What is bilateral otitis media

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Bilateral otitis - an adult disease in a child

Acute inflammation of the middle ear, called otitis media, can develop unilaterally or bilaterally. The pathological process affects both ears in 70% of cases of the disease.

Table of contents:

We will talk about such a disease as bilateral otitis, the differences in the occurrence of pathology of the children's and adult auditory analyzers, as well as the principles of treatment and diagnosis.

How does the disease develop?

The development of otitis occurs due to the penetration of bacteria or viruses into the middle ear of the auditory analyzer. A child's body is more susceptible to the disease because the mucous membrane of the middle ear is looser than in adults and has a small number of blood vessels, which increases the level of vulnerability.

Compared to adults, children have a lower immune response, which also plays an important role in the development of the disease. An adult can talk about his feelings and general condition, but small children, when pain occurs, scream and cry, unable to explain what is happening to them.

The initial stage of bilateral otitis is accompanied by a feeling of weakness and a feeling of stuffiness in the ears. Then there is an increase in body temperature and severe pain of a shooting nature appears. The spread of pain can include the neck, teeth, eye area and pharynx. Nausea, occasional vomiting, and dizziness may occur.

Next, there is a decrease in hearing, and in the case of a rupture of the eardrum, the outflow of purulent contents that was in the cavity of the middle ear occurs. At this stage the pain subsides. The tear begins to heal, and hearing is restored.

Important! Contacting an ENT doctor should be immediate. This is especially true for children under two years of age.

Diagnostic measures

Since bilateral otitis often occurs against the background of respiratory diseases, tonsillitis, and nasal diseases, it will not be difficult for an otolaryngologist to make a diagnosis based on an examination of the patient.

The main clinical sign of the development of the disease in a child is pain when pressing on the tragus. This is a convex cartilage located on the auricle, in its anterior part. The baby responds to pressure with a sharp cry (if the baby is an infant), as the pain in the ear intensifies.

Examination of the auditory canal (otoscopy) allows you to determine the following manifestations:

  • Protrusion of the eardrum;
  • Possible presence of membrane ruptures;
  • Purulent discharge;
  • Hyperemia (swelling).

Next, an endoscopic examination is carried out, which allows a more detailed assessment of the condition of the membrane, taking material for analysis if there is purulent discharge.

Carrying out audiometry allows you to determine the presence of disorders of auditory sensitivity. The test is carried out by an audiologist using an audiometer.

For bilateral otitis media, the air conduction method is used, which evaluates the quality of functionality of the entire auditory tract. The examination result is given in the form of an audiogram. Using it, the ENT doctor determines the level of hearing impairment.

Tympanometry is a diagnostic method used to clarify the following indicators:

  • Eardrum mobility;
  • Level of conductivity and integrity of the auditory ossicles;
  • Pressure in the middle ear;
  • Functionality of the auditory tube;
  • The presence of fluid in the middle ear cavity.

The data is analyzed in parallel with the audiometric results.

Features of treatment

Treatment of the disease, especially in children, should be carried out under the supervision of a specialist. Self-medication in this case is not allowed, since it can not only delay the healing process, but also lead to hearing impairment.

Determining the etiological factor and eliminating it is half the positive result. If the cause is a respiratory disease, it is necessary to use antiviral drugs that can destroy the causative agent of the disease. If tonsillitis is the cause of otitis, both diseases should be treated in parallel.

Treatment of bilateral otitis media in children includes the following groups of drugs:

They are the means of choice in the initial stage of the disease. Sofradex, Otinum, Otipak, Otofa are used. Depending on the cause of the disease, the drops may have an antibacterial or antifungal component. Cannot be used if the eardrum is ruptured.

Vasoconstrictor drugs for the nose.

Used to reduce swelling of the auditory tube. This will help relieve the feeling of stuffiness in your ears. Preparations based on xylometazoline are prescribed.

Also used to eliminate swelling of the nasopharynx and eustachian tube (Fenistil, L-cet, Erius, Suprastin).

They are used in the presence of purulent discharge and in children under two years of age only after determining the sensitivity of the pathogen. The groups of penicillins and macrolides, which are less toxic drugs for babies, are more often used.

Compared to other antibiotics, they do not have a toxic effect on the osteochondral system, hematopoietic system and kidney function. Amoxil, Amoxicillin, Flemoxin, Clarithromycin, Sumamed are used.

From sulfonamide drugs.

Prescribed "Oriprim", "Biseptol", "Sulfadimethoxine".

In addition to specific treatment, symptomatic therapy is also used. For hyperthermia, antipyretic drugs are prescribed, the use of which is advisable when the temperature rises above 38°C. For this purpose, Paracetamol, Bofen, and Nimesil are used. The drugs are used in the form of tablets, syrups, and suppositories.

Anti-inflammatory drugs and analgesics will help relieve pain. "Analgin" is allowed to be used after 12 years of age, since its use can cause the development of aplastic anemia. Prescribed “Paracetamol” in the form of syrup, ear drops “Anauran” with lidocaine and “Saridon”, also used after 12 years.

Physiotherapy, like warming compresses, is allowed only if the body temperature is normal and there is no purulent discharge.

In case of low effectiveness of conservative therapy, paracentesis is performed - a surgical intervention in which the eardrum is pierced. This allows you to remove excess fluid from the middle ear and relieve severe shooting pain. Usually carried out 3-4 days from the onset of the clinical picture.

A timely visit to an ENT doctor and early initiation of therapy will speed up the child’s recovery and prevent the development of ear complications.

Source: http://gaimoritus.ru/otit/dvuhstoronnij-otit.html

Bilateral otitis: treatment features and possible complications

If you consult a doctor in a timely manner, the disease rarely leads to complications. However, ignoring symptoms and attempting to prescribe therapy on your own are fraught with dangerous consequences - from chronic inflammation to hearing loss. Knowing the factors that provoke otitis will help to prevent or suspect the disease in time.

Causes

Several factors can lead to ear inflammation.

