforation of the eardrum also leads to hearing loss. Although, contrary to popular belief, the membrane can become overgrown, even after it is overgrown, hearing sensitivity will be permanently reduced.
Mastoiditis is accompanied acute pain in the parotid space. It is also dangerous due to its complications - the breakthrough of pus on the membranes of the brain with the appearance of meningitis or in the neck area.
Labyrinthitis
Labyrinthitis is an inflammation inner ear. Labyrinthitis is the most dangerous of all types of otitis. For inflammation of the inner ear typical symptoms include hearing loss, vestibular disorders and pain. Treatment of internal otitis is carried out only with the help of antibiotics; no folk remedies will help in this case.
Labyrinthitis is dangerous due to hearing loss as a result of the death of the auditory nerve. Also, with internal otitis, complications such as brain abscess are possible, which can lead to death.
Otitis ear in children
Otitis media in adults is much less common than this disease in children. This is due, firstly, to weaker immunity child's body. Therefore, infectious diseases of the upper respiratory tract are more common in children. In addition, the structural features of the auditory tube in children contribute to stagnant processes in it. It has a straight profile, and the expanded lumen at its entrance facilitates the entry of mucus and even pieces of food or vomit (in infants).
Thorough treatment of otitis media childhood very important. If carried out incorrect treatment, then the disease can become chronic and make itself felt already in adulthood with chronic outbreaks. In addition, if otitis media is not treated in infancy, it can lead to partial loss hearing loss, and this, in turn, leads to a delay in the child’s mental development.
Prevention of otitis media
Prevention includes preventing situations such as hypothermia of the body, primarily the ear area, getting dirty water into the ear canal area. Needs timely treatment inflammatory diseases upper respiratory tract, such as sinusitis, sinusitis, and pharyngitis. It is recommended to use a cap while swimming, and after being in the water, you should completely clear the ear canal of water. During the cold and damp seasons, it is recommended to wear a hat when going outside.
If labyrinthitis was caused by a traumatic brain injury, then the symptoms may be different. When the inner and middle ear are affected, accumulation of inflammatory fluid mixed with blood is often observed ( hemorrhagic exudate), which is visible through the eardrum. Also, damage to the temporal bone can lead to paresis of the facial nerve. This complication is manifested by the inability to voluntarily control the facial muscles ( half of the face on the affected side remains motionless). Facial nerve paresis occurs when the facial nerve canal located in the temporal bone is damaged.
Symptoms of labyrinthitis
| Symptom | Mechanism of occurrence | External manifestation |
| Involuntary oscillatory eye movements (nystagmus) | They arise due to dysfunction of one of the labyrinths. The subcortical and cortical regions of the brain, which process signals from the semicircular canals, in response to dysfunction of the labyrinth lead to nystagmus. At the beginning of the disease, nystagmus is directed towards the affected ear, and then within a few hours it changes its direction in the opposite direction. In the context of damage to the inner ear cavity this symptom is the most important. |  |
| Nausea and vomiting | They appear due to the transfer of nerve impulses from the vestibular nerve to nearby nerve fibers of the vagus nerve. In turn, this nerve can irritate the upper section gastrointestinal tract, which leads to nausea, and with excessive stimulation of the soft muscles of these parts - to vomiting. |  |
| Increased sweating(hyperhidrosis) | Appears on initial stage lesions of the labyrinth or during exacerbation of chronic labyrinthitis. Increased sweating occurs due to excessive stimulation of the vagus nerve. |  |
| Dizziness | Caused by damage to the semicircular canals. Information about the position of the head and torso reaches the brain only from a healthy labyrinth. As a result, the vestibular center is not able to assess the current position, which leads to a disturbance in spatial orientation. Dizziness can manifest itself subjectively as a feeling of rotation of surrounding objects, a feeling of uncertainty in determining one’s current position in space, or as the ground disappearing from under one’s feet. Attacks of dizziness may not last long ( 3 – 5 minutes) or last several hours. |  |
| Hearing loss to the point of deafness | Hearing loss occurs when the cochlea and/or auditory nerve are damaged. Deafness, as a rule, occurs as a result of purulent damage to the cavity of the inner ear or after acute acoustic trauma to the ear. It is worth noting that hearing loss is more pronounced in the high frequency range. |  |
| Impaired motor coordination | It is observed with pathological changes in the semicircular canals and in the vestibulocochlear nerve. These disorders lead to changes in gait ( insecure and shaky), as well as to deviation of the torso and head in the healthy direction. |  |
| Noise in the ears (tinnitus) | Occurs when the auditory nerve is damaged. In the vast majority of cases, tinnitus occurs along with hearing loss. Subjectively, tinnitus is perceived as a hum, buzzing, hissing, ringing or squeaking. |  |
| Change in heart rate | With labyrinthitis, a decrease in heart rate is most often observed. This is due to excessive activation of the vagus nerve, which also supplies nerve fibers and heart. Nervus vagus can change the conductivity of the heart and lead to a slowdown in rhythm. |  |
Diagnosis of labyrinthitis
The diagnosis of labyrinthitis is made by an otolaryngologist ( ENT doctor). In some cases, to make a correct diagnosis, they resort to consulting a neurologist, as well as an infectious disease specialist. Labyrinthitis is characterized by the presence of complaints such as dizziness, impaired coordination of movements, hearing loss, and noise in one or both ears. One of the main symptoms of labyrinthitis is the presence of involuntary oscillatory eye movements ( nystagmus). Having carefully collected all the necessary information about the disease, the ENT doctor can use a number of different instrumental diagnostic methods. The following methods for diagnosing labyrinthitis are distinguished:
- otoscopy;
- vestibulometry;
- fistula test;
- audiometry;
- Electronystagmography.
