Otitis : causes, symptoms, diagnosis , treatment and prevention
Children And Health / / May 05, 2016
Ear disease or otitis - a disease beyond time and space.Otitis sick and in the Sahara, and the Arctic Circle.It's not about the climate.The cause of ear diseases is not dependent on geography.And from what?And that is the organ of hearing?
human ear to classify on the outer, middle and inner.Each of these three performs its function.The outer ear collects sound vibrations or waves that are then transferred through the ear canal to the eardrum.When the sound enters the ear and ear achieves this, it starts to vibrate as the drum (hence its name) by converting sound waves into mechanical energy.
now begins to act the middle ear.It is a rather complicated structure, filled with air.There are three tiny bones.It is they act as drum sticks and transmit sound waves to the inner ear.
inner ear is filled with fluid.Here it is similar to the structure of the hair, which stimulate the nerves.Thus sound waves are transformed into electrochemical impulses.These pul
structure of the inner ear - three semicircular canal.They operate on the principle of the gyroscope body, i.e.regulate the balance.
Talking about the structure of the ear, it is impossible to bypass the Eustachian tube, which is in the middle ear, nasal passages goes to the top of the throat.This tube helps equalize the air pressure in the middle ear to parameters of the external air pressure.Here also it is often ear of infection.
about it - below.In the meantime, let's say that by ear diseases can not be treated casually.However, the pain at the same time a person experiences does not give him the opportunity to dismiss it.It will require treatment.And here the most important thing: treatment should be literate, appointed medical professionals, or too high a price will have to pay.Especially when it comes to children.
kids, and small in the first place, very often suffer from ear diseases.The most common - otitis media, chronic otitis media, acute otitis externa.The causes of diseases and their symptoms, we now consider.
Otitis media - is inflammation triggered by bacteria trapped in the middle ear from the fluid in the Eustachian tube.small child's reaction to this disease is noticeable immediately: he pulls his ear, his feverish, restless wagging his head.But otitis media may take another form - otitis media with effusion.In the middle ear builds up fluid with no obvious signs of infection.Explicit child does not feel pain.A feeling of discomfort that the baby can not yet be described, is already taking place.If your child's vocabulary allows him to explain his feeling, he can say that he has "plug in their ears," and adults will notice that your baby's hearing became worse.
secretory otitis media - another variety of the disease, when there is fluid, the so-called effusion accumulated behind the eardrum.Moreover, it may be in one ear or both.Sometimes this fluid without infection.But it was she who creates a stuffiness in the ears, hearing and impairs attention.The feeling - like being under water.Manifest no pain and discomfort full.If the disease has become chronic, accumulated liquid becomes heavy and sticky.Hence another name - "sticky ear."Lack of acute pain should not blunt the vigilance of parents and physicians: if the disease is left untreated, hearing loss is possible.
There are children who are predisposed to this type of the disease: up to 3 years may have had a few times secretory otitis media.For most of them the disease can last up to 3 months.But 30-40% of children are subjected again and again to glue ear.In special cases, from 5 to 10%, a repetition may be within a year.
Chronic otitis media. When fluid accumulated behind the eardrum, is not an infection, but it continues to be there, then it is chronic otitis media.If parallel is inflammation of the middle ear or round the bone behind the ear (mastoids), there is a rupture of the tympanic membrane with drainage (outflow to the outside) of the accumulated fluid in the ear.This is the chronic suppurative otitis media.
Acute otitis externa, or "swimmer's ear» - inflammation or infection of the ear canal, and (or) the outer ear.Usually it is a consequence of the water entering the ear and the formation of a so-called trap.It can develop bacteria and fungi, which actively proliferate.Another reason - the aggressive, sharp movements ear cleaning with the application of scratches and small wounds.Help may acetaminophen or non-steroidal anti-inflammatory drugs such as ibuprofen.Applying ear drops, in most cases in 2-3 days is possible to remove the problem.
Returning to the reasons.Acute otitis media, or middle ear infection - the result of several factors that increase susceptibility to infections caused by viruses and bacteria.The child has a place of "collection" of infection becomes Eustachian tube.It is, as already mentioned, coming from the middle ear, and touching the throat and nose.The Eustachian tube is shorter in children than in adults, and therefore more vulnerable to blockage.In very young children, this handset is much horizontally, which prevents the fluid drain.
