Acute and chronic tubootitis (eustachitis). Treatment of tubootitis (eustacheitis) What is tubootitis and how to treat it

Age: 25

Hello, Vladimir Mikhailovich!
Since September, my hearing began to deteriorate. Perhaps this is a consequence of a cold, the doctor concluded at the first visit.
The prescribed treatment (vasoconstrictors + a drug prepared by pharmacists) had a positive effect.
I quit treatment, believing that everything had improved, and alas, my hearing deteriorated again. Due to circumstances, I was able to see a doctor again only in January, and from that moment a useless journey from one ENT doctor to another began: the first sent me for an X-ray with a diagnosis of Bilateral eustacheitis. After looking at it, he said “nothing wrong”, blow it off, drip Xymelin into your nose for seven days 3 times a day, methyluracil ointment 2 times a day. The course is over, my hearing is getting worse.
I turned to a second ENT specialist - rinofluimucil for seven days, erespal, otipax, azimitromycin - the course was completed, there was no hearing.
The third ENT doctor generally said, “Everything is fine with you, everything will go away on its own.” How will it go if I’ve been semi-deaf for almost six months?
The fourth doctor was completely afraid, looking at the picture - you may have developed fluid, do a tomography, prescribed sinusitis, Miramistin. I completed the course - the result was absolutely zero, and this despite the fact that all doctor’s appointments are paid.
Tomography, judging by the prices, is not a cheap procedure, and again the problem is - where to do it, I need to decide for myself and look for a clinic.
Your website describes in detail the procedures that are carried out in your clinic for my complaints (I cannot distinguish quiet speech), and what is important, everything is in one place.
I understand that it is difficult to draw a conclusion based on my lines, but I hope that you can guess what is wrong with me, and what will be the first steps towards diagnosis and treatment?
I hope for your answer and help.
With uv. Ruslan, Moscow.

Doctor Zaitsev

Hello Ruslan.
Unfortunately, time has been greatly missed.
To accurately understand your situation, you need to do several studies:
1. Audiometric hearing test (audiogram)
2. Tympanometric (impedansomemetric) hearing test (tympanogram)
3. Computed tomography of the temporal bones.

Only after the diagnosis can one judge the current condition and give prognoses for recovery.
In our clinic you can undergo treatment for eustacheitis.
Here full list all manipulations:

1. Otomicroscopic examination using an otoscope HEINE Beta 200 R (Germany) – 350 rub.

2. Accumetric hearing testing using whispered and spoken speech, as well as a set of tuning forks (must be carried out before and after treatment) – 200 rubles. (per study)

3. Audiometric examination using an Interacoustics AD 226 diagnostic audiometer (before the start and at the end of treatment) – 700 rub. (per study)

4. High adrenalization (anemization) of the nose – 200 rubles.

5. Irrigation of the nasal cavity with solutions on an ENT combine – 200 rubles.

6 Catheterization of the auditory tube – 600 rub.

7. Blowing out the auditory tubes using an Atmos 61 ENT combine or a Politzer balloon – 200 rubles.

8. Pneumomassage of the eardrums – 150 rub.

9. Placement of medicinal turunda in the ear (microcompress according to Tsitovich) – 300 rubles.

10. A session of magnetic-infrared laser therapy with the Rikta device for a sore ear – 200 rubles.

11. Session of ultraviolet irradiation of the ear with the irradiator “OUFd-01” – 150 rubles.

12. Magnetic therapy session with the low-frequency magnetic therapy device “POLYUS – 2D” – 150 rub.

13. Rinsing the ear with a sterile solution on an ENT combine “Atmos 61” – 650 rub.

14. Medicinal (ointment) treatment of the external auditory canal – 200 rubles.

Call me as soon as you are ready and I will schedule a consultation with you.

I hope I can help you.

Hearing is one of those functions that allows a person to receive information about the world around him. Just like vision, hearing is the most important mechanism for exploring and understanding the world around us. The human ear is a complex organ, its physiology and structure are aimed at the perception of sound waves in the range of 16 Hz-22 kHz.

