perinatologyРоссийский вестник перинатологии и педиатрииRossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics)1027-40652500-2228Ltd. “The National Academy of Pediatric Science and Innovation”10.21508/1027-4065-2021-66-5-21-27perinatology-1477Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWSЭкссудативный средний отит у детей: роль недоношенности и сопутствующей патологии в его формировании. Часть IIExudative otitis media in children: the role of prematurity and concomitant pathology in its formation. Part IIhttps://orcid.org/0000-0002-2374-3005СавенкоИ. В.SavenkoI. V.

Савенко Ирина Владимировна – к.м.н., ст. науч. сотр. лаборатории слуха и речи

197022 Санкт-Петербург, ул. Льва Толстого, д. 6/8

Saint Petersburg

irina@savenko.suhttps://orcid.org/0000-0003-2453-523XБобошкоМ. Ю.BoboshkoM. Yu.

Бобошко Мария Юрьевна – д.м.н., проф., зав. лабораторией слуха и речи; проф. кафедры оториноларингологии

197022 Санкт-Петербург, ул. Льва Толстого, д. 6/8

Saint Petersburg

ФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет им. академика И.П. Павлова» Минздрава РоссииРоссияPavlov First Saint Petersburg State Medical UniversityRussian FederationФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет им. академика И.П. Павлова» Минздрава России; ФГБОУ ВО «Северо-Западный государственный медицинский университет им. И.И. Мечникова» Минздрава РоссииРоссияPavlov First Saint Petersburg State Medical University; Mechnikov Northwest State Medical UniversityRussian Federation2021081220216652127Copyright © Ltd. “The National Academy of Pediatric Science and Innovation”, 20212021Ltd. “The National Academy of Pediatric Science and Innovation”Ltd. “The National Academy of Pediatric Science and Innovation”https://www.ped-perinatology.ru/jour/about/submissions#copyrightNoticehttps://www.ped-perinatology.ru/jour/article/view/1477

Несмотря на многолетнее изучение проблемы экссудативного среднего отита, многие ее аспекты до настоящего времени не решены. Широкая распространенность патологии у детей и рост заболеваемости, отмечаемый в последние десятилетия, объясняют интерес специалистов к вопросам его этиологии, которым посвящен обзор литературы. В статье изложены современные взгляды на роль недоношенности, гастроэзофагеального рефлюкса, системного и локального иммунодефицита, нарушений в системе антиоксидантной защиты, мукополисахаридозов, наследственной предрасположенности и ряда других факторов в возникновении экссудативного среднего отита. К сожалению, причину его формирования удается установить не всегда, и это требует дальнейших экспериментальных и клинических исследований с целью разработки эффективных подходов к этиопатогенетически обоснованному, своевременному и полноценному лечению заболевания для внедрения их в практическую медицину.

Despite the long-term study of exudative otitis media, the disease is not well understood. The wide prevalence of exudative otitis media in children and the increase in the incidence during recent decades explain the interest of specialists in the etiology of the disease. The article presents current views on the role of premature birth, gastroesophageal reflux, systemic and local immunodeficiency, disorders in the antioxidant defense system, mucopolysaccharidosis, genetic predisposition, and other factors in otitis media development. Unfortunately, the cause of exudative otitis media cannot always be established, and it requires further experimental and clinical studies in order to develop effective approaches to etiopathogenetically justified, timely and successful treatment of the disease and its implementation in clinical medicine.

