[Residency is a fundamental stage of professional training of an otorhinolaryngologist]. / Ordinatura ­ osnovopolagayushchii etap professional'noi podgotovki otorinolaringologa.

Systematic analysis of various indicators of the educational process becomes important to assess the effectiveness of the training of residents. One of the most common tools for monitoring the effectiveness of the educational process is a questionnaire of students. OBJECTIVE: To analyze the results of the assessment of the quality of training in the residency of the Sverzhevky Research Clinical Institute of Otorhinolaryngology according to the survey of residents. MATERIAL AND METHODS: The study includes the results of an anonymous questionnaire survey of a sample group of residents of the residency of the Sverzhevky Research Clinical Institute of Otorhinolaryngology of the second year of study. RESULTS: The data obtained allow us to judge the satisfaction with the quality of training of the absolute majority of the interviewed residents, their active use of specialized electronic search engines, a high assessment of the level of lectures, the desire to improve their surgical training. The importance for the professional development of residents of participation in weekly scientific and clinical conferences of the Sverzhevky Research Clinical Institute of Otorhinolaryngology, meetings of the Moscow Scientific Society of Otorhinolaryngologists, traditional annual scientific and practical conferences of otorhinolaryngologists of Moscow, as well as in the activities of the Youth Council of the Institute is noted. CONCLUSION: The results of the survey create prerequisites for improving the educational process, the formation of professional competencies and readiness for independent work among residents.

[The medical assistance seeking behaviour of the patients presenting with suppurative chronic otitis media and their treatment in Moscow]. / Obrashchaemost' i lechenie bol'nykh khronicheskim gnoinym srednim otitom v Moskve.

The objective of the present study was the analysis of the medical assistance seeking behaviour of the patients presenting with suppurative chronic otitis media (CSOM) and their treatment in Moscow during the period from 2009 till 2016. The incidence of suppurative chronic otitis media in the city of Moscow in 2016 was estimated to be 0.14 per 1000 population, its prevalence 1.23 per 1000 population. The materials of the statistical reports of Moscow ENT clinics give evidence of the considerable growth in the number of the admitted patients suffering from ear diseases including suppurative chronic otitis media (mean 5.5). The surgical activity of the ENT clinics with respect to CSOM amounted to 46%. The overall increase in the number of surgical interventions is attributable to a rise in the frequency of reconstructive operations. These data give evidence of excellent continuity in the work of outpatient facilities and ENT clinics, intensification of their activities, and a change of the people's attitude toward the care for their health. Suppurative chronic otitis media is the commonest pathology encountered in the specialized ENT hospitals where it accounts for 59.8% of the total number of ENT diseases. The frequency of the surgical interventions performed for the treatment of CSOM amounts to 98.9%. The enhanced attention given to the patients with this pathology resulted in the two-fold increase of the specialized medical assistance provided to the patients presenting with suppurative chronic otitis media. The most frequently practiced form of the surgical treatment employed for the management of CSOM is tympanoplasty (in 72% of the patients on the average). The 'closed' variants of sanitizing operations are performed in 59.8% of the patients presenting with chronic suppurative otitis media and concomitant cholesteatoma whereas the 'open' interventions are used to treat 45.1% of the patients in need of tympano- and mastoidoplasty. On the whole, the priority surgical treatment of the patients with chronic suppurative otitis media in specialized medical facilities is reconstructive operations intended to simultaneously reach the beneficial sanative and functional effects without deterioration of the quality of life of the patients suffering from chronic suppurative otitis media.

[The structure of childhood diseases in the patients presenting with hospital-acquired ENT pathology estimated based on the results of monitoring children's hospitals in Moscow]. / Struktura zabolevaemosti deteĭ s gospital'noĭ patologieĭ LOR-organov po rezul'tatam monitoringa detskikh statsionarov Moskvy.

The objective of the present work was to study the structure of childhood diseases in the patients presenting with hospital-acquired ENT pathology based at the results of analysis of the annual reports presented by the heads of departments of otorhinolaryngology of Moscow children's hospitals for the period from 2011 till 2013. It was shown that pharyngeal pathologies predominate among the children amounting to 43.9% of the total ENT morbidity. These conditions are followed by nose and paranasal sinus pathologies (29.2%), ear diseases (22.5%), laryngeal, bronchial and tracheal pathologies (4.4%). The analysis of the internal structure of different classes of diseases was made separately for the ear, throat, and nose (ICD-10). The results of the study give evidence of the tendency toward the higher incidence of selected forms of acute inflammatory diseases and chronic ENT pathologies in the childhood.

[Conservative therapy and surgical treatment of chronic tonsillitis in the children].

