The thesis is written for the purpose of differential diagnosing of the middle ear pathology to detect the presence of embryonic tissue, amniotic fluid and exudate in the tympanic cavity of premature newborns of different gestational age, using morphological and clinical data and modern methods of audiology. In the course of an initial study, a comprehensive audiological assessment of 102 newborn children, who were divided into 4 groups according to the period of gestation, was carried out, which made it possible to assess and compare the functioning of the middle ear in the groups under observation. The examination included a general examination of ENT organs and carrying out a study of acoustic impedancometry and otoacoustic emission In order to evaluate the content of the tympanic cavity and its influence on the results of the audiological study in newborn children, a pathoanatomical study of 80 temporal bones of children of various gestational age has been carried out. In order to evaluate the functioning of the middle ear in dynamics, a study of 568 children has been carried out during the first year of their life. A total of 245 children who were born prematurely – 43.1% and 323 children who were born mature – 56.9% were examined. Based on the obtained audiological data, it was ascertained that in the structure of pathology of the auditory analyzer in premature infants, a conductive type of hearing impairment is predominant, which was established in 30.4% of those examined and was caused by latent inflammation of the middle ear. The pathology of the inner ear was established in 2.9%. The main method for investigating the middle ear function in newborns is tympanometry with a tone frequency of 1000 Hz, which allows to make a differential diagnosis of the pathology of the middle ear, and unlike the use of a low-frequency tone, to detect exudative diseases of the middle ear of a child with higher probability. During the comparative analysis of the quantitative characteristics of tympanograms with a tone of 1000 Hz, the absence of statistical difference in the functioning of the middle ear in newborn premature infants, the postconceptual age of which reached 36 weeks of gestation, and mature infants. Based on the data of the pathoanatomical study, it has been shown that the presence of embryonic tissue in the tympanic cavity depends on the age of gestation, the quantity of which gradually decreases in the tympanic cavity starting from week 25 of intrauterine development, and during the period of expected childbirth its quantity is the smallest, and it is situated only in the front attic space. In addition to embryonic tissue, the presence of amniotic fluid, bacterial flora and purulent exudate has been established in the tympanic cavity. Based on the audiological assessment of children of the first year of life, it has been shown that during the first 6 months of life, exudative otitis occurs more often and is 15,5% in children who were born prematurely and in mature ones – 6,5%. The acute inflammation of the middle ear in the first half of the year is found in almost the same amount and amounts to 5,9% in mature babies and in premature ones – 6,5%. This pathology occurs more often in the second half of the first year of life and amounts to 26,6% in mature infants and in premature ones – 29%.