- Infections and bacteria. In humans, a lot of bacteria that "to stick" with it and do not bring much harm.This fully applies to the nose throat.But some of the bacteria penetrating the ear (the three bodies knowingly united by one term Lauren), provoke acute otitis media.According to statistics, about 60% of cases of children with acute otitis media caused by the bacteria just provocateurs.And the first of them - the pneumococcus, is the most common bacterial cause of acute otitis media.
- Haemophilus - not less common bacterial infection.It is transmitted by airborne droplets, saliva and in contact.Proceeds such a disease is often in severe forms of invasive meningitis, pneumonia, etc. But it could be a local organ damage -. The same otitis.The share of Hib accounts for between 20 to 30% of cases.
- Moraxella catarrhalis - representative of the normal flora of the upper respiratory tract.This organism is found in the nasopharynx in 10-20% of infants and toddlers.As a rule, the infection is transmitted by airborne droplets or by contact.
- Streptococcus pyogenes - spherical streptococci, which are considered opportunistic, however dangerous enough.Given the absolute health of their development in the body docked immunity.However, the slight decrease in immune status, they cause serious infections of the body, among which otitis.
- Streptococcuspyogenes and (rarely) Staphylococcus aureus - bacterium that can also cause otitis media.As regards Staphylococcus aureus, it is still in the top four leaders in a variety of infections - from skin to joint.
- Viruses - another category provocateurs ear infections.Rhinovirus caused by the cold, the main prerequisite for ear infections.To direct infection of his way to carry it is impossible, but not diminishing the role of rhinovirus from this: it causes swelling and inflammation of the membrane passes.If the Eustachian tube is blocked by a narrow, difficult fluid outflow.It accumulates and becomes a breeding ground for further infections.
According to statistics, it is viruses and bacteria are in first place in ear infections.Viruses do not only aggravate the inflammation of the middle ear, but also hinder the effective treatment with antibiotics.
- Anatomical anomalies also affect the condition of the middle ear.If a child Eustachian tube is shorter and the angle of inclination is small, it is a potential threat for the initial and recurrent infections.Increases risks and natural anomaly such as cleft palate.
- Genetics also plays a role.For example, when located in Kartagener syndrome ear hair-like cilia take standstill, thereby enhancing the accumulation of fluid.This is the risk of getting inflammation of the middle ear.Anatomical abnormalities in Down syndrome or fetal alcohol syndrome can become a cause of the disease of the middle ear.
There is a reasonable question: can infect other children, for example, in kindergarten or school child who has found an ear infection?First of all, he himself should not attend child care until recovery.In addition, direct contact with healthy children can be a threat to them just because of respiratory infections.Yes, by themselves are not terrible ear infections.But the connection of the ear, nose and throat, when one of these organs is infected, increases the likelihood of disease.
risk factors for otitis
If you add up the known medical causes of otitis media can be called such risk factors:
- Age. acute otitis media susceptible to one-third of children under 3 years, - at least one attack of this disease are forced to migrate.Another third have been ill with acute otitis media twice.While there is no clear explanation, but statistics show that boys are less lucky than girls: acute otitis media they happen more often.The most common acute otitis media in children 6-18 months.The sooner the disease occurred, the higher the risk of another episode.Doctors warn even a threefold disease within six months.But as the child grows, their immune system becomes stronger.Consequently, reduced risk of recurrent infections.By age 5, most children are immune to any ear infections.
- Influence cold. The most common ear infections "attack" on the child's fall and winter: it is the effect of cold temperatures.No wonder the caring mother and grandmother are very attentive to the headgear children, protecting them in order to, as they say, "not blown."By itself, this protection is a simple, but effective.
- Allergy. It there is no connection between inflammation in the airways caused by allergies, and ear diseases at first glance.Recall again: ear, nose and throat are in a bundle.Because of airway inflammation could be the backdrop for ear infections.Similarly as asthma is associated with sinusitis.
