Treatment of chronic otitis media in hospital and at home

In chronic otitis, only complex treatment is used, consisting of several therapeutic methods. Thus, conservative measures include local and general impact on the pathology.

The external auditory canal and the tympanic cavity are systematically cleaned using antiseptic solutions. After that, antihistamines and antimicrobials are used to eliminate swelling - in the form of drops or irrigations.

Catheterization of the auditory tube on the affected side demonstrates a good effect: this allows the swelling to be relieved and vasoconstrictor and desensitizing solutions to be introduced into the cavity.

At the next stage of therapeutic intervention, 0.5% dioxidine, 0.01% miramistin and other agents are added. If persistent positive dynamics are detected, the patient is referred for surgical intervention, the purpose of which is to restore the damaged eardrum.

Thus, the main positions in the treatment of the chronic form of the disease look like this:

1. Removal of acute inflammation, preparation for surgery if necessary.
2. Surgical restoration of the integrity of the eardrum.
3. Rehabilitation period.

It is impossible to clearly indicate the drugs used to treat the disease in question - drugs are selected based on the type of pathogen and the severity of the clinical picture.

Uncomplicated purulent otitis requires antibiotic therapy. In this case, the antibiotics of choice are often Amoxicillin, Azithromycin, Clarithromycin, Cefuroxime.

If the fungal nature of chronic otitis is determined by diagnostics, then the standard drugs used are Fluconazole, Nizoral, Brutal, etc.

We can talk about exclusively conservative treatment only if the exudate outflow occurs without any problems. If there is a need to introduce any medicinal solutions into the tympanic cavity, it is necessary to first clean the ear from pus and other secretions.

Disinfectants such as Furacilin, boric acid, Protargol, etc. are introduced into the external auditory canal in the form of drops. In case of fungal infections, cotton swabs soaked in external agents Travogen, Levaril, Nizoral are inserted into the auditory canal: such treatment is carried out for at least a month.

If we take into account that a chronic disease is characterized by a deficiency of immune protection, then as part of a complex treatment, the doctor may recommend taking an immunomodulator (for example, Viferon). Its dosage is determined according to age. It is also no less advisable to take general strengthening medications in the form of lipoic or pantothenic acids, multivitamin preparations.

Drops for chronic otitis

	Method of administration and dosage	Side effects	Special instructions
Furacilin alcohol	A cotton swab is moistened in an alcohol solution and the outer ear is treated. Then cotton turundas are soaked in the preparation and inserted into the affected ear for 60 minutes. Repeat twice a day. The preparation can also be dripped into the affected ear, if there is no perforation in the eardrum.	Rarely – allergic reaction.	Do not put alcohol in your ear if you have a damaged eardrum or abrasions in the ear canal.
Protargol	Instill 1-2 drops of the drug into the affected ear canal up to 3 times a day. Duration of therapy is 5-10 days.	Allergies, irritation and itching of the skin.	In children, the drug is used in the same dosages as in adults.
Otipax	Apply for imperforate eardrum, 3-4 drops up to 3 times a day into the affected ear canal. Duration of therapy is no more than 10 days.	Allergic reactions, local irritation reactions.	The drug can be used in infants starting from one month of age.

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Tablets for chronic otitis

	Method of administration and dosage	Side effects	Special instructions
Amoxicillin	The most common dosage is 0.5 g three times a day. In severe cases of the disease, the dosage is revised.	Skin rashes, redness, joint pain, conjunctivitis.	Amoxicillin is not prescribed for hypersensitivity to penicillins.
Cefuroxime Sandoz	Adults take 250 mg of the drug twice a day.	Headache, dizziness, skin rash, dyspepsia.	The drug is not recommended for use during pregnancy.
Fluconazole	In case of fungal otitis, take 50-100 mg of the drug once a day. The duration of administration is determined individually (from 7 to 30 days).	Rarely – diarrhea, skin rashes, increased gas formation.	The drug is not used during pregnancy or in children under 16 years of age.

