The ear consists of 3 main parts anatomically. (Outer ear, middle ear, inner ear) Infections of these 3 different regions also give different findings. Medically, ear infections are called otitis/otitis. If named according to the settlement area; outer ear infection: otitis externa, middle ear infection: otitis media. In addition, according to the duration of the disease; It is classified as acute (new onset) or chronic (long-standing).
Outer Ear Infections
Outer ear; It consists of the auricle and the external auditory canal. The causative agent is generally of bacterial or fungal origin. It develops after conditions such as impaired hygiene of the external ear canal, water leakage into the ear, ear itching with a foreign body. Results; severe ear pain, ear discharge, ear itching, redness and swelling on the skin of the external ear canal, swelling, redness and tenderness in the auricle. Hearing loss may also develop due to discharge and swelling. It is especially important in patients with uncontrolled diabetes and immune system disorders, as it has the potential to become chronic and spread.
In its treatment; Antibiotic and steroid drops are used to restore ear hygiene, protect it from trauma and water. It is important to reduce pain with oral pain relievers. Antifungal drops should be used in fungal infections and sterile cleaning of the ear canal should be done. Most recover within 1 week. Oral antibiotic therapy can be added depending on the severity of the disease.
Although it is rare; It should be kept in mind that very serious life-threatening conditions may be encountered as a result of the spread of the infection to the middle ear, skull bones, brain and blood, especially in patients with outer ear infections, especially in patients with immune system disorders, and patients in risk groups should be followed closely.
Middle Ear Infections
This disease, defined as otitis media, is an infection of the eardrum, middle ear cavity, mastoid bone and eustachian tube.
Acute Middle Ear Infection (Acute otitis media)
It is a common infection especially in the childhood group. It may occur as part of an upper respiratory tract infection. ku In addition to ear symptoms such as ear pain and hearing loss, general disease findings such as fever and restlessness can also be seen. Complaints and findings may differ according to the age group of the patient. The disease develops due to viruses or bacteria. Familial predisposition (genetic), allergies, cigarette smoke, presence of adenoids, and a history of frequent upper respiratory tract infections are risk factors for the disease.
Examination findings; It can be seen in different stages such as redness and cambering in the eardrum, accumulation of inflammation behind the eardrum, and ear discharge after perforation in the eardrum. Ear pain that starts at night is typical, especially in children.
The aim of the treatment of the disease is; relief of pain, treatment of infection, prevention of complications. Otitis media should be treated systemically and oral medications should be used. These drugs should be in the form of painkillers and antibiotic therapy. After the signs of infection have passed, the accumulation of fluid behind the eardrum may last 1-3 months. If the eardrum is perforated, patients should be followed closely. Subsequently, chronic ear fluid accumulation or chronic otitis media may develop. In addition, patients should be informed about possible complications. These complications of infection; It can develop after spreading to the inner ear, brain, neck and blood.
Complications
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Permanent hearing loss and vertigo due to inner ear spread
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Facial paralysis due to facial nerve involvement
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Inflammation of the cerebral cortex (meningitis) and brain abscess
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Ear posterior abscess, neck lymph node abscess and deep neck infection
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Blood poisoning (sepsis)
Chronic Middle Ear Infections
It is characterized by hearing loss lasting longer than 3 months, perforation of the eardrum and occasional ear discharge. It occurs after recurrent acute middle ear infection or chronic middle ear fluid accumulation after collapse of the eardrum and perforation of the eardrum. Other reasons are; It is the duration of the eardrum hole that occurs after high pressure, sound or trauma to the eardrum (such as earwax) for more than 3 months. Predisposed to chronic middle ear infection, especially in patients with eustachian tube dysfunction
Hearing loss and ear discharge are two important complaints that reduce the quality of life. These two complaints in childhood; It both disrupts language development and causes a decrease in school and academic achievement. In addition, this disease must be treated because chronic infection is open to complications. The disease sometimes persists without discharge in the form of a chronic perforation of the eardrum. However, occasional discharge is a sign of an active infection in the middle ear. ongoing infection; It causes melting in the middle ear structures and ossicles, causes the progression of hearing loss, and the risk of spreading the disease to the inner ear, facial nerve, brain membrane, ear and neck.
The treatment method of chronic ear infection is surgery. Ear drops and oral antibiotic treatments are used to suppress the infection during periods with active discharge.
The main surgical treatment is defined as tympanoplasty. Purpose of surgery; It is based on the principle of clearing the disease from the middle ear, making a healthy eardrum and recreating the ossicles that are responsible for transmitting sound to the inner ear.
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