DISEASES OF THE EAR : THE PURULENT LABYRINTHITIS (LABYRINTHITIS PURULENTA) - etiology, pathogenesis, symptoms and course of, recognition, prediction and prevention
Pathological processes of the internal ear may be:
In acute otitis media, the infection can spread through Windows without compromising the integrity of the membranous formations, normal closing these openings (so-called induced labyrinthitis); chronic - through carious portions of bone walls of the maze. Pathological changes are reduced to the formation of exudate and edema in the soft parts of the maze to the end of labyrinthine fluid, to the disintegration and destruction of the sensitive cells of the cochlear and vestibular apparatus, to the breakthrough of exudate in the middle or posterior cranial fossa; may also occur gradual resorption of fluid with subsequent connective tissue organization. Are festering and the purulent labyrinthitis, acute and chronic; according to the degree distribution of the process is diffuse, covering all divisions of the inner ear, and limited, exciting one part of the maze.
Symptoms. Noise and ringing in the ears, dizziness, nausea, hearing loss, especially the perception of lower tones, complete deafness in diffuse purulent labyrinthitis, balance disorder, vomiting, spontaneous nystagmus to the affected side when the labyrinth of irritation and in a healthy way in the labyrinth oppression; the temperature is usually raised. When the successful outcome gradually leads to the phenomenon of compensation is terminated dizziness, nausea, vomiting, nystagmus. With limited labyrinthitis usually fistula symptom, when serous can remain some remnants of labyrinthine function.
Recognition is not difficult; the dynamics of the process (turbulent flow) allows to distinguish serous forms from festering. The preservation of hearing and vestibular function at least to some extent speaks for serous labyrinthitis.
Penicillin therapy. Distracting (mustard, laxatives), peace, streptocid 6,0 - 8,0 per day; sulfidine every 4 hours for 1.0, narcotic (morphine, belladonna), diet. With limited labyrinthitis with fistula symptom and perfectly preserved the function of the labyrinth after labyrinth attack after 4 to 5 weeks obschepolostnaya operation. In diffuse purulent labyrinthitis with signs of intracranial disease obschepolostnaya operation with simultaneous opening of the maze.