To date, in domestic and foreign literature, there are more and more reports of the successful use of glucocorticosteroids for the treatment of pathology of the inner ear by local intratympanic administration. Many methods are being developed to deliver drugs to the structures of the inner ear. As you know, the systemic administration of glucocorticosteroids has a number of contraindications and a large number of side effects, due to a wide spectrum of action. Exogenous glucocorticoids disrupt the natural balance of the hypothalamic-pituitary-adrenal system, interfering with the negative feedback regulation system, which requires a long time to fully restore. The intratympanic method of administering glucocorticosteroids makes it possible to bypass the above undesirable effects and at the same time provide the desired therapeutic effect on the vestibular and cochlear structures of the inner ear. With regard to the effect on the structures of the inner ear, intratympanic use of glucocorticosteroids turned out to be more effective than the systemic one, which is associated with the presence of a hematoperilymphatic barrier, comparable in its permeability to the blood-brain barrier. Moreover, when administered systemically, large doses of steroids are required to achieve a sufficient concentration of the drug in the fluids of the inner ear. To date, many questions remain regarding the routes by which the drug penetrates to the structures of the inner ear, the principles of distribution of the drug within the cochlear fluids, as well as the anatomical obstacles that may be encountered on the way to achieving the desired therapeutic effect. The purpose of this article is to highlight the current achievements in the field of research on the routes of penetration of drugs, in particular glucocorticosteroids, to the structures of the inner ear from the tympanic cavity.

One of the current trends in otology is the prevention and treatment of chronic purulent otitis media (HCSO). The disease leads to decreased social activity, deterioration in the patients’ quality of life, often causes severe intracranial complications, and reduced perception of sounds at different frequencies with hearing impairment. The social significance of chronic purulent otitis media consists in a violation of working capacity in persons of the most mature age – 25–50 years, in connection with which, the disease causes certain economic damage to the state. In modern otorhinolaryngology, new therapeutic and diagnostic techniques are gradually being introduced, methodological approaches to surgical treatment and medicines for the treatment of HCG are being developed, which causes therapeutic and diagnostic progress, but in this regard has significantly increased the cost of medical care. The purpose of this work is to analyze from an economic, social and clinical point of view the effectiveness of medical care provided to patients with chronic purulent otitis media. The analysis was carried out on the basis of a literature review, collection and processing of material from official studies, published articles in domestic and foreign publications. Despite the significant advances made by modern otorhinolaryngology, the discussion regarding such a sinister disease and its medical and social aspects is still relevant. We can say that the etiological factors, the pathogenesis of HCSO have been studied quite carefully, the basic concepts of treatment have been developed. But there are new information and directions in this matter that need to be investigated. The problem of treating patients with chronic purulent otitis is of urgent importance for otosurgeons. Questions are being discussed about which type of surgical treatment (tympanoplasty) will be optimal, how many stages of intervention are required, what materials should be used. Тhe question of medical, economic and social justification for the disease of chronic purulent otitis media is subject to study. It is in this aspect that this problem is relevant.