Kronična upala srednjeg uha

master's thesis

• Title (english): Chronic otitis media
• Author: Kristina Vučemilo
• Mentor: Srećko Branica (mentor)
• Committee member: Mario Bilić (predsjednik povjerenstva)
• Committee member: Mirko Ivkić (član povjerenstva)
• Committee member: Srećko Branica (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Othorhinolaryngology and Head and Neck Surgery); Zagreb
• Defense date and country: 2016-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Otorhinolaryngology

Abstract

Kronična upala srednjeg uha je upala karakterizirana trajnim, kroničnim iscjetkom kroz perforirani bubnjić. Nastaje kod nedovoljno dobro liječene akutne upale, disfunkcije Eustahijeve cijevi, ako postoji patološki proces u području nosa, jako virulentni uzročnici, oslabljena otpornost sluznice srednjeg uha ili oslabljena imunost cijelog organizma. Bolest se pojavljuje u djece i u odraslih, neovisno o spolu (1). Pojedine populacije kao Eskimi i Indijanci, imaju veću vjerojatnost nastanka kronične upale zbog osobitosti u anatomiji uha i Eustahijeve cijevi (2). Među uzročnicima najčešće su dokazani Streptoccoccus pneumoniae, Haemophilus influenzae i Moraxella catarrhalis. Glavni simptomi su otoreja i provodna nagluhost dok se bolnost rijetko navodi.
Nekoliko je vrsta kronične upale srednjeg uha. Kronična serozna upala srednjeg uha je najčešća vrsta kronične upale pri kojoj upalni proces zahvaća samo sluznicu dok koštane strukture ostaju netaknute. Kronična gnojna ostitička upala srednjeg uha pripada težim vrstama upale uha gdje patološki proces osim sluznice zahvaća i koštane strukture srednjeg uha te ih postupno razara. Kronična upala srednjeg uha s priraslicama je vrsta upale pri kojoj dolazi do djelomičnog ili potpunog fiksiranja lanca slušnih košćica. Posebna vrsta upale je kronična upala srednjeg uha s kolesteatomom koju karakterizira velika sposobnost razaranja kosti. Za postavljanje dijagnoze uglavnom je potrebna dobra anamneza, otoskopija i radiološka obrada (3).
Terapija kronične upale srednjeg uha može biti konzervativna i kirurška. Obično se počne konzervativnim liječenjem koje uključuje antibiotsku terapiju, a ukoliko izostanu zadovoljavajući rezultati, nastavlja se kirurškim pristupom. Glavni ciljevi kirurškog liječenja su: iskorijeniti patološki proces iz srednjeg uha, zatvaranje perforacije i rekonstrukcija lanca slušnih košćica (1). Komplikacije kronične upale srednjeg uha su sve rjeđe zahvaljujući pravodobnoj dijagnostici i antibiotskom liječenju, a ukoliko ipak nastanu mogu biti životno ugrožavajuće (4).

Abstract (english)

Chronic otitis media is an inflammation characterized by persistent, chronic drainage through a perforated tympanic membrane. It can occur if there is untreated acute inflammation, dysfunction of the Eustachian tube, a pathological process in the nasal area or just highly virulent pathogens. The disease occurs in children and in adults, regardless of gender (1). Some populations, as Eskimos and Indians, have a higher probability of chronic inflammation due to peculiarities in the anatomy of the ear and Eustachian tube. Among the most common causes are proven Streptoccoccus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis (2). The main symptoms of chronic otitis media are conductive hearing loss and otorrhea. Symptoms typically do not include pain.
There are several types of chronic otitis media. Chronic serous otitis media is the most common type in which the inflammatory process affects only the mucosa, and the bone structure remains intact. Chronic suppurative otitis media is a serious type where the pathological process not only affects mucosa but also bone structures of the middle ear. Chronic otitis media with adhesions is a type of inflammation in which there is a partial or complete fixation of the ossicular chain (3). A special type of inflammation is chronic otitis media with cholesteatoma characterized by a great ability of bone destruction. The diagnosis is usually made by a good medical history, otoscopy and radiological methods.
The treatment of chronic otitis media can be conservative and surgical. The treatment begins conservatively including antibiotic therapy, and if it is not successful, continues to surgical approach. The main goals of surgery are: to eradicate pathological process of the middle ear, close the perforation and reconstruct the ossicular chain (1). Antibiotics have produced an overall decline in the frequency of complications of chronic otitis media relative to the preantibiotic era. However, severe complications still occur and may be associated with high mortality (4).

• Keywords: kronična upala srednjeg uha; provodna nagluhost; konzervativno liječenje; kirurško liječenje
• Keywords (english): chronic otitis media; conductive hearing loss; otorrhea; conservative treatment; surgical treatment
• Language: croatian
• URN:NBN: urn:nbn:hr:105:028404
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2017-08-21 11:02:05