Treatment of chronic otitis media in the hospital and at home

With chronic otitis media, only complex treatment consisting of several therapeutic methods is used. So, conservative measures include local and general impact on pathology.

Systematically, the external auditory canal and the area of the tympanum are cleaned with antiseptic solutions. After this, antihistamines and antimicrobials are used to eliminate puffiness - in the form of drops or irrigation.

A good effect is demonstrated by the catheterization of the auditory tube from the side of the lesion: this allows to remove the edema and introduce vasoconstrictor and desensitizing solutions into the cavity.

At the next stage of therapeutic treatment, 0.5% dioxin, 0.01% miramistin and other agents are connected. If there is a persistent positive dynamics, the patient is sent for surgery, 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. Withdrawal of acute inflammatory process, if necessary preparation for surgery.
2. Operational restoration of the integrity of the membrane.
3. Rehabilitation period.

It is impossible to single out 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 the use of antibiotic therapy. Antibiotics of choice are often Amoxicillin, Azithromycin, Clarithromycin, Cefuroxime.

If the fungal nature of chronic otitis media is determined by a diagnostic route, then preparations Fluconazole, Nizoral, Brutal, etc.,

Speech about extremely conservative treatment can go only in case the outflow of exudate occurs without any problems. If there is a need to introduce any medicinal solutions into the tympanic cavity, it is necessary to clear the ear of pus and other secretions beforehand.

In the form of drops in the external ear canal are introduced disinfectants, such as Furacilin, boric acid, Protargol, etc. In case of fungal lesions, piley flagella impregnated with external agents are laid in the auditory motion. Travogen, Levaril, Nizoral: such treatment is conducted for at least a month.

If we consider that in a chronic disease, there is a deficit of immune protection, then in the complex treatment the doctor may be recommended to take an immunomodulator (for example, Viferon). Its dosage is determined according to age. Also, it is equally advisable to take fortifying medications in the form of lipoic or pantothenic acids, multivitamin preparations.

Drops with chronic otitis

	Dosing and Administration	Side effects	Special instructions
Furacil Alcohol	The cotton swab is moistened in alcohol solution, the outer ear is treated. Next impregnate cotton wool turundy drug, insert them into the affected ear for 60 minutes. Repeated twice a day. Also, the drug can be dripped into the affected ear, in the absence of perforation in the membrane.	Rarely - an allergic reaction.	Do not drip alcohol into the ear with a damaged eardrum or abrasions in the ear canal.
Protargol	Drip 1-2 drops of the drug in the affected auditory passage up to 3 times a day. The duration of therapy is 5-10 days.	Allergy, irritation and itching of the skin.	In childhood, the drug is used in the same dosages as in adults.
Otipax	Apply with an unperforated membrane, 3-4 drops to 3 times a day in the affected auditory procedure. The duration of therapy is not more than 10 days.	Allergic reactions, local irritation reactions.	The drug can be used in infants, starting with the month of age.

[1], [2], [3], [4], [5], [6], [7]

Tablets from chronic otitis media

	Dosing and Administration	Side effects	Special instructions
Amoxicillin	The most common dosage is 0.5 g three times a day. In severe cases, the dose is revised.	Skin rashes, redness, joint pain, conjunctivitis.	Amoxicillin is not prescribed for hypersensitivity to penicillins.
Cefuroxime Sandoz	Adults take 250 mg twice a day.	Pain in the head, dizziness, skin rash, indigestion.	The drug is undesirable to use during pregnancy.
Fluconazole	In the fungal nature of otitis take 50-100 mg of the drug once a day. Duration of admission is determined individually (from 7 to 30 days).	Rarely - diarrhea, skin rashes, increased gas production.	The drug is not used in pregnancy, in children under 16 years.

Dioxydin for chronic otitis media

Dioxydin is an antimicrobial agent of a wide spectrum of activity, which is often used in ENT practice. The drug is especially effective in relation to infections caused by vulgar proteus, Pseudomonas aeruginosa, salmonella, staphylococcus, streptococcus, intestinal and dysentery rod, pathogenic anaerobes. Dioxydin is used topically, so the drug does not exert systemic and irritant effects. With external otitis, the ointment form of the preparation is used, and when the middle and inner sections are affected, an aqueous solution is shown.

As a rule, with chronic otitis in adults, 0.5% Dioxydin is used, which drips into the affected auditory meatus by 2-3 drops. Before the procedure, the ear should be thoroughly cleaned - for example, a cotton disc moistened in saline or hydrogen peroxide.

If Dioxydin is to be used to treat a child, the solution is diluted with additional sterile water so that the concentration of the active ingredient does not exceed 0.1%.