Otoscopy
Otoscopy is used to examine the pinna, the postauricular area of the external auditory canal ( together with the mastoid process) and eardrum. Also, the doctor must palpate all the lymph nodes nearby the external auditory canal to check for enlargement.The examination always begins with a healthy ear. For a more convenient examination of the external auditory canal, the doctor pulls the auricle backwards and upwards. Using a special otoscope tool, you can visually identify defects in the eardrum. If the eardrum is partially or completely destroyed, using this method you can examine the middle ear cavity. Otoscopy is used if labyrinthitis was caused by acute acoustic trauma to the inner ear or when the inflammatory process spreads from the middle ear cavity to the inner ear.
Vestibulometry
Vestibulometry involves the use of various tests to detect pathological changes in the vestibular apparatus. These methods are evaluated based on the duration and type of nystagmus. It is worth noting that vestibulometry is only an auxiliary method and is used in combination with other methods for diagnosing labyrinthitis.Vestibulometry involves the use of the following functional tests:
- caloric test;
- rotation test;
- pressor test;
- otolith reaction;
- finger-nose test;
- index test.
Caloric test involves slowly pouring water into the external auditory canal, which can be warm ( 39 – 40ºС) or cold ( 17 – 18ºС). If you use water at room temperature, then the involuntary eye movements that occur are directed towards the ear being examined, and if you pour in cold water - in the opposite direction. This nystagmus occurs normally, but is absent when the inner ear is damaged. It is worth noting that the caloric test is carried out only with an intact eardrum, so as not to lead to the entry of a large amount of water into the middle ear cavity.
Rotational test performed on a special chair with a swivel seat. To do this, the subject is asked to sit in a chair, keep his head straight, and also completely close his eyes. Next, carry out 10 rotations to the right side, and then another 10 rotations to the left. In this case, the rotation speed should be 1 revolution per 2 seconds. After this test finished, the doctor monitors the appearance of nystagmus. Normally, nystagmus lasts about half a minute. Shortening the duration of nystagmus speaks in favor of labyrinthitis.
Pressor test carried out using a special Politzer balloon. Air is pumped into the external auditory canal using this balloon. If nystagmus occurs, then this speaks in favor of a fistula ( pathological channel) in the lateral semicircular canal.
Vojacek's otolithic reaction just like the rotational test, it is performed on a special rotating chair. The patient being examined closes his eyes and lowers his head down so that his chin touches his sternum. The chair is rotated 5 times for 10 seconds. Then wait 5 seconds, after which the subject must raise his head and open his eyes. The function of the vestibular apparatus is assessed by various symptoms ( nausea, vomiting, cold sweat, pale face, fainting state).
Finger test is a simple test to identify disorders in motor coordination. The patient is asked to close his eyes and move one of his hands away, and then slowly touch the tip of his nose with the index finger of that hand. In case of labyrinthitis, this test helps to identify vestibular ataxia. Ataxia is a disorder of gait and coordination of movements and can occur due to damage to the vestibular system. Most often, vestibular ataxia is unilateral.
Barani index test carried out in a sitting position. The patient is asked to place his index finger on the finger of the doctor’s outstretched hand, alternately with with open eyes, and then with closed ones. With labyrinthitis, the person being examined misses with both hands with his eyes closed.
Audiometry
Audiometry is a method for studying hearing acuity and determining auditory sensitivity to sound waves. This method is carried out using special equipment - an audiometer. It is worth noting that to perform audiometry, a special soundproof room is required.The following types of audiometry are distinguished:
- pure tone audiometry;
- speech audiometry;
- audiometry using a tuning fork.
Speech audiometry necessary to determine the quality of word recognition at different sound levels. Through air telephones, the person being studied is asked to listen to a recording of 25 or 50 words spoken with varying intensities. At the end of speech audiometry, the number of words that were heard is counted. Any change to a word ( using singular instead of plural and vice versa) is considered an incorrect answer.
Audiometry using a tuning fork used in the absence of pure-tone audiometry. As a rule, the Weber or Rinne test is used. To do this, the stem of a sounding tuning fork is applied to the crown of the head ( Weber test). With an unaffected auditory analyzer, sound is felt in both ears with equal intensity. With unilateral labyrinthitis, the patient will hear better in the affected ear. For the Rinne test, the stem of a sounding tuning fork is applied to the mastoid process of the temporal bone. After the subject says that the sound of the tuning fork has ceased to be felt, it is removed and brought to the auricle. With labyrinthitis, the sound of a tuning fork is not felt when approaching the ear, while normally a person begins to hear the sound of a tuning fork again.
Electronystagmography
Electronystagmography is a method that allows quantitative and qualitative assessment of the nystagmus that occurs during labyrinthitis. This method is based on recording the difference in electrical potential between the cornea of the eye and the retina ( corneoretinal potential). The obtained data is recorded on magnetic tape and further processed by a computer, which makes it possible to determine various parameters of nystagmus ( quantity, amplitude, frequency, speed of fast and slow components). The result of electronystagmometry makes it possible to distinguish nystagmus caused by a disorder of the vestibular apparatus from other types of nystagmus.In addition to the above methods, other highly informative diagnostic methods can be used that can detect damage to the inner ear.
The following are distinguished instrumental methods Diagnosis of labyrinthitis:
- radiography;
Computed tomography of the temporal bone is one of the preferred methods in diagnosing labyrinthitis. This method makes it possible to visualize not only the bony structures of the temporal bone, but also various soft tissue structures in their natural location. Computed tomography allows not only to identify the nature and extent of damage, but also allows you to visualize the condition of blood vessels and nerve tissue in a given segment. Just like with x-rays, the only contraindication for this method is pregnancy.