Dioxidine for chronic otitis

Dioxidine is a broad-spectrum antimicrobial agent that is often used in ENT practice. The drug is especially effective against infections caused by Proteus vulgaris, Pseudomonas aeruginosa, Salmonella, Staphylococcus, Streptococcus, Escherichia coli and dysentery bacilli, and pathogenic anaerobes. Dioxidine is used locally, so the drug does not have a systemic or irritating effect. For external otitis, an ointment form of the drug is used, and for lesions of the middle and internal sections, an aqueous solution is indicated.

As a rule, for chronic otitis in adults, 0.5% Dioxidine is used, which is dripped into the affected ear canal 2-3 drops at a time. Before the procedure, the ear must be thoroughly cleaned - for example, with a cotton pad soaked in saline or hydrogen peroxide.

If Dioxidine is planned to be used to treat a child, the solution is additionally diluted with sterile water so that the concentration of the active component does not exceed 0.1%.

In case of combined lesions, it is permissible to instill the solution not only into the ear canal, but also into the nasal passages.

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Vitamins

The diet of patients suffering from chronic otitis must necessarily include foods with a high content of ascorbic acid, vitamin A and zinc.

Everyone knows that kiwi and citrus fruits contain quite a lot of ascorbic acid, so doctors advise eating oranges and lemons more often when you have otitis, and also drinking highly diluted lemon juice.

Vitamin A is present in tomatoes and carrots – they can be eaten whole or as freshly squeezed juice.

Also, to strengthen the weakened immune system during chronic otitis, it is recommended to eat fresh onions and garlic, drink vegetable juices - this approach will help replace the intake of many multivitamin supplements.

If you are unable to fully establish a healthy diet, you can take ascorbic acid in the form of dragees, chewable and regular tablets. It is optimal to consume about 500 mg of the vitamin per day.

Iron deficiency increases the risk of developing infectious pathologies of the ENT organs. Therefore, you need to take tests and, if iron deficiency is confirmed, consult a doctor to determine the intake of an iron-containing drug.

In addition, you need to eat more foods that reduce the formation of mucus in the body. These foods include most vegetables, fruits, greens, as well as beans, seeds, nuts and green tea.

Physiotherapy treatment

Electrophoresis is one of the most popular treatment methods for chronic otitis. The procedure involves the use of a special device - an ultra-high-frequency current generator. Of course, such treatment cannot be carried out at home: the patient visits a physiotherapy room in a hospital or clinic. More about physiotherapy treatment for chronic otitis.

The procedures should not be carried out during an exacerbation of the disease. The general effect of electrophoresis is that the administered medicinal substance enters the body tissues many times faster: for example, electrophoresis with lidase is often used for chronic otitis. Lidase is an enzymatic substance that promotes:

• removal of swelling;
• improving tissue trophism;
• improving local blood circulation.

In chronic otitis media, a procedure such as UHF is often prescribed - this is exposure to an ultra-high-frequency electric field with a frequency of 40 MHz. The UHF method is able to increase local blood circulation, stop the inflammatory process. As a rule, one session lasts no more than a quarter of an hour.

Treatment of chronic otitis at home

It is possible and even necessary to treat chronic otitis at home - for example, against the background of conservative therapy, it is allowed to use various suitable medicinal plants, bee products, etc. In order not to aggravate the situation, you need to know about several rules that allow you to properly treat chronic otitis:

• In chronic otitis, there is a restriction on the use of drops with an alcohol base. Alcohol solutions are often used for ear pathologies, so many people try to use them in chronic processes - and this can only do harm under certain circumstances. For example, if the patient has a perforated eardrum, or there are wounds and abscesses in the auditory canal, then it is strictly forbidden to drip alcohol drops into the ear.
• The restriction also applies to the use of thermal procedures. The fact is that under the influence of heat and moisture, bacteria begin to actively multiply, which intensifies the inflammatory process. Therefore, intensive warming of the ear can contribute to the aggravation of inflammation, accelerating the production of pus. If the outlet for purulent discharge is closed, then a breakthrough can occur in the meninges - which is considered a very dangerous complication. Dry heat is allowed to be used only after consultation with an otolaryngologist, at the rehabilitation stage, and also when pain is caused by neuralgia.
• Irritating and aggressive agents in high concentrations should not be used for ear drops. For example, you can often hear recommendations to drip onion or garlic juice into the affected ear. But such treatment can lead to tissue burns and even hearing loss. To avoid unpleasant consequences, it is better to refuse such procedures.

