UHF for otitis media

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Vereshchak Vladimir Vasilievich

Otolaryngologist (ENT) of the first category

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If a diagnosis of otitis is established, then treatment may consist not only in the form of drug therapy, it may also include physical procedures. Physiotherapy for otitis media includes a number of procedures that will additionally relieve swelling and inflammation. In order for the prescribed methods to provide only benefit, you need to know all the nuances of their implementation, because often such therapy has contraindications.

Physiotherapy treatment - the effect of the procedure

Physiotherapy is a complementary treatment that is based on various procedures. In case of ear inflammation, such measures help not only to speed up recovery, but also to speed up the effect of prescribed medications. The effect of the prescribed treatment methods is expected to be complex, since physiotherapy, with the correct and timely effect on the patient’s body, is capable of:

Shorten the treatment period;
Increase the effectiveness of prescribed medications;
Reduce the risk of developing allergies from drugs;
Minimize the development of adverse reactions from taking pills;
Remove inflammation;
Reduce pain.

The main goal of physiotherapy is to increase the effect of treatment without negative effects on internal organs, without complications, without side effects.

The list of physiotherapeutic measures for otitis media includes:

UHF;
Electrophoresis;
Ultraviolet radiation;
Microwave therapy;
Pneumomassage;
Blowing and rinsing the ear;
Sollux, etc.

Electrophoresis for otitis media, UHF and magnetic therapy are considered classic treatments for this disease. Often, otolaryngologists refer their patients to such procedures, but it all depends on the type of disease and the stage of exacerbation.

UHF for otitis is considered a universal treatment method, because ultra-high frequency heating of the ears is appropriate to use in the acute phase of the disease, as well as for the treatment of the chronic form.

Drug treatment of exudative otitis media

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In half of the cases, inflammation in the middle ear is aseptic in nature. In other cases, exudative otitis media is bacterial in nature, so it is advisable to carry out antibacterial therapy. Doctors prescribe such patients antibiotics of the same series as those used in the treatment of acute otitis media, but such therapy in some cases may include the use of antibiotics. The effect of using antibiotics is only 15%, and if the use is combined with tableted glucocorticoids, the result increases to 25%. But despite such a low effect from taking it, according to many foreign scientists, taking antibiotics is considered justified. The combination of antibiotics with antihistamines makes it possible to inhibit the formation of immunity to vaccines and suppresses nonspecific anti-infective resistance.

In addition, many doctors prescribe anti-inflammatory, decongestant, hyposensitizing, nonspecific complex therapy, as well as the use of vasoconstrictor drugs, to treat the acute stage.

To liquefy exudate in the ear, powdered mucolytics, syrups and tablets are widely used in everyday practice. This course of treatment takes 10-14 days.

A prerequisite for drug treatment of exudative otitis media is constant evaluation of treatment results, as well as monitoring after a month.

Methodology

For otitis media, physical therapy is considered an essential element of treatment. Electrophoresis is the most common procedure prescribed to most patients for exudative otitis media, when pus begins to accumulate. It is impossible to delay the treatment of such a disease, as it can quickly develop into a chronic form.

Electrophoresis affects the diseased area using direct current and an injected pharmaceutical drug. This procedure allows the drug composition to more actively influence the source of inflammation. The current accelerates the process of penetration of the product through the ducts of the glands on the body.

The electrophoresis device has positive and negative electrodes. Often the negative (cathode) leads and wires are painted black, and the anode electrodes are painted red.

Special gaskets are placed between the electrode and the surface that will be treated. They are pre-impregnated with the medicinal substance. To treat otitis media, an electrode is placed either in the nose or in the ear. When turning on the device, the patient should not feel any discomfort, there may only be a slight tingling sensation.

The current density during the procedure is determined by the doctor. If there is a slight burning sensation, then you need to immediately reduce the density of the waves. This procedure for the treatment of otitis media is considered effective, since the current flows directly into the diseased area without penetrating the skin.

