Features of the clinical course of acute otitis media in patients with impaired carbohydrate metabolism

The aim of the research: study of the features of the clinical course of acute otitis media (AOM) in patients with impaired carbohydrate metabolism. Materials and methods. We examined 140 patients with AOM aged 19 to 72 years, of which 75 patients with impaired carbohydrate metabolism constituted the main group and 65 patients were included in the comparison group. Taking into account the peculiarities of the pathogenesis of AOM and disorders of carbohydrate metabolism, patients were randomized into 4 groups: 1 – patients with AOM (36), 2 – patients with AOM on the background of sinusitis (29), 3 – patients with AOM on the background of non-insulin-dependent diabetes mellitus (DM type II) (37), 4 – AOM patients with impaired glucose metabolism (38). The patients underwent a general clinical examination, determination of glycosylated hemoglobin, leukocyte indices of intoxication, audiometry, computed tomography (CT) of the temporal bones (if indicated). Results. The proportion of patients with impaired carbohydrate metabolism in 2020 was 32.6 %, of which DM type II was diagnosed in 49.3 % earlier. It was shown that a feature of the clinical course of AOM against the background of impaired carbohydrate metabolism is the discrepancy between the duration of the disease history, complaints and objective data to the state of the cellular structure of the mastoid process according to CT data and impaired auditory function mainly by the type of sound perception, which indicates the formation of latent mastoiditis. Clinically significant complaints and objective data for the differential diagnosis of latent mastoiditis in these patients were determined. The absence of statistical significance of differences in indicators in patients with DM type II and against the background of transient hyperglycemia was revealed, and the concept of the latter was characterized. A direct correlation between blood glucose levels and glycated hemoglobin levels was established in patients with DM type II and AOM. Conclusions. DM type II creates a favorable background for the formation of the clinical course of AOM complicated by latent mastoiditis. From the general contingent of patients with AOM, patients should be distinguished not only with DM type II, but also with transient hyperglycemia for its timely diagnosis. Significant symptoms: pain and a feeling of “heaviness” in the behind-the-ear region in the absence of reactive phenomena, a feeling of “pulsation” in the ear, dizziness, a cloudy eardrum with a protrusion or perforation in the posterior or posterior-upper section, an asymmetric increase in sound perception thresholds above 25 dB. Such patients should be observed with “early” CT scan of the temporal bones.