medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2020-16-95-100medsovet-5850Research ArticleАКТУАЛЬНЫЕ ВОПРОСЫ ОТОРИНОЛАРИНГОЛОГИИTOPICAL ISSUES OF OTORHINOLARYNGOLOGYОстрый вирусный средний отит: этиология, диагностика, лечениеAcute viral otitis media: etiology, diagnosis, treatmenthttps://orcid.org/0000-0003-1458-6279МорозоваС. В.MorozovaS. V.

Морозова Светлана Вячеславовна, доктор медицинских наук, профессор кафедры болезней уха, горла и носа

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Svetlana V. Morozova, Dr. of Sci. (Med.), Professor, Chair for Otorhinolaryngology

8, Bldg. 2, Trubetskaya St., Moscow, 119991

doctormorozova@mail.ruhttps://orcid.org/0000-0002-3376-3747КарапетянЛ. С.KarapetyanL. S.

Карапетян Лиана Самвеловна, кандидат медицинских наук, ассистент кафедры болезней уха, горла и носа

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Liana S. Karapetyan, Cand. of Sci. (Med.), Teaching Assistant, Chair for Otorhinolaryngology

8, Bldg. 2, Trubetskaya St., Moscow, 119991

lianaent@gmail.comМагомедоваА. М.MagomedovaA. M.

Магомедова Айна Магомедовна, ординатор кафедры болезней уха, горла и носа

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Ayna M. Magomedova, Resident, Chair for Otorhinolaryngology

8, Bldg. 2, Trubetskaya St., Moscow, 119991

aynamagomedova888@gmail.comПервый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет)РоссияSechenov First Moscow State Medical University (Sechenov University)Russian Federation20201311202001695100Copyright © Морозова С.В., Карапетян Л.С., Магомедова А.М., 20202020Морозова С.В., Карапетян Л.С., Магомедова А.М.Morozova S.V., Karapetyan L.S., Magomedova A.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/5850

Острый средний отит является одним из наиболее распространенных заболеваний у детей и взрослых и наиболее частой причиной назначения антибактериальной терапии, чаще необоснованной. 20–70% респираторных инфекций у взрослых и детей осложняется развитием острого среднего отита. Несмотря на то что только 10% острого среднего отита имеет вирусную этиологию, подавляющее большинство острого среднего отита также является вирусно-бактериальной коинфекцией. В статье представлены основные патогенетические механизмы развития острого среднего отита, такие как вирусный и вирусно-индуцированный. Введен термин «отопатогенные микроорганизмы». Представлен обзор по наиболее частым возбудителям острого среднего отита – вирусным и бактериальным. Описана отомикроскопическая картина на основе общепринятой отечественной классификации острого среднего отита. Представлены основные тимпанометрические кривые и их виды при остром среднем отите. Большое внимание уделено современным принципам патогенетической и симптоматической терапии, в особенности местной противовоспалительной и обезболивающей терапии с использованием ушных капель, содержащих лидокаин. Обсуждается некий прогресс в области профилактики острого среднего отита, что привело к снижению частоты обращений к врачам по поводу отита и назначению антибиотиков. Это связано с широким использованием вакцин, а также введением тактики «выжидательного наблюдения» в легких и умеренных случаях острого среднего отита без первоначального лечения антибиотиками. Успех в снижении заболеваемости острым средним отитом будет зависеть главным образом от предотвращения колонизации носоглотки отопатогенами, а также снижения заболеваемости вирусными инфекциями. Основой профилактики острого среднего отита, согласно международным и отечественным рекомендациям, является вакцинация от пневмококка, гемофильной палочки и вируса гриппа.

Acute otitis media (OSA) is one of the most common diseases in children and adults and the most common cause of antibiotic therapy, often unreasonable. 20–70% of respiratory infections in adults and children is complicated by the development of CCA. Despite the fact that only 10% of CCA has a viral etiology, the vast majority of CCA are also viral-bacterial co-infection. The article presents the main pathogenetic mechanisms of the development of CCA, such as viral and virus-induced. The term “heat-generating” microorganisms is introduced. A review of the most common pathogens of CCA viral and bacterial. An otomicroscopic picture is described based on the generally accepted domestic classification of CCA. The main tympanometric curves and their types during CCA are presented. Much attention is paid to the modern principles of pathogenetic and symptomatic therapy. In particular, local anti-inflammatory and analgesic therapy using ear drops containing lidocaine. Some progress in the prevention of acute otitis media is discussed, which has led to a decrease in the frequency of visits to doctors about otitis media and the appointment of antibiotics. This is due to the widespread use of vaccines, as well as the introduction of “wait-and-see” tactics in mild and moderate cases of CCA without initial antibiotic treatment. Success in reducing the incidence of CCA will depend mainly on preventing the colonization of the nasopharynx by otopathogens, as well as reducing the incidence of viral infections. According to international and domestic recommendations, the basis for the prevention of acute otitis media is vaccination against pneumococcus, hemophilus bacillus and influenza virus.

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The authors declare that there are no conflicts of interest present.