Myringitis

Description:

Myringitis  (from new armor. myringa - a tympanic membrane), an inflammation of a tympanic membrane.

Myringitis reasons:

The acute infectious myringitis usually develops after a viral infection, but the bacterium or other microorganism which is capable to cause an acute infectious disease of a middle ear can also be the activator. Occasionally the myringitis begins after pneumonia. The reason of the chronic granulating myringitis is not established.

Pathogeny:

The inflammation of a tympanic membrane (myringitis) usually accompanies various diseases of an outside and middle ear. As independent primary disease, a myringitis meets seldom, except for cases of traumatic damage. Very often at observation of inflammatory changes it is difficult to establish whether there was at first a disease of a tympanic membrane or defeat is result of it distribution of inflammatory process from outside acoustical pass or a middle ear. The tympanic membrane cannot be considered as independent education as its outside surface is covered by continuation of epidermis of outside acoustical pass, and its internal surface is covered with the mucous membrane covering a drum cavity. That is why the tympanic membrane is almost always involved in process at diseases of both an outside, and middle ear. Nevertheless, nevertheless the possibility of the isolated damage of a tympanic membrane is not excluded.

Myringitis symptoms:

The acute inflammation of a tympanic membrane can develop as a result of action on it mechanical, thermal or chemical irritants. It is known also that at a number of infectious diseases as flu, measles and various septic processes, the isolated inflammation of a tympanic membrane can be observed, without damage of an outside or middle ear.

In an initial stage of an acute myringitis on the surface of a tympanic membrane, mainly, around a short shoot, expanded vessels appear. Further all tympanic membrane is represented to hyperemic, its detail are maleficiated. Quite often defeat extends also to outside acoustical pass. Sometimes on the surface of a tympanic membrane bubbles with serous, bloody and even purulent contents appear. If the big single bubble is formed, then at an otoskopichesky research it can remind the tympanic membrane which is stuck out by exudate of a middle ear that can serve as the reason of a diagnostic mistake.

Usually specified bubbles are opened independently, and from an ear small allocations appear owing to what the strong likeness with an inflammation of a middle ear turns out. In case of infection of the tympanic membrane bared from epidermis, exudate gains purulent character.

The special attention is deserved by the hemorrhagic myringitis developing at a disease of flu. Change of a tympanic membrane usually occurs in several days from the beginning of the general disease and is expressed by formation of one or several phlyctenas executed by hemorrhagic exudate. Quite often along with it education of similar phlyctenas and on walls of outside acoustical pass is had.

Symptoms of an acute myringitis the most part are a little characteristic. Subjective complaints of the patient come down to heavy feeling or small ear pain. In certain cases, however, there is very acute, terebrant pain. The feverish state, as a rule, is absent, but at an influenzal myringitis substantial increase of temperature can take place. Along with it noise in a sore ear is almost always felt. Release of exudate from acoustical pass is in certain cases observed.

The chronic myringitis meets considerably more often acute and is caused by usually chronic eczema or a diffusion inflammation of acoustical pass. Also an opportunity a feather of the course of an acute myringitis in a chronicity is not excluded. Process affects all tympanic membrane, but can be limited also to its certain sites. The membrane is represented reinforced, her epidermis is exposed to maceration. Education purulent separated with an unpleasant smell is noted.

If to exempt a tympanic membrane from the pus covering it and scales of the exfoliated epidermis, then its surface is represented rough, rather dirty-gray and wet. Quite often on the sites of a tympanic membrane bared from epidermis granulations appear. If granulyatsionny fabric covers all tympanic membrane, then at an otoskopichesky research the picture of a chronic purulent inflammation of a middle ear with final fracture of a tympanic membrane turns out. Along with a chronic inflammation of a tympanic membrane also defeat of outside acoustical pass quite often takes place. On the current the chronic myringitis is represented a long and persistent disease which will very slowly respond to treatment. Symptoms of a chronic myringitis can be limited strong, sometimes to an intolerable itch in an ear, heavy feeling and not sharply expressed hearing obtusion. Quite often the patient sees a doctor only when finds allocation from an ear of fetid pus. At simultaneous damage of an outside ear the symptomatology is represented more difficult.

Diagnosis:

The diagnosis is established on the basis of the anamnesis and physical inspection. Laboratory researches and sensitivity tests allow to reveal an infestant.

The diagnosis of an acute myringitis as it was already stated above, sometimes presents considerable difficulties. On the basis of one otoskopichesky picture it is not always easy to exclude existence of average otitis. The isolated damage of a tympanic membrane is spoken well by normal passability of the Eustachian tube that is defined by its blowing off, preservation or very insignificant hearing impairment and, at last, all course of inflammatory process.

The diagnosis of a chronic myringitis is sometimes very difficult because it is necessary to exclude existence of chronic otitis. The myringitis is spoken well by lack of perforation noise at blowing off, preservation of mobility of a tympanic membrane and an insignificant hearing impairment.

Treatment of a myringitis:

Treatment of an acute myringitis, first of all, comes down to elimination of a cause of illness. Injection of warm solution of carbolic glycerin (2-3%) is locally applied. In case of vesiculation on a surface of a membrane (Myringitis bullosa) opening is recommended by their paracentesis needle. At the same time it is necessary to work very carefully not to wound a tympanic membrane or not to cut all its thickness. In the presence of separated put a strip of a sterile gauze in acoustical pass. Recovery usually occurs in several days. At an influenzal myringitis, except the specified actions, treatment of a basic disease is appointed.

Treatment of a chronic myringitis consists the mass of matserirovanny epidermis and injection in acoustical pass of 2-3% of solution of resorcin, 1-2% of a lyapis or boric alcohol at a distance. The granulations covering a tympanic membrane are cauterized by 5-10% solution of a lyapis. Extremely favorable effect gives inflation of powder of boric acid. At plentiful allocation it is reasonable to enter a strip of a sterile gauze into acoustical pass. At persistent and systematic treatment in all cases of a chronic myringitis it is possible to achieve full treatment.

Prevention:

The best protection against a myringitis is a timely treatment. Take necessary measures at the first symptoms of an infection of a middle ear (for example, during the sneezing, cough, temperature increase and the sharp pulsing deep-drawing pain).