[The practice of stapes surgury in Russia]. / Praktika khirurgii stremeni v Rossii.

The aim of this study - to investigate the practice of stapes surgery in Russia using a special questionnaire (Appendix 1). Thirty-three questionnaires were sent to specialists dealing with stapes surgery in various Russian medical institutions. Responses were received from all ENT specialists, of whom 75.7% use stapedotomy as a technique. In most cases, colleagues perform more than 30 operations per year, there were also reports of performing about 100 operations per year and in one case 370 operations annually. 45.5% of respondents preferred a combination of general and local anesthesia for stapes surgery. According to the results of the survey, the titanium K-piston prosthesis is most frequently used. Analysis of the survey results showed that to date there is no unanimous opinion concerning some aspects of stapes surgery; however, in many issues the approaches of Russian surgeons coincide with the general world trends.

[Combination of CT and MRT in the diagnostic of middle ear cholesteatoma. Fusion technology is precise localization tool]. / Sovmeshchenie rentgenovskoi komp'yuternoi i magnitno-rezonansnoi tomografii v diagnostike kholesteatomy srednego ukha. Tekhnologiya Fusion ­ instrument tochnoi lokalizatsii.

Computed tomography (CT) and magnetic resonance imaging (MRI) methods of the middle ear cholesteatoma diagnostic have its advantages and disadvantages. Fusion technology is a post-processing process of CT and MRI images. Its main advantage is the localization of MR-hyperintensive cholesteatoma within the bony anatomical structures obtained on CT, which provides the surgeon with important information both before planning the primary surgical intervention and during a second revision for recurrent cholesteatoma.

[Proteus syndrome in the practice of an otorhinolaryngologist: a clinical case]. / Sindrom Proteya v praktike otorinolaringologa: klinicheskii sluchai.

Described a rare clinical observation of a patient aged 18 years with chronic left-sided otitis media against Proteus syndrome. By this age, the patient underwent a large number of operations regarding the removal of lymphangiomas, hemlimfangiomas, angiokeratitis of the body, as well as several sanitizing surgery on the left ear. A review of domestic and foreign literature showed that this case can be considered unique.

[Complications caused by hearing aid mold impression material - clinical case and literature review]. / Oslozhneniia protsedury sniatiia slepkov naruzhnykh slukhovykh prokhodov - klinicheskii sluchai i obzor literatury.

The procedure of taking an impression of the external auditory canal for the manufacture of individual earplugs in the ear canals can be associated with complications in some cases. The article describes the clinical case of ingestion of the impression mass during taking the impression of the external auditory canal in the patient with chronic otitis media. The presence of pronounced hearing loss has become the basis for the selection of a hearing aid. As a result, during taking a cast of the external auditory canal, the material fell into the middle ear cavity. Despite contacting specialists, the patient experienced earache with periodic suppuration during the year. When contacting our clinic, perforation of the tympanic membrane was detected and a CT of the temporal bones revealed a foreign body in the tympanic cavity. The patient underwent surgical treatment. The clinical case we are observing and the literature data show how important it is collect to carefullythe anamnesis and conduct otorhinolaryngological examination before the procedure for taking an impression of the external auditory canal when selecting a hearing aid.

[The results of surgical ablation of parathympanic spaces in the patients presenting with cholesteatoma]. / Rezul'taty khirurgicheskoi obliteratsii paratimpanal'nykh prostranstv u bol'nykh s kholesteatomoi.

INTRODUCTION: On the one hand, open-type surgical modalities have the advantage of the low frequency of relapses; on the other hand, they lead to the undesirable changes in the anatomical and physiological characteristics of the ear that in the long run create serious problems for both the doctor and the patient. In contrast, the closed-type surgical interventions are associated with a more favourable hygienic status and functional outcome but create a high risk of development of recurrent and residual cholesteatomas. The disadvantages of both types of cholesteatoma surgery motivated the surgeons for the development of the 'hybrid' approaches combining the advantages of open and closed strategies. The obliteration of the paratympanic spaces is one of them. AIM: The objective of the present study was to evaluate the results of the surgical treatment of recurrent and residual cholesteatomas and to optimize the algorithm of the postoperative control with the use of MRI in the non-EPI DWI regime. MATERIAL AND METHODS: The retrospective analysis of the available clinical materials covering the period from 2009 to 2014 included the results of the surgical treatment of the patients suffering from chronic otitis media and cholesteatoma with the use of the method for the obliteration of the paratympanic spaces. RESULTS: A total of 179 patients were operated using the obliteration technique. The patients were under observation for 34 months on the average. We used the otomicroscopy and MRI in the non-EPI DWI regime to examine the patients within 1, 2, and 3 years after surgery. The residual cholesteatoma was discovered in 15 (8.4%) patients out of the total 179 ones. The cases of recurrence of the cholesteatomas were not observed. The diagnostic effectiveness of MRI in the non-EPI DWI regime was estimated for the purpose of the postoperative control. Sensitivity of the method was 93.3%, specificity - 97.1%.

[The consensus view of the treatment of the retraction pockets of the tympanic membrane].

The objective of the present study was to formulate the consensus document «The treatment of the retraction pockets (RP) of pars tensa and pars flaccida¼ as well as to estimate the situation in this country pertaining to the treatment of the retraction pockets of the tympanic membrane. We undertaken a pilot study that involved 91 practicing otorhinolaryngologists based at in-patient and out-patient healthcare facilities in different regions of the Russian Federation. M. Yung's questionnaire for otorhinolaryngologistswas used to gain relevant information. The Delphi technology was employed to process the data obtained. 30% of those who agreed to participate in the study answered to the proposed questions although some of them aroused a discord among the respondents. The results of this questionnaire study provided a basis for the pilot consensus document and allowed for the preliminary conclusion as regards prospects for the further exploration of both the problem in question and the instruments for this purpose with special reference to the awareness of the otorhinolaryngologists.

[The modern approaches to the treatment of chronic suppurative otitis with cholesteatoma].

The objective of the present study was to evaluate the long-term outcomes of the surgical treatment of chronic suppurative otitis with cholesteatoma in terms of prevention of a residual disease and its relapses. The results of the postoperative observation of 149 patients during the period from 2009 till 2013 are presented. All the patients underwent sanation surgery with the obliteration of paratympanic spaces followed by the restoration of the posterior wall of the external auditory meatus and simultaneous tympanoplasty (closed-type surgery). The patients were examined one year after the treatment with the use of the MRI technology in the non-EPI DWI regime for the purpose of monitoring the residual disorders and relapses of cholesteatoma. The follow-up observation revealed 9 cases of residual cholesteatoma, no relapse of chronic suppurative otitis was documented.

[The role of MRI in the preoperative examination and postoperative follow up of the patients presenting with a combination of chronic otitis media and cholesteatoma].

The objective of the present work was to estimate the possibilities of application of different MRI modalities for the diagnostics of cholesteatoma and to develop the criteria for the verification of the proposed protocols. The study was carried out in the standard T1 and T2 regimes as well as in the non-EPI DWI regime. The patients available for the examination presented with both primary cholesteatoma and with residual and recurrent cholesteatoma. The principal radiodiagnostic algorithm for cholesteatoma included the use of a signal of low-intensity in the T1 regime and a high-intensity signal in the T2 and non-EPI DWI regimes. Three clinical observations are reported in this paper. All the patients were examined by MRI in the T1, T2, and non-EPI DWI modalities. The presence of cholesteatoma was confirmed in 2 patients; this finding was verified during surgery. In one case, the use of the proposed method allowed cholesteatoma to be excluded.