Ear compresses are effective.

Folk remedies

Traditional methods of treatment can also be used for chronic otitis. The main condition is a mandatory preliminary consultation with a doctor and compliance with all his recommendations. And traditional treatment will only speed up the recovery process.

• Bay leaf is rich in useful substances, so it is often used for many serious diseases. The infusion is prepared as follows: pour 5 leaves with 200 ml of boiling water, leave under the lid for two hours. The infusion is drunk to strengthen the immune system and eliminate infections in the body - however, its use should be strictly dosed due to possible toxic effects. Thus, an adult patient should take 1 tbsp. of infusion no more than three or four times a day.
• Natural homemade apple cider vinegar can help with fungal etiology of chronic otitis. Vinegar is mixed with warm water in equal quantities. A tampon is soaked in the mixture, which is then carefully inserted into the ear. Additionally, you can gargle with a vinegar solution: for this, you need to take one part apple cider vinegar and three parts warm water.
• The Kalanchoe leaf is crushed, the resulting mass is wrapped in a piece of gauze and inserted into the affected ear for 1-2 hours. The procedure is repeated daily, 2-3 times a day.
• An aloe leaf is cut and placed in the refrigerator for a day. After that, the juice is squeezed out of the leaf, a gauze turunda is soaked in it and placed in the sore ear for several hours. The procedure is repeated every day until the condition is steadily improved.

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Herbal treatment

To speed up the process of healing from chronic otitis, you can use herbs that are natural antiseptics, analgesics and anti-inflammatory agents. Individual plants are used with great caution so as not to cause poisoning or other unpleasant manifestations.

• Ramsons - the leaves of this plant are collected in the spring. The herb with the aroma of garlic perfectly fights microbes, has antiseptic and anti-inflammatory properties. Ramsons are added to food: salads, soups, side dishes. You can also squeeze the juice from fresh leaves and stems and drink it after each meal, 1 tablespoon.
• Chamomile flowers are a natural analgesic and antiseptic. The plant will help with chronic otitis, as it copes well with inflammation and relieves pain. Chamomile flowers can be combined with white elderberry flowers. To prepare a medicine for otitis, take 1 tbsp. of flowers, pour 200 ml of boiling water, and leave for 30-40 minutes. After that, soak a gauze swab in the resulting infusion and fix it in the external auditory canal. Cover the ear with a scarf or towel on top. Keep the swab in the ear for about half an hour.
• Mint leaves also have analgesic properties, and their effect is soft and comfortable. The recipe with mint looks like this: squeeze the juice from a fresh plant, add natural honey and warm boiled water. The proportions are as follows: 2 tsp. juice, 2 tsp. honey and 200 ml of water. In the resulting product, moisten a cotton swab, which is then inserted into the affected ear - for about 30-40 minutes.

Homeopathy

Many people know about the existence of such safe alternative therapeutic means as homeopathic medicines. Not all patients trust such medications, but practical results often demonstrate the pronounced effectiveness of homeopathy, even in comparison with conventional traditional treatment.