With a combined lesion, it is allowed to instill a solution not only into the auditory passage, but also into the nasal passages.

[8], [9],

Vitamins

In the diet of patients suffering from chronic otitis media, foods with a high content of ascorbic acid, vitamin A and zinc must be present.

Everyone knows that kiwi and citrus contain quite a lot of ascorbic acid, so doctors advise using otitis more often to use oranges, lemons, and also drink heavily diluted lemon juice.

Vitamin A is present in tomatoes and carrots - they can be eaten whole, or in the form of freshly squeezed juice.

Also, to strengthen the shaken immunity for chronic otitis, it is recommended to consume fresh onions and garlic, to drink vegetable juices - this approach will help to replace the intake of many multivitamin supplements.

If you can not fully establish a healthy diet, you can take ascorbic acid in the form of dragees, chewable and ordinary tablets. Optimum use of about 500 mg of vitamin per day.

Lack of iron increases the risk of infectious pathology of ENT organs. Therefore, you need to pass the tests and, if the lack of iron is confirmed, go to the doctor in order to determine the intake of iron-containing drug.

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

Physiotherapeutic treatment

Electrophoresis is one of the most popular methods of treatment for chronic otitis media. The procedure involves the use of a special device - a generator of ultrahigh-frequency current. Of course, carrying out such treatment at home is impossible: the patient visits the physiotherapy room in a hospital or in a polyclinic. In detail about physiotherapeutic treatment of chronic otitis media.

Do not perform procedures during the period of exacerbation of the disease. The general effect of electrophoresis is that the injected drug enters the body tissues many times faster: for example, in chronic otitis, lidase electrophoresis is often used. Lidase is an enzyme that contributes to:

• removal of edema;
• improvement of tissue trophism;
• improvement of local blood circulation.

In chronic otitis media of the middle ear, a procedure such as UHF is often called an exposure to an ultrahigh-frequency electric field with a frequency of 40 MHz. The UHF method can strengthen 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 media at home

To treat chronic otitis media at home is possible, and even necessary - for example, against the backdrop of conservative therapy, it is allowed to use various suitable medicinal plants, beekeeping products, etc. In order not to aggravate the situation, it is necessary to know about several rules that allow the competent treatment of chronic otitis:

• With 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 a chronic process - and this can only damage under certain circumstances. For example, if the patient has a perforation of the membrane, or there are wounds and ulcers in the auditory passage, then dripping into the ear, alcohol drops can not be categorically prohibited.
• 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, thereby increasing the course of the inflammatory process. Therefore, intense heating of the ear can contribute to aggravation of inflammation, speed up the development of pus. If the exit for purulent discharge is closed, then a breakthrough can occur in the meninges - which is considered a very dangerous complication. Dry heat may be used only after consultation with an otolaryngologist, at the stage of rehabilitation, and also when pain is caused by neuralgia.
• Do not use irritating and aggressive agents in large concentrations for instillation into the ear. For example, you can often hear recommendations to drip on the affected ear onion or garlic juice. And after all such treatment can lead to burns of fabrics, and even to hearing loss. To avoid unpleasant consequences, it is better to refuse such procedures.

Effective compresses in the ear.

Alternative treatment

Alternative therapies can also be used for chronic otitis media. The main condition is obligatory preliminary consultation of the doctor and observance of all his recommendations. And alternative treatment will only accelerate the process of recovery.

• The Bay leaf is rich in useful substances, so it is often used in many serious diseases. Prepare the infusion so: pour 5 leaves 200 ml of boiling water, insist under the lid for two hours. Infusion is drunk to strengthen immunity and eliminate infection in the body - but its use should be strictly dosed because of the possible toxic effects. So, an adult patient should take 1 tbsp. L. Infusion is not more than three or four times a day.
• Natural home-made apple cider vinegar can help with the fungal etiology of chronic otitis media. Vinegar in equal amounts mixed with warm water. In the mixture, a tampon is moistened, which is then carefully inserted into the ear. In addition, you can gargle with an acetic solution: for this you need to take one part of apple cider vinegar and three parts of warm water.
• Sheet Kalanchoe 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.
• The aloe leaf is cut off, put in the refrigerator for a day. After that, squeeze out the juice from the leaf, impregnate it with gauze turunda and put it into the sick ear for several hours. The procedure is repeated every day until persistent improvement of the condition.

[10], [11], [12], [13], [14], [15],

Herbal Treatment

To accelerate the process of recovery from chronic otitis can be used herbs, which are natural antiseptics, analgesics and anti-inflammatory drugs. Individual plants are used with great care not to cause poisoning or other unpleasant manifestations.

