Features of simultaneous endoscopic otopharyngeal surgery in children undergoing immunosuppressive therapy

Objective. To present clinical observations on the efficacy and safety of simultaneous endoscopic otopharyngeal surgery in children with juvenile idiopathic arthritis receiving immunosuppressive therapy.
Clinical cases. Two clinical cases of pediatric patients with rheumatic diseases complicated by chronic otitis media, tympanic membrane retraction, epidermization, and adenoid hypertrophy are described. Both patients were receiving biological disease-modifying antirheumatic drugs. Simultaneous endoscopic shaver adenoidectomy and middle ear revision with possible tympanoplasty and ventilation tube insertion were performed.
Results. In the first case, true atelectasis and epidermization were confirmed intraoperatively; tympanic cavity sanitation and ventilation tube placement were carried out. In the second case, no signs of true atelectasis were found, and only bilateral ventilation tube insertion was performed. Both patients had an uneventful postoperative period with restoration of middle ear ventilation and tympanic membrane anatomy.
Conclusion. Simultaneous endoscopic otopharyngeal surgery in children with juvenile arthritis on immunosuppressive therapy is a pathogenetically justified, safe, and effective surgical approach. Individualization of intraoperative decisions is crucial for achieving optimal outcomes.
Keywords: juvenile idiopathic arthritis, chronic otitis media, atelectasis, epidermization, adenoids, tympanoplasty, endoscopy, immunosuppression
Conflict of interest. The authors declare that they have no conflict of interest.
Funding. This study required no funding