Magnetic resonance imaging is the “gold standard” in the diagnosis of various lesions of the inner ear. Magnetic resonance imaging is the most informative diagnostic method and allows you to study in detail the structures of the bony and membranous labyrinth. The only drawback of this method is the inability to obtain information about the middle ear cavity.
If labyrinthitis is a consequence of a viral or bacterial infection, then it is necessary to perform a general blood test. If labyrinthitis is caused by a bacterial infection entering the cavity of the inner ear, then it will be found in the blood increased number leukocytes ( white blood cells which protect the body from pathogenic bacteria), and in case of a viral disease - increased amount lymphocytes ( immune system cells). Also, the infectious process leads to an increase in ESR ( erythrocyte sedimentation rate).
If labyrinthitis is caused by otitis media, then in this case it is necessary to conduct a bacteriological study of discharge from the ear ( a method to identify the type of pathogen).
Treatment of labyrinthitis with medications
Treatment of labyrinthitis is most often performed in a hospital setting ( hospital). The treatment regimen is selected depending on the cause of labyrinthitis, as well as on the basis of the symptoms of the disease. Drug treatment includes the use of drugs from various groups. To treat a bacterial infection, antibiotics are prescribed taking into account the sensitivity of microorganisms ( antibiogram). They also prescribe medications that have an anti-inflammatory effect and also normalize metabolic processes in the cavity of the inner ear and the brain.
Antibiotics for the treatment of labyrinthitis
| Antibiotic group | Representatives | Mechanism of action | Application |
| Penicillins | Amoxicillin | By attaching to the cell wall of a bacterium, it destroys one of its components. Capable of inhibiting the growth and reproduction of various types of microorganisms ( has wide range actions). | Inside. Adults and children weighing over 40 kg, 0.5 g three times a day. In case of severe infectious process, the dose can be increased by 2 times ( up to 1 g). Children from 5 to 10 years old: 250 mg ( 1 teaspoon or 1 capsule), from 2 to 5 years – 125 mg. Children under 2 years of age are served in liquid form ( suspensions) 20 mg/kg also three times a day. |
| Piperacillin | Blocks components of the bacterial cell wall, as well as some bacterial enzymes. Suppresses the growth and reproduction of various microbes ( has a wide spectrum of action). | Intravenous drips. The drug is administered dropwise over half an hour or in a stream over 4 to 5 minutes. Starting from 15 years of age, the drug can be administered intramuscularly. When treating moderate infections, the drug is prescribed in a daily dose of 100–200 mg/kg, three times a day. Maximum daily dose is 24 grams. | |
| Oxacillin | Blocks a component of the cell wall of microorganisms. Active against staphylococci and streptococci. | Orally 1 hour before meals or 2 to 3 hours after meals. A single dose for adults is 1 g, and a daily dose is 3 g. It can also be used intramuscularly or intravenously. Adults and children whose weight exceeds 40 kg - 250 - 1000 mg every 5 - 6 hours or 1.5 - 2 g every 4 hours. Children weighing less than 40 kg - 12.5 - 25 mg/kg, and newborns - 6.25 mg/kg, every 6 hours. The maximum daily dose is 6 g. | |
| Macrolides | Erythromycin | The spectrum of action is close to penicillins. Blocks the growth of bacteria by disrupting the formation of protein bonds. | Inside. Adults and children over 15 years of age: 0.25 g every 5 to 6 hours. The drug is taken one and a half hours before meals. The maximum daily dose is 2 g. Children under 14 years old - 20 - 40 mg/kg four times a day. |
| Clarithromycin | Blocks the synthesis of proteins of microorganisms. It affects both intracellular and extracellular pathogens. | Inside. Children over 12 years of age and adults: 0.25 - 0.5 g twice a day. The duration of treatment is 7 – 14 days. The maximum daily dose is 0.5 g. Children under 12 years of age: 7.5 mg/kg twice a day. |
If symptoms of inner ear dysfunction suddenly appear ( labyrinth attack) or during exacerbation of chronic labyrinthitis, vestibulolytics are indicated. This group medications improve blood circulation in labyrinthitis and help reduce the severity of various vestibular symptoms (dizziness, nausea, bradycardia, loss of coordination).
Drug treatment of labyrinthitis
| Group of drugs | Representatives | Mechanism of action | Application |
| Histamine drugs | Betahistine | Improves blood supply in the cavity of the inner ear. They are able to reduce the degree of excitation of the vestibular nuclei and thereby reduce the severity of vestibular symptoms. Accelerate the process of restoration of the vestibular organ after damage to the semicircular canals. | Orally, during meals, 8–16 mg three times a day. The duration of treatment should be selected individually. The effect is observed 2 weeks after taking the drug. |
| Bellataminal | |||
| Alfaserk | |||
| Anti-inflammatory drugs | Diclofenac | They have anti-inflammatory, analgesic and antipyretic effects. Biologically oppressed active substances, which further support the inflammatory process. | Inside. Adults: 25 - 50 mg three times a day. As the condition improves, the dose is gradually reduced to 50 mg/day. The maximum daily dose is 150 mg. |
| Naklofen | |||
| Dicloran | |||
| Drugs that block histamine receptors | Bonin | They have a pronounced antiemetic effect. They act predominantly in labyrinthine structures and lead to a decrease in dizziness. These drugs are effective for 24 hours. | Children over 12 years of age and adults: 25–100 mg per day. The drug must be taken three times a day. |
| Dramamine | |||
| Daedalon |
Surgery for labyrinthitis
In some cases, surgical treatment is the only option, since the effect drug treatment absent. Surgery is performed only when indicated. The following should be mentioned important points regarding the operation for labyrinthitis:
- indications;
- methodology;
- anesthesia;
- hearing prognosis;
- rehabilitation.
