Otolaryngology >>>> Why is adhesive otitis media dangerous?

Why is adhesive otitis media dangerous?

Adhesive otitis media is a non-suppurative inflammatory disease of the middle ear, which most authors consider as a result of chronic or acute purulent inflammations suffered in the past, as well as traumatism of the middle ear. The inflammatory process in the middle ear can have a different outcome depending on how intensely it proceeds and how quickly it is eliminated during the treatment period (in particular, purulent inflammation can lead to the formation of adhesions and scars). One of the possible outcomes of the disease is «purulent otitis media», «tubo-otitis» or trauma to the middle ear may be the formation of fibrous tissue (connective tissue) on the surfaces of the tympanic cavity and the inner side of the tympanic membrane, braiding the internal structures of the middle ear with strands and limiting the mobility of the tympanic membrane and the auditory ossicles.

With adhesive otitis media, the drainage function of the auditory tube is disrupted, which is responsible for the outflow of fluid produced by the mucous membrane of the tympanic cavity and providing mobility of the auditory ossicles, the vibration of the tympanic membrane is disturbed (the tympanic membrane is, as it were, drawn into the tympanic cavity). Adhesive otitis media leads to disturbances in sound conduction, causing hearing impairment and subsequent hearing loss.

The signs of adhesive otitis media do not always clearly indicate the onset of this disease. Most often, patients complain of hearing impairment, extraneous noise in the ear or distortion of sound waves. It is extremely rare for adhesive otitis media to cause painful symptoms in the ear, but it is the intolerable noise in the ear that makes a person seek help from a doctor.

Treatment of adhesive otitis media begins with debridement of the sinuses and nasopharynx. Next, an otoscopy is performed to diagnose the degree of retraction of the tympanic membrane and its mobility. The auditory tube is blown and if it is impossible for air to enter the tympanic cavity, a conclusion is made about the complete fusion of the auditory tube. Using MRI, the degree of adhesion is determined.

Therapeutic manipulations include regular blowing of the auditory tube, as well as pneumomassage of the tympanic membrane, which allows, over time, to restore the patency of the auditory tube and the elasticity of the tympanic membrane. During treatment, if the nervous system is irritated by constant noise in the ear, sedatives are prescribed.

In case of unsatisfactory results of conservative treatment of adhesive otitis media, surgical intervention is indicated for the purpose of tympanoplasty of the tympanic membrane and replacement of the auditory ossicles with artificial ones.

The earlier treatment for adhesive otitis media is started, the more chances you have to stop the fibrolization of the middle ear and preserve hearing.