[Results of a prospective observational study of the effectiveness of the complex drug Homeovox in adult patients with various types of dysphonia]. / Rezul'taty prospektivnogo nablyudatel'nogo issledovaniya effektivnosti kompleksnogo lekarstvennogo preparata gomeovoks u vzroslykh patsientov s razlichnymi vidami disfonii.

The voice as the most important means of communication is of great importance in a person's life. Every year the number of specialties for which voice and speech are a key tool of professional activity increases. Diseases of the vocal apparatus reduce the ability to work, and for some people pose a threat of professional unfitness. The relevance of the study is determined not only by the significant prevalence of dysphonia, but also by the insufficient effectiveness of existing methods of treating voice disorders. OBJECTIVE: To evaluate the clinical efficacy and safety of the use of the drug Homeovox in patients with acute and chronic catarrhal laryngitis as monotherapy. To fulfill the set goal of the study, the following tasks were solved: evaluation of the clinical effectiveness of the drug Homeovox as monotherapy for various types of dysphonia; evaluation of the effectiveness of the drug Homeovox as monotherapy from the 1st day of use. MATERIAL AND METHODS: The basis for the implementation of the tasks was the analysis of the results of the examination and treatment of 60 patients with voice disorders aged 18 to 75 years. Among them, 10 (17%) patients with acute laryngitis and 50 (83%) patients with chronic laryngitis. To establish the diagnosis, a comprehensive examination was carried out, involving examination, videolaryngostroboscopy, acoustic analysis of the voice. The study design included three patient visits, during which the functional state of the vocal apparatus was examined by subjective and objective methods. RESULTS: As a result of the treatment with the use of the drug Homeovox, the efficacy and safety of this drug in the treatment of dysphonia in adult patients with acute and chronic laryngitis from the first days of therapy has been proven, which is confirmed by the method of videolaryngostroboscopy and acoustic analysis of the voice. CONCLUSION: The drug Homeovox is an effective, safe remedy and can be included in the complex treatment of laryngeal pathology in order to increase its effectiveness and achieve a therapeutic effect in a shorter time, manifested by an improvement in the clinical and functional state of larynx.

[Modern methods of early diagnosis of tumors of the larynx and pharynx]. / Sovremennye metody rannei diagnostiki opukholei gortani i glotki.

Worldwide, there is a constant increase in mortality from malignant neoplasms, which is largely due to late diagnosis. One of the reasons for late detection is the lack of conditions for conducting a detailed examination at the outpatient level, since the routine method of examining ENT organs today remains examination using mirrors, but in recent decades, endoscopic methods of examination have become widespread - indirect endoscopy, fibrolaryngoscopy, contact endoscopy, NBI-endoscopy, endoscopy using light filters of the SPIES system, as well as diagnostics using fluorescent technologies. Also, a promising and new direction is the diagnosis of malignant neoplasms at the preclinical stage and precancerous conditions, for which molecular diagnostic methods are used - SCCA and microRNA. OBJECTIVE: To analyze the effectiveness of various methods of endoscopic and molecular diagnostics of malignant neoplasms of the larynx and pharynx. MATERIAL AND METHODS: A study was conducted In the Department of ENT Oncology of the National State Research Center of Otorhinolaryngology of the Federal Medical-Biological Agency of Russia, which involved 46 patients with suspected malignant neoplasms of the larynx and pharynx. All patients underwent direct laryngoscopy under endotracheal anesthesia with simultaneous NBI-endoscopy, spies examination, contact endoscopy, and fluorescence testing, followed by biopsy and tissue sampling for microRNA concentration analysis, as well as blood sampling for SCCA concentration.

[Audiological profile of patients with SARS-Co-V-2 PCR-positive cases]. / Audiologicheskii profil' patsientov pri zabolevanii, vyzvannom virusom SARS-CoV-2.