Indications
Indications for surgery for labyrinthitis include a number of various pathologies and complications. Highlight the following readings to carry out the operation:
- irreversible hearing loss;
- purulent labyrinthitis;
- combination of labyrinthitis with inflammation of other bone structures of the temporal bone;
- penetration of infection from the cavity of the inner ear into the brain.
Purulent labyrinthitis caused by staphylococci or streptococci entering the cavity of the inner ear. This form labyrinthitis leads to complete damage to the organ of Corti. In the future, purulent inflammation of the inner ear can lead to necrotizing labyrinthitis, which is manifested by alternating dead ( necrotic) areas of soft tissue and the bone part of the labyrinth along with foci of purulent inflammation.
A combination of labyrinthitis with inflammation of other bone structures of the temporal bone. In some cases, the inflammatory process, in addition to the labyrinth, can affect adjacent bone segments of the temporal bone. Inflammation of the mastoid process ( mastoiditis) or the apex of the pyramidal bone ( petrosite), usually treated surgically ( surgery to remove purulent lesions).
Penetration of infection from the cavity of the inner ear into the brain. One of the complications of labyrinthitis is the spread of the inflammatory process along the auditory nerve to the brain. In this case, meningitis, meningoencephalitis ( inflammation of the brain and membranes) or brain abscess ( accumulation of pus in the brain).
Methodology
At the moment, there are a large number of different techniques and variations for surgically opening the cavity of the inner ear. In each individual case, the surgeon ( otosurgeon) the most suitable technique is selected. To access the labyrinth, you can use the following techniques:
- Ginsberg method;
- Neumann's method.
Ginsberg's method. The labyrinth is opened in the area of the cochlea and vestibule from the lateral side ( horizontal) semicircular canal. The opening is performed with a special surgical chisel in a place that corresponds to the main curl of the cochlea. It is necessary to carry out surgical manipulations accurately, since if the chisel comes off under the blow of a hammer oval window, this will lead to damage to the facial nerve. Also located nearby is a branch of the internal carotid artery, which can also be easily damaged. At the second stage, the horizontal semicircular canal is opened. Next, scraping is performed through this channel with a special spoon ( destruction) vestibule and passages of the cochlea.
Neumann's method. This method is more radical, since not one, but two semicircular canals are opened at once ( top and side). After these canals have been opened, the cochlea is scraped out. This type of operation is much more complicated than the Ginsberg method, but allows for better drainage of the labyrinth ( outflow of pathological secretions from the cavity of the inner ear).
Anesthesia
When operating on the inner ear, it is usually used local anesthesia. 30 minutes before the start of the operation, 2 turundas are placed in the middle ear cavity, which are moistened with anesthetic drugs local action (3% dicaine solution or 5% cocaine solution). General anesthesia carried out in rare cases. The indication is the patient's increased pain sensitivity. Hearing prognosis
As a rule, an uncomplicated inflammatory process that occurs in the labyrinth, which is promptly diagnosed and treated, does not lead to permanent hearing loss. Hearing loss can occur with acoustic trauma to the ear, when the sensory hair cells of the organ of Corti undergo irreversible degenerative processes. Also, sensorineural hearing loss is observed when the auditory nerve is damaged due to meningitis, tuberculosis or syphilis. Hearing surgery requires special consideration. This method is effective in case of damage to the cochlea of the inner ear and is based on installing a special device in the human body that can convert sound signals into nerve signals. A cochlear implant is used as a prosthesis ( an implant that performs the function of a cochlea), which consists of several parts. An implant body is implanted under the skin in the temporal bone, which is capable of receiving sound signals. A special electrode array is inserted into the scala cochlea. Having received sound signals, a special processor in the body of the implant processes them and transmits them to the cochlea and then to the electrode array, in which the sound is transformed into electrical impulses recognized by the auditory zone of the brain.
Rehabilitation
The rehabilitation period after surgery on the labyrinth, on average, ranges from 3 weeks to 3 months. Long recovery times are associated with slow restoration of vestibular function. Also, the rehabilitation period depends on the general condition of the patient and concomitant diseases. Rehabilitation after hearing loss can last quite a long period of time. This is due to the fact that the adaptation process takes place over several months, and the patient is taught to hear again through this cochlear implant.
Prevention of labyrinthitis
Prevention of labyrinthitis comes down to timely and correct identification of inflammation of the middle ear ( otitis media). Often, otitis media in children is the cause of inflammation of the inner ear. It is also necessary to promptly sanitize the nose, mouth and nasal pharynx. Sanitation is a technique for improving the health of the body. During the rehabilitation of ENT organs ( nasal cavities, sinuses, pharynx, larynx, ears) the destruction of microorganisms that live there and are capable of leading to various diseases when immunity decreases.
The following indications for sanitation of ENT organs are distinguished:
- increased body temperature above 37ºС;
- the appearance of pain in the nose or sinuses;
- difficulty breathing through the nose;
- deterioration of sense of smell;
- painful sensations, soreness or burning in the throat;
- increase in the size of the tonsils ( tonsils) and the presence of films on them.
The following medicinal substances are used for sanitation:
- furatsilin;
- chlorhexidine;
- chlorophyllipt;
- Tomicide.
Chlorhexidine is an antiseptic substance that neutralizes not only various bacteria, but also viruses and microscopic fungi. Chlorhexidine can be used in various dilutions ( 0.05 and 0.2% solution) for rinsing the mouth.
Chlorophyllipt is an oil or alcohol solution, which is effective against staphylococcus. For sinus diseases ( sinusitis, frontal sinusitis) the drug is instilled 5 - 10 drops 3 times a day for a week.
Tomicide is a drug that inhibits the growth of gram-positive microorganisms ( staphylococci, streptococci). To rinse, use 10–15 ml of heated tomicide solution 4–6 times a day. When gargling, contact with this drug should not exceed 5 minutes.