- Artificial feeding. Some studies (American Academy of Pediatrics) see effective protection against otitis in breast, at least up to 6 months, the baby's feeding.However, long ago proved that breastfeeding - the most powerful tonic for the baby.And, say, nipple - on the contrary: it can increase the risk of ear infections.The fact that promotes the development of sucking saliva.And it helps the bacteria to get through the Eustachian tube into the middle ear.
- Overweight. Promotes ear disease and obesity.
- Stories of otitis media in the family. If a family has other children with recurrent ear infections, it is necessary to pay special attention to the youngest child - he may also be subject to ear diseases.
Symptoms of acute otitis media
main symptoms and signs of ear infections are:
- Acute pain in the ear;
- ear congestion;
- Hearing loss, which change the position of the head is usually improved;
- Headache and dizziness;
- temperature rise;
- Nausea, vomiting and diarrhea in children;
- Loss of appetite;
- Discharge from the ear.
now look at them in more detail.
first sign will be a constant severe pain in the ear.Occurrence (often temporary) hearing loss.Toddlers nausea, vomiting, diarrhea, increase in body temperature to 38-39 degrees.
What does it happen?The eardrum is inflamed, changes shape and may even bulge.Sometimes it happens gap: ear fluid is released from the blood.Then, the blood becomes less liquid and more transparent color.And finally, this fluid is released even visually resembles pus.
And then very dangerous complications: inflammation of the surrounding bone, the semicircular canals, paralysis of facial muscles, hearing loss, inflammation of the membranes of the brain and brain abscess.Symptoms of these complications include headache, sudden severe hearing loss, dizziness, chills and fever.
If a child is irritable, cries a lot, he has insomnia, appetite, lethargy long passes, he wags his head, as if unable to find a place - it is also an alarm.Well, if the liquid flows out of the ear, and even mixed with blood, then linger in any case it is impossible!This means one thing: a serious ear infection with a possible rupture of the tympanic membrane.At the time the child feels relief from pain.But treatment is necessary.It is unlikely that they all resulted ear pus.And the fact that he's still the risk of hearing loss.Check out this simple: if the child already knows how to speak, respond to your words, and suddenly does not respond to a voice on the radio or TV sounds, it is necessary to sound the alarm.
should also like to say that mechanical damage to the ear can cause an attempt to clean it from accumulated sulfur: properly clean the ears of a small child may be using a cotton turundochki or wicks carefully, holding hand baby's head.Just be careful to extract trapped in the ears of foreign objects.But the best thing is to trust your doctor.
diagnosis of otitis
- Physical examination of the ear. Ear - complex organ.With his medical examination using special tools.And at first the doctor removes ear wax, and then proceeds to the examination of the middle ear.To do this, the doctor uses an instrument similar to a flashlight - otoscope.It can help you get enough of a detailed picture of the state of the middle ear., The eardrum and, if available, blisters on her.With the otoscope can see all the local places of pain in the middle ear.
to determine ear infections ENT doctor uses a pneumatic otoscope.He is so constituted that makes it possible to detect any reduction in the eardrum.The pneumatic otoscope is a type of blower, through which the doctor compresses the air in the ear.In this light turns on, and the doctor is able to see how the air is moving in the eardrum.
- Tympanometry.Sometimes tympanometry method used to diagnose: use a special probe is very small in size, which is introduced to the top of the ear canal in such a way that forms a hermetic seal.When air pressure changes, the sound is recorded, and its energy is measured.Such sensing helps detect the presence of fluid in the middle ear and to detect an obstacle in the Eustachian tube.
- Reflectometry. used to diagnose and reflectometry.She reminds tympanometry, but measures the reflected sound.Thus there is no need to tightly seal the entrance to the channel, but the presence of liquids and other obstructions OTDR can detect.
- analysis of middle ear fluid. Sometimes the doctor resorts to this method of fluid removal from the ear, like a needle.With the help of typed ear fluid, which is then analyzed to identify the specific bacteria that triggered otitis.This procedure is called timpanotsentez.Usually immediately after it comes into the ear pain relief.But such manipulation requires special training and a doctor prescribed only in severe or recurring cases.
Returning to the most negative consequences - loss of hearing, it is necessary to know a few simple ways to determine the hearing.Because even hearing loss below 20 dB - this alarm: the child has a problem, and perhaps it will progress.That's why parents should be alert to how their child responds to sounds.Why?