Aeriotite

Aerotitis is an inflammation of the mucous membrane of the middle ear and its elements, which occurs as a result of barotrauma. Barotrauma is a mechanical injury to the walls of organs containing air (middle ear, paranasal sinuses, lungs), which occurs with sharp and significant changes in air pressure in the environment (both with an increase and a decrease). Aerotitis occurs mainly in military pilots during high-speed ascents and descents, as well as during caisson work, depressurization of cabins under increased pressure, in divers at great depths, submariners, as well as during explosions, blows to the ear with the palm, falling on it, etc.

Colds, allergic rhinosinusitis, and difficulty breathing through the nose contribute to the development of aerotitis, which contribute to the disruption of the ventilation function of the auditory tube. However, even with normal patency, a sudden and strong change in barometric pressure can lead to barotrauma of the ear and the development of barootitis, since under these conditions the pressure in the tympanic cavity does not have time to balance with the sharply increased or decreased pressure in the external environment.

When pressure drops, the eardrum is primarily drawn in or bulged, with micro- or macro-ruptures of its structures and damage to the integrity of the vessels. Depending on the magnitude of the acting force, changes occur in the eardrum from a slight injection of vessels to hemorrhages, ruptures and bleeding from the external auditory canal. In this case, transudate is formed in the tympanic cavity, and the addition of catarrhal inflammation causes the appearance of exudate and its possible infection. In this case, banal acute purulent otitis media develops.

Symptoms of Aerootitis

Subjective sensations with aerotitis are characterized by pains of varying intensity, from minor to extremely sharp and stabbingly sharp when the eardrum ruptures. In this case, a deafening pop is felt in the ear, after which a sharp hearing loss occurs. Ruptures of the eardrum, the chain of auditory ossicles, especially with subluxation of the base of the stapes, in addition to sharp pain, can be accompanied by sudden dizziness and lack of coordination of movements, which is especially dangerous for the pilot who is currently operating the plane. Hearing loss is accompanied by a strong noise in the ear, a feeling of fullness in it, general malaise.

The pain radiates to the area behind the ear and to the area of the angle of the lower jaw. With a favorable clinical course, recovery and restoration of hearing occurs in 1-7 days, with complications the disease can last for weeks and months.

With sharp and significant pressure changes, a rupture of the auditory ossicle chain and even a fracture of one or two legs of the stapes may occur. In this case, deafness occurs in the affected ear, which persists after recovery. And subluxation of the base of the stapes may be accompanied by a leak of perilymph and a violent vestibular reaction.

Classification of aerotitis

A. Uncomplicated forms:

• I degree - vascular injection and hyperemia of the eardrum
• II degree - I degree + hemorrhages into the thickness of the eardrum
• III degree - II degree + rupture of the eardrum
• IVa degree - rupture of the auditory ossicle chain
• IVb degree - III degree + rupture of the auditory ossicular chain, subluxation of the base of the stapes

B. Complicated forms:

• mild - II degree + acute catarrhal otitis media
• moderate severity - II, III degree + acute purulent otitis media
• severe - IVa, b degree + acute purulent otitis media
• extremely severe - IV degree + serous or purulent labyrinthitis

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Treatment of aerotitis

Treatment of aerotitis is determined by the degree of damage to the elements of the middle ear. Changes in grades I and II usually pass on their own. To speed up the normalization of the otoscopic picture and hearing, it is advisable to instill vasoconstrictor drops into the nose 2-3 times a day and at night. Hemorrhages in the eardrum usually disappear after 5-7 days, sometimes a whitish scar soaked with calcium salts forms in their place, which does not significantly affect hearing acuity.

In case of uncomplicated stage III, the tactics of behavior are the same as in stages I and II, while toilet of the external auditory canal and introduction of any drops into it are strictly contraindicated. A dry cotton filter is inserted into the external auditory canal, and broad-spectrum antibiotics are prescribed per os to prevent purulent complications. In case of nasal congestion and signs of concomitant aerosinusitis, introduction of vasoconstrictor drops or ointments into the nose is indicated, as well as diagnostic and therapeutic measures regarding barotrauma of the paranasal sinuses.

In complicated forms, treatment is carried out as for purulent diseases of the middle and inner ear, with special attention paid to normalizing the function of the auditory tube and sanitation of the upper respiratory tract.

Rupture of the auditory ossicle chain or organization of exudate and hematoma of the tympanic cavity with the formation of tympanosclerosis may require hearing-improving surgical interventions in the future to restore hearing function. The occurrence of purulent labyrinthitis leads to the shutdown of auditory and vestibular functions.

In the event of aero-otitis of any degree, workers employed in the relevant industries, in flight, diving and caisson work, are released from work until full recovery with admission to work after the appropriate medical examination. In the case of aero-otitis of III and IV degree, the victims are subject to hospitalization.