  1. Age-related anatomical features. The disease is more common in children than in adults. This is explained by the special structure of the Eustachian tube, which connects the cavity of the inner ear with the nasopharynx: it is short, wide and has a horizontal location. In addition, the loose mucous membrane of the inner ear, rich in small blood vessels, is prone to swelling even with relatively little inflammation.
  • Infectious diseases. Otitis is often complicated by ARVI, scarlet fever, measles, and diphtheria.
  • Immune disorders. A general decrease in the body's defenses creates conditions for the reproduction and spread of infectious pathogens.
  • Pathology of the structure of ENT organs. We are talking about a curvature of the nasal septum, which interferes with normal ventilation of the airways and contributes to the formation of chronic foci of infection. This is also fraught with the proliferation of tissues of the pharyngeal tonsil (adenoids).

    • Symptoms

    Bilateral otitis in children and adults is similar in clinical course.

    • Feeling of congestion, tinnitus.
    • Hearing loss.
    • Ear pain can be severe, sharp, shooting, radiating to the temples and lower jaw.
    • Increased body temperature - up to subfebrile levels with a mild form of otitis, to high levels with purulent inflammation.

    The clinical course of otitis is directly dependent on its type and stage.

    1. Chronic. It is characterized by a periodic change in phases of exacerbation and remission.
    2. Spicy. It has vivid clinical symptoms that appear in a relatively short period of time.

    Depending on the area of ​​the lesion, bilateral otitis occurs:

    • Limited - the source of inflammation is localized.
    • Diffuse - all parts of the ear are affected.

    Stages

    The disease is conventionally divided into 5 phases.

    1. Stage of acute eustachitis. The infection has not yet reached the middle ear.
    2. Catarrhal otitis. Characterized by inflammation of the mucous membrane of the middle ear. Read more about catarrhal otitis→
    3. Purulent inflammation at the pre-perforation stage. The disease progresses, but the eardrum remains intact.
    4. Postperforative stage of purulent otitis. The formation of pus leads to increased pressure on the eardrum and its rupture.
    5. Reparative phase. The affected areas are healed and the perforation site is closed with connective tissue elements.

    What is the danger of the disease

    Bilateral otitis is a common disease, the consequences of which are underestimated. Decreased or complete loss of hearing is only a small part of the likely complications.

    1. Meningitis. Inflammation of the meninges often occurs with advanced purulent form of otitis.
    2. Encephalitis. Damage to brain tissue is usually closely associated with meningitis.
    3. Facial nerve paresis. The nervous support of the facial muscles suffers.
    4. Labyrinthitis. It is an inflammation of the inner ear. Accompanied by vestibular disorders (dizziness with nausea, gait disorder). The purulent form is fraught with the death of auditory receptors.
    5. Mastoiditis. Inflammation of the mastoid process of the temporal bone can lead to the destruction of the auditory ossicles located in the middle ear.
    6. Chronization of the process. Bilateral or unilateral adhesive otitis media, which occurs in the presence of a permanent inflammatory focus in the middle ear, leads to the formation of connective tissue adhesions that impair the mobility of the auditory ossicles.
    7. Formation of cholesteatoma. This complication is a cavity filled with dead epithelial cells, keratin and cholesterol crystals, surrounded by a connective tissue capsule.
    8. Perforation of the membrane. Pus accumulated in the middle ear puts pressure on the ear membrane. This can lead to its rupture and scarring at the site of perforation.

    The main danger of otitis is that these complications are closely interrelated and can cause each other. For example, rupture of a cholesteatoma can lead to mastoiditis, which, in turn, can lead to paresis of the facial nerve.

    Which doctor treats bilateral otitis media?

    Treatment of this disease is carried out by an otolaryngologist. In a clinic setting, in an uncomplicated case, the patient is sometimes managed by a therapist or general practitioner. Purulent otitis requires mandatory examination by an ENT doctor.

    Diagnostics

    Detection of otitis media does not cause any particular difficulties. The diagnosis is made in an outpatient setting.

    The search for a disease consists of the following measures:

    1. Patient interview. Characteristic complaints (ear pain, hearing loss), as well as their relationship with provoking factors, will help you suspect otitis media. For example, otitis is often preceded by ARVI.
    2. Examination of the ear cavity. Under the otoscope lamp, you can detect redness of the tissues of the ear canal, protrusion and perforation of the eardrum, and traces of pus.
    3. Tympanometry. It is a method for studying the mobility of the eardrum and the auditory ossicular system against the background of changes in air pressure.
    4. Audiometry. It is used to study the level of hearing if a pronounced and persistent decrease is suspected.
    5. Tympanocentesis (puncture of the eardrum with extraction of inflammatory fluid). It is a therapeutic and diagnostic procedure that allows one to prove the presence of purulent otitis media and reduce pressure on the eardrum. Rarely used.

    Diagnosis of otitis is often limited to the first 2-3 points. A competent ENT doctor can detect the disease using an otoscopic examination. Other research methods help clarify the form of otitis and identify its complications.

    Treatment

    Therapy directly depends on the cause, form and severity of the disease. So, if the infection was initially localized in the Eustachian tubes, nasal vasoconstrictor drugs with a decongestant effect are prescribed. In cases where bilateral or unilateral catarrhal otitis is detected without damage to the eardrum, ear drops with an analgesic effect are indicated.

    For otitis of a bacterial nature, antibiotics are prescribed. The pharmacological group of the antibacterial agent and its dosage are determined only by the attending physician. Systemic forms of drugs are indicated for severe otitis, the presence of severe deficiency of the immune system and depending on the dynamics of the development of the disease. Purulent forms with perforation of the ear membrane require the use of local antibacterial drugs.

    Tympanocentesis is used in cases where it is necessary to relieve the pronounced pressure exerted by the inflammatory fluid on the membrane. Restoring the patency of the auditory tubes using blowing, as well as physiotherapeutic procedures are allowed during the recovery period, when the acute phase has been overcome. In case of purulent form of otitis, heating is strictly prohibited.

    Prevention

    To prevent acute bilateral otitis media, factors that contribute to mucus stagnation and the formation of foci of infection in the nasopharynx should be avoided. Regular visits to an otolaryngologist in the presence of chronic ENT diseases play an important role.

    • Timely and competent treatment of acute respiratory viral infections, sinusitis, the use of vasoconstrictor drops for swelling of the nasopharynx.
    • Elimination of pathology that interferes with proper breathing (removal of adenoids).
    • Blowing your nose correctly (pressing each nostril one by one).