The mechanism of sound perception by the human ear can be divided into two parts:

• mechanics – auditory canal, auricle, auditory ossicles, eardrums;
• electrical – auditory center of the cerebral cortex, auditory nerve.

Through the auditory canal, sound enters the eardrum, after which it is amplified many times over with the help of the auditory ossicles, and in the cochlea internal sound From vibrations of air, sound turns into vibrations of liquid and, with the help of special nerve cells, is converted into an electrical signal. For hearing to function fully, the coordinated work of all components of the human ear is necessary.

What is tubootitis?

Tubootitis is a catarrhal inflammation of the mucous membrane of the inner ear, which develops as a result of dysfunction of the auditory tube.

The auditory ossicles are located in the air cavity (middle ear) in the very thickness of the temporal bone, and for their full functioning, the pressure in the middle ear must be the same as in the environment. For this to happen, the air cavity must communicate with the environment, which occurs with the help of a special formation - tuba auditiva (auditory tube). The auditory tube opens into the nasopharynx and in adults its length is 3.5 cm, and in newborns - 2 cm. When a dysfunction of the auditory tube occurs, a disease occurs that is called tubootitis (eustachitis).

Many other names are also used to define this disease: tubotympanitis, salpingootitis, catarrhal otitis media(acute or chronic).

Causes of tubootitis

The main cause of tubo-otitis is an infectious process at the mouth of the tube. The infection enters the tube from the nasal cavity. Thus, acute rhinitis can lead to swelling of the nasal mucosa, including at the mouths of the auditory tubes, resulting in obstruction of the auditory tube. The obstruction of the tube, in turn, makes it impossible to equalize the pressure in the tympanic cavity, which leads to impaired mobility of the auditory ossicles and such a symptom as ear congestion.

Often, with a runny nose or strong nose blowing, mucus enters the mouth of the auditory tube, which causes the development of tubo-otitis. Therefore, in case of acute sinusitis and rhinitis, it is important to blow your nose correctly. When blowing your nose, you need to open your mouth and pinch one half of your nose.

It happens that the cause of tubo-otitis is a persistent dysfunction of the auditory tube due to vasomotor rhinitis. In this case, tubootitis can be called a complication of vasomotor rhinitis. This type of tubo-otitis is difficult to treat, and is characterized by the formation of persistent edema in the area of ​​the posterior end of the lower auditory concha, spreading to the mouth of the auditory tube. Treatment of tubo-otitis in this case must be combined with treatment of vasomotor rhinitis.

In children, tubo-otitis is often bilateral. In adulthood, tubo-otitis is more often observed on the painful side.

Symptoms of tubootitis

The main symptoms of tubo-otitis are decreased hearing, a feeling of congestion, and periodic noise in the ear. Sometimes autophony is observed when a person hears an echo of his own voice in the affected ear. The same complaints are typical for acute respiratory infections. Ear congestion can occur during changes in atmospheric pressure (for example, when flying on an airplane). For tubo-otitis painful sensations in the ear can be intense or insignificant, and general state the patient suffers little.

During otoscopy, the patient experiences a symptom of tubo-otitis such as retraction eardrum. Hearing activity decreases moderately (by 20-30 dB). Symptoms of tubo-otitis also include patient complaints of improved hearing after yawning or swallowing saliva. This occurs as a result of a temporary opening of the lumen of the auditory tube.

In children, tubo-otitis is accompanied by an increase in temperature to 38 degrees or more. Chills, a feeling of ear congestion, noise in the ear, and hearing loss appear. Pain can appear either immediately or after some time. When examining the auricle with tubo-otitis in children, redness and swelling of the auricle are noticeable. Often bubbles appear on the surface of the external auditory canal.

Complications of tubootitis

Tubootitis often progresses sluggishly and is accompanied by mild symptoms, as a result of which patients are not inclined to immediately rush to the doctor. Naturally, untimely detection and treatment of tubo-otitis can lead to various complications, namely: persistent dysfunction of the auditory tube, when negative pressure forms in the ear cavity and exudate begins to accumulate. In turn, this becomes the cause of adhesions between the auditory ossicles, and permanent hearing loss occurs.

