Integrated approach to help patients with acute inflammation of the middle ear structures
Today signs of transition from the stage of inflammation - antrocellulitis (inflammation of the lining cells of the mastoid process) to mastoiditis (purulent fusion of bone cells systems mastoid process) are not studied and not identified the clear evidence of the timing and extent of surgery.The purpose of this work improving the treatment of patients with acute mastoiditis by new scheme of using conservative therapy and modified antromastoidotomy with drainage. Materials and methods. The study was conducted in hospitals, at the Otolaryngology department of the Poltava Regional Hospital and Otolaryngology department of the City hospital 2 city of Poltava. Results in the period from 2009 to 2016 were examined and 83 patients with acute and middle otitis were treated, mastoiditis complicated. All patients were divided into 2 groups - investigated - Group 1 (n=48) and the comparison group - Group 2 (n=35). Results. In patients 1-B and 1-D of investigated group, we used new developed technique of surgical sanitation of papillary process with draining the atico-antral rubber drainage, and postoperative cavity - teflon tubes with momentary wound suturing.Patients of 1-B group were held tunnel antrotomy, the aim was to determine the condition of the cells of mastoid. In cases where we observed the phenomena of destruction and necrosis, antromastoidotomy conducted on own methodology. In carrying out surgery used endoscopic techniques performed air permeability test for atico-antral part.Conclusions. On prescribing the treatment of patients with acute mastoiditis it is necessary to take into account, in addition to clinical signs of disease, data of cone-beam CT, the presence of atico-antral connection, which probably depends on the anatomical features of the structure of the middle ear and the severity and prevalence of inflammatory process. Morphological data necessitate the inclusion in the scheme of treatment of antiviral drugs, which significantly increases the effectiveness of treatment of patients with acute mastoiditis.