[About new possibilities for optimizing the postoperative period in tonsillectomy]. / O novykh vozmozhnostyakh optimizatsii postoperatsionnogo perioda pri tonzillektomii.

Tonsillectomy is one of the most frequent surgical interventions in otorhinolaryngology. This surgical is always accompanied by the development of reactive inflammatory phenomena and pain syndrome. The effectiveness and safety of tonsillectomy can be improved through the use of topical treatment in the postoperative period, including antiseptics in the form of a spray. An observational study was conducted at the Department of Otorhinolaryngology of the Russian University of Medicine of the Ministry of Health of the Russian Federation, the purpose of which was to evaluate the clinical efficacy, tolerability and safety of Viroxynol for oral and throat mucosa in patients after tonsillectomy. As a result of the analysis of the data obtained, it was found that the use of Viroxynol for the mucous membrane of the oral cavity and throat in the treatment of patients in the early postoperative period causes a pronounced clinical effect, reduces the need for additional medications, allows faster reduction of pain syndrome against the background of relief of reactive inflammatory phenomena, improves the quality of life of patients, accelerates the healing process, reduces the risk of bacterial inflammation. The drug may be recommended for use in patients after tonsillectomy.

[New effects of a topical antimicrobial (agent) in the treatment of acute tonsillopharyngitis]. / Novye effekty topicheskogo antimikrobnogo preparata v lechenii ostrogo tonzillofaringita.

Sore throat is the leading symptom of acute tonsillopharyngitis associated with previous acute respiratory viral infections, including COVID-19. The pathogenesis of these nosologies is based on the cumulative result of the primary direct damaging effect of viruses and secondary alternative inflammatory changes in the mucosal epithelium in the focus of infection, which, against the background of changes in the functions of the regional microbiota, leads to the development of viral-bacterial inflammation that goes beyond the protective-reparative level. In the treatment of acute tonsillopharyngitis after exclusion of GABHS etiology, topical etiotropic drugs are often used. It is desirable to achieve a uniform distribution of active ingredients, and to maximize the use of additional pharmacological capabilities (irrigation-eliminative action, reparative effect). To build up the evidence base for the effectiveness of just such medicines on the basis of the Department of Otorhinolaryngology of the Moscow State Medical University named after. A.I. Evdokimov, an observational prospective comparative study was conducted, using, in addition to the clinical assessment method, cytomorphological approaches (cytomorphometry). The results of the study demonstrated that gargling with a solution of hydroxymethylquinoxylindioxide (Dioxydin 0.25 mg/ml solution for topical application) in adult patients with acute tonsillopharyngitis provides rapid relief of pain, a decrease in the severity of inflammation symptoms, and also makes it possible to achieve limitation of the degree of destruction of the epithelium in the height of inflammation and a more complete and rapid recovery of the damaged mucous membrane by the time of recovery.

[FGF23 tumor induced osteomalacia with localization of neoplasm in the tympanic cavity]. / FRF23-indutsirovannaya osteomalyatsiya opukholevogo geneza s lokalizatsiei novoobrazovaniya v barabannoi polosti.

Tumor induced osteomalacia is a rare paraneoplastic syndrome caused by mesenchymal tumors that secrete fibroblast growth factor 23 (FGF23). Patients complain of progressive bone pain, muscle weakness and brittle fractures. Delayed diagnosis of osteomalacia caused by a tumor is often found in clinical practice. When verifying the exact localization of the neoplasm, radical removal within healthy tissues is recommended. The article considers a clinical example of FGF23 tumor induced osteomalacia with localization of neoplasm in the tympanic cavity.

[Influence of the soft palate structure in patients with snoring and obstructive sleep apnea syndrome on the results of surgical treatment]. / Vliyanie osobennostei stroeniya myagkogo neba u patsientov s khrapom i sindromom obstruktivnogo apnoe sna na rezul'taty khirurgicheskogo lecheniya.

OBJECTIVE: To evaluate the variants of the anatomical structure of the soft palate in patients with snoring and obstructive sleep apnea (OSA) syndrome and their relationship with the severity of OSA syndrome. MATERIAL AND METHODS: The study included patients (n=71) with snoring and sleep apnea. For the purpose of treatment, patients underwent reconstructive interventions on the soft palate. All patients underwent a comprehensive examination, including the collection of complaints and anamnesis, examination of the upper respiratory tract, night respiratory monitoring. There are 5 types of soft palate structure, depending on which all patients are divided into 5 groups. The 1st and 2nd groups mainly included patients with simple snoring and mild OSA syndrome, the 3rd and 5th groups were evenly distributed with all degrees of severity of the same pathology, and the 4th group consisted mainly of patients with severe OSA syndrome. The procedure of the operation varied in different groups. 1 month after surgical treatment, there was a decrease in the anpoe/hypopnea index compared with preoperative values in patients of the 1st and 2nd groups by 71.9% and 76.2%, respectively, in patients of the 3rd group by 51.4%, in patients of the 5th group by 65.3%, in patients of the 4th group by 39.6%. CONCLUSIONS: The presented original classification of anatomical variants of the soft palate in patients with snoring and OSA syndrome makes it possible to determine the scope of intervention, predict the feasibility of surgery and can be recommended for practical use. Surgical treatment is indicated for types 1, 2, 3 and 5 of the structure of the soft palate. In patients with type 4, reconstructive operations on the soft palate do not lead to a satisfactory result and can only be used in combination with other methods of treatment.