If negative pressure is present in the middle ear cavity for a long time, irritation of the cochlea occurs, resulting in degenerative changes in the auditory nerve and sensorineural hearing loss. In addition, suppuration of the exudate can occur at any time, which results in acute purulent otitis media, which, in turn, is also fraught with serious complications.

Treatment of tubootitis

First of all, treatment of tubo-otitis should be aimed at eliminating those factors that contribute to obstruction of the auditory tube. In order to reduce swelling of the mucous membrane in the ear, the patient is prescribed vasoconstrictor nasal drops: Sanorin, Naphthyzin, Nazivin, Tizin, etc. Antihistamines also relieve swelling medications(gismanal, suprastin, claritin, etc.).

In order to prevent infectious mucus from entering through the auditory tube from the nasopharynx into the tympanic cavity, the patient is taught to blow his nose correctly, and may also be prescribed Politzer blowing of the auditory tubes. A good therapeutic effect is produced by catheterization of the auditory tube, which is done after anemization of the pharyngeal mouth. A couple of drops of a 0.1% adrenaline solution or a hydrocortisone suspension are injected into the auditory tube through a catheter.

In the treatment of tubootitis, a number of physiotherapeutic measures are also prescribed: laser therapy on the area of ​​the mouth of the auditory tube, UHF on the nose, ultraviolet radiation, pneumomassage of the eardrum.

With adequate and timely treatment acute tubootitis is cured in a few days. The effectiveness of treatment of chronic tubo-otitis depends on the timely elimination of pathologies of the nasopharynx, paranasal sinuses and nasal cavity, which cause the constant occurrence of the disease.

Video from YouTube on the topic of the article:

Tubootitis is one of the common diseases that affects the auditory canal of the human body. The disease is quite insidious and dangerous for all of us. Let's look at the main ways to combat this disease, which you can use yourself in.

Before getting acquainted with the main reasons for the appearance of tubootitis in the body, let’s get acquainted with the description of this pathology. In medical practice, tubo-otitis is often combined into one disease with salpingo-otitis. When it affects the body, significant changes occur that are negative in the area of ​​the Eustachian tube, as well as the tympanic cavity. Often tubo-otitis begins with eustachitis, which also affects the above organs.

In our body, the auditory tube has the function of connecting to the middle ear cavity located near it. The latter ends with a special tympanic opening, which is located in front of the middle ear cavity. At its end is the nasopharyngeal orifice.

The eustachian tube is characterized by the presence of two parts: cartilaginous and bone.

The inner surface of this pipe is lined with a mucous membrane, which is in close connection with the mucous membrane lying in, as well as the tympanic cavity. With this location and structure of the auditory tube, tubo-otitis occurs.

The disease occurs as follows: penetrated into our body through the upper respiratory tract the infectious agent, passing through the nasopharyngeal passage, enters the cavity of the auditory tube. From here, the infection easily penetrates into the tympanic cavity area. Almost all infectious particles that enter the body take this route.

The most obvious reasons leading to the development of tubootitis in the body are:

• Emergence
• Laryngitis
• Development
• Consequences allergic rhinitis
• Rhinitis
• Painful lesions of the upper respiratory tract

Useful video about tubootitis.

All these diseases occur with the appearance inflammatory process in the throat area, as well as the nasal mucosa. From there, the infection easily spreads to the surface of the mucous membrane lining the auditory tube. In this case, swelling often occurs, accompanied by a narrowing of the existing lumen.

The main causative agents of these diseases are different kinds bacterial cocci: streptococci, pneumococci or staphylococci.

In addition, tubo-otitis can occur as a result of mechanical blocking due to the appearance of adenoids, the growth of polyps, the development of tumor processes, or a deviated nasal septum. The cause of the development of tubo-otitis in the body is also tamponade of the nasal passages with increased salivation. In addition, tubo-otitis also appears after barotrauma, which is a traumatic effect due to a rapid drop in pressure from environment. This happens when flying on an airplane.

