Epitimpanitis: symptoms of chronic purulent form, complications, treatment

Epitimpanitis it is customary in medical practice to call a chronic suppurative course of inflammation in the middle ear region. The process is characterized by a long and malignant nature of the destruction of the anatomical structures.

Epitimanitis clinic

Three auditory ossicles of the middle ear cavity are affected. Due to the peculiarities of the structure of the middle ear( numerous pockets and folds) pus under inflammation does not flow out beyond the cavity, accumulating and creating an additional source of threat to the health and life of the patient.

The pressure exerted by the purulent mass and the proximity of the location of the cavity of the inner ear and brain, creates a high risk of spreading the inflammatory process to vital organs.

One of the complications of the destruction of structures of the above-drum space is perforation of the tympanic membrane, as a result of which the cavity of the middle and inner ear is the gate for the rapid penetration of infectious agents.

In practice, there is often an edge perforation of the membrane when the lesion extends to the anterior( posterior) compartment.

Affected eardrum

Symptoms of the disease

Chronic purulent inflammatory process is accompanied by the following symptoms:

  • in the patient's ear lowers acuity;
  • by accumulation in the focus of defeat of scatol and indole, spreading fetid odor from the diseased ear;
  • with acute pains in the affected area, reflected in the temporal and parietal part of the head;
  • a bursting feeling in the middle ear area due to pressure build-up;
  • enhanced sense of heaviness in the affected part of the head;
  • increase in the frequency of rhythmic movements of the eyeballs and increasing circulation in the head;
  • secretion of pus with blood content from the external auditory canal, having a bad smell. Often in the exudate emitted there are particles of destruction of auditory ossicles in the form of a crumb;
  • scars after curing pathologies, requiring differentiation from scars formed during the course of inflammation, making it difficult to separate the purulent exudate.

The photo shows the appearance of the tympanic membrane with epitimipanitis

Causes of

The provoking factors for qualitative transformation of mesotympanite or otitis into epitimpanitis are:

  • activity of pathogenic prokaryotes( streptococci, staphylococci, pneumococci);
  • evasion of the patient from a full treatment of otitis or negligence of the medical specialist to treat inflammation in the middle ear;
  • untimely degeneration of embryonic cartilaginous tissue of the auditory ossicles into the bone, which contributes to the greater vulnerability of myxomatous structures to infectious disease;
  • is a diploid type of mastoid process, most often prone to chronic inflammation;
  • chronic processes in the communicating structures: proliferation of adenoids, inflammation of the tonsils, adenoids, adnexal sinuses. The connection between the curvatures of the nasal septum and the hypertrophied shells of the nasal cavity with epitimpanitis has been noted.

Against the backdrop of provoking factors, several reasons contribute to the initialization of the pathological process:

  • pathological processes in the body, indicating a general decrease in immunity( diabetes mellitus, hypovitaminosis, hematological and infectious diseases, tuberculosis, etc.);
  • allergic reactions;
  • propensity to frequent use of narcotic substances and alcoholic beverages, tobacco smoking;
  • insufficient level of personal hygiene;
  • individual intolerance of pyogenic microbiota;
  • performance of professional duties in adverse conditions( high dust, high humidity or dryness, extreme temperature conditions, fluctuations in pressure in a large amplitude).

What is cholesteatoma?

Treatment of


Timely treatment of epitimpanitis ensures the patient's hearing and excludes complications of the chronic process. Proper treatment of epitimpanitis involves radical intervention in the middle ear cavity for resection of the pathological focus.

Medical method

Prior to surgical excision of the lesion focus, it is recommended to use ear drops that prevent the penetration of infection and reduce the rate of pus formation.

For this purpose, it is appropriate to use local antibiotics and glucocorticosteroid preparations that are buried through the ear canal into the tympanum.

Positive effect in the softening of pus and scar formation, resulting from the release of fibrin in the lesion, produces the use of proteolytic enzymes.

Traditional medicine

The popular way of treating epitimpanitis is not the main method in the treatment of malignant inflammation of the middle ear. After consulting with the doctor and , as an additional method, folk medicine provides faster disposal of damaging agents, promotes the regeneration of healthy tissues, weakens the symptoms of the pathological process, restores the body's immune forces.

A list of medicinal plants and recipes based on them should start with herbs that have anti-inflammatory and antiseptic effects. The list of herbs consists of their celandine large, St. John's wort, perforated triple, elecampane high, calendula officinalis, Sophora Japanese.

As washing of the affected foci, it is allowed to use infusions of camomile officinalis, kapreya narrow-leafed and alcoholic infusions of tobacco leaves of the common.

When treating epitimpanitis, it should be understood that the Eustachian tube connects the nasal cavity and the middle ear cavity. For this reason, it is recommended to treat the nasal cavity from chronic inflammatory processes.

Getting rid of pus from the ear canal during the course of epitimpanitis is facilitated by procedures of instillation of vodka three times a day into the ear canal of the patient ear. And antiseptic and anti-inflammatory action has and juniper alcohol.

Bee adhesive( propolis) is recommended to insist on alcohol or vodka for ten days in a dark place at an ambient temperature of 25-35 degrees. Cotton swabs should be moistened in a tincture of propolis and put in a sick ear for several hours.

After drying the tampon it is recommended to wet it again and pawn. This procedure is carried out until complete recovery.

Alcohol solutions can be replaced with onion juice. Squeezed juice is buried in the diseased ear three times a day.

Antimicrobial solutions or powders are replaced with mummies, the recipes for which are varied: mixed with rose oil or pure water. When perforating the tympanic membrane, the mummy solution can be used not only as a lotion with a cotton swab, but also instilled into the perforation site.


Radical intervention is indicated by retraction of the bone maze, the mastoid process of the temporal bone tissue into the lesion. It is recommended to perform the operation also in the formation of polyps in the auditory canal or the formation of cholesteatoma.

The operation is carried out in 3 stages: sanation of the middle ear cavity, ectomy of the affected tissues and tympanoplasty( restoration of the auditory ossicles and affected areas of the middle ear cavity).Indications for surgery are paresis of the facial nerve and complications of epitimpanitis of the intracranial nature.

Complications of epimipanitis on video:

Complications of

The most dangerous complication of epitimpanitis is inflammation that spreads to the intracranial region. In the absence of radical intervention and sanation of the middle ear cavity, the patient is at risk of death, despite all measures for the use of antibacterial agents.

The prognosis of the course of the disease is favorable if the patient is correctly treated on time. When perforating the tympanic membrane, miringoplasty is prescribed, during which the integrity of the tympanic membrane is restored by stretching the dermal masonry to the perforated site.

With a large perforation diameter, the hyaline cartilage of the patient's auricle is implanted in the tympanic membrane.


In order to prevent epitimpanitis, a person is recommended to carry out a set of healthy lifestyle activities to strengthen the immune system. Acute otitis media needs timely treatment and follow-up of the recovery process in order to detect the onset of an acute inflammatory process in a timely manner .

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