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No6(5) 2022

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DOI 10.37219/2528-8253-2022-6-23

Deeva YV, Naumenko OM, Tarasenko MV
Modern aspects of immune protection of the middle ear in the pathogenesis of acute otitis media and its complications  
Deyeva Julia V.
MD, PhD, professor
Head of the department of Otorhinolaryngology
Bogomolets National Medical University, Kiev
E-mail: deyeva@bigmir.net
ORCID ID: 0000-0003-0552-1254
https://www.scopus.com/authid/detail.uri?authorId=55359076200

Naumenko Olexander
Bogomolets National Medical University, Kiev, Ukraine
First vice-rector for scientific and pedagogical work and postgraduate education
Doctor of Medical Sciences, Professor
E-mail: Naumenko@nmu.ua
https://orcid.org/0000-0002-9001-7580
Scopus Author ID: 7005396556

Tarasenko Maksym V.
Bogomolets National Medical University, Kiev, Ukraine
Candidate of Medical Sciences, Associate Professor
ORCID: http://orcid.org/0000-0002-4991-9910

Abstract

The relevance of the study is due to the need for an extended search for information on the current state of the problem of acute otitis media in adults based on the experience of Ukrainian and foreign authors.
The aim of our research: To analyze the world experience on the etiology, pathogenesis and diagnosis of acute otitis media in adults.
Materials and methods: 125 modern literature sources of electronic databases PubMed, EMBASE, MED-LINE, U.S. National Library of Medicine Clinical Trials, Research Gate and Cochrane Library.
Introduction: The problem of otitis media as a component of the problem of inflammatory diseases of the upper respiratory tract remains relevant in modern medicine, based on its incidence and prevalence in the structure of otolaryngological diseases. Despite the achievements of modern medical science, these indicators remain consistently substantial, which determines the relevance of further research to improve diagnosis and treatment.
Results: By conducting a bibliographic method of research it was found that most scientific articles are devoted to the problem of acute otitis media in children, while the problem of acute otitis media in adults is not sufficiently studied. Clinical and experimental studies have established that the function of immune protection of the middle ear is present at almost all physiological levels from epithelial cells to intracellular nuclear factor. This function is realized through the messengers of the cytokine network. Among the pool of cytokines, IL-1, IL-6 and TNF-α are important for the pathogenesis of acute otitis media. One of the features of the immune defense is a clear succession of stages of inflammation with its own features at each stage. It is shown that each of the links of immune defense (including cytokines) is able to detect (in case of discrepancy in strength and time) a negative effect with the maintenance or intensification of inflammation. The data of experimental analysis of pathomorphological changes in the middle ear depending on the duration of the disease are presented. It is also shown that the
issue of complicated course (in particular mastoiditis) is still relevant. The role of acute otitis media in the deveopment of intracranial complications (meningitis) has been established. The significance of comorbidity for the pathogenesis of acute otitis media and the role of diabetes mellitus in the structure of comorbidity was proved.
The main factors of reducing the effectiveness of diagnosis and treatment of acute otitis media are convincingly outlined: the multifactorial nature of the etiology, the peculiarities of immune protection and the tendency of otopathogens to evade the host's immune response, the importance of comorbid pathology in adult pat ients with ENT diseases. A certain number of literature sources are devoted to the features of the course of acute otitis media in diabetes mellitus.
The shortcoming identified by the results of the analysis of literature sources: the lack of research on the peculiarities of the clinic and diagnosis of acute otitis media in adults, especially in the setting of comorbid pathology, primarily type 2 diabetes mellitus, indicates the relevance of further research on this problem.

Keywords

acute otitis media, comorbid pathology, type 2 diabetes mellitus, complicated otitis media, cytokines, cytokines and bone resorption, latent mastoiditis, the influence of hyperglycemia on the course of otitis media, adults.


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