How does tubo-otitis manifest?

When the body is affected by tubo-otitis, the patient complains of congestion in the ear canal. Often this happens on one side of the ear, but there are many cases where the disease occurs as a bilateral process.

In addition to this, you feel:

• Tinnitus
• Feeling of heaviness in the head
• Hearing loss
• Feeling of fluid in the ear
• Autophony
• Frequent yawning

Sometimes, for a short time, the patient may feel the disappearance of previously existing congestion in the ears. The chronic form of tubootitis is characterized by the same symptoms, especially during its exacerbation.

Stages of the disease

If the patient fully complies with all recommendations for the treatment of tubo-otitis identified in the early stages of its occurrence, then recovery can come in a few days.

If patency in the auditory tube is not restored, intensive proliferation of pathogenic microorganisms may begin due to prolonged stagnation of fluid in the middle ear cavity.

In this case, the onset of the disease quickly passes into the purulent stage from the previous stage - catarrhal.

With the appearance of suppuration from the transudate, the course of the disease can become significantly more complicated. Tubootitis is very insidious, so you should not wait for recovery without taking any action. It is advisable to contact a medical institution for advice and help from an experienced doctor. In this case, timely and correct treatment will be prescribed, suitable for the existing signs of the disease.

Treatment of tubootitis

In order to get rid of this disease as quickly as possible, it is necessary to fight the disease in all possible directions. Firstly, it is worth eliminating the source of the disease, which is always located in the upper respiratory tract. In addition, it is necessary to relieve existing inflammation. Then it is necessary to suppress the inflammatory wave that has begun, affecting the area of ​​the tympanic cavity. As well as the Eustachian tube located nearby. It is also necessary to eliminate swelling in the mucous membrane and restore the patency of the tube.

It is important to ensure that the Eustachian tube begins to function as usual again, while normalizing the blood circulation process. When treating tubootitis, it is advisable to equalize the existing difference between internal and external pressures. With this pathology, it is imperative to take care of increasing activity immune system body.

Experienced doctors in the treatment of tubo-otitis often prescribe:

• Reception medicines, contributing to the elimination of the root cause and only after this infection control. It is often recommended to take antibacterial drugs, sometimes combined with sulfonamide drugs.
• To reduce the resulting swelling, the patient is prescribed nasal vasoconstrictors, which should be instilled into the nasal passages.
• Glucocorticoid and vasoconstrictor drugs are often prescribed, which are injected into the cavity of the auditory tube during catheterization.
• To treat tubootitis, antihistamines administered orally are also used to strengthen the immune system weakened by the disease. These medications include different types of vitamins and immunostimulants.
• When tubo-otitis occurs, developing according to an allergic scenario, I prescribe treatment for the allergy directly progressing in the body. For these purposes, desensitizing therapies are well suited to determine the type of allergen, as well as the mandatory use of antidotes.

When treating a pathology such as tubo-otitis, hospitalization is not necessary. Therefore, you can cope with the disease at home. To do this, you must strictly follow all doctor’s instructions and recommendations and carry out the prescribed procedures. The simplest manipulation against tubo-otitis is periodic pressure on the area of ​​the tragus, which is a cartilaginous process located on the auricle. At the same time, the patient feels a pleasant massage.

Treatment of illness at home

Since ancient times, healers and healers have treated tubootitis with their in effective ways. For these purposes they used various herbal teas. Today, also in the treatment of tubo-otitis, herbal mixtures that were used many decades ago are used.

It is advisable to take prepared herbal infusions more than once during the day. When preparing such infusions, the prepared herbs are poured with boiling water, followed by infusion for several hours.

The following types of herbs are suitable for such infusions:

• Eucalyptus leaves
• Yarrow
• Lavender
• Celandine
• Chamomile

Besides them in folk medicine Plants with antiseptic properties and bactericidal effects are widely used.

