Section: 
Science articles
Science articlesDiagnosis and treatment of protracted acute otitis media and its complications
S. D. Polyakova (1), N. N. Bateneva (1), E. A. Nekrasova (1)
(1) Burdenko Voronezh State Medical University, Ministry of Healthcare of Russia, Voronezh, 394036, Russia
UDK: 616.284-002.1-039.3-06-07-08
DOI: https://doi.org/10.18692/1810-4800-2019-3-44-48
ABSTRACT
The authors have emphasized the growth in the number of complicated forms of acute otitis media in Voronezh Region for the period of 2014–2018. Based on the analysis of the medical histories of 536 patients with protracted acute otitis media, a complex of examinations (pure tone audiometry, otomicroscopy, tympanometry, nasopharynx endoscopy, computer-aided tomography of the temporal bones) is recommended. The article points out the typical mistakes in the therapy of the patients with acute otitis media at the out-patient stage, which has resulted in the protracted progress of the disease and the development of complicated protracted acute otitis media. When choosing an antibiotic, the doctors did not take into account the microflora characteristic of acute otitis media, as well as its resistance to the prescribed antibacterial drugs. Non-compliance with the course dose of antibiotic therapy (usually its reduction to 5 days) prevented the efficient action on the pathogenic agent in the focus of inflammation. The prescription of antibiotic therapy at the stage of catarrhal inflammation inhibits the development of local immune protection; consequently, the inflammatory process in the middle ear mucosa acquires a protracted course, which contributes to the chronization of inflammation and the development of complications. The article determines the tactics of treatment of the patients with the long-lasting exudation in the tympanic cavity, the indications for surgical treatment. The authors have shown the options of treatment of patients depending on the degree of patency of the auditory tube. Bacteriological examination of exudate from the middle ear in the patients after the tympanic cavity shunting confirms the non-purulent nature of inflammation. The article specifies the indications for computer-aided tomography of temporal bones in the patients with protracted acute otitis media to exclude mastoiditis. Most patients (57.1%) have a mixed type of mastoid process structure. The authors have analyzed clinical manifestations and the results of surgical treatment of 84 patients with mastoiditis as the complications of protracted acute otitis media, as well as the records of surgeries and surgical findings. According to the histological study of the material obtained during the operation, in most cases, fibrous granulation tissue with mononuclear infiltration was detected.
Publication date:
18.06.2019
Keywords:
acute otitis media, protracted acute otitis media, mastoiditis, otomicroscopy, audiometry, computer-aided tomography of temporal bones, surgical findings. For citation:
Polyakova S. D., Bateneva N. N., Nekrasova E. A. Diagnosis and treatment of protracted acute otitis media and its complications. Rossiiskaya otorinolaringologiya. 2019;18(3):44–48. https://doi.org/ 10.18692/1810-4800-2019-3-44-48