International Medical Journal, Vol. 23., Iss. 4, 2017, P. 62−65.
STATISTICAL ANALYSIS OF DIAGNOSIS AND TREATMENT OF SEROUS OTITIS MEDIA IN CHILDREN
Kharkiv Medical Academy of Postgraduate Education
City Clinical Hospital № 30, Kharkiv, Ukraine
One of the pressing issues of pediatric otorhinolaryngology is secretory otitis media, a disease characterized by exudate accumulation in the middle ear cavities against a background of aseptic inflammation and the presence of grade 1−2 conductive hearing loss. Absence of pain syndrome in the clinical presentation of chronic otitis media, mild hearing impairment at early stages of the disease impede the diagnosis and timely treatment. The incidence of this disease was analyzed in children who were treated at KhMAPE hospital in 2013−2016. The effectiveness of the treatment algorithm was assessed; the ways to improve it (elimination of recurrence of the disease) were determined. When analyzing the statistical material, both an increase in the total quantity of acute otitis media over the years, and an increase in the number of cases stage 2 chronic otitis media with effusion, which required immediate full−fledged treatment (including surgical −− tympanopuncture, adenotomy under general anesthesia, if indicated) to prevent the transition of chronic otitis media with effusion to heavier forms, leading to adhesive processes in the tympanic cavity and formation of persistent hearing loss, were revealed. The children with recurrence of serous otitis media after performed adenotomy, tympanopuncture and a course of conservative treatment were determined to require an in−depth virological study of the nasopharynx. A more aggressive treatment tactics is used in patients with stage 2 disease: tympanopuncture of the tympanic membranes after confirmation of the diagnosis based on the disease history analysis, classical examination of the organs, impedance measurement, audiometry, endoscopy of the nose and nasopharynx. Expediency to study the persistence of Epstein−Barr virus in the nasopharynx and some immunity factors that undoubtedly affect the course of the disease is emphasized. The studies were carried out by the method of detection of antibodies to EBV using enzyme immunoassay (ELISA) in the blood serum. We consider that correction of these factors is the prospect of achieving a stable remission and recovery with complete restoration of auditory function in these children.
Key words: secretory otitis media, etiology, investigation, treatment.