[Closing of nasal septum perforation using adipose stromal vascular fraction: an experimental study]. / Zakrytie perforatsii peregorodki nosa s primeneniem stromal'no-vaskulyarnoi zhirovoi fraktsii: eksperimental'noe issledovanie.

Nasal septal perforation (NSP) is a complex problem in otorhinolaryngology, which leads to impaired nasal breathing and dryness in the nose. This reduces the patient's quality of life and leads to psychological discomfort. The treatment of nasal septum perforation is selected taking into account the clinical manifestations, perforation parameters and general condition of the patient. Currently, a large number of different surgical methods have been described in order to closing the defect of nasal septum. To date, there is no universally accepted method for closing NSP, which stimulates the search and development of new treatment options. OBJECTIVE: Under experimental conditions, to study a new method for closing nasal septum perforation using a collagen scaffold together with adipose stromal vascular fraction containing multipotent mesenchymal stromal cells. MATERIAL AND METHODS: The experiment was carried out on a model of nasal septum perforation in 24 male rabbits divided into four groups, depending on the construct, implanted into the defect zone: the 1st group was the control group - without the introduction of implantation material; the 2nd group - collagen scaffold without adipose stromal vascular fraction; the 3rd group - collagen scaffold with xenogenic adipose stromal vascular fraction; the 4th group - collagen scaffold with allogeneic adipose stromal vascular fraction with further dynamic evaluation of endoscopic control on day 14, after 1 month, 3 months, and 6 months. At month 6, the animals were removed from the experiment, followed by morphological examination in color with hematoxylin and eosin, as well as safranin and methyl green. RESULTS: As a result of the experiment using adipose stromal vascular fraction of allogeneic and xenogenic origin, closing of perforation of the nasal septum of a rabbit for 3 months of dynamic endoscopic control, as well as according to morphological research, was demonstrated. CONCLUSION: Our study showed that the use of adipose stromal vascular fraction containing not only endothelial cells and pericytes, but also multipotent mesenchymal stromal cells in combination with a collagen scaffold closes the perforation of the nasal septum in a rabbit, without increasing the risk of violations of habitual vital activity.

[Possibilities of usage of modern herbal medicinal product in the treatment of patients with acute viral rhinosinusitis]. / Vozmozhnosti primeneniya sovremennogo rastitel'nogo lekarstvennogo preparata v lechenii patsientov s ostrym virusnym rinosinusitom.

INTRODUCTION: The issues of epidemiology, etiopathogenesis, diagnostics and clinic of acute catarrhal rhinosinusitis are considered, the possibility of using the herbal medicinal product Sinupret extract in the treatment of patients with acute viral rhinosinusitis is substantiated. OBJECTIVE: To evaluate the efficacy and safety of using the drug Sinupret extract in patients with acute viral rhinosinusitis. MATERIAL AND METHODS: A comparative study of the efficacy and safety of clinical use in patients of the drug Sinupret extract in patients with acute viral rhinosinusitis was carried out in comparison with symptomatic treatment. RESULTS AND DISCUSSION: After analyzing and processing the results obtained using statistical methods for the main group, a faster rate of decrease in the severity of complaints (data with the use of the MSS visual analogue scale), the severity of inflammation in the nasal cavity and nasopharynx, the amount of discharge from the nose and its viscosity were confirmed. Restoration of respiratory function according to rhinomanometry and mucociliary transport according to the results of the saccharin test also occurred more quickly in patients of the main group compared to the control group. The effectiveness of using Sinupret extract is also confirmed by the results of photoplethysmography. CONCLUSIONS: The use of the drug Sinupret extract not only contributes to a more rapid improvement in the general well-being of patients and a decrease in the severity of complaints, but also leads to an improvement in the objective picture of the disease (rhinoscopy, the results of anterior active rhinomanometry, saccharin test) compared with the control group, favorably affects the quality life of patients, causes a decrease in economic and social costs against the background of the development of acute viral rhinosinusitis.

[Improving of the nasal cavity mucous membrane restoration efficiency of the after rhinosurgical interventions]. / Primenenie irrigatsionnoi terapii posle khirurgicheskikh vmeshatel'stv v polosti nosa.

The article discusses aspects of the use of irrigation therapy after surgical interventions on intranasal structures, in particular, the features of using the Aqua Maris Leyka device in comparison with traditional methods of nasal cavity care in this group of patients. The use of the Adriatic Sea salt solution for nasal lavage Aqua Maris using a special device in the postoperative period leads to an earlier subsidence of reactive postoperative changes in the nasal cavity, a decrease in edema, an increase of reparative processes. This is evidenced by the dynamics of clinical signs and the results of cytological examination of smears-prints from the nasal cavity. During the irrigation of the nasal cavity using the Aqua Maris Leyka device, the liquid is supplied by gravity, without additional pressure, ensuring safety and uniform irrigation of all parts of the nasal cavity with saline solution, which is especially important in the presence of reactive changes in the postoperative period.

