From secretory otitis to retraction cholesteatoma

Abstract

Based on the preliminary examination and further treatment of 980 children, the most influential consequences of secretory otitis were identified and the means of their prevention were proposed. Based on the results of long-term observation, conclusions were drawn. Chronic secretory otitis develops in 16% of children with recurrent secretory otitis, in 25% of cases the disease becomes malignant, and in 10% of cases goes into the stage of chronic purulent otitis media. In the treatment of recurrent and complicated chronic secretory otitis, it is advisable to follow the sequence of treatment, because 68% of children show existing or hidden signs of sinusitis, which requires prior surgical treatment. Among the detected forms, polyposis sinusitis with deformation of the nasal septum predominates (88,5%). The presence of retraction cholesteatoma with a predominant distribution within the tympanic cavity, limited defects of the chain of auditory ossicles and wide possibilities of their replacement, delayed cholesteatoma process with atrophy of matrix structures create conditions for organ-sparing surgery which corresponds to closed tympanoplasty. The morphological and functional effect of such operations can reach 91,5 ± 1,7% of cases in the group of children and adolescents and 88,2 ± 2,1% of observations in the group of adult patients, while the snail reserve decreased by 10,9 ± 3,3 dB in the group of children and 28,4 ± 3,3 dB in the group of adult patients.