Word - our expert, the head of the department of ear microsurgery Moscow Scientific and Practical Center of Otorhinolaryngology, MD Eugene Garowe .
Originally from childhood
Experienced otohirurg confident that the majority of hearing problems is laid in childhood after correctly or not completely the treated otitis that children get sick very often. Even after the banal at first glance SARS. Which greatly contribute to the particular anatomical structure child's eustachian tube that connects the ear to the nasopharynx cavity: malyshni it is much wider and shorter than that of adults, the microbes get there - a piece of cake.
If you get an infection inflammation of the lining of the middle ear sometimes it swells to such an extent that the Eustachian tube closes, breaking the air exchange between the middle ear and the throat, and creating a perfect environment for bacteria to grow, mucus, and often pus.
Roughly the same thing happens with large adenoids by volume, according to the latest trends that ENT doctors are in no hurry to remove. Otohirurgi such tactics do not share if the adenoids (or rather - pharyngeal tonsil) with its protective, barrier role fail, causing the development of sinusitis, otitis media, the child needs to get rid of them.
Another predisposing to severe hearing impairment factor - properly chosen antibiotic in the treatment of purulent otitis. As a result, affecting the tympanic membrane with a thickness of only 0, 1 mm, the remaining pus her thin, depriving the protective fibrous layer forms in it a dangerous gap through which the middle ear can become infected (especially if it enters the ear of water) .
Kiss Kiss Bang Bang
No less dangerous for the fragile eardrum household injuries that occur all the time. As a "gun" the destruction of most ordinary acts cotton swab (and sometimes pens, pins, clips, etc.) when other patients otohirurgov awkward trying to clear them of accumulated sulfur ear canal. To rupture the eardrum can cause even ringing ... "smack" in the ear, which, without thinking of the consequences, like close to bestow (adults and children) other citizens of the emotional state.
It is not uncommon in the Moscow Center of Otorhinolaryngology and acoustic mines and explosive injuries the victims of the terrorist attacks in Moscow. Especially those who are in a confined space subway car.
- With the explosion of the eardrum is not just tear (like kissing or mechanical injury). It "flies" in the middle ear, often forming in their place of attachment of cholesteatoma - accumulation of desquamated epidermis looks like a pearl, for which it received a beautiful formation called the "pearl tumor," - says Eugene Veniaminovich situation. - Putting pressure on the bone tissue to grow into it, the danger of "Pearl" gradually destroys it.
But perhaps none of the above causes of hearing impairment can not be compared by its devastating consequences with a brain injury as a result of which often occurs not only eardrum, but also the displacement fracture of the auditory ossicles, and even the death of the receptor cells of the inner ear.
- Unfortunately, to us, these patients often come late, when something is done to save their hearing that it was necessary to recover in the first 7-14 days after injury, can not be, - says Eugene Garov.
- But the neurosurgery department, which receives patients with traumatic brain injury, think about it in the least. And they can understand. In the first place neurosurgeons another task - to save lives.
Egg patch
Fortunately, not all is hopeless: cholesteatoma can be removed, the integrity of the auditory ossicles - to restore (for this otohirurgi often use their own cartilage of the patient), and a ruptured eardrum - replace a new one.
And if the first two problems require serious microscopic surgery, the procedure is to restore the integrity of the eardrum is ... damn chicken eggs. In the truest sense of the word. As a frame for which "sticks" epidermis torn eardrum, doctors use the amnion (the internal membrane of the shell) ordinary eggs. In the role of the support can also act as rubber strips, special sponge, hyaluronic film (epidiski). This minimally invasive surgical procedure, though held under the control of the microscope, but without anesthesia and incisions - through the ear canal.
However, it is possible only if the operation is to restore the integrity of the tympanic membrane was made immediately after the injury - in hot pursuit. Otherwise serious revision surgery the patient can not be avoided. Calibration is done under local anesthesia. A damaged eardrum, in this case the patient is recovering tissues. Under the control of the microscope in the ear canal introduced miniature instruments. With their help, the eardrum transplants rises and puts as a patch, a gaping hole in it. On both sides of the eardrum laid special spongiform absorbable materials that help hold the flap in position until it is completely accustomed.
Before it's too late
There are other methods such operations, but their essence is the same: if there is a hole in the eardrum, make sure to close it.
Sometimes surgery is preceded by medication, laser or physiotherapy. Especially when in addition perforated eardrum person suffers mukazitom (chronic inflammation of the mucous membrane of the tympanic cavity), or if it has worsened chronic otitis. In the Moscow Scientific and Practical Center of Otorhinolaryngology convinced not stop the inflammatory process, such a patient can not be operated. Otherwise the operation will be more aggressive, and facial nerve (which runs right through the area of surgical intervention) can be damaged.
Yet to delay the operation is not necessary. The remaining hole in the eardrum is threatened not only by frequent inflammatory diseases and hearing impairment, but also ... an abscess of the temporal lobe of the brain, or meningitis otogennyh. Until this state to better themselves not to bring.
pay attention
In order not to become a patient otohirurga
Treated chronic ENT diseases and avoid the new (this includes acute and chronic rhinitis, sinusitis, and so on. d.). When these diseases occur inflammation and swelling of the mucous membrane, which violates the outflow of fluid from the middle ear, favoring the penetration of infection. Do not leave without attention and the common cold.
Be careful Taking certain medications. Hearing impaired can high doses of aspirin, antibiotics (especially aminoglikozidovogo series), diuretics, heart drugs.
Careful free the ear of accumulated sulfur in it. Not pick it with anything.
Learn properly blow your nose - not both nostrils at once, and each in turn, pre-dripped vasoconstrictor drops.
Without drops from the common cold can not do and those who will
flight. With a blocked nose can not sit on a plane, or under
the influence of the differential pressure can earn otitis media with effusion
or rupture of the eardrum.
If you have suffered otitis, treated it to the end, and under the control of ENT doctor, and after treatment to have your hearing checked - by a whisper voice or audiometric study. Source
Industry News
Go back to the main page
No comments:
Post a Comment