[Dynamic indicators of the use of puncture method for the treatment of acute maxillary sinusitis in healthcare institutions of the city of Moscow]. / Dinamicheskie pokazateli primeneniya punktsionnogo metoda lecheniya ostrogo verkhnechelyustnogo sinusita v uchrezhdeniyakh zdravookhraneniya goroda Moskvy.

According to the statistical forms medical and preventive treatment centres (MPTC), the analysis of dynamic indicators of the treatment of patients with acute sinusitis (AS) in outpatient polyclinic centers (OPC) and ENT hospitals in Moscow for the period from 2017 to 2021 was carried out. The total number of visits to an otorhinolaryngologist in the OPC in Moscow for 2017-2021 amounted to 6 834 952 patients, including 245 172 patients with AS (3.6%).The total number of hospitalizations in the departments of otorhinolaryngology for the same period amounted to 184 735 patients, including 12 906 patients with AS (7%).The number of patients with AS who was consulted by an otorhinolaryngologist from 2017 to 2021 decreased by 18.2%, which can be explained by a change in the routing of patients with mild form of AS to general practitioners. An analysis of the dynamic indicators of maxillary sinus punctures carried out in the medical and preventive treatment centres (MPTC) in Moscow during the period from 2017 to 2021 showed that there was a redistribution of this manipulation from ENT hospitals to the OPC. At the same time, the proportion of patients requiring puncture treatment in the OPC for 2017-2019 was stable and amounted to 9.3%. However, since 2020, there has been an increase in this indicator by more than 2 times (21.7%), which probably indicates an increase in the treatment of patients with moderate forms of AS in the OPC. The frequency of maxillary sinus punctures that were performed in ENT hospitals in 2017-2019 amounted to 83.5%, in 2020-2021 decreased to 63.4%. The average number of maxillary sinus punctures per patient in ENT hospitals from 2017 to 2019 was 13.3. Since 2020, this value has decreased by about 2 times and has become equal to 8.5. The decrease in the number of maxillary sinus punctures that were performed in ENT hospitals is probably due to the fact that patients with severe and complicated forms of acute sinusitis hospitalized from 2020 to 2021 required more radical surgical treatment.

[Epidemiology of spontaneous nasal, ear and throat bleedings]. / Epidemiologiya spontannykh krovotechenii iz ukha, gorla, nosa.

Bleeding is a life-threatening condition, requiring an urgent care. The first line of treatment this kind of patients is ambulance doctors (emergency medical team). Spontaneous bleeding (SB), in this case, don't have a traumatic agent (including surgical trauma). STUDY OBJECTIVE: The purpose of this study was to evaluate spontaneous bleeding epidemiological profile of Moscow city emergency service. METHODS: Study included statistical reports of Moscow city emergency services medical teams (EMT) were servicing adults. We analyzed total number of calls and number of EMT calls to pa-tients with SB during the period between 2015 and 2019. The excluding criteria was EMT re-calls to patents with SB. RESULTS: In a study, it was found that over five-year period of observation, EMT made 15 709 862 calls, included 215 840 calls (1.37%) to patients with SB. It was found that the most frequency sources of SB were: the gastrointestinal tract (33.18%), the nasal cavity (28.14%) and the vagina with the uterus (23.91%). There is the proportion of patients suffering of SB from ENT organs is 28.52% in structure of Moscow city Emergency Medical Service. There are the proportion of epistaxis 98.65%, ear bleeding - 0.89%, throat bleeding - 0.46% in structure of SB from ENT organs. We analyzed, that spontaneous epistaxis most frequent between October and April. This period characterized with 70.6% EMT calls from the total EMT calls to patients with SE.

[Surgical interventions on the pharynx in the structure of otorhinolaryngological care to the population of the city of Moscow]. / Khirurgicheskie vmeshatel'stva na glotke v strukture otorinolaringologicheskoi pomoshchi naseleniiu Moskvy.

The authors studied the reporting documentation of otorhinolaryngological hospitals of the city of Moscow on the surgical treatment of pharyngeal pathology in adults from 2002 to 2017. It was found that for 16 years surgical treatment of 290 362 patients with ENT-diseases was performed: 181.206 (62.4%) patients with diseases of the nose and paranasal sinuses, 24.981 (8.6%) patients with ear pathology, 60.346 (20.8%) patients with diseases of the pharynx and 23.829 (8.2%) - with diseases of the larynx. The assessment of the overall dynamics of the studied indicators was carried out on the 'trend lines'. For the considered period, the number of patients with surgical pathology of the pharynx increased by 33.2%. The proportion of tonsillectomies increased by 1.85 times to 56.5%, drainage of peritonsillar abscesses and abscesses-tonsillectomies decreased by 19%, uvulopalatoplastic increased 4.1 times, removal of neoplasms of the pharynx increased 2.2 times, adenotomies decreased by 2.4 times. Analysis of the data allowed to establish that, against the background of an ever-increasing number of surgical interventions for diseases of the pharynx in adults, a descending trend was noted only in the treatment of complicated forms of chronic tonsillitis and hypertrophy of the pharyngeal tonsil.

[The strategy of the of surgical treatment of the cysts in the maxillary sinus]. / Taktika khirurgicheskogo lecheniia kist verkhnecheliustnoi pazukhi.

Based on the results of the retrospective analysis of 12 094 medical histories available from five large otorhinolaryngological clinics of the city of Moscow the authors arrived at the conclusion that the surgical treatment of maxillary sinus patholologies including the resection of retentional cysts accounts for 4.1% of the total number of surgical interventions on the ENT organs. The endonasal and extranasal approaches were used in 28.5% and 68.9% of the cases respectively. The combined approach to the maxillary sinus was applied in 2.6% of all the cases. The vector studies of the anatomical features of the ostiomeatal complex in 102 patients presenting with cystic lesions of the maxillary sinus with the use of computed tomography have demonstrated that the lumen of the complicated system communicating the maxillary sinus and the nasal cavity remains patent along its entire length; its part in the ethmoidal infundibulum region is as long as 1.31±0.03 mm and amounts to 2.09±0.02 mm in the region of natural anastomosis of the maxillary sinus (p<0,01). The results of the histological study of 81 histological preparations give evidence that the lesions of the mucous membrane in the regions of ethmoidal infundibulum and natural anastomosis of the maxillary sinus have a chronic character and manifest themselves as sclerosis of lamina propria and hyperplasia of mucous glands. The authors nave come to the conclusion that the surgical approach to the maxillary sinus through the middle meatus is not sufficiently well substantiated and therefore can not be recommended for the resection of the cysts from this air cavity in the body of the maxilla.