Electrophoresis with lidase is used for the accumulation of purulent masses in the ears, since lidase is an enzyme product that promotes the breakdown of hyaluronate. The substance helps to quickly relieve swelling, reduce the density of pus, and speed up its release from the ear cavity.

Drug electrophoresis

As you can imagine, this therapy uses an electrical current to deliver medications through the skin. The peculiarity of the procedure is the reduced concentration of the drug introduced into the patient’s body .

The administered drugs begin to be absorbed several times faster. The choice of dose is prescribed based on the characteristics of each individual case. The therapy method is based on the process of electrical dissociation, that is, the drug is separated in distilled water into particles that have an electrical charge.

When the dissolution of the drug into ions occurs very slowly, the water is replaced with ethyl alcohol. Next, the drug particles are transferred under the skin under the action of current and absorbed into the blood.

Electrophoresis for otitis in children and adults should not cause discomfort or burning. The procedure is characterized by only a slight tingling sensation . If there are painful sensations, you need to inform your doctor about this in order to reduce the current density transmitted from the device to the patient.

Carrying out a physical procedure

The duration of the course and each procedure is determined by the type of medication prescribed. For example, in the treatment of exudative otitis media, many procedures are prescribed, but this type of treatment is the most effective. Electrophoresis for exudative otitis media introduces steroid hormonal drugs and proteolytic enzymes (mucolytics) into the body.

Typically, side effects occur due to an allergic reaction to the injected drug. There may also be some redness left after the pad is removed, but it goes away quickly. To avoid negative consequences, it is important to fully comply with the technique of the physiotherapeutic procedure.

Warming techniques

Physiotherapy for adults with otitis media is based on a warming effect, which is achieved by various techniques. The main task is to relieve inflammation and quickly reduce ear pain. The most common warming techniques in this area are:

Phototherapy or Sollux;
Electrophoresis;
UHF.

Phototherapy involves the use of a specialized incandescent lamp or UV lamp. The Sollux lamp, if used for general irradiation, is installed at a distance of 1 m from the patient. The warming up procedure can last from 15 minutes to an hour, it all depends on the diagnosis and form of the disease.

Electrophoresis also has a warming effect, but heating occurs due to direct current. Antibiotic drugs, lidase, etc. are often used to warm the ear. The choice of drug is made by the doctor. The duration of the procedure varies between 10-20 minutes. The procedure allows you to reduce the dosage of the prescribed drug, which minimizes the risk of side effects. Due to the absence of pain during the procedure, electrophoresis is often prescribed for physiotherapeutic treatment of otitis media in children.

UHF is a procedure based on exposure to a high-frequency electromagnetic field. During treatment with this technique, fluid may accumulate in the ear, which is undesirable during the treatment of acute otitis media. UHF is appropriate to use in the early stages of otitis development. For complete recovery, 5-7 procedures of 5 minutes each may be sufficient. If the patient is diagnosed with purulent otitis media, the number of procedures is doubled. In this condition, it is especially important to monitor the activity of pus discharge. If purulent masses flow freely, then the duration of UHF is increased to 1 minute per session.

Symptoms of otitis media in adults

The severity of the clinical picture of otitis in adults depends on the cause of the inflammatory process, the nature of the course and the location of the lesion. Common signs of the disease include:

congestion in the ears;
hearing impairment;
noise;
temperature increase;
general weakness, malaise;
drowsiness;
headache;
ear pain.

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The development of external otitis is characterized by the presence of specific skin lesions in the ear canal (pustules, boils, blisters, redness, etc.). There is lumpy swelling of the tissues, severe pain in the auricle, itching, mucopurulent or serous discharge from the ear. It is possible to develop an otohematoma - a soft tumor of a bluish-burgundy color. When the ear canal is damaged by fungi (mycosis), the clinical picture is erased and symptoms do not appear for a long time.