[Modern aspects of inflammatory external ear diseases treatment]. / Sovremennye aspekty lecheniya vospalitel'nykh zabolevanii naruzhnogo ukha.

The article deals with the problem of inflammatory diseases of the external ear. A review of pruritic dermatoses of the external auditory canal was carried out. It has been shown that in chronic dermatoses, the contamination of the skin with bacterial and fungal pathogens significantly increases, which leads to a high risk of developing secondary infectious pathological processes. Treatment of dermatological inflammatory ear diseases includes careful daily hygiene of the external auditory canal and pharmacotherapy, a key aspect of which is the use of topical etiotropic, anti-inflammatory, and symptomatic drugs. The advantage of the combined drug candiderm is described, which, thanks to the unique combination of beclomethasone, gentamicin and clotrimazole in the composition, effectively relieves the symptoms of external ear dermatoses.

[Disorder of mobility of vocal folds on the background of hypoparathyroidism at patient after subtotal resection of thyroid gland]. / Narushenie podvizhnosti golosovykh skladok na fone gipoparatireoza u bol'noi posle subtotal'noi rezektsii shchitovidnoi zhelezy.

During surgery on the thyroid gland, injury to the recurrent nerve is possible with the development of a clinical picture due to impaired mobility of the vocal fold. A disturbance of the mobility of the opposite vocal fold in the form of a paradoxical spasm may join these manifestations if the parathyroid glands were affected during surgery, followed by a decrease in the level of ionized calcium in the blood. Management of such patients presents certain difficulties. A clinical case of examination and treatment of a patient with bilateral impairment of mobility of the vocal folds resulting from thyroid surgery is presented. The peculiarity of this observation is that because of our treatment, we managed to stop the spasm of one vocal fold, and then restore the mobility of the other vocal fold, due to which a complete restoration of the respiratory and vocal function was achieved.

[Optimization of treatment of patients with acute bacterial rhinosinusitis with relating allergic rhinitis]. / Optimizatsiia lecheniia bol'nykh ostrym bakterial'nym rinosinusitom s soputstvuiushchim allergicheskim rinitom.

The article considers the problem of acute rhinosinusitis and its multifactorial relationship with allergic rhinitis. Data on a higher incidence of acute rhinosinusitis in patients with an allergic background is given, which is primarily associated with a deterioration in the state of the respiratory tract mucous membrane barrier function. It is shown that local allergic inflammation causes a more severe course of acute rhinosinusitis. A review of the combined course of these pathological processes is carried out and options for their treatment are considered. A study of the clinical use of the complex preparation Frinosol is described, which, thanks to the combination of a nasal decongestant and an antihistamine in its composition, effectively alleviates the symptoms of acute rhinosinusitis in patients with allergic rhinitis. It has been shown that the use of Frinosol in the complex treatment of adult patients with acute bacterial rhinosinusitis, combined with allergic rhinitis is safe and effective.

[Experimental evidence for regenerative treatment of chronic tympanic membrane perforation]. / Eksperimental'noe obosnovanie metoda tkanevoi inzhenerii dlya zakrytiya stoikikh perforatsii barabannoi pereponki.

OBJECTIVE: The aim of our study was an experimental evaluation of tissue engineering approach to chronic tympanic membrane perforation closure. MATERIALS AND METHODS: Chronic tympanic membrane perforation models were created both sides in 12 chinchillas. Right sided perforations were divided into two equal groups (A and B) according to treatment; left sided perforations were used as a control group. Group A perforations were treated with collagen scaffold and fibroblast growth factor, group B perforations were treated with collagen scaffold only. During follow-up, we provided otovideoendoscopy for closure rates assessement every 2 weeks. In case of perforation closure, a morphological investigation of the regenerate was performed. RESULTS: Group A perforations were totally closed 2 weeks after treatment in all animals. In group B, complete closure of perforation was achieved after the third treatment procedure in one case. There were no spontaneous perforation closure in the control group. According to morphological investigation, the restoration of trilaminar structure was observed only in tissue engineering group tympanic membranes.

['School of Excellence' in the structure of teaching otorhinolaryngology at the department of diseases of the ear, nose and throat of Sechenov University: experience and perspective]. / Shkola masterstva v strukture prepodavaniia otorinolaringologii na kafedre boleznei ukha, gorla i nosa Sechenovskogo Universiteta: opyt i perspektiva.

