[Possibility of treatment chronic adenoiditis and otitis media with effusion in children, into account the role of the microbiota of the mucous of the nasopharynx]

In recent years, OME in childhood tends to increase. The low efficiency of the currently used traditional methods of conservative therapy and the high rate of relapse of the disease make it necessary to develop new methods of treatment. It is important that there is a connection of development of OME and hypertrophy of the lymphoid tissue of the nasopharynx, which in childhood is considered as a response to the respiratory antigenic virus-bacterial load. The spread of the inflammatory process to the auditory tube with persistence of pathogenic microorganisms in the structure of lymphoid tissue leads to the further development of otitis media effusion; but it is still debatable. All living microorganisms that inhabit a certain anatomical niche (viruses, bacteria, fungi, etc.) are called 'microbiota'. This term includes both commensals and pathogens. 'Microbiome' means the totality of all genes of all microorganisms that inhabit the study area. Thus, the microbiome can be called the collective microbiota genome. Microbiota disorder is a change in the quantitative and qualitative composition of microorganisms, called dysbiosis, and is important in the development of inflammatory pathology. Some drugs (including antibacterial ones) adversely affect indigenous bacteria. Indigenous microbiota develops in abundance in the observed biotope and forms resistance to excessive growth of pathogenic microorganisms. Only NGS sequencing allows to analyze entire mixed bacterial communities ('microbiomes'), which cannot be performed by other diagnostic methods. The use of the NGS sequencing method has proved the important role of microbiota in the development of chronic adenoiditis and OME in children. One of the promising remedies is the inclusion of lysozyme in the treatment regimen. Recent studies indicate the antibacterial and antiviral effects of lysozyme. The use of NGS sequencing made it possible to identify the relationship of the composition of microbiota with the course of chronic adenoiditis and otitis media effusion in children. Inclusion of lysozyme-containing drug Lizobact into therapy promotes colonization of the nasopharynx by indigenous microbiota, while the clinical picture improves.

[Possibilities of treatment of inflammatory pathology of the nasopharynx in children with chronic adenoiditis and otitis media with effusion]

The purpose of observation is to increase the effectiveness of treatment of children with chronic adenoiditis and exudative medium otitis. MATERIAL AND METHODS: In the observation were included 102 children with exudative medium otitis and chronic adenoiditis at the age of 3 to 14 years. All patients passed clinical and anamnestic diagnostic, endoscopic study, study of the nasopharynx, and PCR diagnostics of the stroke of the mucous membrane of the nasopharynx. The treatment was conducted, taking into account the patient's age, in the design of a simple randomized follow-up. RESULTS: In a nasopharynx children with chronic adenoiditis and exudative medium otitis revealed a predominance of viral and bacterial associations; among viruses, rhinovirus and adenovirus occupy a leading place. Effective complex conservative treatment was developed with the use of the Lysobact, which helps to reduce the frequency of prescribing antibacterial therapy. The use of lysozyme is one of the promising areas of treatment of chronic adenoiditis and exudative medium otitis.