Treatment of chronic epitympanoantral otitis

Chronic epitympano-antral otitis media is a long-standing inflammatory disease of the middle ear that involves the upper parts of the tympanic cavity (epitympanum) and the mastoid antrum. This is a dangerous form of chronic otitis media, as the inflammatory process may lead to destruction of bony structures, development of cholesteatoma, progressive hearing loss, and intracranial complications. Treatment is aimed at eliminating infection, restoring the anatomy of the middle ear, and preventing recurrence.

When is treatment for chronic epitympano-antral otitis media required?

• Persistent purulent ear discharge, often with an unpleasant odor.
• Hearing loss, a sensation of ear blockage, or progressive sensorineural or conductive hearing impairment.
• Presence of headaches, dizziness, or coordination disorders, which may indicate complications.
• Detection of a cholesteatoma – a destructive formation that erodes the bony structures of the ear.
• Lack of effect from conservative therapy with progression to a chronic course.

Methods of treatment for chronic epitympano-antral otitis media

Conservative therapy

• Topical antiseptic agents – local ear treatment with antiseptics (e.g., Miramistin, Chlorhexidine).
• Antibacterial therapy – antibiotics (fluoroquinolones, aminoglycosides) in the form of ear drops and systemic medications.
• Mucolytics and vasoconstrictive nasal drops – to improve drainage and ventilation of the middle ear.
• Physiotherapy – laser therapy, ultrasound, and electrophoresis to stimulate tissue regeneration.

Surgical treatment

• Sanitation surgery of the middle ear (radical mastoidectomy) – removal of the infectious focus, affected bony structures, and cholesteatoma.
• Tympanoplasty – reconstruction of the tympanic membrane and ossicular chain.
• Mastoidoplasty – restoration of the bony structures of the mastoid process.

Advantages of surgical treatment of chronic epitympano-antral otitis media in Belarus

• Complete elimination of the infectious source and prevention of recurrence.
• Hearing restoration, especially when tympanoplasty is performed.
• Reduction of the risk of severe complications such as meningitis, brain abscess, and labyrinthitis.
• Use of modern minimally invasive techniques that shorten the rehabilitation period.

Recovery after treatment

• Avoidance of water entering the ear during the postoperative period.
• Strict adherence to medical recommendations, including the use of antiseptics and antibiotics.
• Regular follow-up examinations by an ENT specialist to monitor ear status.
• Management of chronic inflammatory diseases of the nasopharynx if they contribute to otitis development.

Treatment is carried out in modern ENT clinics using endoscopic, laser, and microsurgical techniques, which allow safe removal of the infectious focus and restoration of hearing.