Abstract
The effect of the elemental composition of bone tissue on the destruction of the structures of the temporal bone in chronic suppurative otitis media. The study included 331 patients aged 16-75 years with a verified diagnosis of chronic purulent otitis media, subject to surgical treatment. Depending on the diagnosis and method of surgical treatment, patients are divided into groups: patients with tubotympanic otitis media and epitympanic-antral otitis media after reconstructive sanitation otosurgery in comparison with the control group. The elemental composition of the bone tissue of the cavities of the middle ear obtained intraoperatively was evaluated by x-ray fluorescence spectroscopy. Elements in the bone tissue of the cavities of the middle ear obtained intraoperatively were evaluated by spectrophotometric method. The data are processed by descriptive statistics methods and are presented in the form of a median and a range between quartiles with an estimate of the reliability of the intergroup differences by the Mann-Whitney U-criterion. A comparison of the indicators characterizing the elemental composition of the temporal bone tissue in patients with forms of chronic otitis media demonstrates the progression of the severity of pathological bone remodeling according to various options. In the dynamics of observation in patients with morphological signs of purulent destruction of the structures of the temporal bone, not only the most profound imbalance in the levels of calcium and phosphorus was revealed, but also the limitation of the levels of silicon and sulfur in a progressive and recurrent course at different periods of the disease. X-ray fluorescence spectroscopy allows an elemental chemical analysis of bone remodeling according to the pathological type and reliably differentiate purulent diseases of the temporal bone. The results are promising from the point of view of developing new prognostic approaches in otosurgery in the management of patients with chronic purulent otitis media, involving the combined use of morphological research methods with microelement analysis of the temporal bone bone tissue.
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