детиэкссудативный средний отитэтиологияфакторы рискаchildrenexudative otitis mediaetiologyrisk factorsReferencesСавенко И.В., Бобошко М.Ю. Экссудативный средний отит: основные причины развития в детском возрасте. Часть I. Рос вестн перинатол и педиатр 2021; 66:(4): 32–38. DOI: 10.21508/1027–4065–2021–66–4–32–38Savenko I.V., Boboshko M.Yu. Exudative otitis media in children: the main causes. Part I. Ros Vestn Perinatol i Pediatr 2021; 66:(4): 21–38. (in Russ.) DOI: 10.21508/1027–4065–2021–66–4–32–38Рахманова И.В., Солдатский Ю.Л., Матроскин А.Г., Маренич Н.С., Шеламова В.Н. Роль гастроэзофагеальной рефлюксной болезни в формировании хронического экссудативного среднего отита у детей первого года жизни. Вестник оториноларингологии 2018; 2: 14–16.Rakhmanova I.V., Soldatskii Yu.L., Matroskin A.G., Marenich N.S., Shelamova V.N. The role of gastroesophageal reflux disease in the development of chronic exudative otitis media. Vestnik otorinolaringologii 2018; 2: 14–16. (in Russ.) DOI: 10.17116/otorino201883214-16Boronat-Echeverría N., Aguirre-Mariscal H., Carmolinga-Ponce M., Sevilla-Delgado Y., Miceli-Flores R., Kennedy-Padilla A. et al. Helicobacter pylori detection and clinical symptomatology of gastroesophageal reflux disease in pediatric patients with otitis media with effusion. Int J Pediatr Otorhinolaryngol 2016; 87: 126–129. DOI: 10.1016/j.ijporl.2016.06.023Boronat-Echeverría N., Aguirre-Mariscal H., Carmolinga-Ponce M., Sevilla-Delgado Y., Miceli-Flores R., Kennedy-Padilla A. et al. Helicobacter pylori detection and clinical symptomatology of gastroesophageal reflux disease in pediatric patients with otitis media with effusion. Int J Pediatr Otorhinolaryngol 2016; 87: 126–129. DOI: 10.1016/j.ijporl.2016.06.023Górecka-Tuteja A., JastrzÜbska I., SkáadzieĔ J., Fyderek K. Laryngopharyngeal reflux in children with chronic otitis media with effusion. J. Neurogastroenterol Motil 2016; 22(3):452–458. DOI: 10.5056/jnm16013Górecka-Tuteja A., JastrzÜbska I., SkáadzieĔ J., Fyderek K. Laryngopharyngeal reflux in children with chronic otitis media with effusion. J. Neurogastroenterol Motil 2016; 22(3):452–458. DOI: 10.5056/jnm16013Гаращенко Т.И., Котов Р.В., Полунин М.М. Эндоскопическая хирургия слуховой трубы и среднего уха у детей с экссудативным средним отитом. Российская оториноларингология 2009; 3 (40): 34–41.ГGarashchenko T.I., Kotov R.V., Polunin M.M. Endoscopic auditory tube surgery in children with otitis media with effusion. Rossiiskaya otorinolaringologiya. 2009; 3 (40): 34–41. (in Russ.)Преображенский Н.А., Гольдман И.И. Экссудативный средний отит. М.: Медицина, 1987; 189 с.Preobrazhenskiy N.A., Gol’dman I.I. Otitis media with effusion. M.: Medicina, 1987; 189. (in Russ.)Рахманова И.В., Зинкер Г.М., Матроскин А.Г., Котов Р.В., Донин И.М. Патология среднего уха у детей различного гестационного возраста. Вестник Российского государственного медицинского университета 2015; 1: 21–25.Rahmanova I.V., Zinker G.M., Matroskin A.G., Kotov R.V., Donin I.M. Middle ear pathology in premature infants of different gestational age. Vestnik Rossiiskogo gosudarstvennogo meditsinskogo universiteta 2015; 1: 21–25. (in Russ.)Kemalo lu Y.K., Goksu N., Ozbilen S., Akyildiz N. Otitis media with effusion and craniofacial analysis-II: «Mastoid-middle ear-eustachian tube system» in children with secretory otitis media. Int J