(240) Hyaluronic Acid Level in Relation to OME Severity- cleft Patients

Introduction: Hyaluronic acid (HA) is a linear polysaccharide of high molecular weight stored in extracellular matrix. It is involved in a wide range of biological processes. It has regulatory, anti-inflammatory, immunosuppressive, antiproliferative effects and, last but not least, improves mucociliary properties of the middle ear mucosa and drainage middle ear. The aim of the work was to determine the level of HA in middle ear fluid in newborns with cleft lip and palate and subsequently compare the values with the later clinical course of otitis media with effusion (OME) in individual patients.

Methods: The secretion was collected under general anesthesia during the early stage of lip reconstruction between 2 and 8 days of age. The concentration of HA in the middle ear fluid was determined in 65 newborns (48 boys and 17 girls). The ELISA method was used for measurement -TECO Hyaluronic acis PLUS kit. Samples were frozen at -80°C after collection. The patients were divided into 3 groups according to the further course of secretory otitis during at least the following two years – Favorable (F), Medium (M) and Unfavorable (U). The evaluation criterion was the necessity of another intervention - aspiration of the middle ear secretion or the introduction of ventilation tubes.

Results: Group F included 15, M 25 and U 25 patients. HA levels in F were 14253±2393 μg/L, in M 7503±1345 μg/L and in U 5905±2393 μg/L. Patients with an adverse course showed significantly lower HA level than patients from the F group. (P=0.02 and 0.018).

Conclusions: Hyaluronic acid level in middle ear secretion of newborns with cleft palate may be a predictor of severity the development of secretory otitis in the later period.