Intranasal immunotropic therapy for post-viral exudative otitis media in preschool children

Introduction. Improving the effectiveness of conservative treatment of secretory otitis media (SOM) in children remains an urgent problem because of the multifactorial etiology of the disease and the continued reliance on surgical intervention. The article presents the collective experience of monitoring the course of SOM after ARI with therapy aimed at various links in the pathogenesis of the disease. Aim. To evaluate the clinical efficacy of intranasal azoximer bromide (Polyoxidonium ® , Petrovax, Russia) versus combination therapy with a mucoregulator, topical antibacterial agents, and a decongestant for the treatment of secretory otitis media in children after acute respiratory viral infection. Materials and methods. A randomized, open-label, prospective, comparative clinical study was conducted in 49 children aged 4–7 years with SOM after ARI. The study group included 23 patients who received intranasal azoximer bromide, 3 drops in each nostril three times daily for two weeks. The control group comprised 26 patients who received combination therapy: an intranasal spray containing neomycin, polymyxin, dexamethasone metabenzoate, and phenylephrine (one administration per nostril three times daily for 10 days) plus oral carbocysteine at an age-appropriate dose for two weeks. Results. During azoximer bromide treatment, the dynamics of intratympanic pressure recovery were not inferior to those with standard therapy, and SOM relapses were less frequent at 3 and 6 months. Conclusions. Age-related characteristics of local immunity in children aged 4-7 years may underlie chronic catarrhal inflammation of the mucous membrane of the auditory tube and tympanic cavity after acute respiratory viral infection. Intranasal immunocorrection with azoximer bromide resolves catarrhal inflammation of the tympanic cavity and auditory tube during SOM developing after acute respiratory viral infection.