[The objective method for recording stapedial reflex during surgery for cochlear implantation].

The purpose of the present study was to develop a method for the objective registration of the stapedial reflex at the contralateral ear during cochlear implantation surgery on the affected one. The excessive pressure in the middle ear (up to 500 daPa) was compensated by the administration of an additional air volume (1 liter) into the AA220 impedance meter pneumatic circuit. A syringe was used to measure variations of pressure in the new pneumatic circuit. Eight of the 12 patients demonstrated coincident visual and objective reflex thresholds. In the remaining 4 patients, the visually apparent stapedial reflex thresholds proved higher than those obtained objectively by the standard procedure of impedancemetry. It is concluded that the objective registration of the stapedial reflex excludes the effect of subjective factors interfering with its estimation and provides the possibility for comparative intra- and postoperative studies using one and the same instrument.

[One-step rhinootosurgery. Clinical, economic and social aspects].

The objective of this work was to estimate from the clinical, economic, and social standpoints the efficacy of medical aid provided to the patients with chronic suppurative otitis media (CSOM) and concomitant pathology of the nasal cavity by means of the one-step surgical intervention. The study included a total of 208 patients presenting with CSOM of whom 108 ones were treated by the traditional multistage method and the remaining 108 by simultaneous rhinootosurgery. The latter approach was shown to be much more efficacious in terms of clinical, economic, and social considerations.

[Organization of remote long-term support of the patients with cochlear implants in distant regions].

The concept of remote long-term support of the patients with cochlear implants is suggested to cope with the problem of the increasingly growing number of patients with cochlear pathology. The authors deem it necessary to provide intraoperative support and postoperative follow-up technologies for the patients living far from the cochlear implantation centres. A scheme for the remote selection of patients and their intraoperative monitoring is proposed with the use of implant telemetry, electrical stapedial reflex (eSRT) testing, auditory response telemetry (ART), and surgical on-line counseling. Remote follow-up and rehabilitation should include cochlear implant tuning, speech therapy, and on-line workshops for the patients and/or specialists. The choice and the use of software and hardware for this purpose are discussed. The concept of remote long-term support turned out to be an efficacious, reliable, time-saving, and cost-effective tool for providing high-tech medical aid to patients with ENT diseases in the Krasnoyarsk kray (territory).

[Effect of cleft palate syndrome on quality of life of elderly patients].

The study is devoted to the problem of congenital disorder--cleft palate in elderly population. This theme is almost not investigated in the Russian Federation, whereas such studies are periodically made abroad and foreign investigations describe tasks of rehabilitation of this group of patients including their age features. Main characteristics of cleft palate syndrome and its influence on quality of life are described in the article.

[Effects of the autonomic nervous system function on the course of postoperative period in surgical removal of vocal cords polyps with Nd:YAG-laser].

The study of the effects of autonomic nervous system (ANS) function on the course of the postoperative period after removal of the vocal cord polyps with Nd:YAG laser has shown that laryngeal operations with utilization of Nd:YAG laser accelerate normalization of structural-functional condition of the vocal cords in patients with adequate autonomic support by 25-40 days compared to those with inadequate ANS function.

[The methodology of the theory of self-organization in the development of concepts on the physiological mechanisms of vestibular reactions]. / Metodologiia teorii samoorganizatsii v razvitii predstavlenii o fiziologicheskikh mekhanizmakh vestibuliarnykh reaktsii.

Sources of modern vestibulology's crisis status are determined. New methodological questions of object exploration of vestibular function and vestibular reactions are marked. New theoretical views are developed, some results of these theoretical views's practical realization are presented, perspective possibilities of new approach are defined.

[The interoceptive properties of the vestibular apparatus (a systems analysis of vestibular-oculomotor interaction)]. / Interotseptivnye svoistva vestibuliarnogo apparata (k voprosu o sistemnom analize vestibulo-okulomotornogo vzaimodeistviia).

Modern views about physiological functions of vestibular system are submitted, their contradictions are picked out. The result of development of experimental and clinical vestibulometry till last decades at the foundation of critical estimation of effectiveness of different methods of vestibular receptor's stimulation are summed up. It is proposed to consider vestibular apparatus only as structural sensory element of eye's moving functional system at the foundation of cybernetics' principles of physiological function's regularity. It is proposed to estimate vestibular function as a part of the whole afferent stream in system, which hasn't their own way at effector neurone once which determines together with proprioceptive afferentation internal system's status. Methodological principles of further research of vestibular apparatus and vestibular function are determined.

[Problems in the early rehabilitation of minor casualties with injuries to the ENT organs]. / Voprosy rannei reabilitatsii legkoranenykh s povrezhdeniem LOR-organov.

