TUBO-OTITIS

From Big Medical Encyclopedia

TUBOOTYT (Latin tuba pipe + otitis; synonym: the eustachitis, salpin-

gootit) — an inflammation of an Eustachian tube I a drum cavity. T. (eustachitis) can be acute and chronic.

Evstakhiit develops owing to transition of inflammatory process of a nasal cavity or a nasopharynx (a nasal part of a throat, T.) on a mucous membrane of an Eustachian tube (see. An acoustical pipe) at acute and hron. cold (see Rhinitis), quinsy (see), diseases of adnexal bosoms of a nose (see), pharyngitis (see). In an etiology of an eustachitis the significant role is played by causative agents of acute respiratory diseases; as the factors promoting development of an eustachitis adenoides (see) and the tumors of a nasopharynx breaking passability of a pharyngeal opening of an Eustachian tube can serve. In a pathogeny of an acute eustachitis the thickening of a mucous membrane of an Eustachian tube caused by expansion and overflow krevyo vessels of a submucosal layer plays a role. At the same time the gleam of an Eustachian tube is narrowed that leads to disturbance of ventilation of a drum cavity (see. A middle ear) and to the falloff of pressure in it (due to absorption of oxygen) causing transudation in a drum cavity of a liquid part of blood from blood vessels. Under the influence of atmospheric pressure a tympanic membrane (see) it is involved in a drum cavity, causing a row a wedge, symptoms. With recovery of function of an Eustachian tube of the phenomenon of an acute eustachitis gradually disappear. At long dysfunction of an Eustachian tube acute process passes into chronic. At hron. an eustachitis atrophic and sclerous changes of a tympanic membrane and more resistant stenozirovaniye of an Eustachian tube are observed.

A wedge, manifestations of an acute eustachitis usually arise suddenly. Patients note a congestion and noise in a sore ear, an autophonia (see), the feeling of transfusion of liquid in an ear sometimes appears. Hearing goes down moderately as conductive relative deafness (see Relative deafness). At an otoskopiya (see) note signs of a retraction of tympanic membrane: smazannost or disappearance of a light reflex, imaginary shortening of the handle of a hammer, sharp protrusion of a knaruzha its short (lateral, T.) shoot. Sometimes at the expense of transudate in a drum cavity the tympanic membrane seems to more dark, through it it is possible to see the top level of transudate in the form of the dark line bent in the form of a meniscus. Mobility of a membrane is usually limited. Symptoms of a chronic eustachitis generally the same, as acute, but keep they more long time. The tympanic membrane as a result of an atrophy and a sclerosis in places looks translucent, places of more muddy, from petrifikata. At a chronic eustachitis the labyrinth can sometimes be involved in process (see. Inner ear).

The diagnosis is made on the basis of the anamnesis, otoskopichesky data, by researches of function of an Eustachian tube (see Manometriya ear) and results of an audiometriya (see).

Treatment of an acute eustachitis is directed to recovery of drainage and ventilating functions of an Eustachian tube. Apply vasoconstrictors to decrease in swelling of a mucous membrane of a pharyngeal opening of an Eustachian tube (ephedrine, adrenaline, cocaine in the form of nasal drops). At vasculomotor and allergic diseases of a nose (see Rhinitis) carry out the local and general hyposensibilizing therapy by Dimedrol, glucocorticoids, etc. For a rassasyvaniye of transudate use heat on an ear, physiotherapeutic procedures — radiation by Minin's lamp, a sollyuks-lamp (see Phototherapy), UVCh (see UVCh-therapy), microwave therapy (see). In cases when the acute inflammatory phenomena in a nose and a nasopharynx abated, and function of an Eustachian tube was not recovered yet, make the ear inflation (see) promoting removal of transudate through an Eustachian tube and to improvement of hearing and a pneumomassage (see); at an acute eustachitis sometimes there are enough 1 — 2 such procedures. Good results dayeg introduction through a catheter to an Eustachian tube and a drum cavity of proteolytic enzymes (trypsin, chymotrypsin, etc.) and glucocorticoids (an emulsion of a hydrocortisone). At a chronic eustachitis use generally the same to lay down. methods, as at acute; special significance is attached to treatment of the diseases supporting inflammatory process in an Eustachian tube — delete adenoides, eliminate a curvature of a nasal partition, etc.

The forecast at an acute evstakhpit in most cases favorable. The chronic eustachitis will respond to treatment much more difficultly and quite often leads to development of adhesive average otitis (see).

Prevention consists in active treatment acute and hron. diseases of upper respiratory tracts. For the purpose of the prevention of an evsta-hiit and its complications it is impossible to allow to work in the conditions of fluctuation of atmospheric pressure (flight service, lacunar and diving works, scuba diving) of persons with insufficient function of an Eustachian tube. Bibliography: The multivolume guide

to otorhinolaryngology, under the editorship of

A. G. Likhachev, t. 2, page 66, M., 1960;

Koch U. u. Becker W. Behand-lung von Trommelfellretraktionen, adhasi-ven Trommelfellen sowie Mittelohrergiissen mit dem inerten Gas Schwefelhexafuorid (SF6), Laryngol., Rhinol., Otol., Bd 60, S. 198, 1981; Tos M.

Experimental tubal obstruction, Changes in middle ear mucosa elucidated by quantitative hysto-logy, Acta oto-laryng. (Stockh.), v. 92, p. 51, 1981. H. V. Zberovskaya.

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