    Bilateral otitis is a disease that responds well to therapy on an outpatient basis. However, this does not mean that you can self-medicate. Only a doctor can determine the correct tactics to combat pathology. A timely visit to a doctor at the first symptoms of otitis media will help you avoid dangerous complications and cope with the disease as quickly as possible.

    Source: http://moylor.ru/uho/otit/dvuhstoronniy-otit/

    Bilateral otitis media: treatment methods for children and adults

    A disease such as bilateral otitis media can bother both adults and small children. The disease occurs for completely different reasons and affects both ears simultaneously. This complicates treatment and can provoke various pathologies in the form of complications. Such otitis media must be treated as soon as possible before it becomes chronic. In the future, you need to follow the rules of prevention to prevent relapse.

    Stages, symptoms and causes of development

    Bilateral otitis media differs in that the inflammatory process affects both ears. This complicates the treatment of the patient and increases the risk of complications. Initially, in most cases, symptoms appear on only one side. If untreated, unilateral acute otitis media spreads to the second ear.

    Bilateral otitis media manifests itself in both children and adults with the following symptoms:

    • acute discomfort;
    • noise in ears;
    • feeling of stuffiness;
    • accumulation of exudate behind the eardrum;
    • pain, sharp and shooting;
    • serous or purulent discharge;
    • headache;
    • dizziness;
    • elevated temperature;
    • nausea;
    • general malaise;
    • hearing loss.

    Pronounced signs of the disease indicate that an acute inflammatory process has developed. With minor pain and discharge, purulent otitis media is diagnosed. It often develops to an acute phase, when purulent exudate begins to fill the auditory cavity and then ruptures the eardrum.

    The causes of acute bilateral otitis media can be:

    • hypothermia;
    • water getting into the ears;
    • weakened immune system;
    • infection or virus;
    • injuries;
    • improper hygiene;
    • diseases of the nasopharynx.

    Typically, acute otitis media affects one ear, and the second is affected when an infection occurs due to insufficient treatment. In a child, a risk factor is the short auditory tube, which connects the ear to the nasopharynx. Through it, bacteria can easily enter a healthy organ. In adults, this process is difficult, since the canal becomes narrower and more curved with age.

    If both ears are affected at the same time, this is most likely a consequence of systemic infection and weakened immunity. Often, bilateral purulent otitis media develops in a child with measles, scarlet fever, influenza, prolonged sinusitis, rhinitis and other diseases.

    Otitis media cannot be ignored. If the problem is not resolved in time, the inflammation may spread to other parts of the ear. This can lead to hearing impairment. Late treatment threatens to transition the disease to the chronic stage.

    Treatment and prevention

    To prevent the risk of complications, it is necessary to begin treatment of the disease in a timely manner. To do this, it is recommended to contact an otolaryngologist to make an accurate diagnosis. Sometimes otitis media manifests itself in a low-intensity manner, and therefore the patient has no idea that the infection has affected both ears.

    Treatment of bilateral otitis in adults is as follows:

    Acute otitis media is treated with heating. If there is no damage to the eardrum, it is necessary to drop camphor or boric alcohol into the ear canal, cover the ear with cotton wool and insulate it. Purulent otitis media does not allow heating, as this only stimulates microorganisms to multiply. Compresses and certain types of medications are also prohibited, especially if the membrane has ruptured.

    The main drugs for the treatment of adults are:

    • decongestant nasal drops;
    • anti-inflammatory drugs;
    • local antibiotics;
    • systemic antibiotics;
    • antiseptics;
    • analgesics;
    • vitamins.
    To cure bilateral otitis in a small child, which often occurs as acute, it is almost always necessary to use antibiotics. Due to the aggressive effect of drugs in this group on the child’s body, it is prohibited to arbitrarily determine the list of suitable drugs and set the dose “by eye”. All treatment must be strictly supervised by a pediatrician or ENT specialist.

    There is also a list of prohibited substances for children up to a certain age. Until the age of 3, certain antibiotics should not be used, or boric alcohol or other alcohol-containing medications should be instilled into the ears. This may cause symptoms of intoxication in the child.

    Physiotherapeutic treatment complements drug therapy. It improves the absorption of drugs and stimulates the restoration of damaged tissues. Various types of irradiation are used (laser, ultraviolet, etc.), UHF, pneumomassage of the membrane, electrical stimulation.

    Acute otitis media goes away in a week or two, but if purulent otitis has developed, treatment may take months. To remove pus, it is necessary to restore the functions of the auditory tube. An effective method is paracentesis of the eardrum. With natural perforation, there is a risk of extensive damage, and surgical intervention involves a careful incision of the membrane. In the case of a bilateral form of the disease, it is recommended to insert a shunt so that the pus flows freely from the ear and does not accumulate again.

    To prevent disease, you should regularly monitor the health of your ears. If inflammation is detected, you should not delay treatment. Independent measures rarely give the expected result, especially in children, so contact an otolaryngologist immediately. Diseases of the nose, pharynx and upper respiratory tract also need to be treated.

    If there is frequent development of bilateral acute otitis media in a child, surgery may be necessary to remove the adenoids. Another provoking factor is anatomical deviations in the structure of the nasopharynx, which can also be eliminated during surgery.

    Effective therapy and timely treatment are the key to a successful outcome in any situation. This disease cannot be ignored, as there is a risk of developing bilateral hearing loss due to complications.

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    Causes, symptoms and treatment of bilateral otitis media

    Bilateral otitis is called inflammation of the middle ear of an infectious nature. The disease is quite serious and poses a danger to young children; they are the most common patients with this problem. 80% of children under the age of three experienced at least one episode of the disease. Bilateral otitis media is diagnosed in the vast majority of cases; unilateral inflammation is found in only 10% of patients.

    The disease often occurs with various complications, the development of which can be prevented at the acute stage of the inflammatory process with timely treatment and correctly selected treatment tactics.

    Symptoms of bilateral otitis media

    In adults and children, the symptoms of bilateral otitis are the same:

    Ear pain radiating to the temples, neck or jaw;

    Feeling of stuffiness in the ears, hearing loss;

    General weakness and irritability.

