Kryukov A I, Kunelskaya N L, Ivoylov A Yu, Kunelskaya V Ya, Pakina V R, Yanovsky V V, Morozova Z N
Sverzhevsky Research Clinical Institute of Otorhinolaryngology of the Moscow Healthcare Department, Moscow, Russia, 117152; Pirogov Russian National Research Medical University of the Ministry of Health of Russia, Department of Otolaryngology of Cure Faculty, Moscow, Russia, 117997.
Sverzhevsky Research Clinical Institute of Otorhinolaryngology of the Moscow Healthcare Department, Moscow, Russia, 117152; Pirogov Russian National Research Medical University of the Ministry of Health of Russia, Department of Otolaryngology of Pediatric Faculty, Moscow, Russia, 117997; Speransky Pediatric Municipal Clinical Hospital No. 9 of the Moscow Healthcare Department, Moscow, Russia, 123317.
Vestn Otorinolaringol. 2020;85(1):14-21. doi: 10.17116/otorino20208501114.
To increase the effectiveness of treatment of children with catarrhal and secretory stages of exudative otitis media (EOM) through the development of a therapeutic and diagnostic algorithm for the management of children with this condition.
From 2008 to 2017, 346 children (682 ears) aged from 3 to 13 years with exudative otitis media were examined and treated. Two groups of patients were formed: Group 1 (150 children, 298 ears) - with a catarrhal stage of EOM, group 2 (196 children, 384 ears) - with a secretory stage of EOM. Diagnosis and treatment algorithm was created for such patients based on the results of the examination.
Depending on the treatment, 3 groups of patients were formed: Group I - 150 children with a catarrhal stage of EOM who received conservative and surgical treatment for upper respiratory tract conditions; Group II - 146 children with an a secretory stage of EOM, who underwent conservative and surgical treatment: myringotomy / installation of a shunt in the eardrum simultaneously with surgical removal of the block of the auditory tube ostium, a course of conservative treatment for children who did not require surgical treatment; Group III - 50 children with a secretory stage of EOM and grade III adenoids, whose parents, contrary to the doctor's advice, refused the proposed myringotomy / installation of a shunt in the eardrum simultaneously with surgical removal of the block of the auditory tube ostium. These children underwent only adenotomy.
The developed treatment algorithm for children with EOM, depending on the stage of the disease, demonstrated high clinical efficacy and made it possible to achieve stable positive results in 94.7% of cases in patients with the catarrhal stage of ESO and in 84.8% of cases in patients with the secretory stage of ESO, which makes it possible for us to recommend it as an integrated method that improves the quality of treatment for children with EOM.
通过制定渗出性中耳炎（EOM）卡他期和分泌期患儿的治疗与诊断算法，提高对该疾病患儿的治疗效果。
2008年至2017年，对346名3至13岁的渗出性中耳炎患儿（682耳）进行了检查和治疗。将患者分为两组：第1组（150名儿童，298耳）——处于EOM卡他期，第2组（196名儿童，384耳）——处于EOM分泌期。根据检查结果为这类患者制定了诊断和治疗算法。
根据治疗情况，形成了3组患者：第I组——150名处于EOM卡他期的儿童，接受了上呼吸道疾病的保守和手术治疗；第II组——146名处于EOM分泌期的儿童，接受了保守和手术治疗：鼓膜切开术/在鼓膜中植入分流器，同时手术切除咽鼓管开口阻塞物，对不需要手术治疗的儿童进行一个疗程的保守治疗；第III组——50名处于EOM分泌期且腺样体为III级的儿童，其父母不顾医生建议，拒绝了提议的鼓膜切开术/在鼓膜中植入分流器并同时手术切除咽鼓管开口阻塞物。这些儿童仅接受了腺样体切除术。
针对EOM患儿制定的治疗算法，根据疾病阶段，显示出高临床疗效，使ESO卡他期患者94.7%的病例和ESO分泌期患者84.8%的病例能够获得稳定的阳性结果，这使我们能够将其推荐为一种提高EOM患儿治疗质量的综合方法。