For example, one of these effective recipes recommends taking freshly prepared aloe juice and combining it with warm boiled water in a one to one ratio. The resulting solution should be instilled into the nasal passages, a few drops up to four times during the day. This medicine can also be used as a liquid for wetting a tampon and placing it in the auricle.

Onion juice, which is also instilled into the nasal passages, is effective for tubo-otitis.

At the same time, you can put a small amount of the freshest onion into the cavity for about thirty minutes, preheating it. In some cases, this technique causes an unbearable burning sensation in the ear cavity and therefore it is worth diluting the freshly prepared onion juice a little. You should be treated in this way for a whole month.

Warm garlic oil helps well in getting rid of chronic tubootitis:

• You can prepare it by grinding peeled cloves of garlic in a blender, after adding a little sunflower oil to it.
• The resulting mass must be infused for ten days, shaking occasionally.
• Before use, add a little glycerin to the resulting garlic oil.

When treating tubootitis, it is necessary to take care of your own immunity. To do this, you need to take special medications and eat more vegetables and fruits. It is also necessary to harden the body with the help of sunlight and air baths.

• Ear congestion.
• Hearing loss.
• Autophony (increased perception of one's own voice, hearing one's own voice in the ear).
• Noise and crackling in the ear.
• Feeling of fluid in the ear.
• Nasal congestion.

Forms

• Acute tubo-otitis:
  • ​ ear congestion;
  • hearing loss;
  • autophony (increased perception of one’s own voice, hearing one’s own voice in the ear);
  • noise and crackling in the ear;
  • feeling of fluid transfusion in the ear;
  • nasal congestion.

After treatment and restoration of the function of the auditory tube, signs acute tubo-otitis gradually pass.

If the process becomes protracted (for example, due to the absence or ineffectiveness of therapy), then acute tubo-otitis becomes chronic, which is accompanied by persistent dysfunction of the auditory tube.

• Chronic tubo-otitis:
  • atrophic and sclerotic changes in the eardrum and mucous membrane of the tympanic cavity (that is, a change in the normal structure of tissues with the loss of their original functions);
  • the eardrum becomes cloudy, areas of necrosis (tissue death) appear with deposits in the form of calcium salts encrusted in them;
  • stenosis (narrowing of the lumen) of the Eustachian (auditory) tube. Against the background of these changes, hearing loss (weakened hearing) becomes persistent and long-lasting.
• Allergic eustachitis: develops against the background of allergic reactions (for example, seasonal allergies), accompanied by a runny nose and nasal congestion.

Causes

• “Throwing” of infection from the nasal cavity into the auditory tube. Against the background of infection, inflammation develops in the area of ​​the mouth of the auditory tubes, which is accompanied by prolonged swelling, which ultimately leads to the development of tubo-otitis. Some pathological conditions against which tubo-otitis may develop:
  • severe runny nose, acute sinusitis (inflammation maxillary sinuses): as a result of strong nose blowing, mucus enters the auditory tube, which subsequently develops inflammation of the Eustachian tube;
  • acute viral disease(eg influenza);
  • scarlet fever, measles, whooping cough, diphtheria and other childhood infections accompanied by damage to the upper respiratory tract;
  • chronic tonsillitis (inflammation of the tonsils);
  • adenoids (pathologically enlarged pharyngeal tonsil, which can partially or completely block the mouth of the auditory tube) and adenoiditis (inflammation of the adenoids);
  • inflammatory diseases of teeth and gums (in particular, wisdom teeth), etc.
• (impaired nasal breathing due to narrowing of the lumen of the nasal passages, as a result of persistent swelling of the tissues of the nasal concha). The cause of vasomotor rhinitis is a change in the vascular tone of the nasal cavity. As a result, swelling and thickening of the mucous membranes of the nasal cavity and nasopharynx develops. These changes disrupt the patency of the Eustachian tube and impair its ventilation. Stenosis (narrowing of the lumen) of the Eustachian tube gradually develops, sclerotic and atrophic changes appear in the mucous membrane of the eardrum and the tympanic cavity (i.e., a change in the normal structure of tissues with the loss of its original functions). Tubootitis as a complication of vasomotor rhinitis is difficult to treat. Such tubootitis is treated in combination with the underlying disease, i.e. vasomotor rhinitis.

