[Control of hormonal rhinitis symptoms in patients with hypothyrosis: pathogenetic and clinical aspects]. / Kontrol' simptomov khronicheskogo rinita u patsientov s gipotireozom: patogeneticheskie i klinicheskie aspekty.

BACKGROUND: One of the poorly studied sections of the pathology of ENT organs is chronic rhinitis in patients with hypothyroidism, the pathogenesis of which has not been fully understood, the diagnosis causes significant difficulties, and there are no recommendations for treatment. Despite receiving replacement therapy with levothyroxine, the symptoms of rhinitis persist. OBJECTIVE: To study the effectiveness of the use of intranasal glucocorticosteroids in patients with chronic rhinitis and hypothyroidism. MATERIAL AND METHODS: Patients with chronic rhinitis and hypothyroidism used mometasone nasal spray 100 mcg 1 time per day for a course of treatment of 2 months (n=60). To assess the symptoms of rhinitis, a visual analog scale (0-10 points), endoscopic examination of ENT organs, anterior active rhinomanometry were used. Evaluation of mucociliary transport was used a saccharin test. The concentration of transforming growth factor (TGF-ß1) in nasal secretion and blood serum was studied by ELISA (Enzyme-Linked Immunosorbent Assay), the number of metabolites of NO - nitrites+nitrates (NOx) was recorded by colorimetric method. RESULTS: The use of mometasone nasal spray in patients with hypothyroidism helped to reduce complaints on a visual-analog scale (difficulty in nasal breathing, rhinorrhea) and improve nasal breathing according to anterior active rhinomanometry. The concentrations of TGF-ß1 and NOx in nasal secretions before mometasone treatment were higher than after treatment, which probably indicates the contribution of these substances to the formation of edematous hypertrophic changes from the nose in patients with hypothyroidism.

[Features of adherence to treatment of patients with chronic rhinosinusitis with nasal polyps]. / Osobennosti priverzhennosti lecheniyu bol'nykh khronicheskim rinosinusitom s polipami nosa.

Chronic polypous rhinosinusitis (CPR) is characterized by refractory to drug therapy and a high potential for recurrence after surgical treatment. One of the important factors limiting the effectiveness of drug therapy of CPR, in particular intranasal glucocorticosteroids (inGCSs), is the insufficient level of adherence to treatment of patients with CPR. OBJECTIVE: Generalization of data on the significance and ways to increase adherence to treatment of patients with CPR. MATERIAL AND METHODS: Materials of scientific publications included in the Cochrane Library, Russian Science Citation Index, MEDLINE, PubMed information bases were used as a data source. The material was selected based on the following keywords: "chronic rhinosinusitis", "nasal polyps", "intranasal glucocorticosteroids", "adherence to treatment". RESULTS: Despite the fact that inGCSs are one of the main pathogenetically justified methods of treating CPR, their use is limited by many factors, one of which is the level of patient compliance with the treatment regimen. CONCLUSION: Improving adherence to treatment is one of the important reserves for increasing the effectiveness of drug therapy for chronic polypous rhinosinusitis.

[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.

[External otitis: clinical diagnostics and treatment tactics]. / Naruzhnyi otit: klinicheskaya diagnostika i lechebnaya taktika.

OBJECTIVE: To summarize modern data about the epidemiology, etiology, clinical course and diagnosis of otitis externa. MATERIAL AND METHODS: Materials of scientific publications included in the Cochrane Library, information bases of the RSCI, MEDLINE, PubMed were used as a data source. The choice of material was carried out according to the keywords: otitis externa, etiology, diagnosis, treatment, local treatment. RESULTS: The role of combined drugs in the main etiopathogenetic mechanisms of the external ear inflammatory process is shown. CONCLUSION: Analysis of published data from clinical trials indicates the importance of a fixed antibacterial agents and anesthetic combination in increasing the effectiveness of topical therapy for otitis externa.

[Acute sinusitis: topical issues of terminology and diagnosis]. / Ostryi sinusit: aktual'nye voprosy terminologii i diagnostiki.

OBJECTIVE: To analyze and summarize data on terminology, etiology, diagnostic criteria for acute sinusitis. DATA SOURCES: Publications (articles and related abstracts) submitted to the PubMed database. The choice of material was carried out, according to the keywords: cold, acute viral sinusitis, acute bacterial sinusitis, post-viral sinusitis, acute respiratory viral infection, diagnosis of acute sinusitis. RESULTS: The published research results indicate the existence of certain disagreements regarding the terminology, diagnostic criteria, indications for diagnostic studies in acute sinusitis. The data on the etiology, pathogenesis, and diagnostic features of acute sinusitis are presented in the current guidelines, reviews and publications of the results of clinical trials.

