RESUMEN
This article describes a clinical case of exacerbation of chronic right-sided epimesotimpanitis, complicated by secondary otogenic purulent meningoencephalitis, an abscess of the right hemisphere of the cerebellum and septic thrombosis of the sigmoid sinus. This is a rare complication of chronic epimesotimpanitis. The article describes the dynamics of treatment and diagnostic justifies the optimal choice of personalized tactics of treatment measures in the hospital, as well as further observation of the patient in the conditions of outpatient health care.
Asunto(s)
Meningoencefalitis , Trombosis de los Senos Intracraneales , Trombosis , Absceso/diagnóstico , Absceso/etiología , Cerebelo , Senos Craneales , Humanos , Meningoencefalitis/complicaciones , Meningoencefalitis/diagnóstico , Trombosis de los Senos Intracraneales/complicaciones , Trombosis de los Senos Intracraneales/diagnósticoRESUMEN
The purpose: to compare the types of cytograms of exudate from the middle ear between patients with exudative otitis media (EOM) with congenital clefts of the lip/palate (CCLP) and without CCLP, determining the stages of chronic disease and the significance of surgery on the middle ear. PATIENTS AND METHODS: Two clinics was parallel conducted a cytological examination of exudate of the middle ear in children. The first group consisted of 30 patients aged 2 to 17 years with EOM without CCLP (n=54 ears). The 2nd group included 17 patients aged 1 year 4 months to 10 years with EOM with CCLP (n=34 ears). RESULTS: In the 1st group, in 61% of cases (n=33), an inflammatory-regenerative type of cytogram was detected, in 39% (n=21) - a regenerative, inflammatory type of cytogram was not detected. In the 2nd group, in 82.4% of cases (n=28), an inflammatory type of cytogram was observed, in 14.7% (n=5) - an inflammatory-regenerative type, in 2.9% (n=1 ear) - a regenerative type. CONCLUSION: With CCLP, the inflammatory nature of the cytogram of the resulting exudate from the middle ear is more common, which is characterized by signs of destruction of the mucous membrane, decay and degradation of the basal and cell membranes. Patients with CCLP often suffer from EOM. They are more likely to development of chronic purulent otitis media, including with cholesteatoma. Destructive changes in the mucous membrane of the middle ear are found in children of different ages. Taking into account the analysis of cytograms of the exudate of the middle ear with CCLP, the imposition of long-term ventilation tubes is justified.