Перспективы применения противовоспалительного препарата аммония глицирризината в лечении пациентов с хроническим гнойным средним отитом

Abstract

Rationale. In the context of optimizing the preoperative treatment of chronic suppurative otitis media (CSOM), it is important to study changes in biochemical markers of inflammation in the middle ear to justify the appointment of anti-inflammatory therapy to prevent complications in the postoperative period of surgery. Objective. To study the preoperative level of indicators of inflammatory metabolism and increase the effectiveness of preoperative pharmacotherapy in patients with CSOM by using the anti-inflammatory drug ammonium glycyrrhizinate. Patients and methods. The prospective study involved 48 patients diagnosed with CSOM. As a preoperative treatment, the control group (n = 24) received standard therapy, patients of the main group (n = 24) were additionally prescribed the anti-inflammatory drug ammonium glycyrrhizinate. During the 30-day follow-up, the patient’s diaries were analyzed, and the biomaterial (mucoperiosteum, bone tissue) was assessed by enzyme immunoassay. Results. In patients who received a course of anti-inflammatory treatment with ammonium glycyrrhizinate, the levels of pro-inflammatory markers (matrix metalloproteinases and lipid peroxidation products) of bone tissue and mucoperiosteum of the middle ear were determined significantly lower relative to the control. Patients of the main group already by the 10th day of treatment noted a significant regression of the symptoms of the disease (discomfort, otalgia, and otorrhea in the affected ear) in comparison with the control group. For a period of one year after the surgical intervention, revision of the middle ear with the creation of a neotympanic membrane was required in 6 (25%) patients of the control group and only one patient in the main group (4%). Conclusions. The inclusion of the anti-inflammatory drug ammonium glycyrrhizinate in the preoperative preparation of patients with CSOM made it possible to achieve a significant decrease in the severity of the main symptoms, the objective positive dynamics of biomarkers of inflammation of the bone tissue and mucoperiosteum of the middle ear, improving the prognosis of the course of CSOM in the form of a decrease in the frequency of complications with the need for a second operation within a year after the operation.