Pediatr Otorhinolaryngol 1995; 32(1): 69–76. DOI: 10.1016/0165-5876(94)01117-gKemalo lu Y.K., Goksu N., Ozbilen S., Akyildiz N. Otitis media with effusion and craniofacial analysis-II: «Mastoid-middle ear-eustachian tube system» in children with secretory otitis media. Int J Pediatr Otorhinolaryngol 1995; 32(1): 69–76. DOI: 10.1016/0165-5876(94)01117-gAdil E., Poe D. What is the full range of medical and surgical treatments available for patients with Eustachian tube dysfunction? Curr Opin Otolaryngol Head Neck Surg 2014; 22(1): 8–15. DOI: 10.1097/moo.0000000000000020Adil E., Poe D. What is the full range of medical and surgical treatments available for patients with Eustachian tube dysfunction? Curr Opin Otolaryngol Head Neck Surg 2014; 22(1): 8–15. DOI: 10.1097/moo.0000000000000020Boudewyns A., Declau F., Van der Ende J., Van Kerschaver E. Otitis media with effusion: an underestimated cause of hearing loss in infants. Otol Neurotol 2011; 32(5): 799–804. DOI: 10.1097/MAO.0b013e31821b0d07Boudewyns A., Declau F., Van der Ende J., Van Kerschaver E. Otitis media with effusion: an underestimated cause of hearing loss in infants. Otol Neurotol 2011; 32(5): 799–804. DOI: 10.1097/MAO.0b013e31821b0d07Lammens F., Verhaert N., Devriendt K., Debruyne F., Desloovere C. Aetiology of congenital hearing loss: A cohort review of 569 subjects. Int J Pediatr Otorhinolaryngol 2013; 77(9): 1385–1391. DOI: 10.1016/j.ijporl.2013.06.002Lammens F., Verhaert N., Devriendt K., Debruyne F., Desloovere C. Aetiology of congenital hearing loss: A cohort review of 569 subjects. Int J Pediatr Otorhinolaryngol 2013; 77(9): 1385–1391. DOI: 10.1016/j.ijporl.2013.06.002Савенко И.В., Бобошко М.Ю. Экссудативный средний отит у недоношенных детей первых трех лет жизни. Врач 2014; 2: 56–59.Savenko I.V., Boboshko M.Yu. Exudative otitis media in premature infants at the first three years of life. Vrach 2014; 2: 56–59. (in Russ.)Engel J., Mahler E., Anteunis L., Marres E., Zielhuis G. Why are NICU infants at risk for chronic otitis media with effusion? Int J Pediatr Otorhinolaryngol 2001; 57(2): 137–144. DOI: 10.1016/s0165-5876(00)00462-6Engel J., Mahler E., Anteunis L., Marres E., Zielhuis G. Why are NICU infants at risk for chronic otitis media with effusion? Int J Pediatr Otorhinolaryngol 2001; 57(2): 137–144. DOI: 10.1016/s0165-5876(00)00462-6Савенко И.В., Бобошко М.Ю., Гарбарук Е.С. Экссудативный средний отит у детей, родившихся недоношенными: этиопатогенез, характер течения и исходы. Folia Otorhinolaryngologiae et Pathologiae Respiratoriae 2018; 24(4): 27–37.Savenko I.V., Boboshko M.Yu., Garbaruk E.S. Otitis media with effusion in children born prematurely: etiopathogenesis, course and outcomes. Folia Otorhinolaryngologiae et Pathologiae Respiratoriae 2018; 24(4): 27–37. (in Russ.)Zanchetta S., Resende L.A., Bentlin M.R., Rugulo L.M., Trindade C.E. Conductive hearing loss in children with bronchopulmonary dysplasia: a longitudinal follow-up study in children aged between 6 and 24 months. Early Hum Dev 2010; 86(6): 385–389. DOI: 10.1016/j.earlhumdev.2010.05.006Zanchetta S., Resende L.A., Bentlin M.R., Rugulo L.M., Trindade C.E. Conductive hearing loss in children with bronchopulmonary dysplasia: a longitudinal follow-up study in children aged between 6 and 24 months. Early Hum Dev 2010; 86(6): 385–389. DOI: 10.1016/j.earlhumdev.2010.05.006Coates