It is worth noting that sanitation should be used together with other methods of treating diseases of the ENT organs ( antibiotic therapy). Surgical debridement is resorted to only when drug therapy has no effect.
In many cases, they represent an inflammatory process or irritation of the parts of the ear responsible for balance and hearing. In addition, the cause of inflammation of the inner ear is an infection caused by a virus or bacteria.
This part of the ear is a hollow bony formation, the part that includes the senses of hearing and balance. The system of communicating bone canals inside it is called the bony labyrinth; it contains the membranous labyrinth.
The outlines of the bony and membranous labyrinths completely coincide. The bony labyrinth is divided into three sections: the vestibule, semicircular canals and cochlea. The membranous labyrinth is divided into parts:
- semicircular canals;
- two vestibular sacs,
- vestibule water supply;
- snail;
- The cochlear canal, which is the only part of the inner ear that is a hearing organ.
This entire structure is immersed in fluid - endolymph and perilymph.
What diseases can occur in the inner ear?
Diseases that occur in this part of the hearing organ are less common compared to diseases of the middle or outer ear. The danger of such diseases is associated with insufficient knowledge of the causes of their occurrence and the low effectiveness of treatment for some of them. Moreover, in the case of early detection of pathology, there is not always a need for surgical intervention, which allows one to preserve hearing.
These diseases include the following:
- - means that the hair cells of the inner ear are damaged, or it is a manifestation of damage to the auditory nerve.
- Meniere's disease is a disorder characterized by recurrent attacks of dizziness (false sensation of movement or rotation), fluctuations in hearing (at low frequencies), and noise in the ear (tinnitus). Symptoms include sudden, unprovoked attacks of severe dizziness, nausea and vomiting, often along with pressure in the ear and hearing loss.
- Labyrinthitis is a disease in which the structures of the ear can become inflamed. The two vestibular nerves in the inner ear send information about position in space and balance. When one of these nerves becomes inflamed, a condition called labyrinthitis occurs.
- Otosclerosis is one of the most common causes of progressive hearing loss in young people. It is caused by abnormal bone growth in the ears, leading to hearing problems. In most cases surgery restores hearing.
- Various types of inflammatory processes are lesions caused by infection.
In many cases, such pathological processes are a complication of another disease. They are characterized by frequent involvement in the pathological process of structures that are responsible for the functioning of the vestibular apparatus, which leads not only to loss of hearing acuity, but also to dizziness and problems with balance.
What is labyrinthitis and the causes of its occurrence?
Labyrinthitis is pathological condition, symptoms of which include dizziness, nausea and hearing loss. With the development of otogenic labyrinthitis, the infection penetrates from the middle ear.
The cause of labyrinthitis is unknown. Inflammation leading to the disease can be caused by several factors, including infections and viruses. Acute labyrinthitis with proper treatment passes within a period of several days to about 2 weeks without the threat of pathological disorders.
Signs of the disease depend on the form of labyrinthitis (acute or chronic). The pathology can lead to a condition called benign paroxysmal positional vertigo, which causes short episodes of dizziness, or Meniere's disease, which can cause variable hearing loss, dizziness, ringing in the ears, and a feeling of fullness or pressure.
In the absence of timely treatment, various complications arise. The disease affects the facial nerves and muscles, which leads to the development of paresis. The infection may spread to the bones of the skull and membranes of the brain.
This is any inflammatory process of the middle ear without reference to etiology or pathogenesis. Otitis is another name for the same infection. This type of disease occurs when allergies, colds, sore throat or respiratory infection. There are two forms of otitis media.
The rapidly occurring form is characterized by an increase in temperature, painful sensations in the depths of the ear cavity; the pain may be stabbing, boring or throbbing. The discharge of purulent contents is characteristic. The occurrence of chronic otitis is possible in the presence of gastroesophageal reflux.
Internal otitis is a pathological condition that is an inflammatory process in the inner ear. Purulent otitis media- This is an infectious process that develops against the background of an advanced disease.
The development of this form of the disease is provoked by the following factors:
- the presence of adenoids;
- inflammatory diseases of the nasopharynx (rhinitis, sinusitis);
- viral infections (parainfluenza, ARVI, influenza);
- decreased immunity;
- improper cleaning of the ear cavity.
Characterized by the presence of shooting or aching ear pain and headache, purulent discharge from the ears, congestion and noise in the ear, high temperature, hearing loss.
Incorrect or untimely treatment leads to the development of complications. The chronic form of the disease develops when treatment of otitis media is not started in a timely manner or is inadequate.
Meningitis
Meningitis is a disease in which the lining of the brain becomes inflamed. The main symptoms are headache, fever and hypertonicity of the neck muscles. Most cases of the disease are caused by a viral infection, but other causes include bacterial and fungal infections. Meningitis can cause hearing loss, and it can also be caused by taking certain medications (antibiotics). Meningitis can lead to problems with balance and cause deafness and tinnitus (tinnitus).
Inner ear injury
Trauma - such as injury to the head (base of the skull or temporal bone) from a fall or injury to the neck in a car accident - can also damage this part of the hearing organ. Acoustic injury can occur when exposed to short or long-term loud sounds exceeding 120 dB. Fast development pathology occurs with short-term exposure, the chronic form is associated with constant exposure to intense sounds, including noise combined with vibration.
Viral and bacterial infections
The disease may develop as a complication associated with another bacterial or viral disease. Pathological process can be caused by influenza virus, mumps, syphilis, tuberculosis.
Main symptoms
The development of signs of the disease occurs quickly, symptoms can be intense for several days. After some time they disappear, but can appear with a sudden movement of the head. This condition most often does not cause pain.
