[Pathogenesis and treatment of chronic purulent otitis media and its complications: immunological aspects]. / Immunologicheskie aspekty patogeneza i lecheniia khronicheskogo gnoinogo srednego otita i ego oslozhnenii.

ABSTRACT

Clinicoimmunological, microbiological and cytological examinations were made in 96 patients with otitis media purulenta chronica (OMPC) and otogenic intracranial complications. It was found that in different clinical forms of OMPC nonspecific defense and immunity indices vary. In OMPC and chronic purulent mesotympanitis the indices change insignificantly. In chronic purulent epitympanitis and otogenic intracranial complications there was suppression in T-cell immunity and nonspecific defense. Middle ear secretion contained less SIgA and lysozyme, blood contained more amount of IgA and IgM and less of IgG. Deficiency of general and local defense antiinfectious mechanisms shows significance of immune and nonspecific resistance in transformation of ear inflammation into chronic phase and development of complications. Alterations in immunity, nonspecific defense and tympanic cavity depend on the causative agent of OMPC. Association of St. aureus with gramnegative flora or anaerobic infection cause the greatest immune deficiency. Temporal bone surgery and standard treatment for 21 days fail to eradicate initial immune disorders in the blood and middle ear. Thymalin immunocorrection improves nonspecific defense and immunity, attenuates inflammation and stimulates reparative processes in the trepanation wound of the ear.