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12SCIENTIFIC PROGRESS VOLUME 3 I ISSUE 4 I 2022 _ISSN: 2181-1601
THE PREVALENCE OF CHRONIC PURULENT OTITIS MEDIA IN THE STRUCTURE OF ENT PATHOLOGY OF CHILDHOOD
U. I. Nurov, G. U. Nurova, E. O. Khaitov
Bukhara State Medical Institute
ABSTRACT
The study of the incidence of CHPOM in the structure of ENT pathology of childhood in the city of Bukhara was conducted based on the analysis of archival material for 2017-2021 years and patients who have applied to the ENT department and polyclinic of the Bukhara regional children's Multidisciplinary Medical Center for 2021-2022 years. It showed that the incidence of inflammatory pathology of the ear for the period from 2017 to 2022 increased 1.6 times and in 2017 amounted to 16% against 9.9% in 2017.
Keywords: chronic purulent otitis media, mesotimpanitis, epitimpanitis
Relevance: According to domestic and foreign authors, chronic purulent otitis media (CHPOM) affects from 1.5 to 4% of the world's population, of which children make up 1.5% (2;6). The incidence of CHPOM in children in our country is 37% of the total pathology of the ear (1;3).
CHPOM is a chronic purulent inflammation of the middle ear, characterized by a triad of signs: the presence of persistent perforation of the tympanic membrane, constant or recurrent purulent discharge from the ear and, to varying degrees, pronounced hearing loss, gradually progressing with a prolonged course of the disease (4;7).
It is known that hearing loss in young children leads to serious changes not only in the formation of speech, but also in psychoemotional development, as well as to a significant deterioration in the quality of life and learning outcomes (5;8). CHPOM can occur in several variants. A more favorable form is mesotimpanitis, in which there is an isolated inflammation of the mucous membrane of the auditory tube, meso- and hypothympanum. In the structure of CHPOM in children, mesotimpanitis occupies a leading place and accounts for more than half of all cases of this disease. Another form, epitimpanitis, which accounts for about 20% of cases of CHPOM, is characterized by a more severe course compared to mesotimpanitis. With epithympanitis, the upper floor of the tympanic cavity (attica) and the mastoid process are mainly affected, 4 moreover, with this form of CHPOM, caries of the bone walls of the tympanic cavity, antrum, auditory ossicles necessarily occurs, cholesteatoma may form. About 30% of CHPOM accounts for a mixed form - epimesotimpanitis (2;5). To date, only individual links of the pathogenesis of CHPOM have been studied, but, unfortunately, without taking into
SCIENTIFIC PROGRESS
VOLUME 3 I ISSUE 4 I 2022 ISSN: 2181-1601
account the age characteristics of the child's body. It is known that among the factors influencing the development and course of CHPOM in children, various kinds of abnormalities in the antenatal and postnatal periods of development play an important role. However, to date, no factors have been identified that cause the transition of acute inflammation in the middle ear in childhood to chronic. Only predisposing factors are known, which are: anatomical and physiological features of the middle ear in children; imperfection of their mechanisms of general and local immunity; frequent presence of adenoid vegetations in children, which are a source of constant infection of a relatively wide, straight and short auditory tube in children; high incidence of acute respiratory viral infections in children, influenza, which have a negative impact on the state of general resistance of the child's body to infectious agents; childhood infections.
The purpose of the study. To study the incidence of chronic purulent otitis media in the structure of ENT pathology of childhood.
Materials and methods. The methodology of the work is based on a systematic and comprehensive data analysis. The diagnosis was made on the basis of anamnesis collection; otorhinolaryngological examination; endoscopic examination of the nasal cavity, nasopharynx and ear; radiography of the paranasal sinuses, nasopharynx and temporal bones; examination of the state of the functions of the auditory tubes; catamnestic observation.
The study of the incidence of CHPOM in the structure of ENT pathology of childhood in the city of Bukhara was conducted based on the analysis of archival material for 2017-2021 years and patients who have applied to the ENT department and polyclinic of the Bukhara regional children's Multidisciplinary Medical Center for 2021-2022 years. It showed that the incidence of inflammatory pathology of the ear for the period from 2017 to 2022 increased 1.6 times and in 2017 amounted to 16% against 9.9% in 2017.
The duration of the disease in children ranged from 3 to 6 years, and their greatest number (78.5%) fell ill with CHPOM at the age of 1 to 3 years. According to the classification depending on the nature of the inflammatory process in the middle ear, localization and size of the perforation of the eardrum, is divided into three forms: 1) mesotimpanitis, which is characterized only by varying degrees of severity of chronic catarrhal inflammation of the mucous membrane (mucositis) of the auditory tube, middle and lower parts of the tympanic cavity (meso- and hypo-tympanum) and a central defect of the tympanic membrane; 2) epithympanitis, characterized by a carious-granulation process (often with cholesteatoma) in the supra-drum space (attica) of the tympanic cavity, in which perforation is localized in the unstrung part of the tympanic membrane; 3) epimesotimpanitis (total tympanitis), in which otoscopic changes inherent in the first two forms of CHPOM are observed, and the inflammatory process is of a mixed nature. In the groups of patients, the predominant form of CHPOM was
SCIENTIFIC PROGRESS VOLUME 3 I ISSUE 4 I 2022 _ISSN: 2181-1601
mesotimpanitis - 64.8%, while epithympanitis was observed in 23.9% and epimesotimpanitis -11.3% of cases. In children suffering from HCG, the following concomitant diseases were detected from the ENT organs: adenoids of the I-II-III degree, adenoids of the I degree with the phenomena of chronic adenoiditis, acute purulent sinusitis, chronic tonsillitis toxicoallergic form II, vasomotor rhinitis.
Conclusions. Ear diseases in the structure of ENT pathology of hospitalized sick children amounted to 16% in 2022 against 9.9% (in 2017), which indicates a 1.6-fold increase in morbidity.
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