H., Thornton R., Langlands J., Filion P., Keil A.D., Vijayasekaran S., Richmond P. The role of chronic infection in children with otitis media with effusion: evidence for intracellular persistence of bacteria. Otolaryngol Head Neck Surg 2008; 138(6): 778–781. DOI: 10.1016/j.otohns.2007.02.009Coates H., Thornton R., Langlands J., Filion P., Keil A.D., Vijayasekaran S., Richmond P. The role of chronic infection in children with otitis media with effusion: evidence for intracellular persistence of bacteria. Otolaryngol Head Neck Surg 2008; 138(6): 778–781. DOI: 10.1016/j.otohns.2007.02.009Очиров Д.Д., Щербик Н.В., Кологривова Е.Н. Дифференциальный подход к лечению экссудативного среднего отита с применением мукозальной иммунокоррекции. Вестник оториноларингологии 2012; 5: 65–68Ochirov D.D., Shcherbik N.V., Kologrivova E.N. The differential approach to the treatment of exudative otitis media with the use of mucosal immunocorrection. Vestnik otorinolaringologii 2012; 5: 65–68. (in Russ.)Бурмистрова Т.В. Современные этиопатогенетические аспекты экссудативного среднего отита. Российская оториноларингология 2004; 1 (8): 25–28.Burmistrova T.V. Modern etiopathogenetic aspects of otitis media with effusion. Rossiskaya otorinolaringologiya 2004; 1(8): 25–28. (in Russ.)Щербик Н.В., Юнусов Р.Ш., Староха А.В. Плешко Р.И., Кологривова Е.Н., Литвак М.М. и др. Клинико-иммунологические проявления экссудативного среднего отита у детей на фоне иммуннокоррекции. Омский научный вестник. Медицинские науки 2014; 134(2): 66–69.Shcherbik N.V., Yunusov R.Sh., Starokha A.V. Pleshko R.I., Kologrivova E.N., Litvak M.M. et al. Clinical and immunological features of otitis media with effusion in children with immunocorrection. Omskii nauchnyi vestnik. Meditsinskie nauki 2014; 134(2): 66–69. (in Russ.)Kim M.G., Park D.C., Shim J.S., Jung H., Park M.S., Kim Y.I. et al. TLR-9, NOD-1, NOD-2, RIG-I and immunoglobulins in recurrent otitis media with effusion. Int J Pediatr Otorhinolaryngol 2010; 74(12): 1425–1429. DOI: 10.1016/j.ijporl.2010.09.026Kim M.G., Park D.C., Shim J.S., Jung H., Park M.S., Kim Y.I. et al. TLR-9, NOD-1, NOD-2, RIG-I and immunoglobulins in recurrent otitis media with effusion. Int J Pediatr Otorhinolaryngol 2010; 74(12): 1425–1429. DOI: 10.1016/j.ijporl.2010.09.026Lee H.Y., Kim Y.I., Lee J.W., Byun J.Y., Park M.S., Yeo S.G. Decreased expression of TLR-9 and cytokines in the presence of bacteria in patients with otitis media with effusion. Clin Exp Otorhinolaryngol 2013; 6(4): 195–200. DOI: 10.3342/ceo.2013.6.4.195Lee H.Y., Kim Y.I., Lee J.W., Byun J.Y., Park M.S., Yeo S.G. Decreased expression of TLR-9 and cytokines in the presence of bacteria in patients with otitis media with effusion. Clin Exp Otorhinolaryngol 2013; 6(4): 195–200. DOI: 10.3342/ceo.2013.6.4.195Straetemans M., van Heerbeek N., Sanders E.A., Engel J.A., Schilder A.G., Rijkers G.T. et al. Immune status and Eustachian tube function in reccurence of otitis media with effusion. Arch Otolaryngol Head Neck Surg 2005; 131(9): 771–776. DOI: 10.1001/archotol.131.9.771Straetemans M., van Heerbeek N., Sanders E.A., Engel J.A., Schilder A.G., Rijkers G.T. et al. Immune status and Eustachian tube function in reccurence of otitis media with effusion. Arch Otolaryngol Head Neck Surg 2005; 131(9): 771–776. DOI: 10.1001/archotol.131.9.771Yeo S.G., Park D.C., Lee