Affiliation:
1. Saint Petersburg Research Institute of Ear, Throat, Nose and Speech
Abstract
Anti-inflammatory therapy as part of the treatment of exudative otitis media (EOM) that develops in rhinitis and rhinosinusitis is included in various treatment regimens. If conservative therapy for EOM is ineffective, surgical intervention in the form of various variants of adenotomy and removal of secretions from the tympanic cavity is considered. The authors selected and described in detail a clinical case of observation and treatment of EOM in a 7-year-old child, which allowed to highlight approaches to the diagnosis of the disease, assess her concomitant diseases, choose a method for surgical treatment and conservative therapy with a drug containing tuaminoheptane and acetylcysteine. Eustachian tube drainage followed by the use of an anticongestive drug to treat rhinosinusitis in a 7-year-old girl with EOM showed high effectiveness. The advantages of the drug are as follows: a direct unloading effect, the possibility of evacuation of thickening secretions from the nasal cavity and nasopharynx due to the drug containing acetylcysteine and tuaminoheptane. Thus, the tubular dysfunction in children can be associated with various reasons: inflammatory processes in the nasopharynx and paranasal sinuses (viral and bacterial infection), allergic (exposure to various allergens). EOM may develop in all types of tubular dysfunction in children. The adverse effects of long-term tympanostomy in chronic EOM has led to the search for alternatives. The long-term eustachian tube drainage can be regarded as this method. The anticongestive agent for rhinosinusitis can be used in children with EOM from the age of 6 years. The advantages of the drug include a direct unloading effect, minimal contraindications, restoration of nasal breathing without systemic exposure in frequently ill children, and the possibility of evacuation of thickening secretions from the nasal cavity and nasopharynx. In summary, an anticongestive agent containing acetylcysteine and tuaminoheptane can be recommended for use in paediatric otorhinolaryngological practice to treat acute and subacute rhinitis in children with EOM.