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Otitis in adults: symptoms and treatment, antibiotics

What it is? Otitis is an inflammation of various tissues that form the ear - depending on the localization of the inflammatory process, there are distinguished forms of the disease: internal, middle and external. Moreover, the latter option is most common. To fully understand what otitis and its varieties are, it is important to consider the anatomy of the organ.

The ear is divided into 3 sections:

  • outer ear;
  • middle ear;
  • inner ear.

The outer ear consists of the auricle and the external auditory canal. Inflammation of these structures will be related to the external form of the disease.

The middle ear is formed by the Eustachian tube, eardrum and tympanic cavity. The inflammatory process can capture all these structures, but traditionally otitis media is called inflammation of the tympanic cavity.

The inner ear is represented by a labyrinth. Its inflammation (labyrinthitis) is internal otitis.


Types and causes of otitis

Ear device and otitis media

There are the following external otitis:

  • Inflammation in diseases of the skin of the auricle, such as erysipelas, eczema, herpes, dermatitis;
  • Inflammation of the cartilage - perichondritis. Its cause - the introduction of infection, often Pusa purulent, with injuries;
  • Inflammation in case of infection of the skin lesions of the external auditory canal - diffuse otitis media;
  • Otogematoma with infection. This is an extensive hemorrhage due to injury (often seen in the mentally ill);
  • Furunculosis is an inflammation of the sebaceous glands of the external auditory canal when injected into the roots of staphylococcal hairs or other microbes. Often develops when combing the ear canal and active cleaning of sulfur;
  • Mycosis - a fungal infection of the skin during the reproduction of mold fungi in it. It affects people living in damp, dusty, dark rooms.

Otitis media differ depending on the place of development of the inflammatory process:

  • Eustachitis - inflammation of the Eustachian tube;
  • myringitis - inflammation of the eardrum (almost always associated with inflammation of the tympanic cavity);
  • acute catarrh and inflammation of the tympanic cavity;
  • mastoiditis - inflammation localized in the mastoid process (bone structure of the skull). As a rule, it is a continuation of otitis media with insufficient treatment.

Otitis media, by the nature of the course, are divided into acute and chronic. In acute, first there is catarrh, which then turns into purulent.

The causes of acute otitis media are quite diverse. In almost all cases, it is a gradual penetration of infection from the throat and nose with colds, flu and other acute respiratory viral infections. This is the so-called tube path.

First, the inflammatory process moves from the nasopharynx to the Eustachian tube associated with it. It is very narrow and with the development of inflammatory edema quickly overlaps completely, which leads to a decrease in pressure in the tympanic cavity.

Otitis development in adults

Because of this, the transudate, the liquid part of the blood, begins to stretch out of the blood vessels into the ear cavity. In the future, this fluid can dissolve, and can suppurate - this is facilitated by the penetration of infection from the nasopharynx through the Eustachian tube. The most common pathogens are pneumococcus and hemophilic bacilli.

More rare causative factors are:

  • sudden pressure drops during flushing of the nasal cavity with too much liquid under high pressure, strong blowing of the nose, during takeoff and landing of the aircraft, and diving to the depth when diving;
  • infection can be carried out through the blood in case of flu, measles, typhoid, scarlet fever, tuberculosis, as well as trauma to the eardrum;
  • prolonged hypothermia in combination with a reduced reaction of the immune system and the general weakness of the body. This leads to otitis caused by saprophytic microflora of the tube and pharynx, which is not dangerous in healthy people. The path of infection can be observed with tuberculosis , HIV, syphilis , diabetes.

Chronic otitis media can also be catarrhal and purulent.

The causes of the chronic form are:

  • undertreated or severe acute otitis media, especially in infectious diseases: influenza, bark, scarlet fever;
  • violation of nasal breathing caused by the curvature of the nasal septum, adenoids, allergic rhinitis ;
  • reduction of body resistance, depression of the immune system in blood diseases, diabetes , infectious processes;
  • taking drugs that inhibit immunity (corticosteroids and cytotoxic drugs).

The following factors can cause the infection to drift into the labyrinth with the development of otitis media:

  • chronic otitis media;
  • injury;
  • meningitis;
  • parotitis;
  • syphilis.

Symptoms of otitis in adults by the form of the disease

Symptoms of otitis in adults

The nature of the clinical symptoms and its severity depend on the course of the disease (acute or chronic) and the localization of the inflammatory process within the organ of hearing.

External otitis are characterized by the following symptoms:

  • manifestations of specific skin diseases in the form of vesicles with crusts in case of herpes, bright red redness in erysipelas, ecnema weeping, etc .;
  • perichondritis is manifested by redness, lumpy edema, sharp soreness of the auricle;
  • diffuse form is manifested by itching of the skin, purulent secretions from the ear, pain when pressing on the trestle;
  • otohematoma looks like a soft blue-purple tumor, often painless;
  • furunculosis is accompanied by severe pain that spreads to the neck, teeth, to the eye area, increases with pressure on the trestle, pulling off the ear, chewing movements and talking, and also at night, especially if you sleep on a sore ear. On examination, you can detect an elevation of the skin with translucent yellow purulent content, sharply painful when pressed;
  • at the beginning of mycoses are asymptomatic, with the germination of the mycelium, severe itching, unpleasant smell, noise and congestion, weak pain, and hearing loss occur.

