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CNAA / Theses / 2006 / June /

Diagnosis and treatment of the auditory tube functional disorders in chronic suppurated otitis media


Author: Oleg Losîi
Degree:doctor of medicine
Speciality: 14.00.04 - Otorhinolaryngology
Year:2006
Scientific adviser: Alexandru Sandul
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Institution:
Scientific council:

Status

The thesis was presented on the 13 June, 2006
Approved by NCAA on the 28 September, 2006

Abstract

Adobe PDF document – 0.50 Mb / in romanian

Thesis

CZU [616.284-002.2 + 616.286-002.2]-08

Adobe PDF document 1.13 Mb / in romanian
131 pages

Keywords

tubal disfunction, electromyostimulator, permiability of the auditory tube, pneumotubograme, electrical stimulation of peritubal muscles, auditory tube

Summary

The work presents the results of the study on a lot of 136 patients of 5-60 years of age. 93 patients (68,4%) had chronic suppurated mesotympanitis, 18 patients (13,2%) had chronic suppurated epytympanitis, and 25 patients (18,4%) had chronic suppurated mesoepytympanitis.

The purpose of the study consisted of a complex assessment of all indicators that characterize the functional state of the auditory tube in terms of enhancing the conservative methods efficiency of the patients’ treatment with chronic suppurated otitis media influencing concomitantly the inflammatory process from the auditory tube.

To prove this. the patients were distributed in three lots: 69 patients were included in the experimental lot with chronic suppurative otitis media, .34 patients were in the control lot – LM1, 33 patients were in the control lot – LM2.

The patients from the experimental lot underwent electrical stimulation of the auditory tube muscles, with the purpose of treatment by injecting 1mg of Betametason solution. The patients from the first control lot were administered intratubal suspension Hydrocortison acetate or 4 mg Dexametason solution.

The patients from the second control lot were administered a spray with Beclometason solution intranasaly (one dose contains 50 mkg of Beclometason dipropionate).

The analysis of the auditory tube permeability dynamics indices revealed an improvement of the parameters studied in LB compared with LM1 and LM2. Thus as a result of treatment applied to the patients from the experimental lot, all the pneumotubometric indices were rapidly improved and maintained for a long period. Ventilation and drainage functions in patients from this lot were obviously improved and maintained during the entire period of evidence.

Conclusions: as a results of the study I came to the conclusion that the variety of methods of examination of the auditory tube functions in patients with chronic suppurated otitis media, the crucial role in providing of objective data concerning the functional state of the auditory tube and of peritubal muscles, belongs to the complex utilization of pneumotubometry. Clinical investigation of different treatment methods used by us revealed the fact that injecting of Betametason dipropionate by subsequent electrical stimulation of the auditory tube muscles, is a more efficient method with a rapid action and a long duration without side effects and admissible to all patients with chronic suppurated otitis media. This fact was confirmed by the disappearance of clinical signs of tubootitis (84%) a marked improvement of hearing (78,3%) and of function state of peritubal muscles (98,6%) and the lack of subsequent exacerbations.