[Clinical case of tuberculous otitis media in early childhood]. / Klinicheskii sluchai tuberkuleznogo srednego otita v rannem detskom vozraste.

Nowadays, the incidence of tuberculosis remains high all over the world, despite the vaccination, medical support, social policy. The main reasons for this are the high level of migration, the prevalence of bad habits, the prevalence of immunodeficiency conditions, the formation of resistance to antimicrobial drugs, the tendency to refuse vaccination. At the same time, great difficulties arise in the diagnosis of extrapulmonary forms of infection. The purpose of this publication is to remind about the peculiarities of the course and diagnosis of tuberculous otitis media. According to the literature, the main characteristic features of tuberculous of the middle ear are prolonged suppuration without pronounced pain syndrome, inefficiency of standard antibacterial therapy, the anamnestic data about contacts or violation of the vaccination schedule, multiple perforations and a pronounced granulation process during otoscopy, a pronounced destructive process in the temporal bone during X-ray examination. The article presents a clinical case of the development of tuberculous otitis media in a young child with delayed diagnostics and the development of mastoiditis with required emergency surgical treatment. Verification of the etiology of the disease and the specific treatment carried out made it possible to achieve complete relief of ear symptoms, restoration of the tympanic membrane and ventilation of the middle ear.

[Diagnosis and correction of the obstructive sleep apnea syndrome in children with tonsillar ring pathological conditions]. / Diagnostika i korrektsiya sindroma obstruktivnogo apnoe sna u detei s patologiei limfoglotochnogo kol'tsa.

OBJECTIVE: To summarize the results of a study of the clinical and polygrapic features of sleep in children with pathologic conditions of the tonsillar ring and obstructive sleep apnea. Tonsillar hypertrophy is the most common cause of obstructive sleep apnea in children. Using the data of overnight polysomnographic study and/or nocturnal pulse oximetry, groups of patients were distinguished depending on the presence and severity of their sleep breathing disorders. The effectiveness of adenotomy, adenotonsillotomy and/or adenotonsillectomy in children is demonstrated, depending on the severity of obstructive sleep apnea syndrome. Evaluation of breathing in sleeping children by polygraphic methods is necessary for early detection of obstructive sleep apnea syndrome and monitoring the effectiveness of surgical treatment.

[Auditory tube dysfunction in children. Part 2]. / Disfunktsiya slukhovoi truby v detskom vozraste. Chast' 2.

The presented literature review examines in detail the methods for diagnosing the auditory tube, the history of development of studies of the Eustachian tube and the treatment of its dysfunction in children. The issue of dysfunction of the auditory tube as one of the causes of the formation of chronic hearing loss in childhood is increasingly being identified because of the rapid development of technologies and methods for examining patients. Aim is to study the multiple etiologic factors of the disease and the need for an integrated approach to the study of this condition.

[A case of ear miasis in a 2-month-old child]. / Sluchai ushnogo miaza u 2-mesyachnogo rebenka.

A clinical case is presented - a rare observation of ear myasis in a 2-month-old child.

[Two-year experience in the balloon dilatation treatment of children with persistent auditory tube dysfunction]. / Dvukhletnii opyt lecheniya detei so stoikoi disfunktsiei slukhovoi truby metodom ballonnoi dilatatsii.

OBJECTIVE: Is to study the effectiveness of the of balloon dilatation of the auditory tube in children with persistent dysfunction of the auditory tube. Examination and treatment of 28 children aged 5 to 16 years with persistent dysfunction of the auditory tube was performed. To diagnose and objectify the results of the treatment, taking of complaints and medical history of the patient, examination of ENT organs, endoscopic examination of the nose, nasopharynx and otoendoscopy, functional multispiral computed tomography of the auditory tubes, audiological examination (tympanometry, tonal threshold audiometry) were performed. Treatment included balloon dilatation of the auditory tubes. In 25 (89.3%) children, upon repeated examination after 2, 6, 12 months, the clinical, radiological, and audiological parameters were normal.

[Auditory tube dysfunction in children (literature review, part 2)]. / Disfunktsiya slukhovoi truby v detskom vozraste (obzor literatury, chast' 2).

