STATE OF HEARING FUNCTION AND EUSTACHIAN TONSILS IN PATIENTS WITH SECRETORY OTITIS MEDIA AT DIFFERENT STAGES OF ITS DEVELOPMENT
The problem of hearing pathology is relevant as we have seen the number of those patients increasing yearly. According to the literature, about 30% of all cases of hearing loss are related to middle ear pathology. The cause of the development of many forms of hearing loss is the dysfunction of the Eustachian tube which can lead to retraction of the tympanic membrane, development of secretory otitis media or even adhesive otitis media that can be the reason for constant conductive hearing loss, and require surgical intervention to restore mechanism of sound conduction.
Prevention and treatment of hearing disorders is not only a medical, but also a social-economic problem. In our researches, we’ve decided to study the peculiarities of hearing impairment in patients with secretory otitis media in different stages of its development, depending on the condition of the tubal tonsils and lymphoid tissue around the orifice of the Eustachian tube.
The aim. Study the relationship between the state of auditory function and pathomorphological changes of the tubal tonsils and lymphoid tissue around the orifice of the Eustachian tube in patients with secretory otitis media in different stages of its development.
Material and methods. There were examined 89 patients, age between 18 and 65 years old, with secretory otitis media. All patients were performed a detailed collection of complaints, disease anamnesis, examination of the ENT-organs – by a routine method and with the help of endoscopic and microscopic equipment, as well as pure-tone audiometry and tympanometry. Patients were divided into III groups. Group I – 21 patients with catarrhal stage of secretory otitis media, group II – 38 patients with serous stage, group III – 30 patients with mucous stage.
The results. When examining patients with secretory otitis media during nasopharyngeal endoscopy, the changes in the tubal tonsils and surrounding area in the form of inflammation, hypertrophy, or hyperplasia were found. The form of these changes affects the nature of the disease stage. According to pure-tone audiometry, the average hearing thresholds at speech frequencies by air conductivity in all patients were significantly increased. At the same time, in patients of group III with mucous exudate in the middle ear space, average hearing thresholds by bone conduction were slightly increased, which is associated with significantly restricted or absent movement of the tympanic membrane and ossicular chain in the presence of thick mucous exudate.
Conclusions. Analyzing the patients’ complaints, clinical picture, data of otoscopy, endoscopy of the nasal cavity and nasopharynx, data of pure-tone audiometry and tympanometry – there was determined a cause-and-effect relationship between the condition of the tubal tonsils, the stage of secretory otitis media and, accordingly, hearing impairment in the examined patients. The performed studies indicate that one of the reasons for the development of secretory otitis media in adults may be pathomorphological changes in the tubal tonsils and lymphoid tissue surrounding the orifice of the Eustachian tube, namely their pathomorphological changes: inflammation, hypertrophy, or hyperplasia. Inflammation of the tubal tonsils, as a rule, is the cause of the development of the catarrhal and serous stage of secretory otitis media, and their hypertrophy or hyperplasia leads to the long-term dysfunction of the Eustachian tube, which in turn is the cause of the mucous stage of secretory otitis media.
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