Otitis media present a greater health risk than external otitis. Therefore, early diagnosis with subsequent therapy is required.

Signs of otitis in adults with an acute form depend on the localization of the inflammatory process. So, Eustachitis is characterized by the appearance of noise and pronounced ear congestion.

A specific symptom of eustachitis is autophony, in which the patient's own voice resonates in the diseased ear. If inflammation occurs on the background of acute respiratory viral infections, the temperature is elevated, in other cases, eustachitis is not accompanied by a significant change in well-being and fever.

The inflammation of the tympanic cavity is clinically divided into 2 stages: before the breakthrough (perforation) of the eardrum and after the breakthrough. In the first stage, there is a growing pain in the ear, which spreads to the temple and crown; the hearing gradually decreases.

The temperature increase may increase to 39.0 ° C as the suppuration develops in the tympanic cavity, and also against the background of acute respiratory viral infection, especially flu. There is a general weakness.

The second stage is characterized by a sharp decrease in earache, general well-being improves, and body temperature decreases. Congestion and discomfort in the ear persist for some time. Gradually, the restoration of hearing.

Mastoiditis as a complication of acute otitis media is manifested recurring deterioration of the condition:

  • throbbing pain in the ear and behind the ear, above the mastoid process;
  • body temperature rises;
  • hearing deteriorates.

Otitis of the middle ear of adults , when going into a chronic course, is manifested by the presence of persistent serous or purulent discharge from the ear, impairment of hearing, and regular noise. With exacerbation, there is a headache and earache, the discharge becomes more.

The appearance of a sharp odor of pathological secretion suggests the addition of inflammation of the temporal bone, which is a severe form of otitis - epitimpanitis.

Often this is an indication for emergency surgery, because there is a serious threat to purulent brain damage.

Labyrinthitis (internal otitis) is characterized by the appearance of symptoms indicating a lesion of the vestibular apparatus:

  • the appearance of severe dizziness, which is more often paroxysmal. It is enhanced by changing the position of the head, sneezing;
  • lack of coordination and balance;
  • nausea and vomiting of central character.

Also noted pallor, increased heart rate and a sharp deterioration in hearing.

Otitis Diagnosis

Otitis Diagnosis

Otitis of all forms are detected on the basis of a survey, the identification of complaints and characteristic symptoms. A specific diagnosis is an examination of the ear sections during otoscopy, which is performed by an ENT doctor.

Complement this study by examining the nose, determining the severity of hearing. Blood tests and bacteriological examination of the discharge ear (seeding) to detect infectious agents are also shown.

From instrumental methods using radiography, computed tomography of the temporal areas.

How to treat ear otitis in adults?

Otitis treatment in adults

If symptoms typical of otitis are identified, the treatment is performed by an ENT specialist. Principles of treatment depend on the location of the inflammatory process. So, in some cases, sufficient drug therapy, and in others - surgery is required.

Treatment of otitis externa is based on the following provisions:

- Inflammatory diseases of the skin of the ear are treated in accordance with the principles of treatment of these diseases in other parts of the body. For herpes, antiviral ointments are used, for eczema, hormonal ointments, etc.

- At perichondritis, cold and compresses with Burov's liquid are used at the beginning, and with the appearance of pus, a surgical opening is performed.

- Otogematoma - fluid extraction with a syringe followed by tight bandaging.

- With furunculosis, antibiotics such as erythromycin, rulid, and augmentin are taken from day one. At the same time, the ear canal tampon is produced locally - laying cotton wool, dry or wetted with a solution of boric alcohol, and boils are smeared with iodine.

With the deterioration of overall health prescribe aspirin, ibuprofen, paracetamol. Spend warming ear "blue" lamp. Mature abscess is surgically opened by a small incision.

- Diffuse external otitis involves flushing with a warm solution of furacillin or boric acid; the ear canal is lubricated with a solution of lapis or brilliant green. Also used warming compresses with liquid Burov, ointment with prednisone, hydrocortisone .

In case of itching, sulfathiazole or yellow mercury ointment, menthol in peach oil is prescribed. Polydex and Otof drops are effective. Physiotherapy is performed - UHF, UFO, especially shown in chronic course.

- Treatment of mycoses is the appointment of antifungal drugs, topical and oral. Locally apply the solution and cream of clotrimazole, exoderin, lamisil with pre-cleaning of the ear canal with hydrogen peroxide.

Inside - Nystatin, Diflucan . When itching take suprastin, diphenhydramine, zyrtek, claritin.

With moderate otitis media, treatment is carried out as quickly as possible - to eliminate potential complications. Therapy consists in the initial elimination of the causes that lead to inflammation of the ear - ARVI, flu, rhinitis, etc.