A specific symptom of otitis media is autophony – the resonance of the patient’s own voice in the affected ear. The temperature, as a rule, is not elevated or remains at low-grade levels (37.1–38.0°C). Patients with otitis media often complain of hearing impairment and severe increasing shooting or throbbing pain, which can spread to the teeth, temple, and crown. Inflammation of the inner ear is characterized by the development of symptoms of damage to the vestibular apparatus:

severe paroxysmal dizziness when suddenly turning the head or changing position;
violations of coordination and balance;
nausea and vomiting.

Stimulating treatments

Stimulating techniques in the treatment of otitis media can speed up the process of removing purulent masses, normalize blood flow in the area of inflammation, reduce swelling, and increase muscle tone of nearby tissues. List of procedures that can be prescribed for inflammation of the hearing organs:

Pneumomassage;
Amplipulse therapy;
Magnetotherapy;
Diadynamic therapy.

Pneumomassage consists of active alternation of air flows, which are distinguished by high and low pressure. This pressure helps create a special device that works by constantly oscillating the eardrum. Frequent changes in pressure prevent a decrease in muscle tone. A similar effect can be noticed when pumping air with your palms.

Amplipulse therapy is based on the influence of sinusoidal currents. The amplitude of fluctuations directly depends on the form of the disease. The effect of the procedure is noticeable in cases where the patient experiences severe pain. Sinusoidal currents during amplipulse therapy can accelerate blood flow, quickly eliminate congestion, and reduce swelling during inflammation. By reducing swelling, pain disappears, and accumulated fluid or pus is easily drained.

Magnetotherapy involves the use of a low-frequency magnetic field. Such magnetic waves during treatment often do not exceed a frequency of 50 Hz. The duration of the procedure does not exceed 10 minutes. To combat acute otitis media, a minimum of 10 procedures will be required. Magnetic therapy helps to increase the tone of venules, relieve swelling, and increase the activity of the lymphatic drainage system.

Diadynamic therapy is also carried out using rhythmic currents. Currents can affect the cortical and subcortical centers of the head, which accelerates blood flow in the middle ear. This procedure also helps to increase the mobility of the auditory ossicles. The average duration of one diadynamic therapy session is 10 minutes.

Use of physical therapy

Physiotherapy for otitis media is used quite widely. Doctors distinguish several types of physiotherapy, each of which differs in its mechanism of action, and also has certain indications and contraindications. There are three types of physiotherapeutic methods: warming, cleansing and stimulating.

Methods with stimulation

Stimulating types of physiotherapy are aimed at increasing blood circulation in the affected area, as well as reducing the severity of the inflammatory process. The following methods have a similar effect:

Air massage is a common physical therapy approach that involves applying air to the eardrum. The procedure is very simple and can be used at home using the palms, without harm to the health of a patient of any age.

Amplipulse treatment is based on the use of sinusoidal current modulated by a special device. This type of physiotherapy is effective in patients with severe pain. Sinusoidal currents relax spasmodic muscle fibers and stimulate blood circulation.
The use of a magnetic field to treat otitis media has been known for a very long time. A low-frequency magnetic field has a positive effect on the condition of the microvasculature and quickly reduces tissue swelling. As a rule, such a procedure includes 8-10 sessions and can significantly speed up the patient’s recovery.

Cleansing approaches

If there is a pronounced exudative process in the ear canal, doctors prescribe cleansing methods of physiotherapy:

Blowing the Eustachian tube is aimed at restoring its patency, which improves the outflow of inflammatory contents from the middle ear cavity. It is important to note that for patients with signs of rhinitis or pharyngitis, such a procedure is contraindicated due to the risk of bacteria or viruses spreading to the middle and inner ear.
In case of purulent variants of otitis, which can be observed in acute or chronic cases, it is recommended to rinse the ear. For this procedure, use slightly warm water or a solution of hydrogen peroxide, which has additional bactericidal activity. Under no circumstances should you rinse the ear cavity yourself at home, as this can lead to serious complications.

