Возрастные особенности течения сочетанной острой воспалительной патологии риноорбитальной зоны и среднего уха у детей

Abstract

Acute inflammatory diseases of the nasal cavity and paranasal sinuses can contribute to the development of pathological processes in the auditory tube and middle ear, lacrimal ducts and orbit. Purpose of the study: to identify age-related features of the course of combined acute inflammatory pathology of the rhino-orbital zone and middle ear in children that require consideration in the treatment of these diseases. 248 patients in the study were divided into five groups: children aged 3-4 weeks to 11 months, from 1 year to 2 years, from 3 to 6 years, from 7 to 11 years old, from 12 to 17 years old. In children of the first years of life, a combination of acute otitis media and rhinitis was often noted, with concomitant conjunctivitis, stenosis of the nasolacrimal canal, or dacryocystitis. Acute sinusitis, their orbital complications, occurring in combination with the pathology of the lacrimal system and the middle ear, mainly occurred in children from 3 years of age and older. All patients underwent conservative treatment: topical and systemic decongestant, anti-inflammatory, unloading, irrigation-elimination, mucolytic therapy. Oxymetazoline was used as a decongestant, taking into account the age of the child. Systemic beta-lactam antibiotics were prescribed according to indications. Surgical interventions were carried out: puncture of the maxillary sinuses for sinusitis in children from 7 years of age, endoscopic sinus surgery for reactive edema of the tissue and subperiosteal abscess upholstered. Ophthalmological care was provided aimed at stopping conjunctivitis and disrupting the outflow of tears (using eye drops, probing and recanalization of the lacrimal ducts). In all groups, patients showed a positive dynamics of the course of diseases and recovery.