S.K., Cha C.I. Relationship between effusion bacteria and concentration of immunoglobulin in serum and effusion fluid in otitis media with effusion patients. Int J Pediatr Otorhinolaryngol 2008; 72(3): 337–342. DOI: 10.1016/j.ijporl.2007.11.005Yeo S.G., Park D.C., Lee S.K., Cha C.I. Relationship between effusion bacteria and concentration of immunoglobulin in serum and effusion fluid in otitis media with effusion patients. Int J Pediatr Otorhinolaryngol 2008; 72(3): 337–342. DOI: 10.1016/j.ijporl.2007.11.005Sharma S.K., Casey J.R., Pichichero M.E. Reduced memory CD 4+ T-cell generation in the circulation of young children may contribute to the otitis-prone condition. J Infect Dis 2011; 204(4): 645–653. DOI: 10.1093/infdis/jir340Sharma S.K., Casey J.R., Pichichero M.E. Reduced memory CD 4+ T-cell generation in the circulation of young children may contribute to the otitis-prone condition. J Infect Dis 2011; 204(4): 645–653. DOI: 10.1093/infdis/jir340Smirnova M.G., Birchall J.P., Pearson J.P. The immunoregulatory and allergy-associated cytokines in the aetiology of the otitis media with effusion. Mediators Inflamm 2004; 13(2): 75–88. DOI: 10.1080/09629350410001688477Smirnova M.G., Birchall J.P., Pearson J.P. The immunoregulatory and allergy-associated cytokines in the aetiology of the otitis media with effusion. Mediators Inflamm 2004; 13(2): 75–88. DOI: 10.1080/09629350410001688477Smirnova M.G., Birchall J.P., Pearson J.P. Evidence of T-helper cell 2 cytokine regulation of chronic otitis media with effusion. Acta Otolaryngol 2005; 125(10): 1043–1050. DOI: 10.1080/00016480510035449Smirnova M.G., Birchall J.P., Pearson J.P. Evidence of T-helper cell 2 cytokine regulation of chronic otitis media with effusion. Acta Otolaryngol 2005; 125(10): 1043–1050. DOI: 10.1080/00016480510035449Skotnicka B., Hassmann E. Proinflammatory and immunoregulatory cytokines in the middle ear effusion. Int J Pediatr Otorhinolaryngol 2008; 72(1): 13–17. DOI: 10.1016/j.ijporl.2007.09.005Skotnicka B., Hassmann E. Proinflammatory and immunoregulatory cytokines in the middle ear effusion. Int J Pediatr Otorhinolaryngol 2008; 72(1): 13–17. DOI: 10.1016/j.ijporl.2007.09.005Zielnik-Jurkiewicz B., Stankiewicz-Szymczak W. Proinflammatory interleukins in middle ear effusion from atopic and non-atopic children with chronic otitis media with effusion. Eur Arch Otorhinolaryngol 2015; 273(6): 1389–1378. DOI: 10.1007/s00405-015-3683-9Zielnik-Jurkiewicz B., Stankiewicz-Szymczak W. Proinflammatory interleukins in middle ear effusion from atopic and non-atopic children with chronic otitis media with effusion. Eur Arch Otorhinolaryngol 2015; 273(6): 1389–1378. DOI: 10.1007/s00405-015-3683-9Zielnik-Jurkiewicz B., Stankiewicz-Szymczak W. Evaluation of the interleukin-1 receptor antagonist and immunoregulatory interleukin-10 in the middle ear in chronic otitis media with effusion in children with and without atopy. Clin Exp Otorhinolaryngol 2016; 9(2): 104–108. DOI: 10.21053/ceo.2015.00129Zielnik-Jurkiewicz B., Stankiewicz-Szymczak W. Evaluation of the interleukin-1 receptor antagonist and immunoregulatory interleukin-10 in the middle ear in chronic otitis media with effusion in children with and without atopy. Clin Exp Otorhinolaryngol 2016; 9(2): 104–108. DOI: 10.21053/ceo.2015.00129Ilia S., Goulielmos G.N., Samonis G., Galanakis E. Polymorphisms in IL-6, IL-10, TNF-α, IFN-γ and TGF-β1 genes and susceptibility to acute otitis media in early infancy. Pediatr Infect Dis 2014; 33(5): 518–521. DOI: 10.1097/inf.0000000000000229Ilia S., Goulielmos G.N., Samonis G., Galanakis E. Polymorphisms in IL-6, IL-10, TNF-α, IFN-γ and TGF-β1 genes and susceptibility to acute otitis media in early infancy. Pediatr Infect Dis 2014; 33(5): 518–521. DOI: 10.1097/inf.0000000000000229Иванцова Н.