[The observation, diagnostics, and treatment of a patient presenting with a vascular branched tumour of the external ear]. / Sosudistaia vetvistaia opukhol' ushnoi rakoviny.

This article describes the observation of a clinical case of a vascular branched tumour (hemangioma) of the external ear with special reference to the clinical features and diagnostics of this condition and the methods for its surgical treatment.

[Ionizing radiation and laryngeal cancer]. / Ioniziruiushchaia radiatsiia i rak gortani.

The cause behind the currently ever increasing number of patients presenting with laryngeal cancer lies not only in the lack of the apprehensive attitude toward oncological diseases among the medical profession but also in the changing conditions of human life and environment. As many as 165 patients suffering from laryngeal cancer of the 490 ones admitted to our clinic had undergone the influence of ionizing radiation before they were allocated to the main study group while the remaining 325 cases made up the control group. The former group included 112 firefighters of the Chernobyl disaster. It was shown that the progression rate of the disease among the patients of the main group was much higher than among those comprising the control one. A similar difference was documented in the occurrence of regional and remote metastases that were not infrequently the earliest manifestations of the disease. All the patients of the main study group were given the surgical treatment. The firefighters died within one year after the onset of the treatment due to multifocal tumours, regional and remote metastases.

[The application of the lyophilized xenodermoimplants for the plastic correction of the external auditory canal and nasal septum perforation].

The objective of the present work was to improve the effectiveness of the treatment of atresia of the external auditory canal (EAC). Atresia of external acoustic meatus is a result of a mechanical or thermal injury but can also develop after a surgical intervention for the removal of foreign bodies, benign and malignant tumours. This condition is frequently associated with the narrowing and obliteration of EAC leading to the marked impairment of hearing despite preservation of the middle ear structures. Plastic correction of the external auditory canal for the purpose of its broadening does not always produce the desired result. To improve the efficiency of such intervention, we made use of the lyophilized xenodermoimplants based on porcine skin. Such preparation were applied in 19 patients; patency of the external auditory canal was restored in 16 cases.

[Etiology and pathogenesis of glomus tumours (chemodectomas) of the base of the skull].

The objective of the present work was to describe the poorly known history of the development of the nomenclature of glomus tumours (chemodectomas) of the base of the skull, elucidate etiology and pathogenesis of these neoplasms. The authors present a chronological table illustrating the progress of etiological and pathogenetic studies as well as the surgical treatment of the tumours. The results of analysis and discussion of the controversial issues of the nomenclature are reported.

[Peculiar features of the coagulation, fibrinolytic, and anticoagulation systems of blood in the patients presenting with vascular ENT tumours].

The objective of the present work was to study characteristics of the blood coagulation system in the patients presenting with vascular ENT tumours including the following parameters: a complete blood count, hemorrhage, coagulation, retraction, and blood clot lysis times. The patients with ENT hemangiomas experienced hypocoagulation in the preoperative period in combination with the predominance of the fibrinolytic processes and elevated levels of free heparin. These changes can be interpreted as a protective reaction to prevent intravascular coagulation in the case of the slow blood flow in hemangiomatous cavities. The results of the study indicate that the prophylactic administration of inhibitors of enhanced fibrinolysis in the preoperative period may be dangerous for the patients presenting with hemangiomas because suppression of this adaptive response prior to surgery is likely to promote massive microcoagulation under the influence of tissue thromboplastin.

[The arrest of bleeding from the sigmoid sinus and the upper segments of internal jugular vein].

The objective of the present work was to develop an efficacious non-injurious technique for the arrest of hemorrhage from the sigmoid sinus and the upper segments of the internal jugular vein. The authors proposed a relatively simple and highly effective method to be used to the blockade of the sigmoid sinus. It was employed to treat 8 patients none of whom suffered complications in the late postoperative period (the follow-up study lasting from 6 months to 2 years after the intervention).

[The influence of the defects and deformities in the intranasal septum on the main functions of the nose (preliminary report)].

AIM OF THE STUDY: to estimate the influence of the defects and deformities in the intranasal septum on the main functions of the nose and therefore on the state of the upper respiratory tract and the ears. METHODS: A total of 180 patients suffering deformation of the nasal septum were available for the examination. The study included the evaluation of breath characteristics, excretory and inspiratory functions of the nose compared with control with the use of the conventional methods including rhinometry. RESULTS: The patients presenting with the defects and deformities in the intranasal septum were found to have nasal breathing problems, impaired sense of smell, disturbances of the excretory, inspiratory, air-transporting, and air-heating functions of the nose. Comparative analysis of laryngeal, pharyngeal, tracheal, bronchial, and pulmonary disorders has demonstrated the significant differences in the frequency and duration of these diseases and in the efficacy of their treatment between the patients of the study and control groups. It is concluded that the early recovery of nasal functions, in the first place the respiratory one, is an important precondition for the efficacious prevention of various catarrhal and other laryngeal diseases of the larynx, pharynx, trachea, bronchi, lungs, and ears.

