PECULIARITIES OF HELP MANAGEMENT TO PATIENTS WITH ACUTE OTITIS MEDIA COMPLICATED BY MASTOIDITIS
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 and systems of mastoid process) have not been studied and identified. The purpose of this work is to improve the treatment of patients with acute mastoiditis by new scheme to use conservative therapy and modified antromastoidotomy with drainage. The study was conducted in hospitals, in the Otolaryngology department of Poltava Regional Hospital and Otolaryngology department of Hospital No.2. All patients with acute otitis media were divided into 2 groups: group 1 (n = 48) and comparison group: (group 2 n = 35). In patients of subgroups 1-B and 1- D of investigated group, new developed technique of surgical sanitation of papillary process with draining the atico-antral rubber drainage and postoperative cavity such as teflon tubes with momentary wound suturing was used. Patients of 1-B group underwent tunnel antrotomy. In cases where we observed the phenomena of destruction and necrosis, antromastoidotomy was conducted by our own methodology. Endoscopic methods were used during surgery. During the treatment of patients with acute mastoiditis it is necessary to know and understand 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 of antiviral drugs, in the scheme of treatment which significantly increases the effectiveness of treatment of patients with acute mastoiditis.
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