EFFECT OF N-ACETYL CYSTEIN ON SUPEROXIDE DISMUTASE LEVEL AND MUCOCILIAR TRANSPORT IN CHRONIC SUPPURATIVE OTITIS MEDIA
Pratiwi DEWI1*, Nabila1, Primadewi NOVI1, Sudrajad HADI1

Department of Otorhinolaryngology Head and Neck Syrgery, Medical Faculty of Sebelas Maret University / Dr. Moewardi General Hospital, Surakarta, Indonesia

Abstract

Background: Chronic suppurative otitis media (CSOM) is inflammation of the middle ear characterized by perforation of the tympanic membrane and persistent discharge from the ear. Oxidative stress estimated play an important role in pathogenesis of CSOM. The primary enzyme in the defensive system against oxidative stress which known as Superoxide dismutase (SOD) is elicited to reduce the effect of superoxide radicals. Mucociliary transport of the eustachian tube is crucial for reducing middle ear inflammation, which can interfere with the mucosa^s healing process. N-Acetylsistein (NAC) is known as an antioxidant that is broadly effective despite its limited reactive oxygen species (ROS) activity. Additionally, it can reduce mucosal secretion in order to enhance mucociliary transport and prevent the development of biofilms. Objectives: To analyze the effect of NAC on SOD and mucociliary transport in CSOM patient. Methods: This research was conducted at the ENT Clinic Dr. Moewardi Hospital Surakarta, Indonesia from June - Augustus 2022 with the pretest-posttest control group design. Results: The mean level of SOD was increase significantly (24.37+-28.64 to 175.37+-114.60) (p=0.001) after intervention with NAC in the study group, compared to the control group (25.84+-33.45 to 24.62+-32.87) (p=0.327). There was also significant difference in mucociliary transport time in the study group compares to the control group (16.42+-7.02 vs 0.55+-0.84)(p=0.01) Conclusion: N-acetylcysteine exerts antioxidative effects via raising SOD levels and lowering mucociliary transit time in CSOM, which are associated with shorter healing times for the middle ear mucosa. Therefore the administration of NAC in patients with CSOM is highly recommended.

Keywords: Chronic suppurative otitis media, superoxide dismutase, n-acetylsistein, mucociliary transport

Topic: Medical : basic science, clinical, translational research, medical education, and miscellaneous