The inflammatory process causes loss of coordination, tinnitus (ringing and noise), high-frequency hearing loss in one ear, difficulty focusing the eyes, involuntary oscillatory eye movements, increased sweating, decreased heart rate, dizziness, nausea, and vomiting. In rare cases, complications may include permanent hearing loss.
On the affected side, paralysis or paresis of the facial nerve is manifested: there are no folds when raising the eyebrows, there is asymmetry of the nose, the eye does not close, the corner of the mouth is drooping, increased salivation, the nasolabial fold is smoothed, dryness of the eyeball is noted, problems with speech perception against the background of noise, impaired taste sensations.
The appearance of symptoms intensifies with head movements, turns, rotations, as well as any manipulations with the organ of hearing. The purulent form of labyrinthitis is accompanied by an increase in temperature. This is due to the fact that with the development of this disease, purulent masses accumulate.
In children
The main cause of the disease in childhood is injury or infection. Children often have various respiratory diseases, inflammatory processes of the ENT organs, which can lead to the development of this pathology. Children complain of dizziness and hearing loss, nausea and vomiting.
In adults
The main symptoms in adults are dizziness, vestibular disorders, tinnitus, hearing loss, loss of balance and coordination.
Diagnostic methods
Diagnosis of the disease is carried out by an otolaryngologist. It includes a set of activities. It may be necessary to be examined by other doctors: a neurologist and an infectious disease specialist.
Otoscopy
During otoscopy, the auricle, postauricular area of the external auditory canal, including the mastoid process and the eardrum are examined. Lymph nodes are palpated to determine their possible enlargement. Otoscopy is used when pathology develops against the background of acoustic trauma or the spread of the inflammatory process from the middle ear to the inner ear.
Vestibulometry
Vestibulometry is a set of tests that allows you to detect pathological changes vestibular apparatus. Several functional tests are used:
- caloric test;
- rotational test;
- pressor test;
- otolith reaction;
- finger-nose test;
- index test.
Vestibulometry is used as an auxiliary method in combination with other diagnostic methods.
Audiometry
Audiometry is a method that allows you to examine hearing and determine hearing sensitivity. To carry it out, an audiometer is used. The study is carried out in a special soundproof room. Audiometry can be tonal, speech, or carried out using a tuning fork.
Electronystagmography
Using electronystagmography, a qualitative and quantitative assessment of nystagmus is performed. To do this, the difference in electrical potential between the cornea and the retina is recorded. The obtained data undergoes computer processing, which makes it possible to determine the parameters of nystagmus (quantity, amplitude, frequency, speed).
Treatment
Used in the treatment of disease complex therapy, which is held in inpatient conditions. The treatment regimen depends on the causes of the disease and its symptoms. In this case, anti-inflammatory drugs and drugs are used to normalize metabolic processes in the ear cavity and brain. To treat inflammatory processes, antibiotics and dehydration therapy are prescribed.
When sudden appearance symptoms (labyrinth attack) or worsening of the condition in chronic labyrinthitis, vestibulolytics are prescribed, which improve blood supply in the labyrinth and reduce dizziness, nausea, and loss of coordination.
If there is no effect of treatment medicines there is a need for surgical intervention. In case of diffuse serous or purulent labyrinthitis, anthromastoidotomy or general cavity sanitation of the hearing organ is performed to remove purulent contents. Surgically fistulas are removed. In rare cases, when conservative treatment and sanitation do not help, the labyrinth is opened.
When symptoms of the disease appear, the patient must be provided with bed rest. Treatment at home is ineffective, and self-medication is unacceptable. Traditional home treatment heating can provoke the appearance of purulent contents. The patient must be hospitalized. Treatment in a hospital setting will help prevent the development of a purulent form.
Folk remedies that can be used to treat the appearance of labyrinthitis have the same properties as the drugs that doctors use to treat the disease: antibacterial, anti-inflammatory, diuretic, and reducing nausea. Antiseptic, anti-inflammatory and regenerating properties are inherent in honey and many herbs. To reduce the symptoms of otitis media, some alternative medicine methods are used, for example, sore ear instill a honey-based solution.
Possible complications
The main complications of labyrinthitis are due to the danger of the inflammatory or purulent process spreading to nearby structures. The consequence of this may be peripheral neuritis of the facial nerve, mastoiditis, petrositis. If the infection during purulent labyrinthitis penetrates the cranial cavity, otogenic complications may develop: meningitis, encephalitis, brain abscess. This kind of complication is the most dangerous.
Due to its deep location in temporal lobe head, symptoms of inner ear disease are quite difficult to recognize. Its infection most often occurs due to other foci of inflammation.
Labyrinthitis (internal otitis)
Labyrinthitis is an inflammatory disease of the inner ear that affects the vestibular and auditory receptors. Labyrinthitis accounts for no more than 5% of the total number of diagnosed otitis media. The main pathogens are bacteria (staphylococci, streptococci, mycobacterium tuberculosis, meningococci, pneumococci, treponema pallidum). Mumps and influenza viruses can also activate the process.
Based on the initial focus of the lesion and the route of entry of the pathogen into 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 when various types meningitis (tuberculosis, influenza, measles, typhoid, scarlet fever). Often both ears are affected, which can lead to acquired deaf-muteness.
- Hematogenous. Introduced by blood or lymph flow during illnesses such as syphilis or mumps. Very rare.
- Traumatic. Develops as a result of damage foreign body(with a needle, pin, match) of the eardrum as a result of improper hygiene procedures. May occur with traumatic brain injuries complicated by a fracture of the base of the skull.
Inflammatory disease of the inner ear, symptoms:
- noise and pain in the ears;
- dizziness (appears a week and a half after a person has suffered a bacterial infection and is regular, lasting from several seconds to hours);
- hearing loss (especially high-frequency sounds);
- imbalance;
- reflexive frequent vibrations 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 hearing organs, the symptoms intensify.
