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Middle ear inflammation causes, symptoms and therapy
contents
- The anatomy of the middle ear
- Symptoms of acute middle ear infection
- Symptoms of chronic disease
- Causes of acute inflammation of the middle ear
- Causes of chronic middle ear infection
- Complications of the disease process
- diagnosis
- Treatment for acute middle ear infection
- Therapy of a chronic otitis media
- Naturopathy in middle ear infections
- Cantharide
- Proven home remedies for inflammation of the middle ear
The anatomy of the middle ear
The middle ear is formed from the so-called tympanic cavity (filled with air bone cavity, which occupies the space between the eardrum to a bony wall of the inner ear), the eardrum and a connection to the upper pharynx. This connection between tympanic cavity and pharynx is called Eustachian tube, Tuba auditiva or Eustachian tube. Above all, it is responsible for the air pressure equalization between the two rooms. When swallowing, it opens automatically. Therefore, for example, pressure on the ears helps to consciously swallow several times or force yawns.
The anatomy of the human ear. (Image: bilderzwerg / fotolia.com) Symptoms of acute middle ear infection
In the first place the symptoms of an acute otitis media are relatively sudden onset, stinging, pulsating earache to call, often in conjunction with ear noises or tinnitus and a reduction in hearing. Accompanying may be more unspecific symptoms such as fever and headache.
In infants, the disease is often difficult to interpret. They are more likely to suffer from symptoms such as diarrhea or vomiting. Repeated touching of the affected ear and queasiness can be indications of an existing ear infection here. Larger children may also complain of abdominal pain. The earache is sometimes so strong that even gentle touches of the diseased ear are not tolerated.
In the further course of the disease, an untreated otitis media acuta often leads to a breakthrough of the eardrum (eardrum perforation) with subsequent discharge of purulent secretions. The pain usually subsides abruptly in this case, however, there is just as sudden a greater hearing loss. In general, a severe acute otitis media with appropriate medical care after a maximum of four weeks healed.
Symptoms of chronic disease
The chronic forms are usually characterized less by pain, but rather by prolonged impairments of hearing in the form of a conductive disorder. The sufferers also often complain of persistent Ear Run, the secretion escapes from the middle ear. This is usually odorless in chronic mucosal conductions, while in chronic bone suppuration the secretion can have a very unpleasant odor.
Generally, chronic inflammation is often accompanied by a dull feeling of pressure on the affected ear. However, pain usually only occurs when acute otitis media temporarily develops from the chronic form. Without medical care, otitis media chronica usually has no chance of recovery, even though temporary symptom-free periods are not uncommon.
If babies are very whiny and repeatedly catching their ears, this may indicate an acute middle ear infection. (Image: marchibas / fotolia.com) Causes of acute inflammation of the middle ear
Often the otitis media acuta arises as a result of an existing infection in the nasopharynx or in the upper airways. As already mentioned, the Eustachian tube is located between the pharynx and the middle ear. Via this connection pathogens can reach the middle ear from the pharynx and then multiply further here. The result is an inflammation, which often includes the tuba auditiva (so-called tubal catarrh).
An infection via the bloodstream or even from the outside, however, is rather rare. Generally there is almost always an infection when the acute form of the disease occurs. Most bacteria are responsible for this, such as streptococci, staphylococci or pneumococci, but viruses can also cause a corresponding infection.
Since the tuba auditiva is still relatively short in infants and children up to the age of 8, germs can rise to the middle ear more quickly, which means that more and more complaints can be observed at this age group. In general, ventilation disorders of the Eustachian tube may favor the occurrence of middle ear inflammation.
If the entrance to the mucous membrane-lined eustachian tube is displaced, for example, by a cold, slimy fluid may accumulate in the ear, which forms a good breeding ground for pathogens. In addition, the pressure equalization is no longer guaranteed by the blockade of the tuba auditiva to the extent necessary, which can lead to a negative pressure in the tympanic cavity and a concomitant so-called Paukenerguss.
The combination of cold and air travel is generally considered a risk factor. Because the entrance to the tube is blocked by the cold and the ventilation is not working properly, which is not only unpleasant in the required pressure equalization, but may also have adverse consequences. The germs may migrate towards the middle ear, where they cause inflammation.
