[Epidemiology and treatment tactics for chronic suppurative otitis media].

[UNLABELLED] Data on the epidemiology of ear and mastoid diseases, including chronic suppurative otitis media (CSOM), In Russia are fragmented and presented in various non-specialized journals. However, analysis of incidence and prevalence dynamics allows us to assess the development of this pathology in the population, the accessibility of medical care, the effectiveness of treatment measures, and identify ways to improve these indicators.

[OBJECTIVE] To analyze the epidemiology and treatment of ear and mastoid diseases, including chronic suppurative otitis media, in the Russian Federation and Moscow.

[MATERIAL AND METHODS] A retrospective quantitative assessment of the prevalence (overall) and incidence (primary) of ear and mastoid diseases, including chronic suppurative otitis media, was conducted using data from state statistics services and reports from Moscow otolaryngology hospitals for the period from 2010 to 2024.

[RESULTS] According to statistical reports, in recent years there has been a decrease in the incidence of ear and mastoid diseases in the overall morbidity structure in the Russian Federation from 2.4% to 1.8%. In 2022, the overall incidence was 28.75 cases per 1000 population, primary - 17.6 cases per 1000 population. The average overall and primary incidence of ear and mastoid diseases in Moscow from 2013 to 2023 was 32.9 cases per 1000 population, and primary - 23.2 cases per 1000 population. In the Russian Federation and Moscow over the past 10 years, there has been a tendency towards a decrease in the primary and overall incidence of chronic otitis media (In Russia, the average primary incidence is 0.4, the overall - 2.09, in Moscow - 0.17 and 1.39, respectively). In Moscow, there has been an increase in the proportion of patients with CSOM in hospitals (from 6.2% to 8.1%) and in the structure of ear and otitis media diseases (from 21.7% to 39.2%). A sharp increase in surgical activity was noted for ear and otitis media diseases (from 24.3% to 69.9%), as well as for CSOM (from 50.6% to 87.8%), with CSOM largely due to tympanoplasty (from 66.7% to 85.8%). The increase in surgical activity in the management of patients with CSOM has led to a decrease in the proportion of sanitary operations for urgent or emergency indications (from 10.7% to 2.3%). In a specialized department (using the Ear Microsurgery Research Department of the L.I. Sverzhevsky Research Institute of Oncology and Orthopedics of the Moscow Health Department as an example), which provides elective surgical care to patients with chronic otitis media, a significant (threefold) increase in the number of patients treated and the number of reconstructive and sanitizing surgeries performed was observed from 2010 to 2024, driven by the intensification of the treatment process. Meanwhile, the overall proportion of patients with this pathology in the department's patient population has remained virtually unchanged over the past 15 years (60% on average), as has the percentage of surgical procedures performed.

[CONCLUSION] Optimization of healthcare has resulted in a reduction in the incidence of ear and mastoid diseases and chronic suppurative otitis media, as well as an increase in the volume of care provided to patients with chronic suppurative otitis media due to increased hospital capacity and physician workload.