We describe our experience of teaching practical skills in Otorhinolaryngology in the Department of Ear, Larynx and Nose diseases of the Sechenov First Moscow State Medical University (Sechenov University) as a part of the rector's project 'School of Mastery' Training is held under the program, specially designed at the department. This program takes into account all the aspects of ENT doctor's practice. During their training in the school students actively participate in the work of the ENT department - they visit the dressing room, operating theater, take part in professors' rounds, and oversee the patients with various ENT conditions. Seminars are held weekly to consolidate learned practical skills. Training sessions are also held in departments of Children's Otorhinolaryngology and emergency ENT department. Results of the 'School of Mastery' were analyzed at the Department of Ear, Larynx and Nose diseases. Future perspectives are also stated.

[A glomus tumour of the bulb of the jugular vein: complications during the postoperative period]. / Glomusnaia opukhol' lukovitsy iaremnoi veny: oslozhneniia posleoperatsionnogo perioda.

The article presents a clinical case that reflects the difficulties of postoperative management of patients after the removal of the jugular glomus tumor.

[Malignant externa otitis: the modern principles of diagnostics and treatment]. / Zlokachestvennyi naruzhnyi otit: sovremennye printsipy diagnostiki i lecheniia.

The objective of the present study was to elucidate the specific features of the clinical course of malignant externa otitis in the context of the present-day concepts. A total of 5 patients presenting with the confirmed diagnosis of malignant external otitis were available for the examination. The analysis of the clinical observations provided the basis for the characteristic of pathogenesis of this condition, diagnostic principles, and treatment modalities for the management of the pathology in question. It is concluded that the patients suffering from malignant externa otitis must remain under medical care and observation during a long period and the strategy for the treatment of each concrete patient should be chosen on an individual basis taking into consideration the presence of concomitant pathologies and their adequate therapy.

[The application of the method of radiofrequency myringotomy under the experimental conditions and in the clinical practice]. / Primenenie metoda radiovolnovoi miringotomii v usloviiakh éksperimenta i v klinicheskoi praktike.

Exudative otitis media is a widespread pathological condition in the human population. In the recent years, the treatment with the electric current having the frequency up to 3.8 MHz has found the increasingly frequent application, in addition to shunting and laser myringotomy, for the perforation of the tympanic membrane to facilitate removal of exudate. The objective of the present study was to evaluate the effectiveness of the application of the electric current with the frequency up to 4 MHz for myringotomy in the patients presenting with exudative otitis media under the experimental conditions and in the clinical practice. The experimental studies were carried out with the use of the isolated temporal bones (ex vivo) and laboratory animals (in vivo). The clinical studies included the surgical treatment of 41 patients presenting with exudative otitis media using the electric current with the frequency of 4 MHz and laser irradiation with the subsequent evaluation of the inflammatory manifestations in the tympanic membrane tissues during the early post-operative period. It was shown that the method of myringotomy with the application of the electric current having the frequency of 4 MHz is safe and causes no complications. Moreover, it is accompanied by the development of the minimally active inflammatory processes in the tympanic membrane tissues during the early post-operative period.

[The possibility of using соformulated intranasal drugs after surgical correction of nasal breathing].

One of the major causes of chronic nasal obstruction is the nasal septum deformation and increase of the lower nasal turbinates. The number of septoplasty--operations ranges from 14% to 44,2% of all ENT-operations. The results of surgery are swelling of the tissues and damaged ciliar epithelium, that leads to the inparament of the mucociliar transport. In the postoperati e period the nasal cavity should be cleaned. Drugs, that are used, should reduce swelling, improve regeneration and should not supress ciliar activity. The results of supervisory, non-interventional study have shown, that application of Nasiс after septoplasty and submucose vasotomy of inferior nasal turbinates increases reparative process and leads to more rapid recovery of respiratory function of nasal cavity.

[Optical coherent tomography in diagnosis of peripheral retinal breaks].

The purpose of our study was to develop an optimal method of peripheral retinal breaks visualization and determine the presence of vitreoretinal traction using optical coherence tomography (OCT). A total of 152 patients (176 eyes) with peripheral retinal breaks were assessed, among them 57 men and 95 women, aged from 18 to 76. To visualize retinal periphery we used RTVue-100 optical coherent tomograph (USA). Photoregistration was done with Nikon NF-505 fundus camera (Japan). All patients were examined with Goldmann lens. OCT application enabled us to determine structural features and configuration of peripheral retinal breaks, the presence of vitreoretinal traction, and morphometric parameters of the defects: the average length and height, retinal thickness in three standard points (prior to the break, at its edge and at the bottom), and also the extent of vitreoretinal fusion and local detachment of retinal neuroepithelium (NE). Two groups of peripheral retinal tears were formed: group I (23 eyes)--retinal flap tears and group II (153 eyes)--perforated breaks. Optical coherence tomography is a highly informative method which enables in vivo evaluation of structural and morphometric characteristics of retinal defects and vitreoretinal fusion, as well as possible vitreoretinal traction and subclinical detachment of the retina. Its use will ensure proper documentation of study results and also provide the possibility to determine indications for laser and surgical treatment and perform a late follow-up.