COVID-19 is a new pandemic caused by a novel coronavirus, SARS-CoV-2. COVID-19 has spread throughout China and received worldwide attention. On 11 February 2020, World Health Organization (WHO) officially declared COVID-19. The clinical symptoms of COVID-19 patients may vary, more often include symptoms affected by upper and lower respiratory tract damage. In ENT practice it is used to mention rhinitis, sore throat, anosmia/hyposmia. The effect of COVID-19 is an interesting issue in audiology. There were 78 patients who were confirmed positive for COVID-19 PCR-positive cases and 30 normal non-infected subjects in our study. The patients were divided into two groups according to severity their clinical symptoms from asymptomatic COVID-19 PCR-positive cases to severe form. All patients underwent audiological evaluation included tympanometry, acoustic threshold and transient evoked otoacoustic emission (TEOAE). Although hearing sensitivity was normal among some participants, it was statistically proved that TEOAEs could pick up subtle deterioration in the outer hair cells functions and impact on the cochlear.

[The histiocytoma of the oropharynx (clinical cases)]. / Fibroznaia gistiotsitoma zaglotochnogo prostranstva (klinicheskoe nabliudenie).

The paper presents a case of rare localization histiocytoma of the oropharynx. Some authors consider the existence of this category of tumors controversial, others prefer to consider them tumors of unclear Genesis. Benign fibrous histiocytoma is quite common in the form of a small node with fairly clear boundaries, most often localized on the skin of various parts of the body. We have not found any cases of fibrous histiocytoma localization in the head and neck in the available literature. Given the results of the patient survey (data endoscopy, ultrasound soft tissues of the neck and MRI neck) were diagnosed with benign tumors retrofaringealny space and, given its location, the decision about the feasibility of transoral removal of the tumor with subsequent histological examination of tissue.

[Human papillomavirus and Epstein-Barr virus in the pathogenesis of inverted papilloma and associated sinonasal carcinoma]. / Virusy papillomy cheloveka i Épshteina-Barr v patogeneze invertirovannoi papillomy i assotsiirovannoi s nei sinonazal'noi kartsinomy.

OBJECTIVE: To determine whether Epstein-Barr virus and human papillomavirus (HPV) types 6, 11, 16, 18, 35, and 43 DNA can be present in inverted papilloma (IP) and associated sinonasal carcinoma. MATERIAL AND METHODS: The investigation was carried out using tissue samples obtained during surgery from 76 cases of IP and 4 cases of sinonasal carcinoma that had developed in the presence of IP. PCR was performed in 41 cases of IP and in 4 cases of sinonasal carcinoma; immunohistochemistry was done in 15 cases of IP to identify HPV L1 capsid protein. RESULTS: HPV6 DNA was detected in 20 cases; three of them were simultaneously found to have also HPV11; 1 case had only HPV11. HPV types 16, 18, 35, and 45 and Epstein-Barr virus were not detected. PCR revealed HPV types 16 and 35 in one of the 4 cases of sinonasal carcinoma associated with IP. Immunohistochemical study identified HPV L1 capsid protein in the epitheliocytes and stromal infiltrating lymphocytes and macrophages in two cases of IP with the highest concentration of HPV DNA as evidenced by PCR, as well as in one case of sinonasal carcinoma. CONCLUSION: Taking into account the low HPV DNA concentration detected only for types 6 and 11, as well as the immunohistochemical detection of HPV L1 in the tumor stromal lymphocytes and macrophages and some basal epitheliocytes in individual cases, it can be assumed that HPV does not play a crucial role as an etiological factor for IP. PCR revealed oncogenic HPV types 16 and 35 in sinonasal carcinoma associated with IP only in one case, which makes it untimely to claim that this virus plays a very special role in the etiology of this carcinoma. Epstein-Barr virus was not found in any case.

[The 'major' complications of cochlear implantation]. / 'Bol'shie' oslozhneniia kokhlearnoi implantatsii.