[The effectiveness of complex drugs in the treatment of acute rhinitis]. / Effektivnost' kompleksnykh preparatov v terapii ostrogo rinita.

Purpose of the study. Generalization of data on the value of alternative and additional treatment of acute infectious rhinitis with Korizalia. MATERIAL AND METHODS: The material of scientific publications included in the Cochrane Library, information bases of the RSCI, MEDLINE, PubMed was used as a data source. The choice of material was carried out using the key words: colds, acute rhinitis, herbal medicine, homeopathic remedies. RESULTS: Analysis of published clinical trial descriptions suggests the potential value of homeopathic medicines, in particular Korizalia, in improving the effectiveness of the treatment of acute rhinitis. The use of Korizalia in acute infectious rhinitis was more effective in relation to the main symptoms of ARI compared with placebo. CONCLUSION: The lack of optimal drugs for the etiotropic treatment of viral acute respiratory infections determines the relevance of alternative and complementary methods of treatment using drugs of natural origin. The drug Korizalia can be used for acute respiratory infections (acute infectious rhinitis) as an alternative drug or in combination with other drugs.

[Herbal medicine for acute sinusitis - current trends]. / Fitoterapiya ostrogo sinusita ­ sovremennye tendentsii.

THE AIM OF THE STUDY: Was to summarize data on the role and place of herbal remedies, in particular, the extract from the roots of Pelargonium sidoides (EPs 7630) in the treatment of acute sinusitis. MATERIAL AND METHODS: Materials of scientific publications included in the Cochrane Library, information bases of the RSCI, MEDLINE, PubMed were used as a data source. The choice of material was carried out according to the keywords: epidemiology of acute sinusitis, modern treatment of acute sinusitis, colds, herbal remedies, Pelargonium sidoides. RESULTS: Analysis of published clinical trial data demonstrates evidence that EPs 7630 is significantly superior to placebo in reducing the duration and severity of symptoms of acute respiratory infection and indicates the advisability of including an extract from Pelargonium sidoides (EPs 7630) roots in OS treatment protocols. The high safety profile and clinically significant efficacy of this drug make EPs 7630 an important component of drug therapy for acute sinusitis.

[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.

[A clinical case of radio-induced neurogenic sarcoma of the soft tissues of the neck]. / Osobennosti nablyudeniya i soprovoditel'noi terapii patsientov posle khimioluchevogo lecheniya raka gortani. Klinicheskii sluchai.

The article presents a clinical observation of the surgical treatment of a patient with radio-induced neurogenic sarcoma of the soft tissues of the neck that occurred 6 years after radiation therapy with SOD 66 Gy for stage II laryngeal cancer T2N0M0.

[Systemic and local antibiotic therapy for acute sinusitis]. / Sistemnaya i mestnaya antibakterial'naya terapiya ostrogo sinusita.

The purpose of the study was to summarize data on modern antibiotic therapy for acute sinusitis, the role and place of topical antibacterial drugs, in particular Fluimucil-Antibiotic, in modern treatment strategies for this disease. METHODS: Search in the PUBMED electronic database (articles and related abstracts) for the keywords «acute sinusitis", «antibiotics¼, «thiamphenicol glycinate acetylcysteine¼ «biofilm¼, «respiratory tract infection¼, «N-acetylcysteine¼. RESULTS: The published research results indicate the high antibacterial activity of the Fluimucil-Antibiotic, in particular, for the topical drug use in the form of inhalations, applications, irrigation, and instillations. The published research results indicate a wide spectrum of antimicrobial action of Fluimucil-Antibiotic, its ability to destroy biofilms and prevent their formation, good pharmacokinetics, safety, which makes it possible to consider it as a potential treatment option for acute sinusitis in everyday practice.

[The state of regional lymph nodes in chronic tonsillitis according to ultrasound]. / Sostoyanie regionarnykh limfaticheskikh uzlov pri khronicheskom tonzillite po dannym ul'trazvukovogo issledovaniya.