Diagnostics

• Analysis of medical history and complaints:
  • the presence of infection, ARVI, measles, scarlet fever (infectious diseases, mainly childhood), allergies; tinnitus, autophony (increased perception of one’s own voice, sound of one’s own voice in the ear);
  • determination of the cause of the development of tubootitis (identification of diseases of the nasal cavity that provoke its development, for example, vasomotor, allergic rhinitis, chronic inflammation of the paranasal sinuses (etc.).

• Otoscopy (examination of the external auditory canal and eardrum) to identify a defect in the location of the eardrum (in tubo-otitis it is retracted, redness is observed along the handle of the malleus).

• During nasal endoscopy in the area of ​​the mouth of the auditory tubes, tubo-otitis is characterized by swelling.

• Tympanometry (an instrumental method for studying the mobility of the eardrum, the chain of auditory ossicles and pressure in the middle ear cavity).

• Consultation is also possible.

Treatment of tubootitis

• Drug therapy: administration of drugs through the auditory tube from the nose (catheterization of the auditory tube).
• Prescribing vasoconstrictor nasal drops in a short course (to relieve swelling of the mucous membrane of the auditory tube).
• Intranasal steroid sprays (drugs aimed at reducing inflammation).
• Physiotherapeutic procedures (exposure to high-frequency magnetic or electromagnetic fields for therapeutic purposes).
• Ear blowing and pneumomassage (air massage used in otorhinolaryngology to restore the mobility of the eardrum and the chain of auditory ossicles, and remove fluid from the tympanic cavity).
• Prescription of antiallergic drugs (if the cause of the development of tubootitis is an allergy).
• It is possible to prescribe immunomodulatory drugs (drugs that increase the body's protective functions).
• Antibiotics for severe disease (strictly as prescribed by the doctor).

Complications and consequences

Tubo-otitis in most cases has a sluggish course, which is the main factor in late consultation with a doctor. Advanced tubo-otitis can cause:

• development of chronic tubo-otitis;
• persistent hearing loss;
• the transition of inflammation to the mucous membrane of the tympanic cavity and the development of a purulent process in the middle ear cavity and, as a consequence, acute purulent otitis media;
• Low pressure in the middle ear over a long period of time can lead to persistent retraction of the eardrum and the formation of adhesive otitis media. Adhesive otitis media is a pathological formation of scars and adhesions (growth connective tissue, for example, against the background of an advanced inflammatory process) in the cavity of the middle ear, which leads to impaired mobility of its structures and, as a consequence, persistent impairment of hearing function.

Prevention of tubootitis

• Technique for blowing your nose (you need to blow your nose by pinching one half of your nose and opening your mouth).
• Prevention colds and increasing the body's defenses (avoid hypothermia, mandatory wearing of a hat in the cold season, hardening, taking multivitamins in the autumn-winter period, etc.).
• Timely treatment of diseases of the nose, nasopharynx and oropharynx.
• Timely contact a specialist at the first signs of otitis media.

Additionally

• The human ear is complex organ, which conventionally consists of the outer ear, middle and inner ear.
• Outer ear presented auricle and external auditory canal. The auditory canal is limited by the eardrum, which separates the outer ear and middle ear cavity, which is located in the structures of the temporal bone. The main part of the middle ear is the tympanic cavity, which is connected to the nasopharynx through the eustachian (auditory) tube, the main function of which is to equalize the pressure outside and inside the eardrum. The walls of the auditory tube in an adult are mostly in a half-dormant state (the auditory tube is closed), which prevents mucus from the nasopharynx from entering the middle ear. Under normal conditions, oxygen in the tympanic cavity is gradually absorbed into the blood, the pressure in the middle ear drops, then a reflex swallowing movement occurs, during which the auditory tube opens, air enters the tympanic cavity, and the pressure equalizes.
• Each of us is familiar with the feeling when, when the external pressure changes, our ears become blocked (for example, on an airplane), which reflexively causes us to yawn, thereby compensating for the difference in pressure through the Eustachian tube. The effect of independently blowing the ears in such a situation is also associated with the flow of air into the middle ear through the auditory tube and equalization of pressure.