The objective of the present study was to undertake the statistical analysis of the methods employed to treat tonsillitis in the children with a view to optimizing adequate dispensary observation, planned conservative therapy and surgical treatment of the patients presenting with chronic tonsillitis. The analysis of the excerpts from the annual reports presented by the head of the otorhinolaryngological department of the Children's City Clinical Hospital No 9 involved the patients admitted for the pre-planned and urgent treatment of paratonsillar abscess between 1990 and 2010. It was shown that the number of children with paratonsillar abscess increased during this period from 5.8 to 12.0%. At the same time, the number of such patients undergoing surgery for the treatment of toxico-allergic forms (TAF-I and TAF-II) decreased from 26.7 to 8.7-11.6% of their total number admitted to the department for the treatment of pharyngeal pathology. These diseases developed in the children frequently ill with chronic tonsillitis after its recurrent exacerbations. Importantly, all these children were registered in the dispensaries of district out-patient clinics at the places of residence and repeatedly underwent courses of conservative therapy of chronic tonsillitis that either resulted in the temporary improvement of their health conditions or produced no effect whatever. Nevertheless, no district otorhinolaryngologist recommended tonsillectomy to a child with chronic tonsillitis. It is concluded that adequate regular medical check-ups in combination with the planned courses of conservative treatment and hospitalization of the patients in due time for the surgical treatment (tonsillectomy) permit to reduce the frequency of complications of such an insidious disease as chronic tonsillitis.

[Mortality rate among patients with oto- and rhinogenic intracranial complications].

The authors present selected results of the analysis of medical histories of the subjects who died from complications of inflammatory aural diseases and paranasal sinus pathology in multifield city hospitals of Moscow for the period from 1993 till 2003. The character and the frequency of each intracranial complication are reported.

[Time course changes in surgical activity in chronic tonsillitis].

Surgical activity in chronic tonsillitis analysed for the last 40 years diminished. In particular, the number of tonsillectomies made in ENT hospitals of cities reduced significantly leading to increased occurrence of local complications of chronic tonsillitis and paratonsillar abscesses.

[Therapeutic algorithm in stenosis of the larynx and cervical trachea of various etiology].

An algorithm of the treatment of laryngo- tracheal stenosis (LTS) is proposed to raise efficacy of surgical treatment of LTS and to reduce the number of postoperative complications. The algorithm comprises adequate preoperative preparation of the patients including pharmacological prophylaxis of inflammation in the operative zone; effective use of laryngotracheoplasty; prophylaxis of postoperative scarring including reconstruction of created laryngotracheal passage and administration of medicines influencing general and local immunity, tissue metabolism, repair in the region of postoperative inflammation. The efficacy of the algorithm was followed up un 54 (33.7%) patients with laryngostenosis and 106 (66.3%) patients with laryngo-tracheal stenosis. The algorithm application help rehabilitate all the patients with laryngeal stenosis and 92 (86.8%) patients with laryngo-tracheal stenosis.

[The analysis of adequacy of the treatment for acute otitis media and bacterial sinusitis in outpatient setting].

A retrospective study of adequacy of outpatient treatment for acute otitis media made analysis of 275 case histories of acute otitis media and 271 case histories of acute sinusitis. It was revealed that choice of antibacterial drugs was sometimes made without analysis of most possible pathogens, doses and regimens of pharmacotherapy are often not strictly adhered. The analysis of adequacy of the treatment of acute bacterial sinusitis and otitis in Moscow and 8 cities of Russia is also presented.

[Prevention of postoperative scars in otorhinolaryngology: experimental rationale]. / Eksperimental'noe obosnovanie profilaktiki posleoperatsionnykh rubtsovykh protsessov v otorinolaringologii.

It is demonstrated that in vitro inhibition of fibroblasts proliferation is feasible with the use of 5-fluorouracil. In stimulated growth of fibroblasts, the antiproliferative effect of 5-fluorouracil manifests even in a minimal concentration (2 mcg/ml). Recovery of fibroblast proliferative activity after elimination of 5-fluorouracil occurs in concentration under 63 mcg/ml.

[Validation of application of elastic tamponade of the middle ear postoperative cavities]. / Obosnovanie primeneniia élasticheskoi tamponady posleoperatsionnykh polostei srednego ukha.

It is shown that gauze turunda tamponade of the middle ear postoperative cavities provokes bacterial contamination and formation of the infection focus. Inflatable latex tampon and technique of tamponade of the postoperative middle ear cavities after hearing-preserving sanation operations on the temporal bone were designed and tested. They proved superior to the gauze turundas and allow to avoid bacterial contamination. Microscopic and histological studies confirmed that removal of the latex tampon is safe for the postoperative wound surface making postoperative relapse less probable.

[Prevention of postoperative scar processes in otorhinolaryngology experimental rationale]. / Eksperimental'noe obosnovanie profilaktiki posleoperatsionnykh rubtsovykh protsessov v otorinolaringologii.

It is shown in vitro that fibroblast proliferation may be inhibited by 5-fluorouracil (5-Fu). In stimulated growth of the fibroblasts the 5-Fu antiproliferative effect takes place even in minimal concentration (2 mcg/ml). Fibroblastic proliferative activity recovers after elimination of 5-Fu from the medium at concentration under 63 mcg/ml.