Data on the frequency and nature of hearing impairment in newborns and children during the first months of life after acute otitis media are contradictory. Otoacoustic emission is one of the methods for assessing the hearing function in infants. The main advantages of this method are objectivity, non-invasiveness, speed and accuracy. Objectives. To evaluate the features of otoacoustic emission registration at the frequency of the product distortion in children of the first 3 months of life after an acute inflammation of the middle ear. Material and methods. Distortion-product otoacoustic emission was performed in 36 children after complete recovery from acute otitis media (main group) and in 32 children without otitis media (comparison group). The estimation of the amplitude and spectrum of the response received was performed. The analysis of the otoacoustic response at frequencies of 1 kHz, 1.5 kHz, 2 kHz, 3 kHz, 4 kHz, 5 kHz, 6 kHz, 8 kHz was carried out. Results. Otoacoustic emission was registered in 74.2% of investigations in the comparison group, in 56.0% of observations in otoscopically healthy ears in case of unilateral inflammation, in 35.1% of cases after a non-suppurative form of the disease, and only in 15.4% of cases after a purulent form of acute otitis media. Statistically significant differences were revealed in the frequency of registration of otoacoustic emission in children of the examined groups. The greatest amplitude of the signal/noise relationship was recorded at frequencies of 5 and 6 kHz, and the smallest one at the frequency of 1 kHz in all studied groups. Conclusions. A decrease in auditory function is observed in children of the first 3 months of life after past acute otitis media. This is confirmed by significantly higher rate of absence of otoacoustic emission in this group of patients. Distortion-product otoacoustic emission in children of the first 3 months of life is recommended to be carried out at frequencies of 1.5 kHz and higher.

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Nasal hyper-reactivity (NG) is a clinical phenomenon manifested by increased individual sensitivity of the nasal mucosa to factors that do not cause symptoms in healthy people. The concept of nasal hyperreactivity is accepted in the world literature and implies increased reactivity of the nasal mucosa caused by various physical, chemical or pharmacological stimuli [1, 2]. Nasal hyper-reactivity is found in 86% of children with bronchial asthma.

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П роблема острых средних отитов (ОСО) у детей сохраняет свою актуальность и активно изуча-ется во всех странах мира ввиду стабильно высокой распространенности и отсутствия тенденции к ее снижению. По данным различных авторов, на первом году жизни частота развития ОСО варьирует в широком диапазоне от 21 до 62% [1].Диагностика заболевания в этом возрасте представ-ляет трудную задачу. В значительной степени это связано с малосимптомностью, стертостью клинических проявле-ний болезни, высокой частотой сопутствующей патологии, маскирующей картину воспаления среднего уха. Особую опасность представляют собой ОСО у новорожденных и детей первых месяцев жизни, поскольку в этот возраст-ной период закладываются основы для формирования здорового организма, а младенцы в силу незрелости защитных механизмов наиболее уязвимы перед действи-ем патогенов. В силу указанных причин формирование групп риска развития воспаления среднего уха у детей первых месяцев жизни на основе выявления и стратифи-кации факторов, способствующих заболеванию, пред-ставляет собой важное направление современной педи-атрии. Знание факторов риска имеет смысл использовать как в диагностике, так и в профилактике заболевания.В литературе достаточно много внимания уделяется анатомо-физиологическим особенностям, предрасполага-ющим к развитию ОСО в данной возрастной группе: кра-нио-фациальному дисморфизму, возрастным особенно- Results. In the pregravid health status of the mother the most significant in terms of the risk of developing of otitis media in children in the first months of life are the presence of respiratory allergy (OR = 7,74; P = 0,014) and chronic infections of ENT organs (OR = 1,15; P = 0,022). In the prenatal period the risk of early manifestations of the first episode of otitis media in a child increases obesity during pregnancy (OR = 11,78, p<0,000), waterless period of more than 8 hours (OR = 8,60, p<0,000), TORCH and urogenital infections in the mother (OR = 7,29, P = 0,028). Formula (OR = 4,20, p = 0,004) and mixed (P = 0,008) feeding in the postnatal period and the male sex (58,6%) of the child are also associated with an increased risk of developing otitis media. For this age group otitis media was characterized by a high association with ARI (99,1%). Conclusion. We have identified risk factors of otitis media in infants and children during the first months of life allow us to form a high-risk group for development of this disease.