[Diagnosis and rehabilitation of anterior canal benign paroxysmal positional vertigo]. / Osobennosti diagnostiki i reabilitatsii dobrokachestvennogo paroksizmal'nogo pozitsionnogo golovokruzheniya pri otolitiaze perednego polukruzhnogo kanala.

OBJECTIVE: To assess clinical symptoms and rehabilitation of anterior canal benign paroxysmal positional vertigo (aBPPV) in comparison to horizontal canal BPPV (hBPPV) and posterior canal BPPV (pBPPV). PATIENTS AND METHODS: The study included 22 patients with aBPPV, 450 patients with pBPPV and 88 patients with hBPPV from total 640 patients with definite BPPV. Rehabilitation of BPPV included different manual repositioning maneuvers. In case of unsuccessful reposition during the visit the patients practiced various home-based repositioning maneuvers and underwent reposition in multipositional mechanical chair. Clinical symptoms and repositioning process in patients with aBPPV were compared to patients with hBPPV and pBPPV, nystagmus was analyzed in aBPPV during the rehabilitation. RESULTS: ABPPV is a rare type of otolithiasis (3.4% of all BPPVcases). aBPPV typically has no association with middle and inner ear pathology and head trauma. Clinical symptoms in aBPPV are equal to pBPPV and less severe than in hBPPV. In aBPPV cases dominates cupulolithiasis type of canal involvement, which leads to treatment resistance and complex rehabilitation process, which includes repeat visits, multiple repeat maneuvers by specialist, home-based treatment and use of multipositional mechanical chair. Residual dizziness with duration more than a week after successful reposition occurs more often in patients with aBPPV compared to hBPPV and pBPPV cases. In aBPPV cases atypical change of nystagmus could be observed which could be due to canal switch from anterior to posterior canals, primary location of otoliths in common crus of vertical canals or masking chronic otolithiasis of anterior short arm of posterior canal.

[Features of topical therapy of inflammatory pathology of nasal cavity]. / Osobennosti topicheskoi terapii vospalitel'noi patologii polosti nosa.

Treatment of inflammatory pathology of the nasal cavity at the present stage requires a doctor to clearly understand the physiological mechanisms that implement the main functions of the mucous membrane of the nasal cavity and upper respiratory tract. One of the most important processes that ensure the normal functioning of the respiratory tract is mucociliary clearance. Violations of its work leads to stagnation of mucus and the development of inflammation not only in the nasal cavity, but also in the lower respiratory tract and middle ear cavities. The authors of the article consider the main etiological factors and mechanisms of the pathogenesis of inflammatory diseases of the nasal cavity, discuss approaches to the treatment of these conditions. The authors conclude that in conditions of acute and chronic inflammation of the nasal mucosa, accompanied by the secretion of thick viscous mucus, the most effective topical use of the combined preparation, which includes acetylcysteine, tuaminoheptane and sodium hyaluronate. This combination has both mucolytic, vasoconstrictive and protective effects, which increases the effectiveness of the drug and the adherence of patients to therapy.

[Damage to the inner ear with syphilitic infection]. / Porazhenie vnutrennego ukha pri sifiliticheskoi infektsii.

The epidemiology of neurosyphilis is presented in article. The pathogenetic mechanisms of involvement in the syphilitic process are described already in the early stages of the disease of the central and peripheral nervous system and, in particular, of the auditory and vestibular analyzers. Described classical clinical forms of neurosyphilis. Statistical data on the incidence of syphilis in Russia from the 20-30s of the last century to the present are given. Presented analysis of the development of the incidence rate in Russia of syphilis and neurosyphilis, the main methods for the diagnosis of neurosyphilis. The changes in the structure of neurosyphilis disease that have occurred over the past 20 years, which are characterized by nonspecificity, course wear and inversion of typical clinical symptoms, as a result of pathomorphism, are described. The article describes the mechanism for the development of the pathological process in the inner ear with syphilitic infection. Described changes in the capillary wall of the vascular streak, leading to impaired hematolabyrinth barrier function and the development of the labyrinth hydrops. Literature data on the electron microscopic study of the vascular strip of the rabbit webbed snail infected with syphilis are presented. The article also collected literature data on indicators obtained by audiological and vestibulological studies of the inner ear in cases of early and late neurosyphilis. The article focuses on the possible only manifestation of neurosyphilis in the form of cochleovestibular symptoms.

[The peculiar features of epidemiology and clinical course of syphilis encountered in the otorhinolaryngological practice under the present-day conditions]. / Osobennosti épidemiologii i klinicheskogo techeniia sifilisa v otorinolaringologicheskoi praktike v sovremennykh usloviiakh.

