CLINIC-MORPHOLOGICAL FEATURES OF SYNCHRONIZATION OF INFLAMMATION IN A MUCOUS MEMBRANE OF A MIDDLE EAR IN MODERN CONDITIONS
https://doi.org/10.21518/2079-701X-2017-16-44-47
Abstract
Objective. To determine the clinical and morphological criteria of chronic inflammation development in the middle ear mucosa and the study of local immunity.
Material and methods. 67 patients aged from 19 to 67 years (men-28, women-39) with complaints of pain, congestion in the ear, constant or intermittent mucopurulent discharge from the ear, and hearing loss were examined. The disease duration ranged from 3 days to 20 years or more. We have investigated the mucosa of the pathologically changed parts of the tympanic cavity. The sections were stained with hematoxylin and eosin, and trichromatic color by Mallory. For the immunohistochemical study monoclonal antibodies to T lymphocytes (CD4 T-lymphocytes-helper cells, CD8 T-lymphocytes-suppressors), B-lymphocytes (CD20) were used. The calculation of the immunohistochemical reaction was performed with a standard increase of 40 in 12 fields of view.
Conclusions. On Week 3 of the disease is a clear imbalance in the local immune defense occurs, which is a turning point in the course of the disease. In the period since 6 months and suppression of the immune response was detected. Thus, we believe that in conditions of a purulent inflammatory process the beginning of the process of chronic inflammation (development of granulation tissue) in the mucous membrane of the middle ear occurs on Week 3 from the onset of the disease, which is by 2–2.5 times later than in aseptic conditions.
About the Authors
V. T. Palchun
Pirogov Russian National Research Medical University of the Ministry of Health of Russia; Sverzhevsky Scientific and Research Clinical Institute of Otorhinoparyngology of the Moscow Healthcare Department
Russian Federation
Corresponding Member of RAS, MD, Prof.
Russian Federation
Corresponding Member of RAS, MD, Prof.
A. V. Gurov
Pirogov Russian National Research Medical University of the Ministry of Health of Russia; Sverzhevsky Scientific and Research Clinical Institute of Otorhinoparyngology of the Moscow Healthcare Department
Russian Federation
MD, Prof.
Russian Federation
MD, Prof.
L. M. Mikhaleva
Scientific and Research Institute of Human Morphology
Russian Federation
MD, Prof.
Russian Federation
MD, Prof.
M. V. Gordienko
Pirogov Russian National Research Medical University of the Ministry of Health of Russia
Russian Federation
Russian Federation
References
1. Крюков А.И., Хамзалиева Р.Б., Захарова А.Ф., Изотова Г.Н. Показатели заболеваемости и качества оказания амбулаторной ЛОРпомощи больным с патологией уха и верхних дыхательных путей. Российская оториноларингология, 2008, S1: 117-119.
2. Пальчун В.Т., Крюков А.И. Оториноларингология: Руководство для врачей. М.: Медицина, 2001.
3. Яковлев В.Н., Крюков А.И., Гаров Е.В., Кречетов Г.М., Захарова А.Ф. Заболеваемость хроническим гнойным средним отитом и лечение этой нозологии в Москве. Вестник оториноларингологии, 2010, 6: 31-33.
4. Маллин Д.А. Использование линейно-цепочного углеродного покрытия в тимпанопластике. Вестник оториноларингологии, 2006, S5: 110.
5. Тарасов Д.И., Кузнецов В.С., Морозов А.Б. Итоги развития оториноларингологии по РСФСР за IX пятилетку и очередные задачи по ее совершенствованию. М., 1977.
6. Еремина Н.В., Владимирова Т.Ю., Еремин С.А., Головизнина К.С. Региональная распространенность воспалительных заболеваний уха и их течение с учетом чувствительности микрофлоры. Медицинский альманах. 2008, 3: 51-53.
7. Пальчун В.Т. Предупредить хронизацию и осложнения острого воспаления ЛОР-органов. Вестник оториноларингологии, 2009, 2: 4-6.
8. Пальчун В.Т., Крюков А.И., Магомедов М.М. Руководство по очаговой инфекции в оториноларингологии. М.: ГЭОТАР-Медиа, 2015.
9. Mogi G. Secretory immunoglobulin A in oral and respiratory passages in man. Ann Otol. (St. Louis), 1975, 84(20): 3-22. doi.org/10.1177/00034894750840s301.
10. Park K, Lim DJ. Development of secretory elements in murine tubotympanum: lysozyme and lactoferrin immunohistochemistry. Ann Otol. (St. Louis), 1993, 102(5): 385-395. //doi. org/10.1177/000348949310200512.
11. Pipkorn U, Karlsson G, Enerback L. The cellular response of the human allergic mucosa to allergen exposure. J. Allergy Clin. Immunol., 1988, 81: 172-178. doi.org/10.1016/0091-6749(88)90251-5.
12. Шварцман Я.С., Хазенсон Л.Б. Местный иммунитет. М.: Медицина, 1978.
13. Hanamure Y, Lim DJ. Normal distribution of lysozymeand lactoferrin-secreting cells in the chinchilla tubotympanum. Am. J. Otol., 1986, 7(6): 410-425. doi.org/10.1016/s0196-0709(86)80017-5.
14. Mogi G, Honjo S. Middle ear effusion analysis of protein components. Ann Otol. (St. Louis), 1981, 81(1): 99-105. doi.org/10.1177/000348947208100111.
15. Mullol J, Raphael GD, Lundgren JD et al. Comparison of human nasal mucosal secretion in vivo and in vitro. J. Allergy Clin. Immunol., 1992, 89(2): 584-592. doi.org/10.1016/0091-6749(92)90326-w.
16. Palva T, Taskinen E, Hayry P. Cell subpopulations in chronic secretory otitis media. OtoImmunology, 1987: 63-67.
17. Piedra PA, Bernstein JM, Ogra PL. The muconasal defence system with emphasis on the middle ear. Oto-Immunology, 1987: 35-40.
Review
For citations:
Palchun VT, Gurov AV, Mikhaleva LM, Gordienko MV. CLINIC-MORPHOLOGICAL FEATURES OF SYNCHRONIZATION OF INFLAMMATION IN A MUCOUS MEMBRANE OF A MIDDLE EAR IN MODERN CONDITIONS. Meditsinskiy sovet = Medical Council. 2017;(16):44-47. (In Russ.) https://doi.org/10.21518/2079-701X-2017-16-44-47
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