At the same time, catheterization of the auditory tube is carried out for blowing, normalization of intra-ear pressure and the introduction of anti-inflammatory solutions. Also shown is an air massage of the eardrum.

Of the medications used: otrivin, naphthyzine, galazolin, which need to drip into the nose, from the side of the patient ear. After instillation, turn your head to the side of the affected ear. UHF and quartz tube is used.

Treatment of otitis media without suppuration:

  • Every day, catheterization of the tube is made with the introduction of hormones and antibiotics.
  • Make warming compresses, laying tururens moistened with alcohol and glycerin in the external auditory canal and closing the auditory opening with cotton wool soaked in Vaseline. Compress has a warming and anti-edema effect.
  • Inside take paracetam, ibuprofen.
  • During this period, otitis drops can be used; in adults, drops of Otipaks, Otofa, and Polydex are used.

Antibiotics for otitis in adults are attached to the treatment of acute moderate form in the development of purulent inflammation. Well proven application Augmentina. Also effective Rulid, Amoxiclav, Cefazolin.

Puncture (paracentesis)

puncture of the eardrum

If antibacterial therapy is ineffective, surgical treatment is used. With otitis media, it consists in holding a paracentesis - puncture of the eardrum with pronounced purulent process.

After the operation or spontaneous breakthrough of the membrane, they carry out catheterization of the auditory tube with the introduction of hormones and antibiotics, as well as the infusion of Dimexidum, antibiotics into the tympanic cavity (when the drug enters the destination, the patient tastes it in the mouth).

After breaking the membrane, the use of ear drops is contraindicated. It can lead to severe pain due to irritation of the mucous membrane of the tympanic cavity.

Treatment of mastoiditis begins with the appointment of antibiotics, the use of UHF. In the absence of improvement within 1-2 days, surgical treatment is performed - trepanning of the mastoid process. In severe cases, trepanation is carried out immediately after treatment.

Chronic treatment

Remedies for otitis media in chronic course are somewhat different. First of all, they are aimed at combating the inflammatory process and its consequences, and the second - at the causal factor, since its role in the chronization of the process is secondary (as opposed to the acute course). Therefore, apply:

  • washing the ears with warm solutions of furatsillin, hydrogen peroxide, boric acid, oscicort aerosol;
  • washing with antibiotics with hormones;
  • infusion of solutions of Dimexidum, atofa, quinosol, furacilin, solutions of antibiotics, protargol in the external auditory canal;
  • dusting the ear canal with boric acid powders;
  • general antibacterial therapy is indicated only when the process is aggravated and the temperature rises;
  • physiotherapy: ultraviolet irradiation, laser therapy, in the absence of pus and overgrowths, polyps - UHF;
  • in the event of chronic suppurative epitimpanitis, surgical treatment is carried out.

Treatment of internal otitis media is the appointment of antibiotics, diuretics, vitamins. On the 6th-8th day of the disease, a sanitizing (cleansing) operation is performed. Otherwise there is a risk of hearing loss.

Home Treatment in Adults

At home, treatment of otitis is allowed after consulting an ENT doctor and making a final diagnosis. With otitis media, warming compresses with vodka for 6 hours are recommended.

To do this, cotton wool is impregnated with vodka or diluted by half with alcohol and applied behind the ear. Outside, "warmed" with dry cotton and reinforced with a bandage.

Home treatment can complement ear heating with a Sollux lamp, a “blue” lamp.

Otitis prophylaxis

Otitis prevention is:

  • Rejection of active and deep cleansing of the ears, which leads to injuries of the mucous membrane. Otolaryngologists recommend using cotton swabs to remove sulfur from the external auditory canal without penetrating it;
  • Removal of adenoids, sanation of the oral cavity, pharynx;
  • Prevention of SARS, flu;
  • Strengthening immunity and hardening.
2016-12-13 08:40:05
I recommend Azitral to everyone, if you need to be cured of bacteria, then this is an excellent choice. My brother had a sore throat and another ear ached, otitis. Already close the hospital, and the temperature is kept. What to do did not know. The doctor advised to drink Azitral. Brother took 1 capsule a day before lunch. Already after the second, I felt that the temperature had become normal, just in case I drank the third capsule. Azitral helped, by the way, there were no side effects: my brother's stomach worked normally.
2016-12-18 19:05:40
Timur, I agree with you. My eldest son got sick, and then got a complication in his ear. The doctor said it was otitis. Has registered Azitral. I was afraid that there would be all sorts of side effects. But the son helped very quickly and without any complications to other organs. So you can safely take this drug!
2016-12-21 18:39:42
YES, Love, I agree. I myself had an otitis and prescribed this antibiotic for me. Leaving the doctor's office thought, well, him. But a day later, he ached so much that he ran to the pharmacy, bought it and immediately began to take it. It turned out to be a very effective drug. So Azitral is what the doctor ordered, as they say.
2017-11-09 06:22:40
Thanks for the article, I will keep in mind.

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