[The importance of the pharmaceutical form and the routes of administration of B-group vitamins for the efficacious treatment of neurosensorial hearing loss].

The objective of the present comparative study was to estimate the efficacy of the treatment of neurosensorial hearing loss (NSHL) with the use of milgamma, milgamma compositum, and vitamins B1 and B2 monotherapy. The best results were obtained after the treatment with milgamma and milgamma compositum. It is concluded that the use of these preparations for the combined treatment of neurosensorial hearing loss is pathogenetically justified since it permits to achieve the improvement of the functional state of the cochleovestibular nerve and the enhancement of patient compliance; moreover, it reduces the work load on the medical personnel.

[Capillary ENT hemangioma].

Capillary hemangioma is considered to be one of the most widespread (frequently occurring) vascular ENT tumours. These neoplasms are usually localized in the nasal cavity, sometimes in the larynx or pharynx, and rarely in the outer or middle ear. The principal method for the treatment of this pathology is surgical intervention. Tumour destruction by laser and radiowave radiation finding wide application for the removal of hemangiomas does not substantially lighten the work of a surgeon; moreover the use of these tools is fraught with a high risk of serious intra- and postoperative complications. In an attempt to avoid or reduce bleeding in the course of surgical intervention we used for the first time hemostatic TachoComb and a Fibro-Vein solution. The mode of using these preparations is described in much detail because it determines to a large degree the efficacy and safety of the treatment. The possibility to combine the surgical intervention with the application of TachoComb and a Fibro-Vein solution is considered; also, the advantages of radiowave-induced destruction of hemangiomas are emphasized.

[Otalgia and impairment of hearing in the diagnosis of inflammatory and tumorous diseases of the pharynx and larynx].

Otalgia and/or impairment of hearing is one of the earliest, if not the first, symptom of certain pharyngeal and laryngeal disorders. Underestimation of these conditions or incorrect interpretation of their origin frequently lead to erroneous diagnosis and the wrong choice of treatment strategy. A total of 1074 patients with pharyngeal and laryngeal problems were available for examination that revealed pathologies in which otalgia and/or impairment of hearing is the first or an earlier symptom of the disease. Otalgia proved to be an early manifestation of serious inflammatory diseases affecting the middle part of the pharynx or of metastasis of malignant pharyngeal and laryngeal tumours into deep cervical lymph nodes. Juvenile angiofibroma, hemangiouma, malignant nasopharyngeal tumour are known to disturb functional automatism of pharyngeal openings of Eustachian tubes and cause impairment of hearing long before clinical manifestations of neoplastic growth. Results of diagnostic studies are usually interpreted as middle ear pathology (tubootitis, exudative otitis, middle ear inflammation). Correct diagnosis is possible within 1-12 months (or more) after the appearance of the first symptoms. An error is possible to avoid by thorough examination of the pharynx using endoscopic optics. Target biopsy is indicated as soon as neoplastic microlesions are identified excepting cases of branched arterial-type hemangiomas.

[A new outlook on adenoid hypertrophy: adenoids or adenoid disease?]. / Novyi vzgliad na gipertrofiiu glotochnoi mindaliny: adenoidy ili adenoidnaia bolezn?

Hypertrophy of the pharyngeal tonsil affects functions of some organs and systems producing negative effects on physical and mental development of the child. The existing classification based of the tonsil size does not reflect the complexity of the pathological process. "Adenoid disease" is thought to be a more adequate term. A new classification of adenoid disease is proposed. Indications for conservative and surgical treatments can be well formulated with the new classification. The authors prefer adenotomy as, in their opinion, adenectomy is not safe for health.

[The role of audiological methods of investigation in diagnosis and treatment of chemodectomas and hemangiomas of the middle ear]. / Znachenie audiologicheskikh metodov issledovaniia v diagnostike i lechenii khemodektom i gemangiom srednego ukha.

Diagnostic value of some audiological methods of investigation (pure-tone audiometry, tympanometry, noisimetry) has been determined on the basis of examination and treatment of 114 patients with chemodectoma and hemangioma of the middle ear. Tympanometric evidence directly correlated with primary location and dissemination of the tumor. Changes on tympanograms and noisimetries correlate with the results of the tests with pressure of the neck's vessels and elevation of airpressure in the external acoustic meatus. Audiological findings are comparable with those of CT and MRT of the temporal bones and visualization of the tumor in surgery. High significance of the above methods was proved.