[Modern H1 antihistamines in the treatment of patients with allergic rhinitis and comorbid acute respiratory infections]. / Sovremennye H1-antigistaminnye sredstva v terapii patsientov s allergicheskim rinitom i komorbidnymi ostrymi respiratornymi infektsiyami.

Patients with allergic rhinitis (AR) have a predisposition to frequent acute respiratory viral infections (ARVI). Inflammation of the mucous membrane of the nasal cavity and paranasal sinuses in such patients is more pronounced against the background of a combination of allergic and infectious inflammation. OBJECTIVE: To evaluate the effect of therapy using modern antihistamines on the condition and severity of symptoms in adult patients with exacerbation of AR caused by plant pollen (seasonal) (SAR) and the development of ARVI. MATERIAL AND METHODS: An observational study was conducted at the Department of Otorhinolaryngology of the Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of the Russian Federation from April to August 2021. Included are patients of both sexes aged 18 to 65 years with a previously (at least 1 year ago) verified diagnosis of mild and moderate acute SAR in the acute stage, who sought medical help for ARVI. All patients were prescribed therapy with the inclusion of a drug belonging to the pharmacological group of antihistamines of the 2nd generation (a course of 14 days). In addition, patients received symptomatic ARVI therapy according to indications, including nasal decongestants (as needed), antipyretic and antitussive drugs. RESULTS: Based on the data obtained, it was possible to prove that the use of modern antihistamines in patients comorbid with AR and ARVI has a pronounced therapeutic effect. Theoritin provides a therapeutic effect at an early stage in relation to nasal and non-nasal symptoms of SAR/ARVI, and also quickly improves the quality of life of patients, which makes its use promising for the treatment of ARVI against the background of AR. The drug has an antihistamine activity comparable to cetirizine and surpasses it in its ability to suppress an allergic inflammatory reaction, for example on the skin, as well as in the duration of preservation of the antihistamine effect. CONCLUSION: The presented results indicate the effectiveness of theoritin and cetirizine in the treatment of patients with seasonal exacerbation of allergic rhinitis, comorbid for acute respiratory viral infections.

[Comparative characteristics of the effectiveness of local therapy in acute tonsillopharyngitis]. / Sravnitel'naya kharakteristika effektivnosti mestnoi terapii pri ostrom tonzillofaringite.

Acute tonsillopharyngitis (ATP) is an infectious inflammation of the mucous membrane and lymphadenoid structures of the oropharynx. Sore throat, as the main symptom of ATP, is the most common reason for seeking outpatient medical care or self-medication. Topical therapy of sore throat in the treatment of non-streptococcal ATP is the most effective and safe. In the article, based on their own experience and literature data, the problem of treating patients with sore throat with ATP of non-streptococcal etiology is presented. At the Department of Otorhinolaryngology of the Evdokimov Moscow State Medical University conducted a study to study the clinical features of the course of ATP and improve the results of local treatment of patients with this pathology. In the course of the study, 75 people were examined, in whom subjective and objective symptoms were assessed. Our study showed that the use of the drug Doritricin demonstrated high efficacy in the treatment of patients with ATP, which contributed to an earlier regression of inflammatory-infiltrative changes in the pharynx, as well as a faster decrease in the level of pain syndrome according to the scores of the visual-analog pain scale.

[Sore throat. Recent trends in treatment]. / Bol' v gorle. Sovremennye podkhody k lecheniyu.

According to WHO almost half of the population undergoing infectious diseases of the upper respiratory tract one third of which is inflammatory diseases of the pharynx. This article presents the therapy issue of patients with sore throat due to acute pharyngitis and/or acute tonsillitis of non-streptococcal etiology based on our own experience and literature data. Observational study was carried out at the Otorhinolaryngology department of MSUMD n.a. A.I. Evdokimov in order to evaluate efficacy and tolerability of complex local drug Doritricin. The study involved 52 patients, objective and subjective manifestations of the disease were evaluated. Obtained data indicate the effectiveness and safety of Doritricin, as well as the possibility of reducing the number of drugs used during treatment.