Warming tissues

These procedures are prescribed for the inflammatory process. The following techniques are used:

UHF for otitis media is prescribed to patients of all ages. This method can be used to treat acute pathology or during exacerbations of chronic otitis media. The average duration of a UHF course for otitis media is 5-7 procedures, however, if the patient has a purulent variant, then 13-16 sessions of physical treatment may be needed.
Electrophoresis for exudative otitis media and other types of disease is based on the ability of drug molecules to penetrate biological tissues under the influence of an electric current. As a rule, antibacterial agents or zinc sulfate are used as medications. Sessions should begin with a minimum exposure time.

The choice of a specific method of physiotherapy is always made only by the attending physician, taking into account the patient’s indications and contraindications.

UHF therapy

UHF for purulent otitis and other variants of the disease is highly effective and has virtually no side effects on a person of any age.

Localized effects on body tissues lead to improved blood flow, faster absorption of exudate, and reduced severity of inflammation.

The procedure is carried out using devices that create an electromagnetic field, which causes all the positive effects of physiotherapy. It is important to note that the duration of the UHF session depends on the age of the patient:

For children under 12 months, sessions lasting more than 5 minutes are not recommended;
at the age of one to three years – no more than 7 minutes;
in the age period of 3-7 years, UHF exposure should be up to 8 minutes;
all patients over 8 years of age can receive 10-15 minute physical therapy sessions.

Doctors give certain advice on the use of UHF treatment:

one hour before physiotherapy you should refrain from eating;
in childhood, only 1 physiotherapeutic procedure should be prescribed at a time, since children get tired very quickly;
Repeated course sessions should be carried out no earlier than 4 months after the last course of such treatment.

Following these tips allows you to eliminate the negative consequences of UHF therapy and also ensures its high efficiency.

Application of electrophoresis

Medicinal electrophoresis with various medications (antibiotics, lidase, etc.) is a modern physiotherapeutic method. The electric field facilitates the passage of drug molecules through the skin, which makes it possible to reduce the dosage of medications used.

Electrophoresis is not used for systemic drug exposure.

To carry out the procedure, special electrodes are used, which are placed on areas of the body selected by the doctor. Gauze wipes moistened with medication are placed under the electrodes. The average duration of one session is 15-25 minutes. The course consists of 5-10 similar sessions, depending on the severity of the symptoms of the disease.

Physiotherapeutic methods (UHF, electrophoresis, CUV therapy, laser) are widely used in the treatment of exudative or purulent otitis media. Moreover, the procedures can be performed on both children and adults, including during pregnancy. In no case should you carry out physical treatment yourself, since each method has its own specific indications and contraindications for use, and there is always a risk of developing side effects.

Cleansing methods

During the treatment process, it is often necessary to cleanse the ear canal, so for such purposes, doctors prescribe cleansing physiotherapy procedures in the form of washing or blowing the ear.

Ear blowing involves clearing the Eustachian tube. Often such cleaning is appropriate for otitis media. This procedure should only be performed by a qualified otolaryngologist. If the procedure is performed incorrectly, infection may spread. You should not bleed the ear if the patient has a runny nose or sore throat.

The washing procedure is most often recommended for purulent otitis media. This form of the disease can provoke the rapid spread of infection and the development of complications. Cleaning your ear is quite simple. The procedure can be carried out even at home, but only after consultation with a doctor. Hydrogen peroxide is used as a washing liquid. It is preheated to room temperature and injected into the ear with a special syringe or pipette in an amount of 1 ml. After instillation, the peroxide will begin to hiss, which means the presence of infection. The remaining liquid is simply removed. If the procedure is performed incorrectly, perforation of the eardrum and temporary hearing loss may occur.

Otitis of the hearing organ

Otitis media is a general definition that refers to inflammatory diseases of the ear. The inflammatory process begins with constant aching pain in the ear. Unpleasant sensations are of an increasing nature, they are accompanied by weakness, fever, headache, congestion and tinnitus. You can find out how to relieve ear pain here.