The presented literature review examines in detail the methods for diagnosing the auditory tube, the history of development of studies of the Eustachian tube and the treatment of its dysfunction in children. The issue of dysfunction of the auditory tube as one of the causes of the formation of chronic hearing loss in childhood is increasingly being identified because of the rapid development of technologies and methods for examining patients. Aim is to study the multiple etiologic factors of the disease and the need for an integrated approach to the study of this condition.

[Integration of diagnostic and treatment methods of pediatric ENT diseases into the practice of a pediatrician]. / Voprosy integratsii metodov diagnostiki i lecheniia lor-patologii detskogo vozrasta v praktiku vracha-pediatra.

In his or her daily practice, a pediatrician often has to encounter various ENT diseases, since more than half of visits to children's clinics are associated with various conditions of ENT organs. This article highlights the issues of introducing diagnostic and treatment methods for acute and chronic diseases of ENT organs into the daily practice of pediatricians.

[On the issue of treatment of exudative otitis media in children]. / K voprosu o lechenii ékssudativnogo srednego otita v detskom vozraste.

AIM: To increase the effectiveness of treatment of children with catarrhal and secretory stages of exudative otitis media (EOM) through the development of a therapeutic and diagnostic algorithm for the management of children with this condition. MATERIAL AND METHOD: From 2008 to 2017, 346 children (682 ears) aged from 3 to 13 years with exudative otitis media were examined and treated. Two groups of patients were formed: Group 1 (150 children, 298 ears) - with a catarrhal stage of EOM, group 2 (196 children, 384 ears) - with a secretory stage of EOM. Diagnosis and treatment algorithm was created for such patients based on the results of the examination. RESULTS: Depending on the treatment, 3 groups of patients were formed: Group I - 150 children with a catarrhal stage of EOM who received conservative and surgical treatment for upper respiratory tract conditions; Group II - 146 children with an a secretory stage of EOM, who underwent conservative and surgical treatment: myringotomy / installation of a shunt in the eardrum simultaneously with surgical removal of the block of the auditory tube ostium, a course of conservative treatment for children who did not require surgical treatment; Group III - 50 children with a secretory stage of EOM and grade III adenoids, whose parents, contrary to the doctor's advice, refused the proposed myringotomy / installation of a shunt in the eardrum simultaneously with surgical removal of the block of the auditory tube ostium. These children underwent only adenotomy. CONCLUSION: The developed treatment algorithm for children with EOM, depending on the stage of the disease, demonstrated high clinical efficacy and made it possible to achieve stable positive results in 94.7% of cases in patients with the catarrhal stage of ESO and in 84.8% of cases in patients with the secretory stage of ESO, which makes it possible for us to recommend it as an integrated method that improves the quality of treatment for children with EOM.

[Fungal otitis externa in children: principles of diagnosis and rational therapy]. / Gribkovyi naruzhnyi otit u detei: printsipy diagnostiki i ratsional'noi terapii.

AIM: To study the current diagnosis and treatment of fungal inflammation of the external auditory canal in children. This article summarizes the literature on predisposing factors for the occurrence of fungal infections of the external auditory canal in children. PATIENTS AND METHODS: In this study, we present modern approaches to the diagnosis and treatment of external fungal otitis media in children depending on the isolated genus and species of fungus. RESULTS: We established that, according to the study conducted from 2015 to 2017 in the L.I. Sverzhevskiy Clinical Research Institute of Otorhinolaryngology, the incidence of the external fungal otitis media in children is 13,0%. The primary causative agents of fungal inflammation are fungi of the genera Aspergillus, Candida and Geotrichum. CONCLUSION: In the presented study, the rationale for the selected treatment regimen was made based on data obtained during microbiological studies.

[Auditory tube dysfunction in children (literature review, part 1)]. / Disfunktsiia slukhovoi truby v detskom vozraste (obzor literatury, chast' 1).

We present the review of the literature on the anatomical and physiological features of the structure of the auditory tube in children, epidemiology, etiology, and the pathogenesis of the formation of auditory tube dysfunction is presented. The first part of the article presents in more detail the structural and functional differences in the Eustachian tube in children, the classification and mechanism of the occurrence of the auditory tube dysfunction in pediatric practice.

[Surgical interventions on the pharynx in the structure of otorhinolaryngological care to the population of the city of Moscow]. / Khirurgicheskie vmeshatel'stva na glotke v strukture otorinolaringologicheskoi pomoshchi naseleniiu Moskvy.