The use of a nasal spray before and during the flight can free the entrance to the tuba auditiva and counteract the ascension of the germs. But not only a cold, but also infectious diseases in the throat can form the basis for an infection of the middle ear. In addition, systemic diseases such as measles, the flu or scarlet fever are known as possible causes of otitis media acuta.
If the ear is already damaged in the form of a tympanic membrane perforation (such as after several middle ear inflammations experienced), the ingress of water alone during bathing or diving easily leads to a renewed infection. The pathogens are entered from the outside.
This happens with a middle ear infection. Image: www.fotolia.com © bilderzwerg Causes of chronic middle ear infection
An otitis media chronica usually develops on the basis of a persistent tube ventilation disorder (malfunction of the tuba auditiva) - especially in patients who have frequently suffered from acute middle ear infections. Also, a disturbed physiology in the area of the middle ear can lead to the development of the chronic form. In addition, genetic factors are also discussed as a possible cause of the disease.
In general, two forms of otitis media chronica can be distinguished; A so-called chronic bone suppuration caused by a cholesteatoma and a chronic mucosal suppuration.
Both forms are associated with tympanic perforation and are associated with recurrent suppurative secretion. In a cholesteatoma, there is the risk that the causal ingrowths of multilayer keratinizing squamous epithelial cells into the middle ear also lead to damage to the surrounding bone structures. In the worst case, complications threaten, ranging from destruction of the ossicles to life-threatening diseases such as inflammation of the brain (meningitis), brain abscess or blood poisoning.
Complications of the disease process
If an acute inflammation of the middle ear is inadequate, too late or not at all medically treated, various, in the worst case life-threatening complications threaten. For example, this may affect the area of the inner ear and cause complete hearing loss.
In severe forms of the acute variant is also increasingly the so-called mastoid (the tympanic cavity goes back into the mastoid) over affected. A corresponding inflammation of the mastoid is called mastoiditis. It is the most common complication of otitis media and usually does not appear until a few weeks after the onset of the original disease.
In addition to the inflammatory processes, so-called bone melts are also part of the symptoms of mastoiditis. In this way, the disease can expand significantly in the further course and breaks through in most patients initially outward. It forms a larger abscess and clearly visible swelling and redness behind the ear.
In the worst case, the inflammation of the mastoid subsequently breaks through into the skull, which can be accompanied by life-threatening events such as brain abscess, meningitis or sinus thrombosis. Breakthroughs in the area of the zygomatic arch and the attached neck muscles are also possible, which in turn can trigger a variety of complaints. In the case of mastoiditis usually shows a renewed increase in fever and a tender swelling over the mastoid behind the ear. The affected ear also stands out conspicuously.
Overall, the risk of serious complications in the chronic form of mucosal conduction is relatively low, while osteotomies can lead to the destruction of surrounding bone structures and, at worst, to life-threatening spreads of inflammation.
If inflammation is suspected, the doctor examines the ear using the otoscope. (Image: Werner / fotolia.com) diagnosis
If the description of the symptoms is suspected to be an infection of the middle ear, a so-called otoscopy (visual examination of the ear canal and eardrum by means of an otoscope) is usually performed. This can be reddening and possibly structural changes of the eardrum, such as a tympanic membrane perforation or blisters on the eardrum, recognizable.
For chronic forms of the disease and complications (for example, mastoiditis), other examination methods such as X-rays or computed tomography (CT) are often used to assess the extent of the damage. By means of a hearing test, a so-called Tonaudiogramms or a Tympanometrie, reductions of the hearing and sound conduction disturbances can be determined.
Treatment for acute middle ear infection
Since acute inflammation not infrequently heal without further therapeutic measures by itself, can be waited for a few days first. However, a medical examination is urgently required during this time. Patients should take care and avoid cold. Accompanying decongestant nasal sprays are often prescribed to keep the entrance to the Eustachian tube free and again to achieve adequate ventilation of the middle ear.
If the symptoms do not improve after around three days, antibiotics are usually used, as most of the acute middle ear infections are caused by bacteria and also threaten a bacterial secondary infection in viral infections of the middle ear. Furthermore, analgesic and anti-inflammatory preparations can be used.
