EFFICIENCY AND SAFETY OF USING “OZONE” IN THERAPY OF PATIENTS WITH CHRONIC TUBERCULOSIS OF THE MIDDLE EAR IN PATIENTS WITH PULMONARY TUBERCULOSIS

Аннотация

Chronic tuberculosis of the middle ear (CTME) is one of the urgent problems of modern clinical otology and phthisiology. Among the various methods of treating chronic tuberculous otitis media, a rational combination of systemic etiotropic therapy of exposure to the body with local treatment is currently considered. A comparative analysis of the effectiveness of transtepanal injection of a solution of decasan o, oo2% in combination with O3 in special therapeutic regimens is carried out, the advantage of this technique and its mechanism are described. The results of treatment of 20 patients are presented. All patients underwent daily ear toilet, rinsing of the middle ear cavity with antiseptic solutions followed by the introduction of a solution of decasan in combination with ozone. Despite this, in patients of group 1 (9%), group 2 (2.6%), the effect was noted. Key words: chronic tuberculous otitis media, otoendoscopy, otomicroscopy, transtymponal injection of drugs, ear lavage, ozone. Introduction. Chronic middle ear tuberculosis (tuberculous otitis) is a relatively rare, but severe form of tuberculosis infection, characterized by long-term consequences. It often occurs in combination with complicated forms of the general tuberculosis process, especially pulmonary tuberculosis. In such cases, patients have a weakened general immunity, prolonged intoxication and foci of inflammation, hematogenous or lymphogenous spread of tuberculosis bacteria to other organs and tissues. Middle ear tuberculosis can manifest clinically with various symptoms: persistent or recurrent ear discharge, hearing loss, earache, and sometimes neurological symptoms such as facial nerve paralysis. In cases of chronic form, complete loss of the ear, bone tissue erosion, and intracranial complications may develop. This makes traditional treatment measures for such patients completely 149 “JOURNAL OF SCIENCE-INNOVATIVE RESEARCH IN UZBEKISTAN” JURNALI VOLUME 03, ISSUE 06, 2025. JUNE ResearchBib Impact Factor: 9.654/2024 ISSN 2992-8869 ineffective. Although standard anti-tuberculosis treatment regimens (DOTS strategy) are currently used, complications arise in extrapulmonary forms of tuberculosis, in particular in ear foci due to drug-resistant strains or slow inflammatory and regenerative processes. Therefore, the need for additional or adjuvant therapy is increasing. Main part. In recent years, interest in ozone therapy has increased. Ozone is a gaseous substance with strong oxidizing, bactericidal and immunomodulatory properties, which is used in medicine for local and systemic effects. It has the properties of reducing inflammation, accelerating tissue regeneration and improving microcirculation. At the same time, ozone therapy can increase the overall reactivity of the body in tuberculosis and enhance the effectiveness of basic treatments. In this study, the therapeutic efficacy and safety of ozone therapy are studied in patients with pulmonary tuberculosis and chronic middle ear tuberculosis. The goal is to determine the impact of ozone therapy on the healing process, its role in suppressing infection, and its importance in improving the overall condition of patients. HTSU occurs with the involvement of the mucous membrane of the tympanic cavity and other formations related to the middle ear system. [2]. Despite scientific achievements aimed at diagnostics, treatment and prevention of ear tuberculosis (TU), the frequency of their occurrence does not decrease, constituting 3-5% among specific lesions of the ENT organs [1,3]. In 1% of all cases, tuberculous ear damage is primary, not combined with tuberculosis of other organs. The main principle of conservative treatment of CTSU, as well as other focal infections, is a rational combination of general measures of influence on the body with local treatment. The former should be aimed at eliminating the general infection in CTSU and increasing the body's immunological strength. Local treatment consists of creating optimal conditions for elimination in the focus of inflammation, suppression of local infection and stimulation of reparative processes [4,7]. The effectiveness of the treatment of CTSU largely depends, along with systemic etiotropic therapy, on the local treatment used for introduction into the tympanic cavity (TC). Drug-resistant microflora is the cause not only of increased treatment periods, but also of a more severe course of diseases and the development of complications [2]. In this regard, it is necessary to study the effectiveness of new anti-tuberculosis drugs in the treatment of CTSU and to develop optimal methods for their use. 150 “JOURNAL OF SCIENCE-INNOVATIVE RESEARCH IN UZBEKISTAN” JURNALI VOLUME 03, ISSUE 06, 2025. JUNE ResearchBib Impact Factor: 9.654/2024 ISSN 2992-8869 Taking into account the above, we found it interesting to study the effect of medical ozone (O3), ozone-containing drugs in the treatment of CTSU in combination with a solution of decasan. Ozone,