Sulfuric stopper — the congestion of ear sulfur blocking external acoustical pass over time getting a dense consistence. The sulfuric stopper to become notable for the patient only when it completely blocks acoustical pass. Treat signs which clinically show a sulfuric stopper: noise in an ear and its congestion, a hearing impairment, an autofoniya, reflex reactions (dizziness, cough, nausea, a headache). The sulfuric stopper is diagnosed when carrying out an otoskopiya. The way which the sulfuric stopper is removed is chosen depending on its consistence and integrity of an eardrum. It can consist in washing of external acoustical pass or dry extraction of a sulfuric stopper by means of various tools.
The sulfuric stopper completely consists of ear sulfur which represents mix of a secret of glands located in skin of external acoustical pass. Superficial sebaceous glands produce skin fat. Sulfuric glands are located more deeply and their secret has dairy coloring. Besides, in skin of acoustical pass there are apokrinovy sweat glands. Besides a ferruterous secret the sulfuric stopper incorporates the horny particles of an epithelium of skin of external acoustical pass.
Ear sulfur performs protective function, protecting acoustical pass from damages, dryings and macerations in case of hit of water in it. Acidic environment of ear sulfur adversely influences the bacteria and mushrooms which got to acoustical pass, preventing thereby development of external otitis. During chewing, a conversation or yawning there is a movement of ear sulfur to an opening of external acoustical pass. At the same time together with it from an ear dirt, particles of dust and small foreign matters are removed. The formed sulfuric stopper breaks the protective mechanisms which are implemented by means of ear sulfur.
Reasons of formation of a sulfuric stopper
In clinical otolaryngology a number of the reasons for which the sulfuric stopper can be formed is known. One of them is the increased sekretorny activity of sulfuric glands leading to formation of such amount of ear sulfur that she does not manage to be brought from acoustical pass and accumulates in it, turning into a sulfuric stopper. Hyper secretion of ear sulfur can be observed at dermatitis, eczema, chronic otitis, increase in level of cholesterol in blood, frequent and wrong cleaning of ears.
The sulfuric stopper can be connected with difficulty of removal of ear sulfur from acoustical pass. Violation of the mechanism of evacuation of sulfur as a result of which the sulfuric stopper is formed is often observed at anatomic narrowness or an izvitost of acoustical pass; at its narrowing due to inflammatory changes; at a partial or full obturation of acoustical pass by a foreign matter of an ear; with the increased growth of hair in external acoustical pass that is observed at patients of advanced age; when carrying earphones or the hearing aid. The sulfuric stopper is often formed at the persons working in the conditions of the increased dust content of air: millers, miners, workers of tobacco shops, etc. Constant moisture content of acoustical pass at divers and swimmers leads to the fact that even the small congestion of sulfur in it inflates and the sulfuric stopper is formed.
The sulfuric stopper can appear as a result of incorrectly carried out hygiene of external acoustical pass. Between an external webby and cartilaginous part of acoustical pass and its more internal bone part there is a narrow isthmus. Ear sulfur is produced only in webby and cartilaginous department, but can get to a bone part of acoustical pass at the wrong cleaning of ears. Removal of ear sulfur back through an isthmus is complicated. The sulfuric stopper results. Often the sulfuric stopper is formed due to regular pushing through of sulfur for this isthmus and its spressovyvaniye at an eardrum that occurs at too deep introduction of an ear stick or other subject during cleaning of ears.
Signs of a sulfuric stopper
The sulfuric stopper gradually increases in sizes and gets firmer consistence. But while the sulfuric stopper completely does not block acoustical pass, the patient does not experience any changes in an ear. On the consistence the sulfuric stopper can be pastopodobny, plastilinopodobny and firm.
Usually sulfuric stopper proves suddenly. Often it occurs after hit in a water ear. At contact with water the sulfuric stopper promptly increases in volume and completely obturirut a gleam of acoustical pass. Arise typical, pointing to a sulfuric stopper, signs: an ear congestion, noise in it, a hearing impairment (relative deafness). The sulfuric stopper can be shown by an autofoniya — an echo of own voice in an ear. If the sulfuric stopper makes pressure upon an eardrum, then reflex nausea, cough, headaches, dizzinesses can be observed. At a long sdavleniye of an eardrum a sulfuric stopper the inflammation of a membrane can develop (miringit) also cavities of a middle ear (average otitis) that is shown by emergence of a pain syndrome.
