[The diagnostic significance of the clinical methods for the investigation into the oculomotor reactions to dizziness].

The objective of the present study was to estimate the diagnostic significance of the physical vestibular tests designed to investigate the oculomotor reactions in order to determine the severity of disturbances in the vestibular analyzer during the primary examination of the patients presenting with dizziness symptoms. The results of the study suggest the desirability of using the Frenzel goggles for the detection of the presence of latent spontaneous nystagmus and the performance of additional testing. The study of the vestibular-ocular reflex should begin from the head turn test to be supplemented, in the case of the dubious result, by the dynamic visual acuity test. The smooth pursuit test, the visual saccade test, and the optic nystagmus test need to be performed on a full scale. The subjective visual vertical test should be carried out at the later stages of diagnostics when the detailed investigation of the vestibular function is conducted. The positional manoeuvers are the indispensable components of the examination of the patients presenting with pathological changes in the vestibular analyzer by virtue of their high diagnostic significance for the detection of benign paroxysmal positional dizziness.

[The use of immunocorrection therapy for the combined treatment of the inflammatory diseases of the pharynx].

The objective of the study. To estimate the efficacy of the combined treatment of the patients presenting with chronic tonsillitis, acute and chronic pharyngitis with the use of traditional methods supplemented by the immunocorrective preparation imudon. A total of 320 patients with inflammatory pharyngeal diseases were examined and treated. It was shown that the introduction of imudon therapy in the combined treatment of chronic tonsillitis, acute and chronic pharyngitis produces a more pronounce and stable beneficial effects than conventional therapy.

[The use of multimedia technologies in otorhinolaryngology].

The possibilities of using computer-assisted technologies in otorhinolaryngology have been analysed with a view to enhancing the efficacy of the teaching activity and improving the quality of diagnostics and treatment of various ENT diseases. It is emphasized that computers may be used not only to reproduce traditional teaching modalities but also to supplement them with new approaches inaccessible with conventional methods; the introduction of these approaches is of special importance for medical universities and institutes. The use of computer-based technologies in otorhinolaryngological practice made it possible to significantly improve the quality of diagnostics and treatment of the most widespread ENT diseases. For all that, however, the potential of computer technologies in otorhinolaryngology is by no means exhausted.

[The diagnostics and treatment of subclinical forms of labyrinthitis in the patients presenting with inflammation of the middle ear].

The current concepts of diagnostics and treatment of labyrinthitis in the patients presenting with acute and chronic forms of otitis are considered. It is emphasized that early recognition of the pathological process underlying the evolvement of tympanogenic labyrinthitis is of paramount importance for the efficacious treatment of this disease. This inference implies the necessity to improve diagnostics of its subclinical forms and develop a universal strategy for the management of the patients with the pathology being considered.

[Somatosensorial disorders. Alterations in the quality of life in patients presenting with peripheral vestibular dysfunction].

The authors undertook the assessment of the available methods for the analysis of the sensations of patients suffering pathology of the vestibular analyzer. The fact that such conditions as dizziness and disequilibrium have great influence on the social status of a patient and his (her) position in society accounts for the use of functional stabilometry in the clinical practice along with the evaluation of quality of life. It is emphasized that the timely diagnosis of these disorders and elucidation of their primary causes are as important for the successful treatment of this pathology as the choice of an adequate course of medicamental and rehabilitative therapy.

[Peculiarities of emergency care for ENT patients in the admission department of a multifield hospital].

A major prerequisite for efficacious emergency care to an ENT patient being admitted to the reception ward of a multifield hospital is the correct diagnosis of his (her) condition that may be either immediately life-threatening or pass into local or systemic complication of the ENT disease. Adequate assessment of the patient's condition provides a basis for the choice of correct and sufficient diagnostic and therapeutic means necessary to provide urgent care. Examples are given to illustrate the actions of a physician for the management of the most common forms of ENT pathology in emergency situations.

[Principles of early diagnosis of malignant neoplasms in ENT organs].

According to Moscow city Oncological Dispensary, the number of patients with malignant neoplasms of ENT organs has increased during the last 5 years. In 79-84% of the patients the diseases is diagnosed at stage III-V which leads to rather poor results of treatment. Results of analysis of causes for late diagnosis of ENT neoplasms point out to the necessity to raise oncologic alertness among ambulatory physicians. Up-to-date methods of early diagnosis of oncological diseases of ENT organs are discussed.

[Posturographic rapid diagnosis of a vestibular function in vestibulology].

The integral index of equilibrium function (IIEF) was proposed for rapid diagnosis of the equilibrium function. Calculation of IIEF is based on comparison of the results of resting stabilometry in European position of the patient's feet with those of functional tests (optostimulation, sight deprivation, Romberg's position with sight deprivation). Calculations of stability and dynamic component indices were made using the parameter of the deviation rate of the pressure center of a human body standing on the stabilometer platform. IIEF was estimated in 118 healthy subjects aged from 17 to 82 years. Age- and sex-related differences in some age groups were studied.

[A record system in otorhinolaryngology].

Introduction of a record system in practical medicine is discussed. Based on a logic relationship between standards of diagnosis, treatment and health service management, the record system raises efficacy of treatment. Main stages of this system design and principles of preparing a log list of drugs used in otorhinolaryngology are presented. This list must include drugs with definite, documented evidence-based pharmacological properties with high efficacy and safety.

[Current knowledge on diagnosis and treatment of mastoiditis]. / Sovremennye predstavleniia o diagnostike i lechenii mastoidita.

