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
External ear; It consists of the auricle and the external auditory canal. The cause is generally bacterial or fungal. It develops after conditions such as deterioration of the 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 of the external ear canal skin, 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 the treatment; Antibiotic and steroid drops are used to restore ear hygiene, protect it from trauma and water. Reducing pain with oral pain relievers is valuable. Antifungal drops should be used in fungal infections and sterile cleaning of the ear canal should be done. Most recover within 1 week. Depending on the severity of the disease, oral antibiotic therapy can be added.
Rarely; It should be kept in mind that very important life-threatening situations may be encountered as a result of the spread of the infection to the middle ear, skull bones, gentleman and blood, especially in patients with outer ear infections, especially in patients with immune system disorders, and patients with risk cluster 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 cluster. It can occur as part of an upper respiratory tract infection. In addition to ear symptoms such as ear pain and hearing loss, general disease findings such as fever and restlessness can 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, frequent upper respiratory tract infections are risk factors for the disease.
Examination; It can be seen in different stages in case of redness and cambering in the eardrum, accumulation of inflammation behind the eardrum and ear discharge after the perforation of the eardrum. Night-onset ear pain is typical, especially in children.
The aim in the treatment of the disease; 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. Afterwards, chronic ear fluid accumulation or chronic otitis media may develop. In addition, patients should be informed about possible complications. These complications include infection; It can develop after spreading to the inner ear, gentleman, length and blood.
Complications
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Permanent hearing loss and vertigo due to inner ear invasion
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Facial paralysis due to end-face involvement
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Meningitis and brain abscess
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Behind the ear 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 more than 3 months, perforation of the eardrum and middle 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. Especially in patients with eustachian tube dysfunction, there is a predisposition to chronic middle ear infection.
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 success. In addition, this disease should definitely be treated, since chronic infection is prone to complications. The disease sometimes continues without discharge in the case of a chronic tympanic membrane perforation. However, mid-range discharge is a harbinger of an active infection in the middle ear. ongoing infection; It causes melting in the middle ear structures, ossicles, causes the progression of hearing loss, and the risk of spreading the disease to the inner ear, facial border, brain membrane, ear and length.
The treatment for chronic ear infection is surgery. Ear drops and oral antibiotic treatments are used to suppress the infection during periods of active discharge.
The main surgical treatment is defined as tympanoplasty. Purpose in surgery; It is based on 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.
