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Diseases of the middle ear: causes, symptoms, diagnosis, treatment
Last reviewed: 20.11.2021
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Diseases of the middle ear are among the most difficult pathological processes in the etiology and pathogenesis of ENT organs, primarily due to the fact that the middle ear borders on the posterior and middle cranial fossa and directly communicates with the formation of the inner ear, and through the auditory tube - with the cavity of the nasopharynx and the upper respiratory tract as a whole. According to the figurative definition of B.S. Preobrazhensky, the middle ear is a peculiar paranasal sinus of the nasopharynx, hence all the pathological processes taking place in it and the auditory tube invariably affect the condition of the middle ear. Therefore, in the inflammatory processes developing in the middle ear, a crucial role belongs to the nasopharynx and the state of the auditory tube, providing drainage and ventilation functions for the middle ear.
In connection with this topographic position of the middle ear can accumulate pathological influences from neighboring anatomical formations (auditory tube, meninges, sigmoid sinus, etc.) and, in turn, is a source of infection spreading to neighboring organs, often causing dangerous complications (sine thrombosis, meningitis, brain abscess, labyrinthitis, apizitis, etc.).
It should also be noted that the middle ear, being a hollow body, is sensitive to changes in barometric pressure in the environment.
His reaction to these changes entirely depends on the physical state of the auditory tube, and in case of insufficient functioning, the tympanic membrane and the vascular system of the mucous membrane of the tympanum react first, causing the appearance of so-called baro or aero-otites.
All inflammatory diseases of the middle ear can be divided into acute and chronic, banal and specific, uncomplicated and complicated, tubogenic and hematogenous.
Classification of inflammatory diseases of the middle ear
- Acute catarrh of the middle ear (otitis media catarrhalis acuta)
- Chronic catarrh of the middle ear (otitis media catarrhalis chronica)
- Aerootitis
- Acute inflammation of the middle ear (otitis media acuta):
- non-perforative (stage of catarrhal inflammation)
- perforated (stage of purulent inflammation)
- allergic otitis media (otitis media allergies)
- acute otitis media with common infectious diseases
- acute mastoiditis (mastoiditis acuta)
- Acute inflammation of the middle ear with traumatic lesions:
- traumatic otitis and mastoiditis
- contusion otitis and mastoiditis
- otitis and mastoiditis with injuries of the temporal bone
- Chronic suppurative otitis media (otitis media purulenta chronica):
- mesotympanite
- epitimpanitis:
- uncomplicated
- complicated - granulation, caries of bone, cholesteatoma
- Specific inflammation of the middle ear:
- influenza inflammation
- middle ear tuberculosis
- syphilis of the middle ear
- "Exotic" diseases of the middle ear
This classification reflects the most common diseases of the middle ear, but it does not exhaust all possible combinations of these diseases and those conditions that are interpreted by clinicians as paradoxical, rarely encountered, especially when the banal infection is combined with a specific or with some genetic dysgenesis. The least known and poorly studied in Russia are the so-called exotic diseases (leprosy, yaws, etc.).
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