The authors studied the reporting documentation of otorhinolaryngological hospitals of the city of Moscow on the surgical treatment of pharyngeal pathology in adults from 2002 to 2017. It was found that for 16 years surgical treatment of 290 362 patients with ENT-diseases was performed: 181.206 (62.4%) patients with diseases of the nose and paranasal sinuses, 24.981 (8.6%) patients with ear pathology, 60.346 (20.8%) patients with diseases of the pharynx and 23.829 (8.2%) - with diseases of the larynx. The assessment of the overall dynamics of the studied indicators was carried out on the 'trend lines'. For the considered period, the number of patients with surgical pathology of the pharynx increased by 33.2%. The proportion of tonsillectomies increased by 1.85 times to 56.5%, drainage of peritonsillar abscesses and abscesses-tonsillectomies decreased by 19%, uvulopalatoplastic increased 4.1 times, removal of neoplasms of the pharynx increased 2.2 times, adenotomies decreased by 2.4 times. Analysis of the data allowed to establish that, against the background of an ever-increasing number of surgical interventions for diseases of the pharynx in adults, a descending trend was noted only in the treatment of complicated forms of chronic tonsillitis and hypertrophy of the pharyngeal tonsil.

[Features of thermal effect at high-frequency laser impact on biological tissue (experiment). Technique of laser ablation of a pharyngeal tonsil]. / Osobennosti termicheskogo éffekta pri vysokochastotnom lazernom vozdeistvii na biologicheskuiu tkan' (éksperiment). Metodika lazernoi abliatsii glotochnoi mindaliny.

In the conditions of the experiment the peculiarities of thermal influence of Ho:YAG on biological tissue in the ablation mode were studied. In the experiment we used: surgical laser system LUMENIS VersaPulse PowerSuite 20, universal thermal imaging camera FLIR SC7000. The biological object (turkey meat) was remotely, at a distance of 5 mm, affected by a Holmium laser (E = 0.9 J and R = 12 Hz) for 6 seconds. The maximum temperature (Tmax, °C) in the ablation zone was measured in real time. As a result, it was found that laser ablation of a biological object is characterized by thermal effects, which largely depend on the state of irradiated tissue: the temperature of the irradiated object rises to critical values equal to 100.07-111.24 ° C, after which the surface layer of biological tissue is charred, and the process of laser "removal" stops; intact biological tissue reaches critical heating after 3.48 s, while under the influence of a high-frequency laser on the previously irradiated biological tissue development period It was also established that in order to continue laser ablation with controlled thermal effect it is necessary to remove charred areas of biological object. On the basis of the obtained data the method of laser ablation of pharyngeal tonsils was developed.

[Middle ear osteoma: case report and literature review]. / Osteoma barabannoi polosti. Klinicheskii sluchai i obzor literatury.

The short literary review of frequency of occurrence, complaints, results of diagnostics and surgical treatment of patients about osteomine is presented to a drum cavity in article. Two own cases of clinical inspection and surgical treatment of patients about osteomine of a drum cavity are described.

[Sintopy of the distal end of the nasolacrimal duct detected by means of the vector analysis of the CT-identified anatomical features of the nasal cavity]. / Sintopiia distal'nogo kontsa nososleznogo kanala po dannym vektornogo analiza KT-anatomii polosti nosa.

The objective of the present work was to study syntopy of the distal end of the nasolacrimal duct based on the results of the vector analysis of the CT-identified anatomical features of the nasal cavity and the paranasal sinuses in 102 patients (204 nasolacrimal channels). The main criterion for inclusion in the study was the absence of traumatic injuries and inflammatory changes in the nasal cavity and the paranasal sinuses. X-ray studies of the distal end of the nasolacrimal duct (NLD), turbinate crest (crista conchalis), the edge of the nasal aperture, and the floor of the nasal cavity were carried out. The vector and angle measurements were made with respect to the bottom of the nasal cavity in the perpendicular and parallel planes. The study has demonstrated that the distal end of the nasolacrimal duct was located 3.49 mm above the level of crista conchalis of the maxillary bone 19.77 mm and 22.04 mm apart from the edge of the aperture of the nose in the individuals younger than 20 years and in the older subjects respectively. Syntopy of the distal end of NLD relative to the bottom of the nasal cavity did not depend on the sex and age of the patients and was localized at a depth of 13.93 mm from the edge of the aperture of the bone and 11.86 mm above the bottom of the nose.