With the help of the Eustachian, or auditory tube, the nasopharynx and the internal cavity behind the eardrum communicate with each other. This way the external and internal pressure is equalized for functioning. internal organs hearing For optimal operation of the sound conducting system, the pressure in this area must correspond to atmospheric parameters. That's why tubo-otitis must be treated promptly.

The diameter of the auditory tube is only about 2 mm, so even slight swelling of its mucosa negatively affects conductivity. Inflammation of tubo-otitis leads to the fact that the canal becomes impermeable to air coming from the pharynx, and ventilation of this area becomes impossible. Under the influence of these processes, low pressure occurs in the tympanic cavity and the membrane is retracted. Gradually, exudate containing cells characteristic of inflammatory reactions leaks into the internal cavity.

A prolonged absence of air exchange in the inner ear against the background of reduced immunity can provoke the transition of inflammation into a purulent course, and also contributes to the development of the adhesive process characteristic of adhesive otitis.

Most often, with tubo-otitis, inflammation of the auditory tube spreads from the nasopharynx as a result of chronic or acute infectious processes. Children younger age are especially susceptible to this disease, since their auditory tube is shorter and more straight than that of adults, which contributes to the development of tubo-otitis.

CAUSES

Etiological factors for the development of tubootitis:

• staphylococci;
• streptococci;
• viral agents;
• in children - pneumococci.

Less commonly, fungal microorganisms and specific infections such as chlamydia become the causative agent of the disease. A runny nose and strong nose blowing can contribute to the development of the disease.

The development of acute tubo-otitis can be influenced by allergic reactions And nasal tamponade during bleeding. Chronic inflammation on the surface of the auditory tube develops in response to protracted inflammatory processes in the nasopharynx (adenoids, sinusitis, etc.) that were not cured in time. The natural ventilation of the airways can be disrupted by deformation of the nasal septum, various neoplasms in the pharynx and nasal cavity, as well as hypertrophy of the inferior turbinates.

Such a specific form of eustachitis as aerootitis is rare. This condition can be caused by sudden changes in pressure that occur during air travel during takeoff and landing. Mareotite is provoked by changes in water pressure during sudden diving and surfacing by divers.

CLASSIFICATION

Based on the nature of the inflammatory process, two types of tubo-otitis are distinguished: chronic and acute.

SYMPTOMS

The severity of symptoms of tubo-otitis depends on the intensity of the inflammatory reaction on the surface of the Eustachian tube. Acute inflammation has a more vivid clinical picture than chronic inflammation, but is characterized by the absence of pain.

Symptoms of acute tubo-otitis:

• a feeling of stuffiness in the ears on one or both sides;
• noise in ears;
• overflow of liquid when turning or tilting the head;
• sense of resonance (autophony);
• hearing loss due to loss of low-frequency sounds.

The patient's condition during acute tubo-otitis is stable. Typically body temperature is normal indicators, there is no increased pain syndrome. In some people, when yawning or swallowing, hearing is briefly restored due to the expansion of the auditory tube during muscle contraction.

The cause of tubo-otitis is often infectious diseases, which are accompanied by decreased immunity in the upper respiratory tract. If left untreated, such eutstachyitis can become chronic.

Symptoms of chronic tubo-otitis:

• hearing impairment;
• partial redness of the mucous membrane;
• steady decrease in the lumen of the Eustachian canal;
• change in the position of the eardrum.

Pathological changes in the tympanic membrane are accompanied by protrusion of the process auditory ossicle. Sclerotization of the membrane looks like clouding. All the symptoms described are permanent. The chronic form of tubo-otitis is determined by alternating exacerbations with periods of remission.

Symptoms of tubo-otitis in children have the same manifestations as in adult patients, but due to anatomical features the auditory canal, children are especially susceptible to this disease.