The process usually occurs against the background of an infection that has entered the ear from the upper respiratory tract. It is the auditory tube that carries pathogens into the organ of hearing. Also, the cause may be improper ear cleaning, allergies, or frequent contact with water.

Procedures used in treatment

Otitis media are classified depending on its location. There is otitis of the external, internal and middle ear. To diagnose the exact type of disease, the doctor must examine the ear and determine in which part of the hearing organ functional disorders occur.

If the appearance of otitis media is left unattended, it can take on a more aggressive form, accompanied by the release of pus. The complication occurs due to inflammation and bursts the middle ear cavity, causing shooting pain. Pain is reduced if pus breaks through the eardrum and flows out.

Benefit

The benefits of the listed procedures will only be if they are performed by a qualified doctor. The effect directly depends on the correct implementation of the techniques and strict adherence to the recommendations of the otolaryngologist. You should not reduce or increase the number of scheduled sessions. It is worth continuing to undergo physical procedures even after the pain has decreased. The absence of pain is not yet an indicator of complete recovery. After completing the treatment course, you need to visit the ENT specialist again so that he can prescribe further therapy.

If all the recommendations were followed correctly, the effect of physiotherapy may be as follows:

Increase the permeability of the walls of blood vessels;
Reduce body intoxication;
The inflammatory process will decrease and localize;
The acidity of the treated area is normalized;
The process of tissue stimulation will accelerate;
The severity of pain will decrease;
In acute form of otitis, body temperature will decrease;
Increase local immunity;
Swelling will decrease.

You should not put off visiting a physiotherapy room, since on average 5-10 procedures will already give a positive result. Before carrying out the prescribed procedure, you should definitely ask about possible contraindications.

Surgical treatment of exudative otitis media

Surgical treatment of chronic exudative otitis is carried out if conservative therapy does not bring the required result. The purpose of the operation is to remove exudate, restore hearing function and prevent relapse of the disease. Otosurgical intervention can be performed only during or after sanitation of the upper respiratory tract. After the operation, careful and long-term follow-up of the patient by an otolaryngologist and audiologist is required, since very often the disease often recurs.

Contraindications

Not everyone can undergo physical therapy, so you should not use such treatment methods if you have:

Pacemaker;
Oncological processes;
Uterine fibroids;
Mastopathy;
Fiber nodes;
Pathologies of the thyroid gland (thyrotoxicosis);
Blood pathologies;
Mental disorders.

Also, you should not resort to such methods if the patient is prone to frequent bleeding. You should choose a physiotherapy procedure only together with your doctor.

Treatment of otitis media involves complex therapy, so you should not postpone the prescribed procedures. Often patients simply do not realize the full effectiveness of this type of treatment.

Indications and contraindications for use

Electrophoresis of medicinal substances is used to treat local and regional processes of various nature:

Inflammatory.
Dystrophic.
Allergic, etc.

Electric current is successfully used for:

Vertebrogenic diseases.
Diseases of the central and peripheral system (encephalitis, myelitis, neuritis, pleiasitis, radiculitis).
Neurosis (neurasthenia).
Bronchial asthma.
Muscle hypertonicity.
Osteochondrosis.
If there is a threat of miscarriage.
For problems with conception.
For kidney diseases.
Chronic hepatitis.
Cirrhosis of the liver.
Liver damage.
Dyskinesia of the gallbladder.

The electrophoresis procedure is safe and accessible to everyone.

However, there are diseases for which it is undesirable to use these devices:

Malignant neoplasms.
Various stages of heart failure.
Purulent formations on the skin.
Various skin diseases (dermatitis, eczema and others).
Diseases of the genitourinary system.
Increased or decreased blood clotting.
The procedure is prohibited when body temperature increases.
In addition, electrophoresis devices should not be used if a person suffers from intolerance to electric current.
If the patient has metal dentures, then electrodes should not be applied to the face.

If you follow the doctor’s recommendations and follow the instructions of the special device, the procedure will bring a positive result. In fact, using an electrophoresis device at home is in no way inferior to performing the procedure in a hospital.