[Prevention and treatment of post-implantation maxillary sinusitis]. / Profilaktika i lechenie postimplantatsionnykh verkhnechelyustnykh sinusitov.

The state of the nasal cavity, especially the region of the osteomyomatic complex, plays a significant role in the development of chronic maxillary sinusitis. Odontogenic maxillary sinusitis, as a complication of dental implantological treatment on the upper jaw, is increasingly common. The aim of the study was to increase the effectiveness of prophylaxis and treatment of odontogenic purulent upper jaw sinusitis during reconstructive operations on the alveolar region of the upper jaw. 3 groups of patients were examined: before dental treatment, after dental treatment in the development of odontogenic maxillary sinusitis and 30 patients were selected and examined, who underwent reconstructive surgeries on the alveolar process of the upper jaw and in whom the postoperative period was without complications. The diagnoses of 1st and 2nd group patients required surgical treatment. FESS allows restoring the physiological aeration of maxillary sinuses as naturally as possible, which is important for correct reparative bone regeneration in the alveolar region of maxilla.

[Resolution of the Council of Experts «Bioregulatory drugs in the complex treatment of common ENT diseases¼]. / Rezolyutsiya Soveta ekspertov «Bioregulyatsionnye preparaty v kompleksnoi terapii rasprostranennykh LOR-zabolevanii¼.

Within the framework of the III All-Russian scientific and practical conference of otorhinolaryngologists, audiologists, somnologists and maxillofacial surgeons with international participation, a meeting of experts in the field of ENT diseases was held with the support of Heel RUS LLC, October 17-18, 2019, Kazan.

[The innovative surgical technologies for the treatment of chronic suppurative otitis media]. / Innovatsionnye khirurgicheskie tekhnologii lecheniia khronicheskogo gnoinogo srednego otita.

Chronic suppurative otitis media (CSOM) is a most common pathology among all other ENT diseases that accounts for approximately 48% of the total number of their cases. Modern surgery witnesses the advent of new methods for the management of these conditions in parallel with the modification of the known techniques intended to improve the post-operative outcomes of the treatment and rehabilitation of the patients. The objective of the present study was to enhance the effectiveness of the surgical treatment of the patients presenting with chronic suppurative otitis media by making use of the relevant navigation systems. A total of 29 patients presenting with CSOM underwent the surgical intervention on 31 ears. The open variant of sanation surgery on the middle ear was chosen including the hearing-improving component or without it depending on the extension of the pathological process under control of the Navigation Panel Unit ('Karl Storz', Germany) and KICK ('BrainLab', Gerfmany) navigation systems. Special emphasis is placed on the selected peculiar features of their application. It was shown that the use of the aforementioned navigation systems considerably improved the field of vision and the orientation in all compartments of the middle ear which made it possible to prevent the potential intra-operative (in all 31 cases) and post-operative complications. None of the patients suffered complications within 2 months after the onset of the treatment. The microotoscopice examination revealed the signs of the inflammatory process in three patients 6 months after surgery. Only one patient was suspected to have a recurrent cholesteatoma 12 months after the surgical intervention. The second operation included the removal of the cholesteatoma pearl, revision of the post-operative cavity, and re-tympanoplasty. The most important positive effects expected from the application of the navigation systems include the improved orientation in three dimensions that gives assurance to the surgeon thereby making his actions more accurate and precise and the reduction of the duration of the surgical intervention.

[The new possibilities for the treatment of chronic cough associated with postnasal drip]. / Novye vozmozhnosti terapii khronicheskogo kashlia pri postnazal'nom zateke.

Cough is considered to be one of the leading clinical symptoms associated with the pathological changes in the respiratory system. Notwithstanding a great variety of therapeutic pharmaceutical products possessed of the antitussive action, physicians tend the give preference to the preparations producing the combined effect. The present article reports the results of the clinical study designed to evaluate the effectiveness and safety of the application of rengalin exhibiting the combined antitussive, anti-inflammatory, and broncholytic action in the patients presenting with the postnasal drip syndrome. The comparison of the therapeutic effects of rengalin with those of other therapeutic modalities frequently employed for the management of postnasal drip give evidence of the high efficiency of this product for the optimization of the treatment of this condition and the associated chronic cough.

[Efficacy of Dioxidine antimicrobial preparation for the treatment of inflammatory diseases of the external and middle ear].

In this article, the comparative analysis of the clinical efficacy of drugs for local therapy in patients with acute external otitis, acute purulent otitis media and exacerbation of chronic suppurative otitis media is presented. The results of the clinical study, dynamic bacteriological investigation confirmed the high efficacy, safety and good tolerance of dioxidine in treatment of external and middle ear infections.