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CURRENT ISSUE

№1' 2022

OTORHINOLARYNGOLOGY

International Medical Journal, Vol. 28., Iss. 1, 2022, P. 71−78.

DOI (https://doi.org/10.37436/2308-5274-2022-1-15)

PATHOGENETIC SIGNIFICANCE OF HYPERGLYCEMIA IN FORMATION OF THE COURSE PECULIARITIES OF ACUTE OTITIS MEDIA AND ITS COMPLICATIONS

Kharkiv Medical Academy of Postgraduate Education
Municipal Non−Profit Enterprise "City Clinical Hospital of Ambulance and Emergency Medicine named after Prof. O. I. Meshchaninov", Kharkiv City Council, Kharkiv, Ukraine

The study of the manifestations of acute otitis media in type 2 diabetes is becoming increasingly important. The clinical course of acute otitis media in combination with intracranial complications with hyperglycemia, severity of intoxication syndrome, presence and direction of changes in laboratory parameters, magnetic resonance imaging of the pyramids of the temporal bones and brain and features and therapeutic features were studied and comprehensively analyzed. It was found that in the vast majority of patients with hyperglycemia, acute otitis media was complicated by purulent meningitis and meningoencephalitis. The discrepancy between the history of acute otitis media, complaints, otoscopic picture on other objective data and laboratory parameters, the severity of intoxication syndrome, results of MRI of the temporal bones and intraoperative findings were found. The unidirectional tendency of growth of average daily glycemia and its fluctuations, content of glycosylated hemoglobin of blood serum in all groups of patients in the presence of reliable difference between them has been shown. The severity of endogenous intoxication, negative results of microbiological examination of blood, cerebrospinal fluid and contents of the middle ear with bacterial infection within moderate severity do not preclude the idea of "other", not primary bacterial pathogenetic mechanism of latent mastoiditis under the influence of hypermia. The presence of changes in laboratory parameters and MRI data in patients with newly diagnosed hyperglycemia, similar to the results of examination of the patients with diabetes, suggests that it should not be considered hyperglycemia of critical conditions. Therefore, it is advisable to conduct further examination in such patients to diagnose, correct hyperglycemia and the resulting pathogenetic mechanisms.

Key words: acute otitis media, otogenic meningitis, hyperglycemia, parathyroid hormone, leukocyte intoxication indices, fluctuations in average daily glycemia, magnetic resonance imaging of temporal bones.

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