Clinical and hematological characteristics of complicated and intact otitis media

Purpose: to evaluate clinical and hematological features and identify patterns in hematological indices in patients with complicated and uncomplicated forms of otitis media.

Materials and methods: The study included 30 patients with otitis media aged from 18 to 70 years: 24 patients (80%) had an uncomplicated course, 6 (20%) had a complicated course (cholesteatomas, mastoiditis). The diagnosis was established taking into account the clinical recommendations of the Russian Ministry of Health (2022) on the basis of a comprehensive clinical and laboratory examination, otoscopy, and audiological studies.

Clinical, anamnestic and statistical methods were used. Calculation of hematological indices was carried out using a computer program. Statistical analysis was carried out using the Statistica 10 package. The critical level of statistical significance when testing scientific hypotheses was p < 0.05.

Results and conclusions. In the group of patients with complicated otitis media, a more vivid clinical picture and more pronounced changes in hematological parameters were observed. Noteworthy are the features of disturbances in the state of immune homeostasis: with complicated otitis, the ISLE indicator increased 3 times more often, which indicates the predominance of an immediate type reaction in the development of complications. The macrophage system index (MSI) was changed in uncomplicated otitis compared to complicated patients, which indicates a violation of cellular phagocytic protection in otitis media. In all cases, a violation of the effector and affector links of immunity (IAM) was revealed, with a predominance of the effector pathway. In 80% of cases of otitis, disturbances in the interaction of humoral and cellular immunity (LI) were observed.

The multidirectionality of the results obtained requires their further study in order to develop an algorithm for personalized diagnosis of patients with otitis media.