MORPHOLOGICAL AND IMMUNOHISTOCHEMICAL CHANGES IN TISSUES IN RECURRENT CHRONIC SUPPURATIVE OTITIS MEDIA

Recurrent chronic suppurative otitis media is characterized by a persistent inflammatory process involving the structures of the middle ear, with repeated exacerbations and structural alterations of the mucosa, granulation tissue, and bony components. Impaired tissue repair, persistent inflammatory cell infiltration, fibrosis, microcirculatory abnormalities, and disturbances of the local immune response may contribute to recurrence and persistence of the pathological process. The aim of the study is to evaluate the morphological and immunohistochemical characteristics of middle ear tissues in recurrent chronic suppurative otitis media and to determine their role in maintaining chronic inflammation. Morphological assessment of surgical specimens includes evaluation of inflammatory cell infiltration, epithelial alterations, granulation tissue formation, fibrosis, and destructive tissue changes. Immunohistochemical examination provides additional information on cellular proliferation, inflammatory activity, angiogenesis, apoptosis, and connective tissue remodeling. Identification of relationships between structural tissue damage and local immune responses contributes to a more comprehensive understanding of the pathogenetic mechanisms responsible for recurrent disease. Combined morphological and immunohistochemical assessment may be useful for determining the activity of the pathological process, assessing the risk of recurrent inflammation, and improving approaches to surgical treatment and postoperative follow-up of patients with chronic suppurative otitis media.