Petrositis is a complication after an average purulent otitis or mastoiditis. Sometimes it occurs after the transferred operations. More often the disease is found in men and women aged 40 to 60 years.
Pathogenesis of the disease
This is an inflammation of the tip of the pyramid of the temporal bone. It develops a few days after the middle otitis, but sometimes it is a consequence of chronic ear diseases. The newly froliced ​​inflammation is purulent.
Since the cells of the pyramid are separated from the middle ear, and the message occurs with the help of tortuous cellular strands, the outflow of pus is difficult, and with the development of granulations is interrupted.
Especially difficult disease occurs in the cell-free pyramid and bone marrow spaces. Then doctors often detect osteomyelitis and cell damage.
Petrositis develops in the absence of a hole in the tympanic membrane. If it is a perforating closure, the disease is called closed petrositis.
Symptoms of
The temperature may not rise to high marks. There is a headache, in some cases begins the paralysis of the cranial nerve on the side of the development of the disease. The latter appears due to swelling of the canal.
The triad of symptoms of apical petrositis was described by Gradenigo. The most frequent manifestations are:
- otitis,
- trigeminal neuralgia,
- nerve palsy.
Strong pains in the temple, lower jaw and eye. Paralysis of the nerve can be considered as a sign of limited meningitis. At the same time, the mobility of the eyeball is limited. Patients complain of double vision, disruption of the vestibular apparatus.
The severity of the symptoms varies depending on the severity of the purulent focus. If there is a gap in the middle ear, a person begins to feel much better, the intensity of the pain syndrome decreases. However, a new aggravation is possible in the near future. Without treatment, it leads to complications, including purulent meningitis.
Diagnosis
If paralysis of the nerve is attached, there is soreness, the doctor diagnoses without problems.
Difficulties arise when it comes to latent forms of the disease. Then the focus becomes the cause of intracranial complications.
Therefore, the doctor in the dynamics of monitoring the patient. Assign blood tests, examined the fundus. In some cases, the cerebrospinal fluid is studied.
The patient must go to X-ray. Such a study allows you to accurately determine the presence of the disease, and also indicates the destruction of the top of the pyramid.
Difficulties arise if the cellular systems have different structures. Disease may not be established and with a small size of the source of destruction. Then it is advisable to carry out repeated radiography.
Differential diagnosis of the disease and complications is often difficult. The most important is the timely detection of a beginning intracranial complication or tumor.
Treatment of petrositis
Petrositis is found 3-4 weeks after the secondary otitis media. Sometimes this period increases to several months. Conservative treatment is the main tactic, but severe pain and the appearance of other symptoms can lead to surgical intervention.
The operation allows you to identify the lesion and remove it. After manipulation, the body temperature rises, and then a significant improvement occurs. Surgical intervention is topical if petrositis is burdened by septic or intracranial processes.
It is carried out through a sidewise wound, a drum cavity or a labyrinth. The operation through the latter is permissible only with a simultaneous purulent labyrinth, since there is an opportunity to injure the facial nerve. In some cases, a combined method is used.
In this disease, hospitalization is mandatory. Treatment is appointed after confirmation of the diagnosis.
Medicated
The main type of treatment is taking antibiotics. Before their appointment, a smear of pus is taken to determine the sensitivity to different groups of antibacterial drugs.
Penicillin, biomycin, streptomycin, sulfonamides are often prescribed. Sometimes these funds are combined. To achieve a rapid effect, antibiotics are imported intramuscularly or intravenously.
In addition, prescribed restorative therapy, hyposensitizing agents. If there is a pronounced intoxication syndrome, then appropriate treatment is performed. Strengthening of the immune status occurs with the help of:
- multivitamin complexes,
- natural adaptogen.
Folk remedies
The use of traditional medicine is possible only for the general strengthening of the body. You can not warm up the sick area, do lotions without prescribing a doctor. Often such
natural adaptogens are prescribed:
- ginseng,
- Schisandra,
- echinacea.
They allow to improve the state of immunity. Improve the condition will help and a decoction of chamomile with the addition of aloe. These two components help to relieve inflammation, and help in the fight against purulent diseases.
Take a look at our video about the structure of the temporal bone and its functions:
Prevention of
Prophylaxis of petrositis is the timely treatment of acute otitis forms, dynamic observation of the patient's condition after treatment.
It is also important to carry out diagnostic measures for chronic forms of the disease. A prognosis with a timely begun treatment is favorable.