From the labyrinth, the inflammatory process on the affected side can reach the trunk of the facial nerve and cause its paralysis. Signs of this are:
- fixed corner of the mouth;
- asymmetry of the tip of the nose;
- absence of folds on the forehead when raising the eyebrows;
- inability to completely close the eye;
- increased salivation;
- dry eyeball;
- change in some taste sensations.
If there are symptoms of labyrinthitis, an in-depth examination is carried out to establish an accurate diagnosis: blood test, magnetic resonance therapy, audiometry, electronystagmography (study of eyeball reflexes), bacteriological examination. An otolaryngologist or neurologist can diagnose diseases of the inner ear, the symptoms of which are not clearly expressed.
Labyrinthitis can be treated conservatively and surgical methods. Drug therapy is used in cases where there are no purulent formations and the disease is not widespread.
Antibiotics of the cephalosporin and penicillin series are prescribed.
To dehydrate the body, do not take liquids ( daily norm- no 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 antiemetics (cerucal), antihistamines (fenistil, suprastil) and sedatives (lorazepam, diazepam). Vitamins C, K, B, P, cocarboxylase, as well as intravenous atropine prevent the occurrence of trophic disorders.
In case of complicated purulent form, pus is removed by general cavity trepanation after conservative treatment. Labyrinthectomy is very rarely performed. Produced on time surgery can prevent the diffuse form of labyrinthitis and preserve the patient’s hearing.
The etiology of this disease is unknown. The main signs of the disease are periodic attacks of dizziness, decreased perception of sounds and tinnitus. With each attack, hearing gradually worsens, although for a long period it may remain in a state close to the normal limit.
The suspected causes of the disease in different time considered: disturbance of the ionic balance of fluids, water and vitamin metabolism, vegetative-vascular dystonia, vasomotor disorders. By far the most common variant is intralabyrinthine edema due to increased endolymph.
Clinical picture:
- progressive hearing loss in one or both ears;
- regular attacks of dizziness, accompanied by loss of balance, vomiting and nausea;
- tinnitus (one or two, usually at low frequencies)
- tachycardia.
The patient's head may feel dizzy either often (1-2 times a week) or very rarely (1-2 times a year). Often, as a result of this, a person is unable to stand on his feet.
Temporary memory loss, drowsiness, forgetfulness, and fatigue are possible.
Based on these signs, the disease is diagnosed. For a more accurate diagnosis, audiometry, computed tomography or MRI, brain stem response test, and electronystagmography are used.
At conservative therapy apply:
Surgical intervention has several techniques:
- 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 responsible for balance is cut, hearing is not lost, but the operation is fraught with errors);
- labyrinthectomy (the labyrinth is removed, resulting in hearing loss).
There are other treatment methods, but they have a number of disadvantages and are therefore used only in certain clinics.
Otosclerosis
Otosclerosis is a degenerative disease that affects the bone capsule of the labyrinth, in which bone tumors 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, and their disease progresses during pregnancy and childbirth. The first manifestations are usually recorded at 20-40 years of age.
The main symptoms are decreased conductive hearing and tinnitus. Over time, neuritis may occur.
Hearing loss begins in one ear, and much later the other becomes involved. In this case, the enlarged cochlea interferes with the normal movement of the ossicles of the hearing aid.
Drug treatment can only provide a noise reduction effect. Therefore, if hearing deteriorates by 30 dB, the situation is corrected surgically, this helps more than 80% of patients. Surgical intervention consists of installing a stapes prosthesis in each auditory organ, one at a time, at intervals of six months. In some cases the only way out for the patient - a hearing aid.
Sensorineural hearing loss
Sensorineural hearing loss is a lesion of the organs responsible for the perception of sound. In this regard, the sound is received weakly 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.
When detected on early stage Therapy is carried out with medications, electrical stimulation, and physiotherapy. In other cases, it is necessary to resort to hearing aids.
Inner ear inflammation occurs in all people age groups. Therefore, it is important to know not only the causes and symptoms, but also treatment options. It is also better to adhere to the basic rules for preventing this pathology.
Inflammation of the inner ear is a rare form of otitis media. The disease depends not only on an infection in the nasopharynx or some kind of mechanical injury. It can be caused by various ailments associated with inflammation-provoking microorganisms. For example, measles or mumps.
First of all, the causes of the disease should be established. And then determine the treatment and symptoms of inflammation of the inner ear in adults or children.
The inner ear is located quite deep, so the inflammatory process most often occurs as a result of infection.
There are several main reasons that can cause inflammation of the inner ear (labyrinthitis).
Inflammation of the middle ear (otitis media)
The middle ear is separated from the inner ear by connective tissue. Therefore, when a membrane consisting of such tissues is infected, harmful microorganisms can easily get inside. The pus begins to stagnate, and as a result, pressure on the labyrinth increases.
Infectious diseases
Pathogenic microorganisms are able to penetrate into the inner ear and from the brain area. In this case, the cause of inflammation is various shapes meningitis. In this situation, the infection affects both ears of the patient, which can lead to deafness.
Injuries
Pathogenic bacteria can enter the labyrinth due to injury. Therefore, you need to protect yourself from negative external influences on your ears.
Viral diseases
This form of the disease can develop as a result of complications suffered during mumps, syphilis, measles, tuberculosis and others. viral infections. According to the form of the course, inflammation of the inner ear can be acute and chronic, according to the nature of the inflammatory process - purulent, serous and necrotic. And inflammation can spread both locally and to both organs of hearing.
Symptoms
Signs and symptoms of inflammation of the inner ear (labyrinthitis) will be as follows:
- dizziness;
- hearing may deteriorate temporarily;
- strong noises in the head;
- nausea;
- problems with orientation in space.