Despite the variety of chronic tonsillitis clinical symptoms, none of the known signs of this disease is typical for it. PURPOSE OF STUDY: Is development of a method for differential diagnosis of complicated (toxic-allergic) and uncomplicated (simple) forms of chronic tonsillitis. METHODS: 147 patients were divided into 2 groups: 1) 61 (42%) - with a simple form and 2) 86 (58%) - with a toxic-allergic form of chronic tonsillitis of the II degree. Patients underwent ultrasound examination of regional lymph nodes, to determine their localization, quantity (single, multiple), shape, size and structure. RESULTS: According to ultrasound data, it was revealed that for the simple form of chronic tonsillitis the following characteristics of the lymph nodes were typical - bean-like form, single, clear contours, homogeneous central parts and reduced vascularization; for the toxic-allergic form of chronic tonsillitis, the following characteristics of lymph nodes were revealed - oval shape, lymph nodes conglomerates, hypoechoic central parts, increased vascularization and irregular shape of the gates. CONCLUSION: The proposed method allows to quickly and efficiently conduct differential diagnosis of chronic tonsillitis. This technique is easily reproducible in the conditions of any (outpatient, inpatient) medical facility using standard equipment for ultrasound examination, does not require the use of any drugs.

[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.

[Peculiarities of the ENT-organ condition in hypothyroidism]. / Osobennosti sostoianiia LOR-organov pri gipotireoze.

BACKGROUND: The interrelationship of thyroid pathology and ENT organs is one of the least studied aspects of iodine deficiency diseases. Diseases of this localization are distinguished by a variety of their causes, high prevalence, a tendency to prolonged and chronic process, resistance to drug therapy and a negative effect on the quality of life of patients. AIM: To study the state of ENT organs in hypothyroidism in the iodine-deficient region of Eastern Siberia (Irkutsk Region). MATERIAL AND METHODS: The main group consisted of 302 patients with hypothyroidism, and the control group - 116 people without thyroid pathology. All patients who participated in the study were on replacement therapy (Levothyroxin). An objective study of the ENT organs was performed using an endoscope and a microscope. The SF-36 questionnaire was used to study the indicators of quality of life. A questionnaire was used to assess the symptoms of rhinitis, which provided clarification of the severity of symptoms on a visual analogue scale. RESULTS: Among patients with thyroid dysfunction, various changes characteristic of chronic pathology of the pharynx, larynx, and ear were found with almost the same frequency as among those examined without thyroid pathology. Chronic rhinitis in hypothyroidism is characterized by manifest edematous-hypertrophic changes in the turbinate, intense hyperemia of the nasal mucosa, the presence in the nasal passages of viscous, thick mucous discharge. The most important integral indicators of health components are physical (PH) and psychological (MH) patients with chronic rhinitis were reduced (50.6±1.96 and 53.0±2.08 respectively). CONCLUSION: The symptoms of rhinitis are leading in the structure of the pathology of the upper respiratory tract in hypothyroidism and have a significant negative impact on the patient's quality of life indicators.

[Nasal irrigation: opportunities and disadvantages]. / Promyvanie nosa: vozmozhnosti i nedostatki.

RELEVANCE: Despite the widespread use of nasal irrigation in routine medical practice and a significant list of salt solution for nasal irrigation on the pharmaceutical market, contradictions remain in understanding of process essence, when salt solution acts on the mucous membrane of nasal cavity and evaluation of their effectiveness. AIM: analysis of current data of frequency, methods and efficiency of systematic nasal irrigation and effect of salt solution at the mucous membrane of nasal cavity. RESULTS: In review the authors generalized and analyzed recent information about meaning of nasal irrigation for upper respiratory tract disease, about role of nasal mucus at maintaining homeostasis in nasal cavity and initial respiratory tract in general. Describes the data about effect of nasal irrigation on antinfectious protect of mucous membrane of nasal cavity.

[The use of modern topical medications for the stepwise treatment of allergic rhinitis: the effectiveness and prospects for the further extension of their application]. / Sovremennye topicheskie preparaty v v stupenchatoi terapii allergicheskogo rinita - éffektivnost' i perspektivy.

The objective of the present work was to summarize the results of clinical studies designed to evaluate the effectiveness of 'Momate Rhino Advance' in the form of the nasal spray (based on the fixed combination of mometasone furoate and azelastine) that finds an increasingly wide application for the treatment of allergic rhinitis. The available data give evidence that this medication can be prescribed to the patients presenting with the severe and moderate form of allergic rhinitis. The treatment should be started with the use of the combined preparation and continued, after the adequate control of the clinical symptoms of allergic rhinitis is achieved, using 'Momate Rhino' during the next 2-4 weeks for the reliable management of the disease. It is concluded that the proposed strategy makes it possible to avoid the simultaneous application of multiple medications (polypragmasy) and thereby reduce the intake of medicines by the patients suffering from allergic rhinitis.

[The peculiar features and significance of the psycho-emotional status of the patient in the context of functional and aesthetic rhinosurgery]. / Osobennosti i znachenie psikhoémotsional'nogo statusa patsienta v funktsional'no-ésteticheskoi rinokhirurgii.

