К вопросу о патогенезе затянувшегося течения экссудативного среднего отита

Abstract

The article is devoted to the role of the regional lymphatic system of the middle ear, from the point of view of the pathogenesis of the prolonged presence of fluid in the air cavities of the temporal bone with a prolonged course of serous otitis media. The study was carried out in an experiment on a model of exudative otitis media in laboratory animals (20 sexually mature male Wistar rats). Studied the state of regional (superficial, facial, and deep) lymph nodes collecting lymph from the mastoid process, tympanic cavity; external auditory canal, auditory tube. Comparative morphological and morphometric studies of lymph nodes were carried out on the 12th day of experimental otitis media and were assessed according to 19 criteria: total area of the node section, area of the capsule, marginal sinus, cortex, paracortex, medullary sinuses, medullary cords, number and area of primary and secondary lymphoid nodules, area of germinal centers, specific areas of cortical and medullary substance, sinus system, cortical/medullary ratio (C/M index), T- and B-dependent areas. Disorders of lymph outflow in the middle ear area, different nature, and degree of response of regional lymph nodes of different groups to the exudative process were revealed. It is assumed that the restructuring of the structural organization of the nodes, reflecting the inhibition of their protective and drainage functions, can prolong the phenomena of lymphostasis in the area of the primary focus and lead to the protracted course of exudative otitis media in clinical practice.