Л., Белякова А Г., Дмитриевская М.И., Мельникова В.М., Полевик И.В. Участие активного метаболита витамина D в качестве иммуномодулятора гуморального и клеточного иммунного ответа. Таврический медикобиологический вестник 2017; 20(3): 152–158.Ivantsova N.L., Belyakova A.G., Dmitrievskaya M.I., Mel’nikova V.M., Polevik I.V. Participation of active metabolites of vitamin D as the immunomodulator of humoral and cellular immune response. Tavricheskiy mediko-biologicheskiy vestnik 2017; 20(3): 152–158. (in Russ.)Colotta F., Jansson B., Bonelli F. Modulation of inflammatory and immune responses by vitamin D. J Autoimmun 2017; 85: 78–97. DOI: 10.1016/j.jaut.2017.07.007Colotta F., Jansson B., Bonelli F. Modulation of inflammatory and immune responses by vitamin D. J Autoimmun 2017; 85: 78–97. DOI: 10.1016/j.jaut.2017.07.007Walker R.E., Bartley J., Camargo Jr C.A., Flint D., Thompson J.M.D., Mitchell E.A. Higher serum 25(OH)D concentration is associated with lower risk of chronic otitis media with effusion: a case-control study. Acta Paediatr 2017; 106(9):1487–1492. DOI: 10.1111/apa.13908Walker R.E., Bartley J., Camargo Jr C.A., Flint D., Thompson J.M.D., Mitchell E.A. Higher serum 25(OH)D concentration is associated with lower risk of chronic otitis media with effusion: a case-control study. Acta Paediatr 2017; 106(9):1487–1492. DOI: 10.1111/apa.13908Asghari A., Bagheri Z., Jalessi M., Salem M.M., Amini E., GhalehBaghi S. et al. Vitamin D levels in children with adenotonsillar hypertrophy and otitis media with effusion. Iran J Otorhinolaryngol 2017; 29(90): 29–33. DOI: 10.22038/ijorl.2016.8066Asghari A., Bagheri Z., Jalessi M., Salem M.M., Amini E., GhalehBaghi S. et al. Vitamin D levels in children with adenotonsillar hypertrophy and otitis media with effusion. Iran J Otorhinolaryngol 2017; 29(90): 29–33. DOI: 10.22038/ijorl.2016.8066Akcan F.A., Dündar Y., Akcan H.B., Uluat A., Cebeci D., Sungur M.A., Ünlü ø. Clinical role of vitamin D in prognosis of otitis media with effusion. Int J Pediatr Otorhinolaryngol 2018; 105: 1–5. DOI: 10.1016/j.ijporl.2017.11.030Akcan F.A., Dündar Y., Akcan H.B., Uluat A., Cebeci D., Sungur M.A., Ünlü ø. Clinical role of vitamin D in prognosis of otitis media with effusion. Int J Pediatr Otorhinolaryngol 2018; 105: 1–5. DOI: 10.1016/j.ijporl.2017.11.030Testa D., Guerra G., Marcuccio G., Landolfo P.G., Motta G. Oxidative stress in chronic otitis media with effusion. Acta Otolaryngol 2012; 132(8): 834–837. DOI: 10.3109/00016489.2012.663504Testa D., Guerra G., Marcuccio G., Landolfo P.G., Motta G. Oxidative stress in chronic otitis media with effusion. Acta Otolaryngol 2012; 132(8): 834–837. DOI: 10.3109/00016489.2012.663504Sale M.M., Chen W.M., Weeks D.E., Mychaleckyj J.C., Hou X., Marion M. et al. Evaluation of 15 functional candidate genes for association with chronic otitis media with effusion and/or recurrent otitis media (COME/ROM). Plos One 2011; 