DIAGNOSTICS

Typically, the diagnosis of tubo-otitis is not difficult and is made on the basis of a medical history and examination of the ear and nose cavities. A detailed examination of the ear canal reveals a hollow tympanic membrane and hyperemia along the process of the malleus. During an endoscopic examination of the mouth of the auditory tube, tissue swelling is observed.

To test sound sensitivity perform audiometry, and to study the patency of the auditory tube - Valsalva maneuver. To determine the type of pathogen, swab samples are taken. If an allergic nature of the disease is suspected, allergy tests are prescribed.

TREATMENT

For the treatment of uncomplicated forms of tubootitis outpatient treatment is sufficient. Treatment of tubootitis is aimed at suppressing the inflammatory response and eliminating factors that provoke the disease.

Basic principles of treatment:

• Relieve puffiness Tubootitis is treated with a short course of vasoconstrictor nasal drops and decongestant systemic antihistamines with a desensitizing effect.
• Reproduction and spread of bacterial infection, prone to the development of purulent processes, suppressed with antibiotics from the group of macrolides and penicillins. With pronounced pain syndrome Analgesics are prescribed for treatment. To improve the patency of the Eustachian canal, its blowing (catheterization) may be recommended.
• If inflammation of the mucous membrane of the auditory tube is a secondary symptom infectious diseases, then first of all they pay attention to the suppression of their foci. If symptoms of eustachitis of allergic origin are detected, it is prescribed taking antihistamines.
• To prevent the spread of infection during tubo-otitis from the nasopharynx into the cavity of the tympanic membrane through the Eustachian tube, the patient prohibited from blowing your nose too much. It is necessary to clean each nostril one by one, without straining too much.

The complex of therapy includes physiotherapeutic procedures that help speed up recovery.

Physiotherapy methods in the treatment of eustachitis:

• local ultraviolet irradiation;
• warming dry heat;
• eardrum massage;
• local exposure to high-frequency currents (UHF);
• laser therapy on the area of ​​the mouth of the tube.

At proper treatment acute eustachitis noticeable relief is observed after 3-6 days. For treatment chronic forms tubootitis requires more time, in addition to anti-inflammatory therapy and physiotherapeutic techniques can be prescribed immunomodulators. If tumors are identified that obstruct the patency of the auditory tube, they are removed surgically.

COMPLICATIONS

Tubootitis acute form characterized by a sluggish course, often its symptoms are not accompanied severe pain, and therefore remain unattended by the otolaryngologist. These factors contribute to the transition of tubo-otitis into a chronic course, while its clinical picture lubricated.

If a person does not apply for medical care, then there is a high probability of developing dysfunction of the eardrum, stenosis and scarring of the tissues of the auditory canal. All these manifestations can negatively affect hearing, up to and including irreversible deafness.

Lasting impact low pressure in the middle ear cavity can lead to irritation of the cochlea and can provoke the development of sensorineural hearing loss.

A serious consequence of tubootitis can be purulent otitis media, which threatens infectious lesion brain and

PREVENTION

If symptoms of inflammation appear inside the ear canal, the patient is not recommended to do any activities associated with sudden changes in pressure, for example, air travel and deep diving.

General measures to prevent the development of tubo-otitis:

• hardening, strengthening the immune system;
• treatment of infectious diseases of the nasopharynx;
• See a doctor when the first symptoms of tubo-otitis (ear congestion) appear;
• prevention of head, nose, ear injuries;
• rejection of bad habits;
• mastering the technique of blowing your nose correctly: without making any effort, alternately pinch each nostril and open your mouth.

PROGNOSIS FOR RECOVERY

The patient can count on full recovery when contacting an otolaryngologist in the first stages of inflammation. Late treatment of tubootitis leads to the fact that it becomes difficult to completely get rid of the feeling of discomfort and autophony.

The prognosis significantly worsens with suppuration of the transudate and perforation of the tympanic membrane, while the possibility of partial hearing loss. Such severe complications of tubo-otitis, like those arising as a result of a purulent process, are life-threatening and require immediate treatment.

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