1 Causes of the development of the disease
Most often, adhesive otitis media develops against the background of exudative or simple otitis media. The launch of a pathological process can be facilitated by the misuse of antibacterial drugs. With the extinction of the inflammatory process and the release of the liquid accumulated in the tympanic cavity, fibrin fibers and connective tissue formations form in it. The latter grab the ears and the tympanic membrane, reducing the mobility of these areas, necessary to transfer auditory vibrations. Striations and cords can appear in the auditory canal, which contributes to its blockage.
Adhesive otitis media often occurs spontaneously, without previous inflammatory processes. In this case, the causes of its appearance are diseases that violate the permeability of the auditory canal and stop the flow of air into the tympanum. These are: acute infections and inflammatory diseases of the upper respiratory tract( influenza, laryngitis, pharyngitis), chr
onic tonsillitis, sinus cysts, proliferation of mucous membranes of the nasal passages, malignant neoplasms of the larynx and nasal sinuses.
2 Clinical picture
Adhesive otitis begins with the appearance of symptoms such as hearing loss and the presence of extraneous sounds in the ears. When collecting an anamnesis it turns out that in recent times a person has suffered acute or slow otitis media. Examination of the auditory canal in this disease reveals a conductive mechanism of development of hearing loss - deafness arising on the background of violation of the processes of sound transmission. As such, there are no specific signs of adhesive inflammation of the middle ear. Therefore, the final diagnosis can only be made after a series of studies. During the diagnosis, the doctor should exclude other pathological conditions that contribute to hearing loss: trauma to the auditory ossicles and tympanic membrane, the formation of sulfur plugs and otosclerosis.
The examination of the patient begins with an examination by an otolaryngologist, assesses the patency of the Eustachian tube, endoscopic examination, measures the acuity of hearing and catheterization of the auditory canal. When audiometry is performed, a hearing loss of varying degrees is detected, up to a complete loss of hearing. Channel penetration is determined by filling it with air. With adhesive otitis this procedure gives a slight improvement, in severe cases the result is absent. Such conditions do not always indicate clogging of the auditory canal. The final diagnosis can be made on the basis of the results of otoscopic examination.
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The main stage of diagnosis is the evaluation of the otoscopic picture of the disease. Endoscopic examination allows to detect the concavity of the tympanic membrane, the change in its structure, the appearance of cicatricial phenomena that cause damage to the auditory ossicles. The adhesive process in the tympanic cavity is revealed, the cords often completely embrace it. Determination of the volume of movements of the membrane is carried out by means of impedanceometry. The procedure involves thickening and dilution of air filling the Eustachian tube, in which the eardrum starts to move. Adhesive otitis media is distinguished by the absence or limited amplitude of the oscillations. Acoustic muscular reactions are not observed.
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3 Treatment methods
Treatment of adhesive otitis begins with the elimination of the causes of occlusion of the auditory tube. This includes the treatment of nasal sinuses, removal of adenoids in children, the restoration of nasal breathing - correction of deformity of the septum and elimination of pathological proliferation of mucous membranes. A sufficiently high efficiency for this disease has a course of blowing at the Politzer in combination with physiotherapy procedures. Hormonal preparations are introduced into the tympanum by means of a catheter, Lydas, Fluimutsil. Particular attention should be given to strengthening immunity. For this purpose, immunostimulants, vitamins, aloe extract, vitreous are taken orally. To reduce the severity of the symptoms of inflammatory processes, antihistamines and NSAIDs are prescribed.
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The drug treatment of adhesive otitis is combined with the performance of physiotherapy procedures. Microwave and ultrasound effects, pneumomassage of the tympanic membrane, mud therapy are applied. Useful phonophoresis and electrophoresis of lidase and potassium iodide. Conservative therapy in severe forms of the disease is ineffective. In such cases, surgical treatment is prescribed. The operation is indicated with progressive hearing loss. Dissection of cords and removal of scar tissue contributes to the restoration of the volume of movements of the auditory ossicles. The operation has insufficient efficacy in severe forms of adhesive otitis media. After surgery, spikes often appear again. Long-term effect has tympanoplasty - prosthetics of auditory ossicles. Elderly patients with a bilateral nature of the disease recommended wearing hearing aids.
With adhesive otitis treatment with folk remedies does not allow to completely get rid of the disease, it only removes some of its symptoms. Before using this or that remedy, it is necessary to consult the attending physician. Home methods of treatment include heating with ultraviolet lamp, the introduction of tampons with decoctions of medicinal plants.
The prognosis for adhesive otitis is determined by the prevalence and nature of pathological changes in the middle ear. They are irreversible, so they can only be suspended. The earlier the disease was detected, the less the degree of hearing impairment. With neglected forms of adhesive otitis and its prolonged course, incorrect or untimely treatment, the auditory ossicles are completely immobilized, which contributes to the final loss of hearing.