    In some cases, nausea and vomiting may occur, as well as tenderness and enlargement of the lymph nodes. In severe otitis media, purulent discharge from the ear is possible.

    The acute form of bilateral otitis is characterized by a rapid increase in pain, it intensifies with every hour or minute. In addition, nasal congestion, mucous discharge and sore throat are possible. The symptoms of chronic otitis are less pronounced; with this course of the disease, its development occurs slowly.

    Causes of bilateral otitis media

    There are many factors that can provoke the appearance of bilateral otitis media. In young children, the tendency to inflammatory processes in the middle ear is explained by the peculiarities of the anatomical structure of the hearing aid. The Eustachian tube, which connects the nasopharynx with the cavity of the inner ear, is short, wide and located horizontally. These factors contribute to the rapid penetration of infection into the middle ear and its inflammation.

    The structural feature of the mucous surface of the inner ear can play a negative role in the development of pathology. If in an adult it is smooth, then in a child it is loose and soft with a small number of blood vessels, which makes it vulnerable to pathogenic microorganisms. The disease can also develop against the background of decreased immunity or as a complication after viral cold infections. Otitis often accompanies diseases such as scarlet fever, diphtheria and measles.

    In an infant, inflammation in the ear may occur after the mother's milk enters the Eustachian tube. Therefore, you should feed your baby holding him at an angle, and after feeding, carry him in a column, and not lay him horizontally in the crib.

    In adults, despite prejudices, acute otitis media is not directly associated with hypothermia, exposure to drafts, walking in cold weather with your head uncovered, and water getting into the ear. Pathogenic bacteria and viruses penetrate the auditory tube and then into the middle ear cavity when improperly blowing the nose with both nostrils at the same time with the mouth closed.

    Various chronic pathological conditions can contribute to the disease: the presence of adenoids and a deviated nasal septum. In addition, the causative agent of the flu or other infectious disease can enter the cavity of the inner ear with the blood flow. Also, the inflammatory process can begin as a result of damage to the eardrum and the penetration of a pathogen from the external environment.

    Types of bilateral otitis media

    There are two forms of bilateral otitis:

    Depending on the extent of spread, the disease is:

    Limited (in the form of local inflammation);

    Diffuse (applies to the entire ear canal).

    It is possible to conditionally divide otitis into two forms:

    Exudative - characterized by acute inflammation in the passage of the Eustachian tube and on the eardrum with the formation of serous, hemorrhagic or purulent exudate.

    Congestive is the same inflammatory process, but without the release of exudate.

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    Diagnosis of bilateral otitis media

    Complaints from the ear often arise against the background of acute respiratory viral infections, influenza, diseases of the nose, sinuses, and pathological enlargement of the tonsils. For an experienced otolaryngologist, it is not difficult to establish an accurate diagnosis based on an examination of the patient and his interview. In the case of bilateral otitis in a small child, pressing on the protruding cartilage in the front of the ear causes sharp pain and crying, this sign indicates inflammation in the ear canal.

    Upon careful examination, the doctor detects protrusion and redness of the eardrum; ruptures and purulent discharge in the ear canal may also be observed. Difficulty in nasal breathing is the reason for an endoscopic examination of the nasopharynx and the mouth of the auditory tube. Tuning fork tests are indicated for hearing loss, and tympanometry makes it possible to assess the mobility of the eardrum and the pressure in the cavity behind it. For an accurate hearing test, audiometry is prescribed.

    Treatment of bilateral otitis media

    Before starting treatment for otitis, the cause of its occurrence is determined. If bilateral otitis media is a consequence of any disease, then all efforts are directed towards treating the underlying disease. In the case where the inflammation initially occurred in the area of ​​the Eustachian tube, local treatment with ear drops and vasoconstrictor drugs for the nose is prescribed. At the initial stage, in the absence of a purulent process, physiotherapeutic measures and warm compresses on the parotid area may be recommended.

    If there is no damage to the eardrum, anesthetic drops are prescribed, and if it is perforated, local antibiotics are prescribed. Self-medication in such a situation can be extremely dangerous and lead to hearing loss.

    Systemic antibiotics are immediately prescribed to children under two years of age, with severe development of otitis media and people with severe immunodeficiency. In other cases, these drugs can be used depending on the patient's condition 2-3 days after the onset of the disease.

    The accumulation of pus in the tympanic cavity of the ear causes tension on the membrane, increased body temperature and severe pain. To relieve symptoms, a puncture of the eardrum under local anesthesia (paracentesis) may be recommended. When the acute period of the disease has passed, physiotherapeutic procedures, ear blowing and a number of special exercises for the auditory tube are prescribed.

    Traditional medicine is not always able to show the necessary therapeutic effect, therefore, at the first symptoms of the disease, you should seek help from an otolaryngologist and not self-medicate.

    Author of the article: Lazarev Oleg Vladimirovich, ENT doctor, especially for the site ayzdorov.ru

    If the disease develops unfavorably, the pus cannot find a way out, and this risks the infection starting to spread inside the skull. Such otitis media can develop into meningitis, as well as into a brain abscess. In order to avoid such possibly dire consequences,

    Otitis is an inflammatory disease of the ear of a bacterial, less often fungal nature. Small children under 3 years of age usually suffer from otitis media; they cope with the disease the fastest and easiest. But for an adult, otitis media can become a real disaster, and if not properly treated, it can become chronic, impair hearing, or even lead to complete deafness.

    In order to achieve the maximum positive effect from treatment, it is recommended to combine ear instillations with antibiotics. At the same time, antibacterial drugs, like drops in the ears, are prescribed exclusively by a doctor after a thorough examination of the patient and diagnosis. What kind of medicine will it be?

    Otitis media is an inflammatory process that is infectious in nature, characterized by rapid development and localized in the middle ear cavity. The ear cavity is located inside the temporal bone and is covered from the outside by the eardrum. This membrane is the partition that separates the middle ear.

    Otitis in children is an inflammatory process that affects various parts of the ear. The outer, middle and inner space can be affected by pathology. The disease has a variety of symptoms, the severity of which depends on the form, stage and nature of the course of otitis media. This disease is known to affect children.