6(8): e22297. DOI: 10.1371/journal.pone.0022297Sale M.M., Chen W.M., Weeks D.E., Mychaleckyj J.C., Hou X., Marion M. et al. Evaluation of 15 functional candidate genes for association with chronic otitis media with effusion and/or recurrent otitis media (COME/ROM). Plos One 2011; 6(8): e22297. DOI: 10.1371/journal.pone.0022297Samuels T.L., Yan J.C., Khampang P., Dettmar P.W., MacKinnon A., Hong W. et al. Association of gel-forming mucins and aquaporin gene expression with hearing loss, effusion viscosity, and inflammation in otitis media with effusion. JAMA Otolaryngol. Head Neck Surg 2017; 143(8): 810–817. DOI: 10.1001/jamaoto.2017.0386Samuels T.L., Yan J.C., Khampang P., Dettmar P.W., MacKinnon A., Hong W. et al. Association of gel-forming mucins and aquaporin gene expression with hearing loss, effusion viscosity, and inflammation in otitis media with effusion. JAMA Otolaryngol. Head Neck Surg 2017; 143(8): 810–817. DOI: 10.1001/jamaoto.2017.0386Mittal R., Robalino G., Gerring R., Chan B., Yan D., Grati M. et al. Immunity genes and susceptibility to otitis media: a comprehensive review. J Genet Genomics 2014; 41(11): 567–581. DOI: 10.1016/j.jgg.2014.10.003Mittal R., Robalino G., Gerring R., Chan B., Yan D., Grati M. et al. Immunity genes and susceptibility to otitis media: a comprehensive review. J Genet Genomics 2014; 41(11): 567–581. DOI: 10.1016/j.jgg.2014.10.003Allen E.K., Chen W.-M., Weeks D.E., Chen F., Hou X., Mattos J.L. et al. A genome-wide association study of chronic otitis media with effusion and recurrent otitis media identifies a novel susceptibility locus on chromosome 2. J. Assoc Res Otolaryngol 2013; 6(14): 791–800. DOI: 10.1007/s10162-013-0411-2Allen E.K., Chen W.-M., Weeks D.E., Chen F., Hou X., Mattos J.L. et al. A genome-wide association study of chronic otitis media with effusion and recurrent otitis media identifies a novel susceptibility locus on chromosome 2. J. Assoc Res Otolaryngol 2013; 6(14): 791–800. DOI: 10.1007/s10162-013-0411-2MacArthur C.J., Wilmot B., Wang L., Schuller M., Lighthall J., Trune D. Genetic susceptibility to chronic otitis media with effusion: candidate gene SNPs. Laryngoscope 2014; 124(5): 1229–1235. DOI: 10.1002/lary.24349MacArthur C.J., Wilmot B., Wang L., Schuller M., Lighthall J., Trune D. Genetic susceptibility to chronic otitis media with effusion: candidate gene SNPs. Laryngoscope 2014; 124(5): 1229–1235. DOI: 10.1002/lary.24349Einarsdottir E., Hafrén L., Leinonen E., Bhutta M.F., Kentala E., Kere J., Mattila P.S. Genome-wide association analysis reveals variants on chromosome 19 that contribute to childhood risk of chronic otitis media with effusion. Sci Rep 2016; 6: 33240. DOI: 10.1038/srep33240Einarsdottir E., Hafrén L., Leinonen E., Bhutta M.F., Kentala E., Kere J., Mattila P.S. Genome-wide association analysis reveals variants on chromosome 19 that contribute to childhood risk of chronic otitis media with effusion. Sci Rep 2016; 6: 33240. DOI: 10.1038/srep33240Andersen T.N., Alanin M.C., von Buchwald C., Nielsen L.H. A longitudinal evaluation of hearing and ventilation tube insertion in patients with primary ciliary dyskinesia. Int J Pediatr Otorhinolaryngol 2016; 89: 164–168. DOI: 10.1016/j.ijporl.2016.08.011Andersen T.N., Alanin M.C., von Buchwald C., Nielsen L.H. A longitudinal evaluation of hearing and ventilation tube insertion in patients with