The article examines the questions of a specialized otorhinolaryngological care to the minor wounded with mine injuries. There are description of evacuation procedures for this category of wounded. Up to 70% of such patients can be treated at the HMW. The article contains schemes concerning the conservative treatment of auditory disorders caused by mine traumas. The authors describe the methods of conduction anesthesia via the low palpebral fissure in cases when patients have traumas of the middle facial zone.

[Perilymphatic fistulas of the labyrinth: diagnostic problems]. / Problemy diagnostiki perilimfaticheskikh fistul labirinta.

Basic diagnostic criteria for perilymphatic fistulas of the labyrinth (PFL) comprise previous trauma or psychoemotional stress, unilateral acute affection of the acoustic and vestibular functions, severe noise in the ears, mixed hypoacusis, lower hearing thresholds in change of the head position, alteration of stabilogram parameters in rising pressure in the external acoustic meatus.

[Etiology of labyrinthine perilymphatic fistula]. / K voprosu ob étnologii perilimfaticheskikh fistul labirinta.

The examination of 120 patients with verified labyrinthine fistulas (LFs) has demonstrated that perilymphatic LFs most often are caused by rupture of the cochlear window's membrane (54%). Among other reasons were broken base of the stapes (6%), the defect in the area of both windows (17%), rupture of the annular ligament of the stapes (15%), defects in the area of semicircular canals. Incompetence of the stapedial piston prosthesis is documented.

[The physiological functions of the vestibular apparatus]. / O nekotorykh fiziologicheskikh funktsiiakh vestibuliarnogo apparata.

Physiological functions of the vestibular apparatus were considered in terms of functional systems, permanent physiological activity and robot theories. A working hypothesis is assumed on vestibular receptor as a sensory detector of some functional systems of the body which enables creation of the internal coordinate system together with proprioreceptors of ocular, cervical, trunk and limb muscles, articular and tendinous receptors for adequate spacial perception via ocular and tactile analyzers; extrapolation of somatic responses. Vestibular reactions in disease and experiment are believed to be systemic responses primarily of functional and oculomotor systems. Isolation of vestibular afferentation from the total afferent flow is impossible already at the level of vestibular nuclei. Perspectives of further usage of rotatory and caloric tests for investigation of vestibular function are outlined.

[Agents for combined pharmacotherapy in severe trauma to the brain and ENT organs]. / Sredstva kompleksnoi farmakoterapii pri tiazheloi travme golovnogo mozga i LOR-organov.

Early complex treatment of a critical brain traumas should be aimed not only at men's life and personality saving, but also at their performance' rehabilitation. Complicity and to some degree individual nature of a critical trauma pathogenesis depend on the associative active methods of surgery interference and conservative pharmacotherapy. The article deals with well-practiced means and methods of symptomatic pharmacotherapy at the early and later stages of the brain traumas with vestibular and hearing system injures and with theoretical and clinical base for modern "quick-action adaptogens" usage in addition to psychoneurocorrectors.

[Clinical and statistical patterns of the hearing system lesions caused by explosive mine trauma]. / Kliniko-statisticheskie zakonomernosti porazhenii slukhovoi sistemy pri minno-vzryvnoi travme.

Mine-explosive trauma has become the predominant type of pathology in the structure of surgical sanitary losses. In 70-75% of the cases it is combined with acoustic injury that requires the improvement of diagnosis and prediction of acoustic injuries at the stage of qualified medical care. In 772 casualties with mine-explosive trauma admitted to the different departments of Kabul Central Hospital the conditions of explosive injury were identified and statistical analysis of acoustic injury dependence on the above-mentioned conditions was conducted. The quantitative patterns obtained could be used in prognosis of the possible value and structure of acoubarotraumatic losses in the mine-explosive injuries.

[The diagnosis of damages to the auditory system in the early period of explosive mine trauma and the optimization of treatment for the victims]. / Diagnostika povrezhdenii slukhovoi sistemy v rannii period minno-vzryvnoi travmy i optimizatsiia lecheniia postradavshikh.

The wide use of the mine-explosive weapon in modern military conflicts is accompanied by high specific weight of mine-explosive traumas (MET), which achieve 30-40% of all traumas. In the departments of the hospital in 21.3-35.8% of the wounded with MET accompanying defeat of acoustical system with probable subsequent development of neurosensory hypoacusis and invalidism of the injured is established. It defines necessity of early ENT-inspections of all injured with such traumas. Steady up to 1-6 months reduction of hearing is accompanied by biochemical infringements of a cerebrospinal liquid.

[Sudden hearing loss in inner ear trauma]. / Vnezapnaia tugoukhost' pri travmakh vnutrennego ukha.

Quite often a sudden surdity can appear after baro or mechanical traumas, it happens because of rupture of the round window membrane which leads to the formation of the perilymphatic fistula. The article deals with the syndrome of the round window membrane rupture. The authors describe two successful cases of treatment of patients with vestibular disorders caused by posttraumatic perilymphatic fistula. Practical recommendations are given for providing a tertiary medical care in emergency situations.