Almost each of these signs is directly related to the impact of the inflammatory process on the vestibular system. In the absence of timely treatment, it is difficult for the patient to even stand on his feet and move independently in space.
If a patient develops this disease, he may experience discomfort in the head. The main symptom of inflammation of the inner ear in children and adults is constant dizziness. The patient will feel that things and objects are spinning in space, and feel dizzy after sneezing or driving in a car.
When this disease occurs, vibrations occur on the front of the eyeball caused by reflexes; they first appear on the side of the healthy ear, then move towards the diseased organ.
A person has difficulty hearing, this can be seen due to noise in the ears, and the patient also does not perceive high frequencies. Labyrinthitis when not timely treatment may lead to complete deafness in the patient.
This disease manifests itself in damage to the facial nerves; if the disease is not cured in time, this part of the face remains paralyzed.
How to determine?
To determine the disease, you need to know the symptoms. Diagnosis of inflammation of the inner ear will begin with an examination. The doctor should be alert to:
- If the patient raises his eyebrows, but there are no folds on the forehead.
- There is no symmetry with the tip of the nose.
- The corners of the mouth become motionless.
- The patient experiences increased salivation.
- The eyeball becomes completely dry, and the patient is unable to close his eyes.
- The taste of food changes.
- The patient hears various sounds better in a noisy room.
In addition to these symptoms, there may be paleness of the face, vomiting, irregular heartbeat, increased sweating, and discomfort in the chest area. In this case, a person can completely lose orientation in space, in severe forms With this disease, the patient can neither stand on his feet nor sit down.
Otitis externa
The easiest way to determine this disease is to press on the outside of the ear canal, the patient will feel pain. Hearing basically remains at the same level as before. Now, if pus appears inside the ear canal, then hearing may deteriorate.
Otitis media
Occurs in a patient in acute or chronic form, there are two types of this disease. In the case of the first, fluid collects inside the ear, in the second case - pus. Spicy, sharp pain in the back of the head, crown and general headaches. A sound may also be felt, as if liquid is splashing in the ear, blocking the ears.
The pain is sharp, hearing deteriorates, heat. If timely treatment is started, the patient’s hearing remains the same and does not deteriorate.
Any of these diseases can be cured; it is only necessary to make a diagnosis in time and begin therapy.
Diagnostics
To diagnose inflammation of the inner part of the ear, it is necessary to conduct a number of specific studies, which are prescribed by an otolaryngologist.
The first stage of diagnosing the disease consists of a doctor examining parts of the ear such as the pinna, eardrum, and the area behind the outer ear canal (behind the ear). This study is carried out using a device specially designed for this purpose - an otoscope.
At the first signs of illness, you should immediately contact a specialist. It is important to prevent complications from occurring. Next are laboratory research. They do a general blood test. If fluid is released from the auditory organ, it is also examined. X-rays also help determine an accurate diagnosis. To detect suppuration, a computed tomography is performed. As for such a procedure as examining the eardrum, it is resorted to if internal otitis arises from inflammation of the middle ear.
In addition, other diagnostic methods are possible using certain tools:
- Using special device- audiometer - determines how acute and sensitive the hearing is. The procedure is called audiometry.
- The state of the vestibular apparatus is determined using vestibularometry.
- When inflammation of the inner part of the ear occurs, nystagmus appears, it is examined using electronystomography.
To confirm or refute the diagnosis, magnetic resonance and computed tomography scanners and x-rays are also used. The patient also donates blood and discharge from the diseased ear for tests, the delivery of which is necessary in order to determine whether the disease is viral or bacterial, because the difference in treatment is significant.
Treatment
The entire treatment process takes place exclusively in a hospital setting under the constant supervision of doctors. If the cause is a bacterial infection, then antibiotics are required. If the cause is a viral pathogen, then antibacterial agents are ineffective.
Medications for labyrinthitis
When treating inflammation of the inner ear, preference is given to conservative therapy. In order to reduce symptoms, treatment is recommended, including the following medications:
- Various antiemetic medications. Among the popular ones are “Cerukal” or “Compazin”.
- To relieve inflammation, steroids are recommended medications. For example, Methylprednisolone is suitable.
- In some cases, you will need drugs from the group of anticholinergic drugs.
- Special patches can be easily applied to the ear area, and the results will be felt fairly quickly.
- To reduce dizziness and nausea you need antihistamines. One of the popular drugs is Suprastin. It is suitable for adults and children. Affordable price, minimum quantity side effects.
- To decrease anxiety, light sedatives are prescribed.
- Vestibulolytics will be prescribed only if blood circulation in the body is impaired.
Other treatments
Also, for symptoms of inflammation of the inner ear, the following treatment options are used:
- Diuretics.
- Diet.
- Use of glucose and calcium chloride.
Surgical intervention
If the entire surface of the inner ear is affected or there is any suppuration, then surgery is necessary. Sanitated general cavity trepanation helps to remove all pus in the labyrinth. Labyrinthectomy is needed for uncomplicated cases of suppuration. But it is carried out only in exceptional cases. However, most often, before any surgical intervention, the patient is prescribed medication for a week.
Folk remedies
- Take two tablespoons of medicinal burnet roots. Pour two glasses of boiling water. Heat the future broth in a water bath for half an hour. It is enough to take one tablespoon up to three times a day.
- Tampon soaked in onion juice And vegetable oil, must be kept in the auricle for several hours.
- It is strictly forbidden to apply a warm heating pad to the area where the inflammatory process is localized. There is a high risk that pus will enter the cranial cavity.
When treating inflammation of the inner ear, it is important to consult a specialist in a timely manner. In most cases, complications can be avoided.