primary ciliary dyskinesia. Int J Pediatr Otorhinolaryngol 2016; 89: 164–168. DOI: 10.1016/j.ijporl.2016.08.011Zanetti D., Vezzani M., Di Bernandino F., Gasperini S., Parini R. Characterization of hearing loss in children with mucopolysaccharidosis. In.: An excursus into hearing loss. Ed.: S. Hatzopoulos, A. Ciorba. London: IntechOpen Limited, 2018: 55–70. DOI: 10.5772/intechopen.74196Zanetti D., Vezzani M., Di Bernandino F., Gasperini S., Parini R. Characterization of hearing loss in children with mucopolysaccharidosis. In.: An excursus into hearing loss. Ed.: S. Hatzopoulos, A. Ciorba. London: IntechOpen Limited, 2018: 55–70. DOI: 10.5772/intechopen.74196Chantzi F.M., Papadopoulos N.G., Bairamis T., Tsiakou M., Bournousouzis N., Constantopoulos A.G. Human rhinoviruses in otitis media with effusion. Pediatr. Allergy Immunol 2006; 17(7): 514–518. DOI: 10.1111/j.1399-3038.2006.00448.xChantzi F.M., Papadopoulos N.G., Bairamis T., Tsiakou M., Bournousouzis N., Constantopoulos A.G. Human rhinoviruses in otitis media with effusion. Pediatr. Allergy Immunol 2006; 17(7): 514–518. DOI: 10.1111/j.1399-3038.2006.00448.xKaya S., Selimo÷lu E., Cureo÷lu S., Selimo÷lu M.A. Relationship between chronic otitis media with effusion and overweight or obesity in children. J Laryngol Otol 2017; 131(10): 866–870. DOI: 10.1017/S002221511700161XKaya S., Selimo÷lu E., Cureo÷lu S., Selimo÷lu M.A. Relationship between chronic otitis media with effusion and overweight or obesity in children. J Laryngol Otol 2017; 131(10): 866–870. DOI: 10.1017/S002221511700161XWalker R.E., Bartley J., Flint D., Thompson J.M., Mitchell E.A. Determinants of chronic otitis media with effusion in preschool children: a case-control study. BMC Pediatrics 2017; 17(1):4. DOI: 10.1186/s12887-016-0767-7Walker R.E., Bartley J., Flint D., Thompson J.M., Mitchell E.A. Determinants of chronic otitis media with effusion in preschool children: a case-control study. BMC Pediatrics 2017; 17(1):4. DOI: 10.1186/s12887-016-0767-7Дмитриев Н.С., Милешина Н.А., Колесова Л.И. Экссудативный средний отит у детей: Метод. рекомендации. М.: Научный центр аудиологии и слухопротезирования, 1996. 22.Dmitriev N.S., Mileshina N.A., Kolesova L.I. Otitis media with effusion in children: guidelines. M.: Nauchnyy tsentr audiologii i slukhoprotezirovaniya, 1996. 22. (in Russ.)Kong S.K., Chon K.M., Goh E.K., Lee I.W., Lee J.W., Wang S.G. Histologic changes in the auditory tube mucosa of rats after long-term exposure to cigarette smoke. Am J Otolaryngol 2009; 30(6): 376–382. DOI: 10.1016/j.amjoto.2008.07.009Kong S.K., Chon K.M., Goh E.K., Lee I.W., Lee J.W., Wang S.G. Histologic changes in the auditory tube mucosa of rats after long-term exposure to cigarette smoke. Am J Otolaryngol 2009; 30(6): 376–382. DOI: 10.1016/j.amjoto.2008.07.009Mills R., Hathorn I. Aetiology and pathology of otitis media with effusion in adult life. J Laryngol Otol 2016; 130(5): 418–424. DOI: 10.1017/S0022215116000943Mills R., Hathorn I. Aetiology and pathology of otitis media with effusion in adult life. J Laryngol Otol 2016; 130(5): 418–424. DOI: 10.1017/S0022215116000943Савенко И.В., Бобошко М.Ю. Экссудативный средний отит. СПб.: Диалог, 2020; 168.Savenko I.V., Boboshko M. Yu. Otitis media with effusion. SPb.: Dialog, 2020; 168. (in Russ.)

The authors declare that there are no conflicts of interest present.