Abstract

To date, there is a large number of works devoted to the effect of the SARS-CoV-19 virus on various systems of the human body, including ENT organs. Hearing impairment, damage to the auditory system after Covid is one of the fairly common complications. And although over the years the SARS-CoV-2 infection has lost its aggressiveness, the presence of post-Covid lesions of the sensory systems, including the auditory system, remains at a fairly high level.

Aim: to investigate the secretory otitis media in patients with COVID-19.

Materials and methods: An analysis of the clinical and instrumental examination results of 38 patients with COVID-19 with secretory otitis media was carried out. The results of the questionnaire, otolaryngological examination, subjective audiometry, and acoustic impedance measurement were analyzed. The investigation was carried out using audiometers АС-40 (“Interacoustics,” Denmark) and MA 31 (Germany), impedance audiometers АТ-235, Ad 229e (“Interacoustics,” Denmark), and MAICO (Germany). In addition, an endoscopic examination of the nasal cavity was carried out using the workplace of an otorhinolaryngologist with the Mega Medical NET-1100 endovideo complex.

Results and their discussion: In the patients we examined, secretory otitis media developed during or after COVID-19. The patients complained of a feeling of congestion and pressure in the ear, decreased hearing function, and tinnitus. In most of them, problems with the auditory system began during COVID-19 and they consulted a doctor after recovery, when they noticed that unpleasant sensations in the ear persisted for a long time. In most of them, the clinical picture in terms of the patient’s sensations was vague and therefore they were consulted by an otolaryngologist when the disease had lasted more than 2 weeks. However, in 32.6% of cases, secretory otitis media developed after a certain period of time after complete recovery from COVID-19. According to the data we obtained, among the 264 patients we examined with COVID-19 who complained about the state of the auditory system, a conductive component occurred in 32.2% of cases. Moreover, almost half (44.7%) of them are secretory otitis.

As for the clinical picture, the peculiarity of secretory otitis in adults after COVID-19 is a prolonged nature, persistent ear congestion, a feeling of pressure and discomfort in the ears. According to subjective audiometry, patients have a bone-air interval within 10-25 dB. According to impedance audiometry, there are tympanograms of type B or C, a decrease or absence of an acoustic reflex, depending on the severity of the process.

It should be noted that secretory otitis after COVID-19 is prolonged and very difficult to treat. Therefore, with COVID-19, secretory otitis in adults often develops, which requires special attention from otolaryngologists.

Conclusions:

1. With COVID-19, secretory otitis media is quite common in adults, which is protracted in nature. Often, the disease develops in patients after recovery from COVID-19.
2. Secretory otitis media in adults with COVID-19 is difficult to treat with traditional conservative methods and requires more prolonged and active therapy.
3. Patients who have had COVID-19 and have complaints of ear congestion and impaired hearing function need to consult an otolaryngologist for the timely detection of secretory otitis media.

Keywords: COVID-19, auditory function, conductive hearing impairment, secretory otitis media.