Homeopaths advise patients with chronic otitis to pay attention to the following remedies:

• Aconite is used for chronic otitis with mild symptoms, as well as for severe ear pain, combined with nasal congestion and dry cough.
• Belladonna - is suitable for eliminating throbbing, stabbing, shooting, acute pain that lasts no more than three days.
• Chamomilla - helps with ear congestion, tinnitus, severe pain and irritability.
• Gepar sulfur is used for mild symptoms of chronic otitis, increased sensitivity of the affected ear, and a tendency for pain to decrease after applying warm compresses.
• Mercurius is prescribed for chronic otitis, the symptoms of which intensify at night. Otitis may be accompanied by inflammation of the pharyngeal tonsils, the appearance of an unpleasant odor - both from the affected ear and from the oral cavity. Homeopaths advise using Mercurius iodatus ruber for left-sided otitis, and Mercurius iodatus flavus for right-sided otitis.
• Pulsatilla is used in case of exacerbation of the inflammatory process after hypothermia or water getting into the ear.
• Verbascum (mullein) - can be used for ear drops for pain or a feeling of congestion. The remedy is not suitable if there is discharge from the ear.

The selected drug is taken in 30C or 30D potencies. In case of pronounced signs of exacerbation, the drug is offered every two hours, then every 4 hours. Standard administration is carried out 4 times a day. As a rule, visible improvement occurs within three days, and after persistent improvement, treatment is stopped.

Surgical treatment

The basic procedure for treating chronic tubotympanic otitis is considered to be an operation called tympanoplasty. Since this form of the disease is not accompanied by the destruction of bone tissue, and the auditory ossicles are preserved, the main focus of the surgeon's work in this situation is to restore the eardrum.

Surgery for chronic otitis can be performed while monitoring the functionality of the facial nerve: this is necessary for interventions in the middle and inner ear. During the operation, the electromyographic activity of the nerve is measured, which makes it possible to perform the procedure in the required volumes, minimizing the risk of damage to nerve fibers and the development of an unpleasant complication in the form of facial nerve neuropathy.

The operation is performed under local anesthesia (provided that the body is not allergic). The surgeon's manipulations are controlled by special high-resolution surgical optical devices. In most patients, the intervention can be performed using intra-aural access by making a small incision. Less often, the surgeon is forced to make an incision behind the ear - for example, if the perforation is localized in the anterior section and cannot be seen through the external auditory canal.

During the operation, the doctor examines the tympanic cavity, analyzes its condition, collects cartilaginous tissue and restores the integrity of the membrane. Cartilaginous tissue is used (this can be the tragus or auricle), which is removed in a special way. It can also be replaced with the fascia of the temporal muscle.

Next, a tamponade of the external auditory canal is performed, which is removed after about a week.

• How is the postoperative period?

The patient may notice the appearance of a pulsating noise in the operated ear, a feeling of congestion - such symptoms are considered a normal variant.

The patient stays under inpatient observation for an average of 10-14 days. Then he is prescribed rehabilitation therapy and physical procedures. On the eve of discharge from the hospital, a repeated control diagnosis is carried out, which is then repeated after another month.

For at least 4 weeks after surgery, do not allow water to enter the ear.

Final conclusions about the effectiveness of surgical treatment for chronic otitis are made three months after the intervention. As a rule, positive dynamics are recorded in 84% of patients.

Is it possible to fly to the sea with chronic otitis?

A seaside vacation in itself will only benefit a sick person suffering from chronic otitis. If we talk about the flight, then this question does not have a clear answer, because everything is individual. Let's try to figure it out.

As we have already said, there are several types of otitis, for example:

• The external inflammatory process spreads to the external auditory canal and the wall of the eardrum facing it.
• Otitis media affects the middle ear area and extends beyond the eardrum.
• Labyrinthitis is a disorder of the inner ear, which contains auditory and vestibular receptors.

If a person suffers from external otitis, then the flight will not have any negative consequences for him. But with middle or internal otitis, problems can really arise - especially during takeoff and landing of the plane. It is during these periods that the pressure increases, and the eardrum is squeezed out to the outside. If we consider that with chronic otitis, the cavity walls are damaged and inflamed, and there is exudate in the cavity, then this condition can lead to quite unpleasant consequences.

Therefore, if possible, you should consult with your doctor before deciding to fly, as each case is individual.

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