OPTIMIZATION OF CONSERVATIVE TREATMENT FOR EXUDATIVE OTITIS MEDIA IN CHILDREN: THE SYNERGISTIC EFFECT OF PILN, TOPICAL IMMUNOCORRECTION, AND PLAY AUTOINSUFFLATION
Keywords:
exudative otitis media, children, low-intensity laser radiation, autoinsufflation, topical immunomodulation, transferrin, ceruloplasmin, sIgA, noninvasive monitoring, OS, 95% CIAbstract
Objective: To conduct a comparative evaluation of the clinical and biochemical efficacy of an optimized three-component treatment regimen for the secretory phase of exudative otitis media (EOM) in children aged 1–5 years, comprising low-intensity laser therapy (LILT), topical immunocorrection, and playful autoinsufflation, compared with standard treatment. Methods: 172 children (ages 1–5 years) were examined: subgroup A (n=40) — LI + lysates + autoinsufflation; subgroup B (n=37) — standard treatment; comparison group (n=60); control group (n=35). Salivary biomarkers (transferrin, ceruloplasmin, sIgA, myeloperoxidase), tympanometry data, OEA, and CSVP were assessed every 5 days. Results: In group A, by day 14, the transferrin level decreased 3.2-fold (to 3.8 ± 0.5 mg/L), while sIgA increased 2.3-fold (to 0.28 ± 0.03 g/L; p < 0.001). By day 30, type A tympanogram was restored in 92.5% of children in group A (OR = 7.8; 95% CI 1.9–31.6; p < 0.05) and in 62.2% in group B. The need for adenotomy in Group A decreased by a factor of 4.9 (5% vs. 24.3%). During the 6-month follow-up, recurrence rates were 2.5% in Group A and 18.9% in Group B (p<0.05). Conclusion: The three-component regimen combined with non-invasive monitoring of biomarkers is an effective non-surgical method for treating ESO. At the 6-month follow-up, the recurrence rate was 2.5% in Group A and 18.9% in Group B (p<0.05).
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