الفهرس 
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Abstract
____________ SUMMARy & CONCLUSION -70-
SUMMARY &. CONCLUSION
Otitis media occurs most frequently during the first years of life.
So that by 3 years of age one - third of all children have experienced
three or more episodes.
Treatment of r.AO.M can be achieved by various methods and
techniques. Each method or technique used still has certain advantage as
well as specific disadvantages and limitations.
Prevention of otitis media in children should be based on exact
knowledge of the risk factors for the illness. This controlled study
describes the risk factors in 25 otitis - prone children chosen with regard
of the following steps:
1- Research case sheet.
2- Radiological examination of nose, paranasal sinus and nasopharyngeal
space in selected patients.
3- Bacteriological investigation and culture of ear discharge.
4- Blood examination includes: AS.O.T, C.R.P and and C.B.C.
5- Immunological investigations; serum examined for IgG, IgA, IgM,
IgG subclasses and specific antibodies against capsular polysacharides
of streptococcus pneumoniae.
The patients were divided into two groups according to the
causative microorganism:
Group (A) :
Including 15 patients and the orgamsm IS streptococcus
pneumomae.
------- __ SUMMARY & CONCLUSION. -71a-
Group (B) :
Including 10 patients and the organism is str. pyogenes.
The control group:
Also, they was exposed to similar questionnaires as the patient’s group
to evaluate the epidemiological risk factors.
In the present study we can conclude that:
1- Passive smoking; day care attendance centres; artificial pattern of
feeding (or short period breast - feeding i.e <6 months) and the early
age of initial episode are considered risk factors for LA.O.M.
2- All LA.O.M. cases have normal IgG, IgM, IgA and IgGsubclasses3,4 .
3- All cases of group (A) have low or no specific antipenumococal antibodies
and they subclassified according to IgG2 (antipemunococcal response) into:
..-’ i- normal IgG2 ( selective deficiency of specific antibodies) .
ii- IgG2 deficiency.
4- Cases of group (B) have normal general and specific immunoglobulinexcept
IgG1 ( anti protein antigen response) and they subclassified accordingly to :
i- IgG1 normal.
ii- IgG1 deficiency..
-------- RECOMMENDATION -71 b-
We recommended that regimen of treatment
1) Avoid risk factors for r.A.O.M. as passive smoking; day care
attendance centres; artificial pattern of feeding ( or short period
breast- feeding i.e <6 months) and antibiotics therapy course less
than 10 days.
2) Further studies to involve a big number of cases to evaluate the
immune aspects of r.A.O.M. especially the selective deficiency of
specific pneumococcal antibodies.
3) Trials of polyvalent anticapsular polysaccharides vaccines or long
-’ acting penicillins therapy for cases of r.A.O.M. due to selective
pneumococcal antibodies deficiency.