ANTRIT (antritis; lat. antrum a cave, a cavity + - itis; synonym otoantritis) — inflammation of a mucous membrane of a cave of a mastoid (antrum mastoideum) and osteomyelitis of periantralny area. Arises in the form of an independent disease at children of the first months of life or is a complication of bronchial pneumonia, toxic dyspepsia, dysentery, the umbilical sepsis and granulyatsionny purulent average otitis connected with inoculations of BTsZh; sometimes And. only accompanies these diseases. On incidence And. artificial feeding, a hypotrophy, rickets, dyspepsia, dysentery, bronchial pneumonia and other debilitating diseases influence. Microflora at And. it is various: often the pneumococcus meets, the diplococcus, a streptococcus, staphylococcus, enterokokk is more rare.
A clinical picture
Distinguish two forms A.: explicit, shown the expressed symptoms of an acute average otitis (see), it is frequent with education subperiosteal abscess, and latent at which local symptoms of average otitis are expressed poorly, and the general phenomena of toxicosis prevail. Latent form A. mostly occurs at a hypotrophy at the children sick with rickets, and at acute infectious diseases. On a clinical picture A. also the type of a pnevmatization of a temporal bone exerts impact. The developed pnevmatization in periantralny area meets at children with a normal trophicity more often, they have symptoms And. are usually brightly expressed. At a hypotrophy the detained pnevmatization of a temporal bone is noted and And. proceeds inertly, taking the latent form. Latent current And. it is often connected also using antibiotics which, shading symptoms of acute average otitis, do not prevent development of osteomyelitis of periantralny area.
it is, as a rule, difficult to Establish the diagnosis, especially at a latent form. Bleach And. is the only center of an infection in an organism and proceeds with explicit general and local symptoms, the diagnosis is established on an otoskopichesky picture (a hyperemia and protrusion of a tympanic membrane, existence of perforation or emergence of pus after a paracentesis or developing of subperiosteal abscess). From the general phenomena toxicosis — high temperature, failure of the child from food, a frequent chair, vomiting, vomiting and a weight loss is observed. At a latent form A. the general symptoms prevail over local changes. Otoskopichesky changes are poorly expressed; dimness of a tympanic membrane and small protrusion in back department is noted, sometimes the tympanic membrane has a normal appearance. Only systematic observation of the otologist together with the pediatrician allows to diagnose And., proceeding latentno. The great value for diagnosis as is explicit, latentno the proceeding forms A. the X-ray analysis of temporal bones has (through eye-sockets).
At And. sometimes resort to a puncture of an antrum with the diagnostic and therapeutic purposes (see. Antropunktion ).
Forecast at And. depends on degree of toxicosis and on defeat of other bodies and systems (bronchial pneumonia, toxic dyspepsia, dysentery, sepsis), and also on timely operational treatment. In a crust, time mortality at And. considerably decreased that is connected with broad use in complex treatment And. various type of antibiotics.
Intramusculary injections of penicillin, streptomycin and other antibiotics. Antibiotics also enter into a drum cavity by a tympanopuncture and antropunktion are more rare. The choice of antibiotics depends on character of microflora. At toxicosis it is necessary to resort to hemotransfusion and plasmas, · to intravenous administration of glucose, vitamin therapy. Initial forms of toxicosis will respond to conservative treatment. At suspicion on availability of exudate on average the paracentesis is shown to fish soup; at the expressed osteomyelitis of periantralny area the antrotomy is made (see. Mastoiditis ). It is quite often observed bilateral And., at Krom operation along with both parties is necessary (if the condition of the child allows). In the presence of subperiosteal abscess and poorly expressed toxicosis it is enough to be limited to a puncture of abscess with suction of pus and introduction to an abscess cavity of antibiotics. Timely made operation (antrotomy) prevents exhaustion of an organism of the child.
Bibliography: Kruchinina I. L., Tulina T. V. and Ryzhova O. M. Features of clinic and difficulty of diagnosis of otitises and antrit at treatment by antibiotics, in book: Questions of otorhinolaryngology of children's age, under the editorship of I. I. Shcherbatov, page 51, M., 1973; To at r and - a lean I. A. and Lisovskaya A. I. Otitises and antrita at children of chest age, Kiev, 1969, bibliogr.; Leontyeva T. N. To a question of an etiology of acute otitises, antrit at children, Vestn. otorinolar., No. 1, page 74, 1972; The Multivolume guide to otorhinolaryngology, under the editorship of A. G. Likhachev, t. 2, page 196, M., 1960.
I. I. Shcherbatov.