RESUMEN
This publication continues the preceding paper entitled "Early diagnostics of the retraction pockets in the tympanic membrane of the children". The objective of the present work was to develop the criteria for the objective estimation of the dynamic state of the retraction pockets (RP) in the children at different stages of excudative otitis media. The secondary objective was to develop an approach to the early diagnostics of cholesteatoma of the middle ear. A group of 138 children at the age varying from 1 to 17 years was placed under dynamic observation for the purpose of drawing up the individual "photo-roentgenological passport of the retraction pockets". Special attention was given to RP-semiotics of different forms of the syndrome and its severity in accordance with the classification universally accepted by foreign researchers. The results of the dynamic observations were used to develop the indications for the early preserving surgical treatment. It was given to 16 children six of which presented with cholesteatoma. The original illustrative materials for all variants of the retraction pockets are presented.
Asunto(s)
Colesteatoma , Monitoreo Fisiológico/métodos , Otitis Media con Derrame , Adolescente , Niño , Preescolar , Colesteatoma/diagnóstico , Colesteatoma/etiología , Colesteatoma/fisiopatología , Colesteatoma/prevención & control , Técnicas de Diagnóstico Otológico , Diagnóstico Precoz , Intervención Médica Temprana , Endoscopía/métodos , Femenino , Humanos , Lactante , Masculino , Otitis Media con Derrame/complicaciones , Otitis Media con Derrame/diagnóstico , Otitis Media con Derrame/fisiopatología , Otitis Media con Derrame/cirugía , Selección de Paciente , Índice de Severidad de la Enfermedad , Hueso Temporal/patología , Hueso Temporal/fisiopatología , Hueso Temporal/cirugía , Tomografía Computarizada por Rayos X/métodos , Resultado del Tratamiento , Membrana Timpánica/patología , Membrana Timpánica/fisiopatología , Membrana Timpánica/cirugíaRESUMEN
The most important literature data concerning retraction pockets (RP) of the tympanic membrane and their currently accepted classification are presented. The objective of the present work was to develop criteria for the objective estimation of the dynamic state of the tympanic retraction pockets in children presenting with non-perforating forms of otitis media. A total of 138 children suffering from exudative otitis media were available for observation; retraction pockets were found in the majority of these patients. Otomicroscopic characteristics of various RP species are described. A diagnostic approach to the observation of the dynamic state of the tympanic retraction pockets is proposed. The presence of the retraction pockets of the tympanic membrane is considered to be a risk factor of the development of cholesteatoma and chronic purulent pathology of the middle ear in the children. Deep retraction pockets without a controllable bottom and attic cholesteatomas were identified in 16 (11.6%) and 6 (4.3%) of the examined children respectively. They were treated by means of sparing otosurgery.
Asunto(s)
Colesteatoma del Oído Medio/patología , Otitis Media/complicaciones , Otitis Media/diagnóstico , Membrana Timpánica/patología , Adolescente , Niño , Preescolar , Colesteatoma del Oído Medio/etiología , Diagnóstico Precoz , Humanos , Lactante , Otitis Media/etiología , Factores de Riesgo , Membrana Timpánica/anomalíasRESUMEN
The examination of 103 children aged 1 year to 5 years had acute otitis media purulenta. They were treated with paracentesis which had a positive effect on recovery of the acoustic function. It is shown that children with previous acute otitis media should be followed up to control recovery of hearing.