Exudative otitis  media  in  childhood is most  often  associated with  chronic inflammation in the  nasopharyngeal area,  with  immediate participation of phagocytic cells. Our  paper  presents  the  data  on evaluation of clinical  and immunological efficacy of intranasal Imunofan use included into  complex therapy of exudative  otitis  media.  Dynamic observation (before  treatment, 1 and  3 months after treatment) of these parameters included regular  evaluation of the  neutrophil and  monocyte amounts in peripheral blood  and  in smear imprints from nasal mucosa, determination of myeloperoxidase activity in circulating neutrophils, and the content of interleukin IL-8 and IL-18  in the nasal washouts. The clinical status was assessed using a scoring system, which subjectively reflected the state of the nasopharynx and auditory function. Fourty-three children aged from 3 to 7 years with exudative  otitis media associated with chronic adenoiditis were examined. Patients of the first group (22 children) were treated using only conventional approaches (basic therapy). The patients from  the  second  group  (21 children) received  Imunofan in addition to the  basic therapy. The  control group consisted of 16 relatively  healthy  children. Before  treatment of the  children with exudative  otitis  media, an increase  in the relative content of monocytes in their blood,  a decreased activity of myeloperoxidase and lower concentration of IL-8  and  IL-18  in the  nasal  wash was observed  in comparison with  healthy  controls. No differences in severity  of clinical  symptoms were revealed  between  the  groups  of patients. Baseline  therapy was not  accompanied by positive  dynamics in the  clinical  pattern of the  disease.  Relative  monocytosis and reduced activity of neutrophilic myeloperoxidase persisted  in peripheral blood;  the concentration of IL-8  and IL-18  in the  nasal washings  remained low. Following intranasal use of Imunofan, the  number of circulating monocytes was restored by the  third  month from  the  start  of treatment, there  was an  increased activity  of myeloperoxidase registered  in blood neutrophils, as well as higher IL-8  and IL-18  concentrations in the nasal washings. Normalization of the phagocytos-related parameters, according to this scoring,  was associated with clinical remission of the disease. The revealed relationships between clinical data and the results obtained in the course  of laboratory research  suggest a positive effect of Imunofan as an agent that may enhance effectiveness of conventional basic therapy  of otitis media in children.

There were 46 children with chronic otitis media with effusion (OME) under the supervision. After carried out virologic research by immune-enzyme analysis, polymerase chain reaction, metod-immunofluorescence-antitel, prevalence Epstein-Barr virus infection — 41 person (89,1 %), a smaller part children with respiratory syncytial virus — 18 children (39,1 %) and adenovirus infections — 15 children (32,6 %) — are noted. All patients were undergone surgical treatment — middle ear bypass surgery, after the surgery the thirst group patients received antiviral drug while the second group patients received standard treatment. Inclusion antiviral drug into the OME treatment algorithm decreases terms of patient¢s treatment.

Current paper describes an experience of cochlear implantation in elderly. Cochlear implantation has become a widely accepted intervention in the treatment of individuals with severe-to-profound sensorineural hearing loss. Cochlear implants are now accepted as a standard of care to optimize hearing and subsequent speech development in children and adults with deafness. But cochlear implantation affects not only hearing abilities, speech perception and speech production; it also has an outstanding impact on the social life, activities and self-esteem of each patient. The aim of this study was to evaluate the cochlear implantation efficacy in elderly with severe to profound sensorineural hearing loss. There were 5 patients under our observation. Surgery was performed according to traditional posterior tympanotomy and cochleostomy for cochlear implant electrode insertion for all observed patients. The study was conducted in two stages: before speech processor’s activation and 3 months later. Pure tone free field audiometry was performed to each patient to assess the efficiency of cochlear implantation in dynamics. The aim of the study was also to evaluate quality of life in elderly with severe to profound sensorineural hearing loss after unilateral cochlear implantation. Each patient underwent questioning with 36 Item Short Form Health Survey (SF-36). SF-36 is a set of generic, coherent, and easily administered quality-of-life measures. The SF-36 consists of eight scaled scores, which are the weighted sums of the questions in their section. Each scale is directly transformed into a 0-100 scale on the assumption that each question carries equal weight. The eight sections are: physical functioning; physical role functioning; emotional role functioning; vitality; emotional well-being; social role functioning; bodily pain; general health perceptions. Our results demonstrate that cochlear implantation in elderly consistently improved quality of life and enhance the efficiency of audiologic rehabilitation.

There were 24 patients with chronic adenoiditis in the 1st group, another 24 patients with chronic adenoiditis in association with otitis media effusion (OME) were included in the 2d group. The study of mucosal immunity included assessment of SIgA, IL-6, IFN- and IL-10 levels in nasal washes. Decrease of SIgA content and increase of the number of IFN-γ-positive samples was revealed in children from the 2nd clinical group, which allows to regard these characteristics of the mucosal immunity as the risk factors for the development of otitis media with effusion.