    Otitis externa most often affects people who swim. Inflammation of the external auditory canal is limited, as a rule, mainly to skin manifestations: pustules, various rashes. Severe ear pain is usually accompanied by otitis media, which is why the term “otitis media” is used in most cases.

    Otitis externa is an infectious disease characterized by inflammation of the skin lining the external auditory canal. Most often, the causative agent of this disease is Pseudomonas aeruginosa. This disease has several varieties: otitis externa can be simple, malignant, diffuse and fungal. According to statistics from.

    Fungal otitis is one of the types of inflammation of the ear, characterized by the fact that certain parts of it are affected by moldy yeast-like fungi. Most often, the pathological process includes the walls of the external ear canal, the skin lining the auricle, the eardrum and the middle ear cavity.

    When copying materials, an active link to the website www.ayzdorov.ru is required! © AyZdorov.ru

    The information on the site is intended for informational purposes only and does not encourage self-treatment; consultation with a doctor is required!

    Source: http://www.ayzdorov.ru/lechenie_otita_dvyhstoronnii.php

    Providing assistance with bilateral otitis media

    Among diseases of the ENT organs, bilateral otitis occurs in 60% of cases. Children under three years of age and adults often suffer from the disease. The ear has its own structural features at each age, which causes an acute inflammatory process. The causes of the disease are bacteria and viruses that support inflammation and contribute to complications. Treatment of bilateral otitis is carried out with folk remedies, antibiotics, and drugs for topical use.

    Symptoms in adults

    Symptoms of bilateral otitis depend on the stage of the process. During the period of precursors of the disease, adults complain of general weakness, headache with sudden movements of the head. Low-grade body temperature (up to 380) appears due to intoxication with waste products of bacteria. In the exudative and purulent phase of inflammation, bilateral otitis is characterized by the following symptoms:

    • ear pain;
    • Hearing impairment;
    • Dizziness;
    • Sensation of shooting and noise in the ear on both sides;
    • Feeling of fullness in the ears.

    Bilateral catarrhal otitis of the middle ear is caused by swelling of the auditory tube, due to chronic or acute rhinitis. Patients complain of difficulty breathing through the nose and runny nose. Bilateral otitis exudative is associated with the accumulation of infected fluid in the middle ear. Adults present with symptoms of ear congestion, headaches, and hearing loss. If pus accumulates, the eardrum may be perforated and patients may experience discharge from the ears.

    Causes and diagnosis

    The causes of bilateral otitis are primarily considered to be bacteria and viruses. Infection can begin spontaneously with a weakened immune system or long-term use of antibiotics to treat other diseases. Predisposing factors are chronic and acute inflammation of the respiratory tract - rhinitis, tonsillitis, adenoids in children, sinusitis, nasopharyngitis. In this case, the infection spreads through the auditory tubes into the middle ear. Often the illness comes after swimming in rivers and lakes, in winter during a thaw, when children are carried in light clothing.

    An otolaryngologist is required to diagnose acute catarrhal or exudative otitis media. The doctor performs an otoscopy (examination of the ear) and examines the condition of the eardrum. With the accumulation of exudate in the middle ear, hyperemia of the skin of the auditory canal is pronounced. The eardrum swells and a hole may appear in the lower quadrant from which pus is discharged. They also perform computed tomography, video endoscopy, and magnetic resonance imaging (MRI) of the head.

    Treatment with folk remedies

    Hardening and proper nutrition with plenty of vitamins help prevent the appearance of bilateral otitis media. Prevention of chronic nasal diseases prevents the migration of microbes into the auditory tube and middle ear. Constant physical exercise and visiting the bathhouse for adults improve blood circulation, stimulate the functioning of the heart and immune system. When symptoms of otitis media appear, herbal remedies and other folk remedies are used, namely:

    • collection of chamomile, St. John's wort, calendula, oak bark;
    • geranium leaves;
    • juice of lemon, onion and garlic;
    • boric alcohol, diluted vodka.

    These products are used in the form of ear drops. Only fresh geranium leaves are used differently. You need to twist the piece of paper into a tube and insert it into the ear canal. This manipulation is done 3 times a day for 1 week. The method helps relieve ear pain, and the essential oils of the plant moisturize and disinfect the skin of the ear, nourish the epithelial cells.

    The herbal mixture has an anti-inflammatory effect and relieves the symptoms of catarrhal otitis media. To prepare the solution, add 20 grams of the mixture to 100 ml of boiling water. Steam for 20 minutes and inject 3 drops into each ear canal 4 times a day. After this, place a cotton swab in the ear for 30 minutes.

    Antifungal and warming agents

    A solution of 3% boric alcohol, diluted 1:1 with boiled water, has warming properties. This method should be used in catarrhal or exudative otitis, when there is no pus. Inject 2 drops into the ear three times a day. Each time, the ear canals are tamponed for 20 minutes, after which time they are removed. Vodka is used in the same way.

    For fungal external otitis, a 0.5% soda solution is injected into the ear canals. Its alkaline properties do not allow the mycelium of the fungus to multiply and reduce hyperemia. Administer 2 drops 3 times a day for one week. It is prohibited to heat the ear during purulent inflammation, due to the possible spread of infection. Alcohol solutions should not be used for children, especially for newborns.

    Physiotherapeutic procedures

    Physiotherapeutic procedures are used as an addition to the treatment of catarrhal or exudative otitis media. In the phase of purulent accumulation in the middle ear, these methods are not used. The warming effect provokes the spread of pus into the inner ear. In this case, there is a high probability of pus breaking through the eardrum. The following methods are distinguished:

    Sollux, or blue lamp, is used to improve blood flow and reduce swelling and itching of the skin. Used for external otitis. Sessions are carried out for 5-10 minutes 5 times a day. A positive effect is also observed when the ear is exposed to infrared and ultraviolet rays. They have bactericidal and anti-inflammatory properties.

    Galvanization is based on the effect of low-level direct current. To do this, a working galvanometer is brought to the ear. This method increases blood flow, allowing excess fluid to be removed from the tympanic cavity. Another effective method is electrophoresis. This method enhances the local penetration of medications into the skin, bone tissue and middle ear cavity.

