Khoruzhyi I. Pathomorphological and clinico-biochemical study of treatment strategy for acute otitis media complicated by sensorineural hearing loss

The focus of this research is in the area of investigation of increasing of efficiency of treatment of acute otitis media complicated by sensorineural hearing loss, by the study of differentiated treatment strategies for such patients, based on the identified clinical and biochemical disorders in patients and pathological changes of cochlea in laboratory animals. According to our studies (295 patients), acute otitis media in 10,8 % was complicated by acute sensorineural hearing loss. In most patients with acute otitis media (61 %) were observed clinical and biochemical manifestations of endogenous intoxication, and in patients with acute otitis media complicated by sensorineural hearing loss, indices of leukocytic index of intoxication, molecules of average weight were significantly higher than in patients with uncomplicated acute otitis media (p<0,01). These data can serve as a credible criterion for tympanopunctio to take away pathological content and reduce the effects of endogenous intoxication. Timely detection of sensorineural hearing loss in patients with acute otitis media after tympanopunctio and administration of adequate treatment, which included antibacterial, detoxification therapy and drugs that improve microcirculation and nootropics allowed to achieve positive results in 96,9% of patients. Pathological changes that occurred at experimental acute otitis media were characterized not only by inflammation in the mucous membrane of tympanic cavity, but significant restructuring of cochlear of inner ear. There were performed morphometric studies that confirmed contraction of hair cells in animals with acute otitis media, which was manifested by significant decrease in size of nucleus and cytoplasm (p<0,01) compared with the group of intact animals and is a prerequisite for the development of apoptosis.