[TREATMENT OF SECRETORY OTITIS MEDIA IN CHILDREN, DEPENDING ON THE STAGE OF THE PROCESS AND ON THE BACKGROUND OF THE PATHOLOGICAL CONDITIONS].

The purpose of the work is to develop individual treatment regimens for children with secretory otitis media (SOM) depending on the results of an in-depth examination of them, in particular, the identification of Epstein-Barr virus (EBV), the presence of pathogenic microflora in the nasopharynx and the results of a level 1 immunogram. Laboratory examination for the presence of serological markers: IgM to the capsid complex (VCA), IgG to the early antigen (EA) and the nuclear antigen EBNA in the blood serum by enzyme-linked immunosorbent assay (ELISA). 68 children were exposed, children's department of the 30th hospital. Kharkiv during 2017-2019 with a diagnosis of secretory otitis media. The same children underwent a classic bacteriological study of the nasopharynx and level 1 immunogram. Among 68 children with secretory otitis media, a high percentage (16.2%) of infected patients with acute EBV in the acute phase and 20 children previously infected were detected. In total, out of 68 children, 31 (45.6%). In most SOM infected children with EBV, a decrease in the cellular component of immunity was revealed: a decrease in the subpopulations of T-lymphocytes from CD4 helper cells and CD16 from NK killer cells. Streptococcus pyogenes-13 (19.1%) cases prevailed in the nasopharynx in children with SOM, 2nd in frequency. H.influenza was detected in 13 cases (19.1%), Streptococcus pneumonia, the third strain, 11 strain (16.2%), and the fourth, Staplylooccus aureus, 12 strains (17.6%) were seeded 3rd in frequency. The lowest levels of immunograms were found in children infected with EBV. Immunocorrection, require and carriers of streptococci (other drugs). Therefore, the examined children, divided into 3 groups, received various immunomodulating agents: thymalin and Broncho-Vaxom (bacterial lysate), and in some cases we combined topical administration of thymalin with endaural phonophoresis followed by treatment with Broncho-Vaxom. It was these children who had the least number of relapses SOM of against the background of the best indicators of immunity.