• Cheremsha - the leaves of this plant are harvested in the spring. The herb with the scent of garlic perfectly fights with microbes, has antiseptic and anti-inflammatory properties. The sour cream is added to the food: salads, soups, side dishes. You can also squeeze juice from fresh leaves and stems and drink it after each meal for 1 tbsp. Spoon.
• Camomile 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 the flowers of white elderberry. To prepare a medicine for otitis, take 1 tbsp. L. The flowers are poured into 200 ml of boiling water, insist for 30-40 minutes. After that, moisten the gauze swab in the received infusion and fix it in the external auditory canal. On top of the ear cover with a handkerchief or a towel. The tampon is held 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, a cotton turunda is moistened, which is then inserted into the affected ear - approximately 30-40 minutes.

Homeopathy

Many are aware of the existence of such safe alternative therapeutic agents as homeopathic drugs. Not all patients have confidence in such medicines, but practical results often demonstrate the pronounced effectiveness of homeopathy, even when compared to conventional traditional treatment.

Patients with chronic otitis homeopaths are advised to pay attention to such means:

• Aconite - used for chronic otitis with mild symptoms, as well as with severe ear pain, combined with nasal congestion and dry cough.
• Belladonna - suitable for eliminating throbbing, stitching, shooting, acute pain, which lasts no more than three days.
• Hamomilla - helps with zalozhennosti in the ear, noise in the ears, with severe pain and irritability.
• Gepar Sulfur - is used with a low degree of symptoms of chronic otitis, with increased sensitivity of the affected ear, with a tendency to reduce pain after putting on warm compresses.
• Mercurius - is prescribed for chronic otitis, the symptomatology of which is intensified at night. Otitis can be accompanied by inflammation of pharyngeal tonsils, the appearance of an unpleasant odor - both from the affected ear and from the oral cavity. Homeopaths are advised to use iodatus ruberum with left-sided otitis Mercury, and with right-sided otitis, Mercurius iodatos flavus.
• Pulsatilla - is used for exacerbation of the inflammatory process after hypothermia or water ingress into the ear.
• Verbaskum (mullein) - can be used for instillation in the ear with pain or sensation of congestion. The remedy is not suitable for the presence of secretions from the ear.

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

Surgery

The basic procedure for the treatment of chronic tubotymnal otitis is 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 tympanic membrane.

Operation with chronic otitis can take place against a background of monitoring the functionality of the facial nerve: this is necessary for interventions in the middle and inner ear. In the course of 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 nerve fiber damage and developing an unpleasant complication in the form of the facial nerve neuropathy.

The operation is performed under local anesthesia (under condition of absence of allergic mood of the body). The manipulation of the surgeon is controlled by special operational optical instruments with high resolution. Most patients manage to intervene with the help of the in-the-ear access by carrying out a small incision. Less often the surgeon is forced to make a cut behind the ear - for example, if the perforation is localized in the anterior section and can not be seen through the external auditory canal.

During the operation, the doctor examines the tympanum, analyzes its condition, performs the removal of the cartilaginous tissue and restores the integrity of the membrane. Used cartilaginous tissue (it can be a tragus or auricle), which is withdrawn in a special way. It is also permissible to replace it 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 can note the appearance of pulsating noise in the operated ear, a sense of congestion - such signs are considered a variant of the norm.

On inpatient supervision, the patient stays on average 10-14 days. Further, he is given restorative therapy, physical therapy. On the eve of discharge from the hospital, a repeated control diagnosis is carried out, which is subsequently repeated a month later.

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

The final conclusions about the effectiveness of surgical treatment for chronic otitis media are made, three months after the intervention. As a rule, positive dynamics is fixed in 84% of patients.

Can I fly to the sea with chronic otitis media?

By itself, rest at sea will only benefit the sick person suffering from chronic otitis media. If we talk about the flight - then this question does not have an unambiguous 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 extends to the external auditory canal and the wall of the tympanic membrane facing it.
• Middle otitis affects the middle ear area and extends beyond the tympanic membrane.
• Labyrinthitis is a lesion of the inner ear, in which the auditory and vestibular receptors are located.

If a person suffers from external otitis media, the flight for him will not have any negative consequences. But with the average or internal otitis, there can indeed be problems - especially during the takeoff and landing of the aircraft. It is during these periods that the pressure rises, and the tympanic membrane is squeezed outward. If we consider that with chronic otitis, the cavity walls are damaged and inflamed, and there is exudate in the cavity, then such a state can lead to quite unpleasant consequences.

Therefore, if possible, before making the decision to fly, you should consult your doctor, as each case is individual.

[16], [17], [18], [19], [20]