    The child has an earache. What if it’s otitis media? What are recognized

    The child has an earache. What if it’s otitis media? What are recognized

    http://dokmag.ru/ — Medical devices from the Dokto company

    http://dokmag.ru/ — Medical devices from the Dokto company

    Magnetic therapy is classified as a mechanical treatment method. After use, pain, redness of the skin disappear and exudation decreases. Bilateral otitis is treated in sessions of 10 minutes for 2 weeks. In addition to suppressing inflammation, the magnet causes a calming effect, improves sleep, and relieves irritability. These properties of physiotherapy are irreplaceable for some pathologies.

    Treatment with drops

    Local treatment with solutions is used in complex therapy. Anatomically, the middle ear and nasal cavity are connected to each other through the auditory tube. Inflammation of one structure leads to the involvement of another in the process. Therefore, otolaryngologists recommend the use of ear and nasal drops. The basic rule for using drops is the absence of perforation (perforation) of the eardrum.

    Ear drops

    To treat a bilateral process, use anti-inflammatory, antibacterial and hormonal drops. Otipax solution is intended for topical use. Administer 2 drops three times a day for a period of days. The drug reduces swelling, hyperemia of the skin and eardrum. The product is allowed to be used by pregnant and nursing mothers, as no systemic effects have been detected. Here are a few more medications in this group:

    1. Anauran in drops has an antibacterial and analgesic effect. The drug is used for local administration into the outer ear. Indications are acute bilateral exudative and catarrhal otitis, other inflammations without signs of perforation of the tympanic membrane. 3 drops are administered into each ear 4 times a day for 7-10 days. In children under three years of age, use is contraindicated, and after 3 years, 2 drops 3 times a day.
    2. The drug Otofa contains the antibiotic rifampicin, which has a bactericidal and antiseptic effect. Should only be used topically. Adults are administered 5 drops 3 times a day, for children 3 drops three times a day for no longer than 1 week. Side effects include red discoloration of the eardrum and allergic reactions. There is no reliable data on the negative effects on the fetus in pregnant women due to the lack of clinical studies.

    It is impossible not to mention Dimexide. Dimexide has a pronounced anti-inflammatory effect and carries antibiotics deep into tissues. Apply only topically, diluting in boiled water before use, the ratio is one to five. Bilateral otitis is treated by injecting 2 drops of solution into each ear 3 times a day. After waiting 15 minutes, remove dimexide from the ear with a cotton swab to prevent burns. Children and pregnant women are prohibited from using the drug.

    Nasal drops

    Nasal (nose) drops are an integral part of the treatment of bilateral otitis media. They are used to eliminate the symptoms of rhinitis and sinusitis. With these diseases, swelling of the nasal mucosa occurs and the exit from the auditory tube is blocked. As a result, exudate accumulates in the middle ear, and after the addition of bacteria, purulent inflammation occurs. In most cases, bilateral otitis media is accompanied by rhinitis, the symptoms of which can be eliminated by the following types of nasal drops:

    Vasoconstrictor drops are very popular among patients. They are used with or without just cause. Otolaryngologists recommend instilling the drugs Sinerus and Rinotaiss into the nose 3 times a day. The drops are effective for 6 hours, quickly eliminate swelling of the mucous membrane and resume nasal breathing. These equalize the pressure in the middle ear and improve the outflow of exudate.

    Hormonal sprays are used in cases of bilateral vasomotor rhinitis. This variant of the disease causes persistent swelling of the mucous membrane and dilation of blood vessels, which impair the patency of the auditory tube. Apply Beconase, Nasobek, Aldecin 2 injections 4 times a day, but not longer than 7 days. In children under 6 years of age, the use of the spray is prohibited, as it can have a systemic effect. The drug has a powerful and long-lasting anti-edematous effect and inhibits local immunity.

    Combined drops consist of vasoconstrictor components, sea water or hormones. The drug Snoop is injected 3 drops three times a day inside each nostril for 10 days. The composition contains sea salt and xylometazoline, which remove secretions and stimulate the movement of epithelial villi. Sanorin is administered 2 drops 4 times a day; it can be used for children.

    Treatment with antibiotics

    Systemic antibiotic treatment is necessary to combat the bacterial infection. Acute catarrhal and exudative otitis media can be cured with ear and nasal drops and folk remedies. However, if there is a fever, severe pain in the ears, or hearing loss, then it is necessary to use antibiotics. Choose drugs that do not have an ototoxic effect (on the auditory nerve), namely:

    The use of cephalosporin antibiotics requires intramuscular or intravenous injections. Ceftriaxone, Tsafoperazone, Ceftazidime, Cefotaxime are administered 1 gram IM or IV 2 times a day for 7 days. The drugs have a wide spectrum of action and do not adversely affect the auditory nerve and vestibular apparatus. For children, use a reduced dosage according to the drug instructions.

    Penicillins also have a broad spectrum of action. They inhibit the growth of gram-positive and gram-negative bacteria. Doctors prescribe Amoxicillin and Augmentin, which are protected by clavulonic acid. This drug increases the resistance of antibiotics against bacteria. Patients take 1 capsule (650 mg) 3 times a day for 7-10 days. Children are prescribed 250 mg 3 times a day, which depends on the child’s weight.

    Fluoroquinolones are modern highly active antibiotics that act on bacteria resistant to penicillins and cephalosporins. Ciprofloxacin is prescribed in tablets, and in case of complications - intravenous solutions. Use 250 mg 2 times a day for 1 week. The drug is indicated for children if the expected effect is higher than the possible complications.

    All antibiotics can cause side effects. Among them, the most common are nausea, diarrhea, and thrush. An allergic reaction occurs with prolonged use of antibiotics. Pregnant and lactating women use antibiotics only in case of purulent complications. In the postoperative period, antibiotic therapy should be accompanied by the administration of antifungal drugs.

    Symptomatic treatment

    This type of treatment is aimed at combating the symptoms that accompany bilateral otitis media. These signs include headache, fever, weakened immune system, and nasal congestion. Many medications combat these symptoms. These funds can be divided as follows:

    • non-steroidal anti-inflammatory drugs (NSAIDs);
    • antihistamines;
    • vitamin.