If tufts of the tympanic membrane or complications such as mastoiditis are detected, surgical intervention is required to avoid further health risks for those affected. The removal of mastoiditis is a more extensive procedure, in which the skull is opened behind the ear and the damaged material is cleared.
Therapy of a chronic otitis media
Chronic forms of the disease do not heal on their own without therapeutic care. Although the symptoms can be temporarily alleviated by the administration of decongestant nasal sprays, anti-inflammatory drugs and analgesics, especially in the mucous membrane, but a final cure requires surgical intervention. The tympanic membrane perforation is repaired in the course of a so-called tympanoplasty (reproduction of the eardrum) in order to prevent the re-entry of pathogens and corresponding infections.
Chronic obstruction requires surgical removal of the causative cholesteatoma. If larger parts of the surrounding bone structures have been damaged, an operative reproduction may also be appropriate here.
With the help of naturopathic treatments and home remedies the symptoms can be alleviated. (Image: pathdoc / fotolia.com) Naturopathy in middle ear infections
Naturopathy offers various options for the treatment of the acute form, but these can not replace the doctor's visit in an emergency. However, targeted naturopathic support for self-healing can often achieve a significant improvement within a very short time and further therapeutic measures are not required.
First, the heat treatment by means of a red light lamp should be mentioned, which remains controversial until today, as under certain conditions, an unfavorable effect on the disease is predicted.
Homeopathy has resources ready to help. For example, in acute otitis media with massive pain, Aconitum is the drug of choice. Belladonna is used when there is a fever in addition to the pain and the patients tend to redden. Chamomilla is used for young children who are very tearful because of the pain and just want to be carried around. Ferrum phophoricum is an agent that is generally aimed primarily at eliminating inflammation. Furthermore, various homeopathic mixed preparations are available, which should support the overall decay.
If the ear infections occur unusually frequently, the naturopathic therapy also takes a closer look at the intestine, since according to the wholeness principle possible connections are suspected here. It is not without reason that bowel rehabilitation is often the beginning of successful therapy for recurring diseases of the middle ear.
If patients tend to increase middle ear infections in case of runny nose, naturopathy also resorts to nose drops, so that the tuba auditiva is kept free and no inflammation in the ear can develop. This is especially important in children. Here are various preparations containing natural substances, so that the mucous membranes are not affected.
Cantharide
Another option for naturopathic treatment is the so-called Cantharidenpflaster dar. This special plaster is coated with a paste of powdered Spanish fly. The poison cantharidin contained in it triggers an artificially produced combustion. The blood circulation is promoted, wheals and smaller bubbles arise at the scene. Metabolic waste products and pain mediators come to the skin surface, the immune defense is stimulated.
The Cantharidenpflaster is applied to the mastoid (mastoid) and sterile after receiving the resulting wound. This is an ancient but very effective method for otitis media. A more gentle treatment is the Baunscheidtherapie dar. This slight carving of the skin is also in the area of the mastoid, behind the diseased ear. The blood circulation is stimulated, the lymphatic flow is stimulated, thus accelerating the removal of the inflammation.
The onion is a commonly used home remedy for inflammation of the middle ear due to its antibacterial effect. (Image: Andrew / fotolia.com) Proven home remedies for inflammation of the middle ear
Home remedies such as the well-known onion wrap often have a very promising effect on middle ear infections. To do this, chop an onion and wrap it in a tissue handkerchief. This is placed on the sick ear and fixed with a cap or a headband. Above that comes a heat source, for example in the form of a warmed cherry stone sack.
Inhaling and other home remedies for earache can counteract the middle ear infection. However, if the naturopathic treatment approaches do not lead to a significant improvement in the state of health in the short term, a treatment based on conventional therapeutic approaches should be carried out in a timely manner.
In general, it is important that otitis media is always completely cured. This is all the more true in children, since recurrent ear infections, which are often associated with hearing loss, can trigger a marked developmental delay in them. The risk of long-term damage should therefore not be underestimated.
There is also the risk of delayed, life-threatening complications such as mastoiditis. In a final medical check-up, it should therefore be checked whether the disease has actually completely subsided. (sw / fp, last updated 18.1.2018)
Specialist supervision: Barbara Schindewolf-Lensch (doctor)