AIM: The objective of the present study was to improve the selected surgical stages of cochlear implantation (CIP) taking into consideration the results of the analysis of the outcomes of re-operations. MATERIAL AND METHODS: A total of 53 patients (4 adults and 49 children) were referred to our clinic for re-operations deemed to be required for the management the major complications following CI during the period from 2014 to 2017. Primary cochlear implantation was performed in other clinics. Re-operations were carried out at different time intervals after the primary surgical intervention under the guidance of a single experienced surgeon. RESULTS: The technical malfunction of the inner part of the implant prevailed among the causes behind the major complications of CI. It accounted for 47% of the total number of complications and required the replacement of the device. The next most frequent form of the complications (that accounted for 15% of all the cases) was the introduction of an active electrode into the cells of hypotympanum. The remaining complications occurred only in isolated cases. The detailed analysis of all the revealed complications was undertaken with the description of their causes and variants and the surgical strategy chosen for the management of each concrete patient. The decision about the necessity of either the removal or the substitution of the implant was taken on an individual basis. The successful outcome of the surgical treatment of all the operated patients with the major complications of cochlear implantation was achieved. CONCLUSION: The frequency and severity of the major complications of cochlear implantation are directly dependent on the patient's anatomical features, surgeon's qualifications, the quality of the implants, and lifestyle factors (e.g. head trauma, etc.). Cochlear implantation continues to be the only method for hearing rehabilitation in the patients suffering from severe sensorineural impairment of hearing. In the cases of cochlear implantation with the prospects of delayed re-implantation, leaving the active electrode in the scala tympani of the cochlea is a necessary measure to prevent synechiae.

[Criteria for the objective assessment of the dynamic state of the retraction pockets in the children presenting with excudative otitis media].

This publication continues the preceding paper entitled "Early diagnostics of the retraction pockets in the tympanic membrane of the children". The objective of the present work was to develop the criteria for the objective estimation of the dynamic state of the retraction pockets (RP) in the children at different stages of excudative otitis media. The secondary objective was to develop an approach to the early diagnostics of cholesteatoma of the middle ear. A group of 138 children at the age varying from 1 to 17 years was placed under dynamic observation for the purpose of drawing up the individual "photo-roentgenological passport of the retraction pockets". Special attention was given to RP-semiotics of different forms of the syndrome and its severity in accordance with the classification universally accepted by foreign researchers. The results of the dynamic observations were used to develop the indications for the early preserving surgical treatment. It was given to 16 children six of which presented with cholesteatoma. The original illustrative materials for all variants of the retraction pockets are presented.

[The early diagnostics of retraction pockets of the tympanic membrane in children].

The most important literature data concerning retraction pockets (RP) of the tympanic membrane and their currently accepted classification are presented. The objective of the present work was to develop criteria for the objective estimation of the dynamic state of the tympanic retraction pockets in children presenting with non-perforating forms of otitis media. A total of 138 children suffering from exudative otitis media were available for observation; retraction pockets were found in the majority of these patients. Otomicroscopic characteristics of various RP species are described. A diagnostic approach to the observation of the dynamic state of the tympanic retraction pockets is proposed. The presence of the retraction pockets of the tympanic membrane is considered to be a risk factor of the development of cholesteatoma and chronic purulent pathology of the middle ear in the children. Deep retraction pockets without a controllable bottom and attic cholesteatomas were identified in 16 (11.6%) and 6 (4.3%) of the examined children respectively. They were treated by means of sparing otosurgery.

[Preoperative and postoperative management of patients with congenital defects of the external and middle ear]. / Osobennosti vedeniia bol'nykh s vrozhdennymi porokami razvitiia naruzhnogo i srednego ukha v predoperatsionnom i posleoperatsionnom periodakh.

Laser techniques introduction in preoperative and postoperative management of patients operated for congenital defects of the external and middle ear promotes retention of the graft and activation of regeneration, improves treatment results. More advanced methods of care for the postoperative cavity increase quality and duration of hearing-improving operative effects, shorten hospital stay, minimize risk of long-term complications.