Causes and clinical course of atypical mastoiditis were studied by cases treated in the ENT clinic of the Moscow Medical Academy and relevant literature. Therapeutic policy in mastoiditis is described. Early surgical intervention is recommended in unfavorable mastoiditis course to prevent complications.

[Equilibrium function in Menière's disease]. / Funktsiia ravnovesiia pri bolezni Men'era.

In order to assess objectively the equilibrium function in Ménière's disease, stabilographic measurements were performed in combination with a battery of provocative tests. In 55 patients, static and dynamic equilibrium was investigated on a differential basis and compared with the data calculated for healthy people of the same age. In Ménière's disease, patients showed a decline of the equilibrium function (P less than 0.001) between attacks, the decline enhancing with the duration of the disease. It was found that one of the early signs of functional insufficiency of the equilibrium function in Ménière's disease was a poor correlation between the level of the stimulus presented and that of the response. At early stages of Ménière's disease, the equilibrium function deteriorated due to dynamic components and at stage III due to both dynamic and static components.

[Posturography: efficacy and prospects in Otorhinolaryngology]. / Posturografiia - vozmozhnosti i perspektivy ispol'zovaniia v otorinolaringologii.

Static and dynamic computer posturographies are used in diagnosis of vestibular disorders associated with impairment of the equilibrium. Posturography demonstrated high sensitivity and diagnostic abilities. Posturographic correction of the equilibrium defects basing on biological feed-back is successfully tried. Computer posturography is promising for wide medical practice.

[The effectiveness of stabilographic vertebrogenic test in diagnosing secondary cochleovestibular disorders]. / Effectivnost stabilograficheskoi vertebrogennoi proby v diagnostike vtorichnykh kokhleovestibuliarnykh rasstroistv.

The study included 211 healthy subjects, 65 and 95 patients with affected vestibular analyzer without hemodynamic disorders in the vertebrobasilar branches and with them, respectively. It was found possible to use the stabilographic vertebrogenic test (SVT) both for diagnosis of vestibular dysfunction in vertebrogenic insufficiency and prediction of its appearance. The range of SVT changes (12-17%) reflects subclinical level of vertebrogenic impact on equilibrium system induced by unfavorable effects on the peripheral or central structures of the vestibular analyzer.

[Equilibrium function in patients with chronic encephalopathy as an indicator of compensation level in cerebral circulation insufficiency]. / Funktsiia ravnovesiia u bol'nykh s khronicheskoi éntsefalopatiei kak pokazatel' urovnia kompensatsii nedostatochnosti mozgovogo krovoobrashcheniia.

The equilibrium function of 52 patients suffering from chronic hypertensive encephalopathy was examined using a stabilographic method combined with provocative tests. It was found that their static and dynamic equilibrium declined when compared to that of healthy subjects of matched age. Dynamic equilibrium varied to the greatest extent, especially their capacity of responding adequately to strong stimuli, whereas static equilibrium changed in a far lesser degree. Comparison of the functional stability of the equilibrium system and the compensation level of cerebral circulation lesions revealed significant (p less than 0.01) changes in patients with varying degree of compensation. This observation suggests that the factor of functional stability can be used to measure the level of compensation of cerebral circulation lesions.

[Characteristics of the vestibulo-vascular interaction in patients with chronic hypertensive encephalopathy]. / Osobennosti vestibulososudistogo vzaimodeistviia u bol'nykh s khronicheskoi gipertonicheskoi éntsefalopatiei.

Vestibulo-vascular responses were investigated in 52 patients suffering from hypertensive encephalopathy and cochleovestibular disorders. All the patients underwent neurological and otoneurological examinations, tachooscillographic and vestibulometric measurements during optokinetic stimulation and air calorimetry (T-20 degrees C) as well as rotatory tests (V-45 degrees/S). In 35 patients, vestibular stimulation caused variations in vital hemodynamic parameters which led to characteristic changes during vestibulometry. In remaining 17 patients, vestibulo-vascular reactions were less variable; in these patients arterial hypertension was of secondary origin and mostly a manifestation of pathologic changes of great vessels. It is concluded that the type of vestibulo-vascular interaction should be taken into consideration when treating patients suffering from chronic hypertensive encephalopathy and cochleovestibular disorders.

[Therapeutic errors in otorhinolaryngology]. / Vrachebnye oshibki v otorinolaringologii.

Therapeutic errors in otorhinolaryngology, their causes and approaches to their correction are considered.

[Paratonsillitis: aspects of therapeutic policy]. / Paratonzillit -- osobennosti lechebnoi taktiki.

A questionnaire has been distributed among ENT physicians in Russia and CIS on their approaches to management of paratonsillitis with reference to the disease stage. Many respondents approve active surgical policy and on demand perform abscesstonsillectomy in acute period. Those who perform the operations in "hot", "warm" and "cold" period fall into approximately equal groups.

[Pre- and postseptal orbital rhinosinusogenic complications]. / Pre- i postseptal'nye orbital'nye rinosinusogennye oslozhneniia.

The authors present examination and surgical data on 78 patients with different forms of orbital rhinosinusogenic complication. One of the major factors for the course and therapeutic policy in such complications is pre- or postseptal location of the process in the orbit. Such local signs as exophthalmos, chemosis, dislocation, reduced motility of the eye ball and, later on, sight disorders indicate the lesion focus location behind the orbital septum. Clinical comparisons of the pre- and postseptal orbital complications evidence for more severe and prognostically unfavorable course of the inflammation in the posterior part of the orbit. This urges early active combined therapy and cleansing of the affected paranasal sinuses in such patients.