[Olfactory impairment in patients of the older age group with COVID-19 in the acute period and in the period of convalescence.]

Complete or partial loss of sense of smell significantly reduces the quality of life and in some cases is life-threatening. A new coronavirus infection in some cases leads to hypo- or anosmia. The defeat of the olfactory epithelium, swelling of the mucous membrane, the presence of discharge in the nasal cavity complicate the effect of odorants on the neuroepithelium. With COVID-19, anosmia may be the first and leading symptom. The restoration of the sense of smell occurs more often during the first weeks, but in some cases it is persistent. A special group of patients are older patients, older than 60 years. The course of a new coronavirus infection due to concomitant pathology proceeds in a more severe form. We present the experience of olfactory training with a set of essential oils (juniper, turmeric, eucalyptus and rose). Aromatherapy was preceded by irrigation of the nasal cavity with isotonic saline solution. In the absence of a clear clinical effect for 3 weeks, the set of oils was changed to fir oil, rosemary oil, monarda and lavender. The course of treatment continued for an average of 2 months. The technique included physiotherapy (endonasal electrophoresis with 0,25% zinc sulfate solution № 10), zinc preparations, pumpkin seeds 20-30 g per day, B vitamins (B6 and B12).

[Functional endoscopic sinus surgery in a patient with cystic fibrosis after lung transplantation]. / Funktsional'naya endoskopicheskaya khirurgiya pazukh nosa u patsientki s mukovistsidozom posle peresadki legkikh.

Cystic fibrosis is genetic multisystem disorder with a predominant lesion of the respiratory tract. The duration and quality of life of these patients depends on the state of respiratory function. Progressive lung dysfunction is still the leading cause of mortality patients with cystic fibrosis. End-stage lung diseases in patients with cystic fibrosis, lung transplantation is a viable method of treatment. It has the ability to prolong life of these patients. Survival in cystic fibrosis has steadily increased medical treatment and post-transplant. Chronic rhinosinusitis (with nasal polys and without) impacts almost all cystic fibrosis patients, leading to significant reductions in quality of life. Chronic rhinosinusitis with nasal polyps is prevalent in the cystic fibrosis patients, and it is often a recalcitrant infection with multidrug resistant organisms. Medical therapies such as nasal irrigations, nasal steroids, and antibiotics are critical for managing symptoms, but functional endoscopic sinus surgery is necessary for refractory cases. The unified airway hypothesis suggests that sanitation bacterial infection in the upper airway can also decrease bacterial burden in the lungs. The article presents a clinical case of successful endoscopic sinus surgery in a 15-year-old patient with chronic rhinosinusitis with nasal polyps and cystic fibrosis after lung transplantation. The intervention was performed under General anesthesia and controlled hypotension. Bilateral antrostomy, ethmoidectomy and Draf IIb frontal sinusotomy were performed by endoscopic endonasal approach. There were no intra - and post-operative rhinosurgical or lung complications. The follow-up period was 18 months. At present, there is no relapse of chronic polypous rhinosinusitis, and there are no indications for revision intervention.

[Tonsillitis and tonsillogenic conditions]. / Tonzillit i tonzillogennye zabolevaniia.

The objective of the present study was to analyze and summarize the literature publications concerning tonsillitis and related (tonsillogenic) pathological conditions. The retrospective analysis of these materials made it possible to collect and summarize information about the influence of palatine tonsillar pathology (chronic tonsillitis) on the function of various organs and their systems. It has been shown that pathogenesis of a great variety of disease is underlain by pathology of palatine tonsils. Also, the possibility to stabilize the pathological processes in certain organs and systems by the conservative and/or surgical treatment of chronic tonsillitis has been demonstrated. It is concluded that the patients presenting with chronic tonsillitis make up a group of risk of development of many serious somatic diseases and require enhanced attention not only of otorhinolaryngologists but also specialists representing other medical disciplines. The multidisciplinary approach to the management of such patients is the sole way to reduce the frequency ofgeneral complications in the patients with chronic tonsillitis.