    NSAIDs have a strong decongestant effect, improve blood flow in the mucous membrane and relieve headaches. The best effect is observed after using powders in bags. Fervex, Nimesil, Nemulex are poured into a glass of warm water, stirred and drunk. The drug should be used four times a day along with antibiotics. The analgesic effect lasts about 5-6 hours.

    Antihistamines have an antiallergic effect, reduce vascular permeability and the release of inflammatory mediators. Use Fenkarol and Suprastinex tablets once a day. These drugs do not cause drowsiness, fatigue, or interfere with driving. For children, a reduced dosage is used; it is not advisable for pregnant and lactating women to use such drugs.

    Vitamin complexes help the body fight infection, strengthen the immune system, strengthen blood vessels and the protective properties of cells. It is better to use multivitamin preparations that contain the entire complex of microelements and enzymes. Use Pikovit, Supradin, Elevit, 1 capsule 3 times a day for 1 month. For children, the use of vitamins is allowed, but allergy history must be taken into account. Side effects of the drugs include urticaria, nausea, and itchy skin. But these reactions appear as an exception to the rule.

    Surgery

    The choice of surgical method depends on the stage of otitis media, chronic or acute inflammation. The surgical tactics are determined by the otolaryngologist; for this, the patient undergoes additional studies: audiometry to test hearing, SCT of the skull. For catarrhal or exudative inflammation of the middle ear, a catheter is inserted into the auditory tube. Through it, a mixture of hydrocortisone, antibiotic and saline solution is delivered into the tympanic cavity. The procedure is carried out on both sides 2 times a day, and these drugs relieve swelling and have a bactericidal effect.

    In the case of bilateral suppurative otitis media, tympanopuncture is performed, in which the eardrum is pierced. This frees up the ear cavity and reduces pressure. Every day, the middle ear cavity is washed with antiseptics through a catheter. If the process decreases, then the perforation hole in the eardrum closes on its own.

    Purulent otitis media is sometimes complicated by mastoiditis. This situation occurs when the purulent process has spread to the cells of the mastoid bone in the skull. In this case, patients complain of body temperature up to 400, severe headache and a feeling of pressure in the ear. Then, in the operating room, trepanation of the mastoid process is performed under general anesthesia. Treatment is supported by massive antibacterial, infusion and detoxification therapy.

    All information on the site is presented for informational purposes. Before using any recommendations, be sure to consult your doctor.

    Source: http://kakiebolezni.ru/otolaringologiya/otit/dvuhstoronnij-otit.html

    How to treat bilateral otitis media and what complications can it cause?

    Inflammation of the middle ear is always accompanied by unpleasant symptoms - pain, hearing impairment, and discharge of pus. If measures are not taken in a timely manner, such pathologies can become persistent.

    In especially severe cases, the patient may completely lose hearing if the process is bilateral. To avoid this, middle ear diseases need to be treated promptly.

    Causes of bilateral otitis media

    Otitis media is an infectious inflammation of the middle ear.

    The greatest problem for patients is otitis media, since inflammation of the outer ear is quite mild, while inflammation of the inner ear is rare. Otitis media can threaten the integrity of the eardrum.

    Causes of otitis media:

    1. Anatomical pathologies of the ear (presence of communications between the middle and outer ear).
    2. Age characteristics (abundance of blood vessels in children).
    3. Penetration of infection through the Eustachian tube.
    4. Penetration of infection from the outer ear.
    5. Hematogenous (with blood) infection.
    6. Immunity disorders.

    Penetration of infection due to pathologies of the ENT organs is the most common cause of otitis media. This is a complication of sore throat, adenoids, pharyngitis, colds, childhood infections, accompanied by cough and sore throat. Penetration of a pathogen from the outer ear is quite rare - normally, both of these sections do not communicate, and the eardrum does not have holes.

    A decrease in immunity to one degree or another always has an impact on middle ear diseases - it can lead to both the activation of opportunistic microflora and the increased spread of infection from other foci, including its introduction with blood.

    Classification of the disease

    Most often, the disease occurs against the background of other infectious diseases of the ENT organs.

    Based on the type of pathogen, otitis media is divided into bacterial and fungal. By type of discharge - catarrhal, purulent and necrotic. Based on the localization of the process, limited and diffuse otitis is distinguished.

    The process can be either unilateral or bilateral, and in the latter case, the rate of development of the pathological process on both sides is not the same.

    The following stages are distinguished during the course of the disease:

    • Acute eustacheitis is inflammation of the Eustachian tube. Many experts consider it a separate disease, and not a stage of otitis media.
    • Catarrhal otitis media can be an independent disease, but most often it is an early phase of a purulent process.
    • Purulent preperforative otitis is the active phase of the purulent process, which is accompanied by the most striking symptoms.
    • Perforated (post-perforated) phase – the appearance of a hole in the eardrum, discharge from the ear, improvement of the condition.
    • Reparative – restoration of the middle ear after a disease, recovery.

    In some cases, a separate stage of chronicity is distinguished - the transition of untreated otitis media to chronic purulent otitis. If this process occurs on both sides, it gradually leads to hearing loss and complete deafness.

    First signs and symptoms

    Ear pain is the main symptom of the disease

    Symptoms of otitis media quite clearly follow the stages of the inflammatory process.

    • Eustacheitis is manifested by a feeling of ear congestion, slight pain in the ear, extraneous sensations (“croaking”) when swallowing and turning the head. These sensations are not constant and go away easily with warming procedures. There may be a slight enlargement of the lymph nodes.
    • Catarrhal otitis media is accompanied by a slight enlargement of the cervical lymph nodes, constant pain and congestion in the ear, and extraneous sensations that intensify in the cold (when going outside in cold or windy weather) and weaken during warming procedures. It is impossible to recognize the transition of eustachitis to catarrhal otitis based on symptoms.
    • The purulent phase is accompanied by a sharp increase in temperature, deterioration of health, and headache. The pain in the ears becomes shooting, sharp, and interferes with sleep. Hearing is impaired, the feeling of congestion in the ear reaches its maximum. In this case, the lymph nodes in the neck and under the lower jaw, and sometimes in the armpits, can be significantly enlarged.
    • After perforation of the eardrum, the patient experiences relief - the temperature decreases, pain and congestion in the ear decrease, but hearing is not restored at this stage. Discharge from the ear appears - purulent or whitish if the inflammation is fungal. The greatest intensity of discharge is observed immediately after perforation of the eardrum.
    • Reparative stage – it is characterized by gradual improvement of the condition, disappearance of symptoms, cessation of discharge from the ear, gradual restoration of hearing (it may be incomplete). If complete recovery occurs, the symptoms of the disease disappear completely.