Diagnostics of a sulfuric stopper
The sulfuric stopper comes to light the otolaryngologist when carrying out an otoskopiya or mikrootoskopiya. During inspection by means of the pugovchaty probe is defined what consistence the sulfuric stopper has. The eardrum for an exception of existence in it of a perforative opening after earlier postponed sharp or chronic purulent average otitis, injury of an eardrum is examined. Definition of violation of integrity of an eardrum has decisive values for the choice of a way which will remove a sulfuric stopper. Also during an otoskopiya the sulfuric stopper is differentiated from an epidermalny stopper, a foreign matter of an ear, a tumor of an ear, a holesteatoma.
Treatment of a sulfuric stopper
Independent attempts of removal of a sulfuric stopper various make-shifts are strictly forbidden. They can bring to traumatizing skin of external acoustical pass, perforation of an eardrum, to secondary infection with development of otitis or an otomikoz. The sulfuric stopper has to be removed by the expert the otolaryngologist. The choice of a way of removal of a sulfuric stopper is based on data of an otoskopiya.
The most often sulfuric stopper is removed from an ear by washing. However this method of removal cannot be applied at violation of integrity of an eardrum as in such cases liquid can get into a cavity of a middle ear and provoke inflammatory reaction. The Pastopodobny and plastilinopodobny sulfuric stopper can be removed with washing at once after its diagnosing. Removal of a sulfuric stopper washing is made with use of the syringe Zhane in which gain 150 ml of solution of Furacilin or sterile physical solution. The liquid used for washing has to be heated to temperature of 37 °C. It allows to avoid the irritating impact of the procedure on receptors of skin of acoustical pass and to prevent reflex reactions (dizziness, nausea, a headache).
The firm sulfuric stopper demands a preliminary softening. It is made within several days before the appointed washing. As a rule, the sulfuric stopper is softened at an instillation in an ear of 3% of the peroxide of hydrogen which is warmed up up to the temperature of 37 °C. The procedure of an instillation is carried out by 3 times a day. At the same time the patient having a sulfuric stopper is warned that in the period of an instillation of peroxide there can be an aggravation of a congestion in an ear and relative deafness strengthening. It is connected with the fact that the sulfuric stopper inflates under the influence of the dug-in solution and even more densely obturirut acoustical pass.
In cases when the sulfuric stopper cannot be eliminated by washing, so-called dry tool removal is applied. Like removal of a foreign matter of an ear it is carried out by means of special tools: ear hook, ear nippers or spoon. In order to avoid damages of acoustical pass and an eardrum the sulfuric stopper has to be taken from an ear under obligatory visual control. After the sulfuric stopper was removed, for prevention of infection at several o'clock enter a turunda with boric alcohol into an ear.
Prevention of formation of a sulfuric stopper
As often sulfuric stopper is formed in connection with the wrong cleaning of ears, a basis of its prevention is acquaintance of patients with the basic principles of hygiene of an ear. Removal of ear sulfur has to be carried out only from the surface of an auricle and around an opening of acoustical pass. Introduction of ear sticks to acoustical pass causes, at least, its consolidation breaking the natural mechanism of clarification of an ear therefore the sulfuric stopper appears. If the patient considers that he in acoustical pass has a congestion of ear sulfur and is afraid that the sulfuric stopper shortly will appear, then he should address the otolaryngologist. The doctor will perform inspection of external acoustical pass and at identification in it an excess congestion of ear sulfur will make professional cleaning. Periodic carrying out professional hygiene of an ear will allow to avoid formation of a sulfuric stopper to people with the increased growth of hair in acoustical pass and to owners of hearing aids.
The sulfuric stopper also arises because of hyperproduction of ear sulfur. The prevention of the increased secretion of sulfur consists in timely treatment of inflammatory diseases, eczema and dermatitis, control of level of cholesterol of blood.