The article was designed to report the available information about the main characteristics of epidemiology and pathomorphism of syphilis. It describes the process of development and clinical symptoms of syphilis, both classical and undergoing modification, under the present-day conditions, with special reference to the distinctive features and peculiarities of ENT organ lesions with the underlying syphilitic etiology.

[The pedagogical activities at the Department of Otorhinolaryngology of the Faculty of General Medicine]. / Pedagogicheskaia deiatel'nost' kafedry otorinolaringologii lechebnogo fakul'teta Rossiiskogo natsional'nogo issledovatel'skogo meditsinskogo universiteta im. N.I. Pirogova.

This article was designed to substantiate the main principles of the academic process as practiced at the Department of Otorhinolaryngology of the N.I. Pirogov Russian National Research Medical University under the current conditions of the ongoing modernization of the system of higher medical education. The authors emphasize the necessity of the combination of theoretical and practical training with special reference to the specific features of the curricular and extracurricular activities. The importance of the formation of the properly functioning teaching staff is underscored. To enhance the efficiency of the educational process, the wide application of the computer-assisted technologies is recommended that can be simultaneously used to improve the methods for diagnostics and treatment of various pathological conditions. The activities based at the specialized students' scientific circle may prove very helpful to facilitate the acquisition of the necessary theoretical knowledge and practical skills by the medical students and thereby to promote the formation of professional otorhinolaryngologists.

[Acoustic impedanceometry: the evolution of diagnostic possibilities].

The present review of the literature reports the materials concerning the application of the acoustic impedance measurements of normal ears and pathologically charged organs of hearing that are important for the differential diagnostics and monitoring of the hearing system condition during the conservative and surgical treatment.

[Assessment of efficacy and tolerance of tanakan during treatment of sensorineural bradyacuasia and tympanophonia].

The objective of the study was to evaluate efficacy and tolerance of tanakan during treatment of neurosensory hearing loss and subjective tinnitis supposedly of vascular etiology. The secondary purpose was to analyse late results of 3 month courses of therapy and changes in the clinical course of the disease during treatment and within 6 months after its termination. Tanakan was first given at a dose of 40 mg thrice daily for 90 days. Results of the treatment were estimated on days 90, 180, and 240. The second course (40 mg thrice daily for 90 days) was initiated 180 days after the end of the first one. The final outcome was evaluated on day 360. It was shown that monotherapy with tanakan effectively improved the hearing function and had the most pronounced beneficial effect on subjective tinnitus. Results of the treatment remained stable throughout the entire observation period (12 months).

[Current methods of rehabilitation of patients with vestibular disorders]. / Sovremennye metody reabilitatsii bol'nykh s vestibuliarnymi rasstroistvami.

Efficacy of pharmacological, physical treatments in monotherapy and in combination was compared in rehabilitation of 173 patients with various forms of vestibular disorders. High efficacy of physical methods especially with the use of biological feedback is shown. Factors influencing final results of the above rehabilitation are analysed. Wide use of physical rehabilitation is recommended.

[Criteria of predicting efficacy of vestibulo-adaptive therapy in patients with equilibrium disturbances]. / Kriterii prognozirovaniia éffektivnosti vestibuloadaptatsionnoi terapii u bol'nykh rasstroistvom ravnovesiia.

Effects of some factors on efficacy of vestibulo-adaptive therapy were analysed for 109 patients with equilibrium dysfunction. Efficacy of vestibulo-adaptive therapy is shown to depend on location of the vestibular analyser lesion, involvement of alternative sensory systems providing information on spatial position of the body, duration of the vestibular analyzer affection, determination of the patient to adhere to the program of physical rehabilitation.

[Mechanisms of physical rehabilitation of patients with vestibular disorders]. / Mekhanizmy fizicheskoi reabilitatsii bol'nykh s vestibuliarnymi rasstroistvami.

The following methods of rehabilitation of patients with equilibrium disturbance have been analysed: 1) nonspecific exercise; 2) specific physical training to enhance the flow of impulses providing formation of the mechanism of the vestibular function compensation at the subconscious level; 3) specific training on the stabilographic platform based on the biological feedback principle. It was found that the most effective recovery of the statokinetic function was achieved under combination of the above methods. The effect manifested both in subjective improvement of the patients' general condition and objective response as shown by functional computed stabilometry.

[Biological feedback techniques in rehabilitation of patients with impaired equilibrium function]. / Metodika biologicheskoi obratnoi sviazi v reabilitatsii bol'nykh s narusheniem funktsii ravnovesiia.

Vestibular rehabilitation with application of biological feedback methods has been performed in 25 patients with vestibular disorders. In them, an objective method of functional computer stabilometry verified equilibrium disturbance. Compared to the control group of 30 patients treated conventionally with drugs, biological feedback methods proved high effectiveness.