    What complications can it cause?

    An advanced form of purulent bilateral otitis media can cause meningitis

    The most common complication of acute otitis media is its transition to the chronic stage. In this case, the patient periodically experiences pain in the ear and experiences discharge (suppuration) from the external auditory canal. Such periods are followed by relative calm, when the patient feels well.

    Another common complication is persistent perforation of the eardrum. If the hole in it does not heal, the communication between the outer and middle ear remains, which becomes an entry point for infection. In this case, patients have to follow a number of preventive measures to avoid recurrence of the disease.

    Hearing loss and deafness are a consequence of improperly treated or chronic otitis media.

    This complication is caused by damage to the auditory ossicles, disruption of their interaction, and the appearance of adhesions in the middle ear. As a result, the patient's hearing condition continuously deteriorates until complete deafness in both ears. This condition can be treated with a hearing aid.

    It is also possible for the infection to spread to neighboring organs - the inner ear, meninges, facial nerve, mastoid cells.

    How can it be diagnosed?

    A doctor can confirm the diagnosis after examination.

    The doctor begins the diagnostic process by interviewing the patient, collecting anamnesis and carefully examining the external auditory canal, nose and throat. As a rule, the patient's complaints are sufficiently characteristic to make a preliminary diagnosis. The examination confirms the presence of an inflammatory process and the suspected source of infection.

    Additional diagnostic methods are used in cases where it is necessary to determine the degree of hearing impairment.

    For this purpose the following examinations are prescribed:

    1. Audiometry – determination of hearing acuity, as well as the frequency range of sound where disturbances occur.
    2. Tympanometry - determination of the mobility of the eardrum if thickening is suspected.
    3. Tympanocentesis is a puncture of the eardrum to take discharge from the middle ear for analysis. It can also be a therapeutic procedure.
    4. Bacteriological analysis - it uses discharge obtained during tympanocentesis, or discharge from the ear after perforation of the eardrum. Along with it, an antibiotic sensitivity test is carried out. Most often, this analysis serves to confirm or refute the correctness of the prescribed treatment.

    As a rule, an experienced ENT specialist makes a diagnosis based on the clinical picture. Additional diagnostic methods are necessary to establish the degree of hearing impairment, determine the type of pathogen, and clarify the treatment regimen already in use.

    Drug treatment

    Therapy depends on the cause, form and severity of the disease

    The basis of treatment for bilateral otitis is drugs that act on the pathogen (antibiotics or antifungals). For purulent otitis they are prescribed empirically, without waiting for the results of an antibiogram:

    • The most commonly used antibacterial agents are Amoxicillin, Cefixime, Amoxiclav.
    • Against fungi - Fluconazole, Miconazole and others.

    As a rule, medications are used in tablets, and in case of serious condition of the patient, they are administered intravenously.

    To combat inflammatory phenomena, anti-inflammatory tablets are prescribed - Nurofen, Paracetamol, vasoconstrictor drops in the ears. You can use compresses in the form of a cotton swab dipped in antiseptic solutions - hydrogen peroxide, boric alcohol and others. For fungal infections, it is important to use drying agents.

    After perforation of the eardrum, you should stop administering ear drops and compresses (this can damage the middle ear) and switch completely to taking medications orally.

    Tympanocentesis as a therapeutic procedure is prescribed if otitis media does not go into the perforated stage for a long time, and the patient’s condition worsens or there are symptoms of hearing loss. In this case, part of the inflammatory exudate is removed with a syringe to alleviate the condition. The puncture after the procedure is small and heals faster than a hole after perforation.

    Traditional methods

    We treat otitis media with warming compresses if the body temperature is normal

    Alternative treatment can be used to alleviate the patient’s well-being in the catarrhal and pre-perforation phase. In this case, decoctions and infusions of anti-inflammatory herbs in the form of compresses - chamomile, sage, calendula - give a good effect. Gargling with infusions of these herbs will also be useful to eliminate the source of infection.

    As compresses in the ear, you can use tampons moistened with tea tree oils, eucalyptus and other essential anti-inflammatory oils. For an additional effect, you can wrap your head in a warm woolen scarf. It is often recommended to wear earplugs or cotton swabs to cover the external auditory canal when going outside.

    Ethyl alcohol-based products should be used with great caution and only in adults.

    You can use a tampon soaked in vodka no more than twice a day with an interval of 6 hours to prevent drying out the mucous membrane. This remedy helps quite well with fungal otitis, creating unfavorable conditions for pathogens.

    More folk recipes for the treatment of otitis media can be found in the video:

    What cannot be treated?

    Improper treatment of bilateral otitis media can cause serious complications. How to prevent dangerous consequences:

    1. If you have otitis, you should not clean your ear with cotton swabs or other hard objects - there is a risk of damaging the eardrum or leaving a foreign body in the ear.
    2. Do not allow moisture to penetrate into the ear - this stimulates the inflammatory process and the addition of a fungal infection. For the same reason, you should avoid baths, saunas and swimming pools - moist hot air creates ideal conditions for fungus.
    3. Do not use ear tampons or ear drops after perforation of the eardrum or tympanocentesis. Penetration of these agents into the middle ear can only worsen the condition.
    4. You can take antibiotics only as prescribed by a doctor and following the instructions for use. It is impossible to use such drugs uncontrollably - there is a risk of pathogen resistance.
    5. Alcohol-based drops should not be used. As for compresses with alcohol, this has already been mentioned above - their use requires extreme caution. It is advisable to replace such means with more modern, safe and effective ones.

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    Source: http://tvojlor.com/lor/ear/otit/dvuhstoronnij-otit.html