Chronic suppurative otitis media fairly common disorder that represents a greater danger to your hearing. Typically, a continuation of acute suppurative otitis media, which can not be cured more than a month in consequence of various causes.
On the clinical course and severity of chronic suppurative otitis media medium is divided into two forms: mezotimpanit attic disease.
Mezotimpanit occurs in 55% of cases. In this form of otitis media in the process involves mainly mucosa of middle and lower parts of the tympanum and the auditory tube. When mezotimpanite determined Intact loose part of the eardrum and the presence of perforation, perforation is different from its location, shape and size.
Subjective symptoms expressed little. Patients complain of intermittent or continuous suppuration from the ear and hearing loss, in rare cases - the sensation of noise in the ear and dizziness. Ear pain occurs only during exacerbation of the process, sometimes it appears in the secondary diseases of ear - the outer diffuse or limited external otitis.
Isolation of the ear is purulent mucous character. Hearing at mezotimpanite reduced lesion type sound conducting apparatus. Therefore, the intensity of hearing loss in one and the same patient depends on the activity of inflammation in the ear, auditory ossicles safety functions and functional state of the labyrinthine windows. The value of perforated eardrum hole does not significantly influence the degree of hearing loss.
During mesotympanitis usually quiet, isolation from the ear continued sometimes for years, causing no serious complications. Suppuration often stop on their own, resuming an exacerbation.
Causes deterioration of the process can be cold, water in ear, nose disease, nasopharyngeal. In these cases, increased suppuration, increased body temperature, a feeling of pulsation in the ear, sometimes not sharp pain in the ear.
Under favorable conditions, and appropriate treatment after complete cessation of suppuration small perforated holes can heal. Despite the favorable course, with chronic mezotimpanite may develop severe intracranial complications.
In chronic suppurative inflammation of attic disease is localized predominantly in nadbarabannom space - attic, perforated hole is usually a slack of the eardrum.
Attic disease is characterized by more severe than mesotympanitis flow. Suppurative process takes place in a region rife with narrow and winding pockets formed by folds of mucous membrane and auditory ossicles.
Usually accompanied by epitimpanitam polyps. Carious process, extending into the interior, can capture large portions of the temporal bone, including the capsule of the labyrinth. When a destructive process in bone formation, substances such as indole, skatole, so the pus becomes fetid smell, which is one of the hallmarks of epitimpanita. In addition to this may be a periodic pain in the temporo-parietal region, as well as sensations of pressure in the ear. When caries capsule horizontal semicircular canal, patients may complain of dizziness.
Particularly heavy damage in the temporal bone occur in cholesteatoma ear, which is formed at the boundary of perforation, when the skin between the ear canal and nadbarabannym space no barriers in the form of the remainder of the eardrum. Under these conditions, there are growing into the epidermis of the skin external auditory canal into the middle ear to the granulating surface of his bony walls. Thus, the epidermis is a wrapper cholesteatoma. The epidermal layer is constantly growing and exfoliate, and under the influence of stimulation of pus and decomposition products of this process is enhanced. Holesteatomnye mass increases grow, and therefore the cholesteatoma starts to put pressure on surrounding tissues, destroying them.
Auditory function in epitimpanitah reduced in severe degree. When the phenomenon of headache, facial nerve palsy or vestibular disorders in patients with epitimpanitom it should be immediately hospitalized for examination and surgery on the ear.