The objective of the present study was to summarize the literature data concerning the peculiar features of the psycho-emotional status of the patients presenting with nasal deformities and the importance of its evaluation for the preparation for the surgical rhinoplastic intervention. We present the results of analysis of the materials pertinent to the history and the current state of the psychological aspects of rhinoplasty, the importance of the development and application of the diagnostic tools for the evaluation of the psycho-emotional status of the patients presenting with deformations of the external nose. It is concluded that the disregard of the psycho-emotional status of the patients by a thonosurgeon and the resulting mistakes in determining indications for the surgical intervention can be the causes accounting for the patient's dissatisfaction with the outcome of even an ideally performed operation.

[The modern strategies for the treatment of allergic rhinitis].

The present literature review had the objective to analyze the published data concerning the effectiveness of intranasal administration of antihistamine preparations and intranasal glucocorticoids for the treatment of allergic rhinitis. Special emphasis is placed on the clinical significance and the further prospects for the application of a fixed combination of these medications including azelastineplusmometasonefuroateas the first choice therapy of moderately severe and severe manifestations of allergic rhinitis.

[The remote post-graduate education in otorhinolaryngology: the first results and further prospects].

The objective of the present work was the retrospective analysis of the efficiency of two courses of remote education of otorhinolaryngologists in the real-time mode based on the results of the on-line questionnaire study. We analyzed the data obtained during the implementation of the pilot project of the remote post-graduate education at the Department of Otorhinolaryngology,Russian Medical Academy of Post-Graduate Education making use of the independent Internet resource for the professional training of otorhinolaryngologists. The two programs of remote education realized in 2012 and 2013 involved 7.9% of all otorhinolaryngologists practicing in the Russian Federation. The fraction of those who passed through all stages of the learning process increased almost two-fold, that is from 10% in 2012 up to 19% in 2013. About 14% of the participants made themselves familiar with all program modules; this result is in agreement with the data obtained in mass on-line remote teaching of the non-medical audience. It is concluded that the results of the present study provide a basis for the elaboration of the remote education programs for the training of specialists not only in otorhinolaryngology but also in other fields of medicine.

[Acute tonsillopharyngitis: the effectiveness of topical therapy].

The objective of the present study was to evaluate the clinical effectiveness of a furasol sore throat gargle solution for the treatment of acute tonsillopharyngitis. Forty patients presenting with acute tonsillopharyngitis were allocated to two groups, 20 subjects in each, by means of independent sequential randomization. Prior to the onset of the treatment, all the patients were examined for determining the species composition of pharyngeal microflora with the use of an «AutoScan4 System¼ analyzer («Siemens¼, USA) and estimating the resistance to antibacterial preparations (by the disk diffusion method). All the participants of the study were prescribed antibacterial therapy. In the patients of group 1 (study group), the antibacterial treatment of acute tonsillopharyngitis was supplemented by a furasol sore throat gargle solution whereas those of group 2 (controls) were treated without topical therapy. The quantitative evaluation of the severity of manifestations of the disease before and after the treatment was based on a 5-point visual-analog scale. It was shown that systemic antibacterial therapy resulted in the consistent decrease of the frequency of occurrence of pathogenic and potentially pathogenic microflora in the patients comprising both groups. Treatment with a furasol sore throat gargle solution did not lead to the appearance of bacterial species alien to the oropharynx, nor was it accompanied by the impairment of resistance of its mucous membrane to the colonization by microorganisms. The results of the study give evidence of the well apparent regression of the subjective signs of tonsillopharyngitis and the inflammatory changes in the mucous membrane of the pharynx in the patients given the topical treatment in the form of a furasol sore throat gargle solution in addition to antibacterial therapy. It is concluded that a furasol sore throat gargle solution can be recommended for the introduction into the combined treatment of the patients presenting with acute tonsillopharyngitis.

[The importance of test control for the post-graduate education in clinical rhinology].

This publication deals with the problems pertaining to the improvement of the system of the post-graduate education in otorhinolaryngology with special reference to one of its topical fields, clinical rhinology. The authors emphasize the importance of one of the principal components of the post-graduate education under the present-day conditions, namely organization of control and self-control of learning the new material, self-monitoring and individual correction of the level of knowledge. Special attention is given to the training tests that can be used to adequately simulate the decision-making process with respect to a concrete clinical situation. It is concluded that the systematic application of test control is one of the most important prerequisites for the enhancement of the effectiveness of the post-graduate education in clinical otorhinolaryngology.