Aeroetite

Aerotitis is an inflammation of the mucous membrane of the middle ear and its elements, resulting from barotrauma. Barotrauma is a mechanical damage to the walls of organs containing air (middle ear, paranasal sinuses, lungs) that occurs when there are sharp and significant differences in air pressure in the environment (both with and without a rise). Aerotitises occur mainly in military pilots with high-speed lifts and descents, as well as during caisson works, depressurization of booths under high pressure, divers at great depths, submariners, as well as explosions, blows to the ear, falling on it, etc. .

Aiditis causes catarrhal diseases, allergic rhinosinusitis, nasal breathing difficulties, which contribute to the disturbance of the ventilation function of the auditory tube. However, even with its normal patency, a sudden and strong change in barometric pressure can lead to barotrauma of the ear and the appearance of baroiditis, because under these conditions the pressure in the tympanum cavity does not have time to balance with the sharply increased or lowered pressure in the external environment.

When pressure drops, especially in the middle ear, there is an entrainment or protrusion of the tympanic membrane, micro- or macrofractures of its structures with violation of the integrity of the vessels. Depending on the magnitude of the acting force in the tympanic membrane, there are changes from a slight injection of blood vessels to hemorrhages, ruptures and bleeding from the external auditory canal. In this case, a 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, a banal acute purulent otitis media develops.

Symptoms of aeration

Subjective sensations in aero-ity are characterized by pains of different intensity, from minor to extremely sharp and dagger sharp at rupture of the tympanic membrane. In this case, a deafening cotton is felt in the ear, after which a sharp hearing loss occurs in it. Tears of the tympanic membrane, the chains of the auditory ossicles, especially with the subluxation of the base of the stapes, in addition to sharp pain, can be accompanied by sudden dizziness and discoordination of movements, which is especially dangerous for the pilot who is currently controlling the aircraft. Hearing impairment is accompanied by a strong noise in the ear, a feeling of fullness in it, a general malaise.

The pain radiates into the BTE and into the angle of the lower jaw. With a favorable clinical course, convalescence and hearing restoration occurs in 1-7 days, with complications, the disease can last weeks and months.

With sharp and significant pressure drops, a rupture of the auditory ossicles can occur, and even a fracture of one or two legs of the stirrup. In this case, deafness comes to the affected ear, which persists after recovery. A subluxation of the base of the stapes may be accompanied by the efflux of the perilymph and a violent vestibular reaction.

Classification of aero-types

A. Uncomplicated forms:

• I degree - the injection of vessels and the hyperemia of the tympanic membrane
• II degree - I degree + hemorrhages in the thickness of the tympanic membrane
• III degree - II degree + rupture of tympanic membrane
• IVa degree - rupture of the chain of auditory ossicles
• IVb degree - III degree + rupture of the auditory ossicles, subluxation of the base of the stapes

B. Complicated forms:

• lungs - grade II + acute catarrhal otitis media
• medium severity - II, III degree + acute purulent otitis media
• severe - IVa, b degree + acute purulent otitis media
• extremely severe - grade IV + serous or purulent labintnitis

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Treatment of aeration

The treatment of aero-otitis is determined by the degree of damage to the elements of the middle ear. Changes at I and II degree usually pass independently. To accelerate the normalization of the otoscopic picture and hearing, it is advisable to let the vasoconstrictive drops into the nose 2-3 times a day and at night. Hemorrhages in the tympanic membrane usually disappear after 5-7 days, sometimes in their place a whitish scar is impregnated with calcium salts that does not significantly affect the acuity of hearing.

At III uncomplicated degree, the tactic of behavior is the same as for I and II degrees, while the toilet of the external auditory canal and the introduction of any drops are categorically contraindicated. In the external ear canal, a dry cotton filter is inserted, and antibiotics of a wide spectrum of action are prescribed for prevention of suppurative complications. With nasal congestion and signs of concomitant aerosynsitis, the introduction of vasoconstrictive drops or ointments into the nose, as well as diagnostic and therapeutic measures for barotrauma of the paranasal sinuses.

When complicated forms are treated, as with purulent diseases of the middle and inner ear, with special attention paid to the normalization of the function of the auditory tube and the sanitation of the upper respiratory tract.

A rupture of the auditory ossicles or the organization of exudate and hematoma of the tympanic cavity with the formation of tympanosclerosis in the future to restore auditory function may require an auditory-improving surgical intervention. The appearance of a purulent labyrinthitis leads to the switching off of auditory and vestibular functions.

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