[A case report of organ-preserving surgical treatment for large pleomorphic adenoma of the larynx]. / Klinicheskii sluchai organosokhranyayushchego khirurgicheskogo lecheniya pri pleomorfnoi adenome gortani bol'shikh razmerov.

Tumors of the salivary glands account for no more than 5% of all neoplasms of the head and neck. About 70% of all benign neoplasms of the salivary glands are pleomorphic. One of the rare localizations of pleomorphic adenoma is the larynx. Not more than 30 cases of laryngeal localization of pleomorphic adenoma are described in the literature currently. The article presents the result of organ-preserving surgical treatment of the patient with large pleomorphic adenoma of the larynx.

[COVID-19 associated sino-orbital mucormycosis]. / COVID-19-assotsiirovannyi sinoorbital'nyi mukormikoz.

OBJECTIVE: To analyze the dynamics of symptoms in patients with COVID-19 associated sino-orbital mucormycosis. MATERIAL AND METHODS: We describe a series of 13 patients with COVID-19 associated sino-orbital mucormycosis aged 43 to 80 years diagnosed from August to October 2021. All of the patients had a severe disease and required noninvasive ventilation or intubation and administration of dexamethasone. 12 out of 13 patients (92.3%) suffered from diabetes mellitus. Symptoms of fungal infections of the nose and paranasal sinuses appeared in the interval from 7 to 25 days of hospital stay, most often in the second week (from 8 to 12 days). According to clinical and CT features the patients were divided into three groups, combining similar phenotypes of the disease. Group 1 - 1 patient with sinonasal mucormycosis, destruction of the alveolar ridge and the hard palate. Group 2 - 12 patients with sino-orbital mucormycosis. We noted, that in cases of bilateral sinus lesions orbital complications were unilateral in all patients, on the side of more severe lesion. Group 2 was divided into 2 subgroups: subgroup 2a included 2 patients with the superior orbital fissure syndrome: ptosis, proptosis, ophthalmoplegia, periorbital pain, pain or hypoesthesia of half face; subgroup 2b included 10 patients with the orbital apex syndrome, who, in addition to the above symptoms, had loss of vision and conjunctival chemosis. Group 3 - rhino-sino-cerebral mucormycosis. 2 patients from subgroup 2b were transferred to this group due to the intracranial spread of the process and focal neurological symptoms. CONCLUSION: Clinical forms of mucormycosis reflect successive stages of invasive spread of fungi.

[Anomalous bony portion of the Eustachian tube]. / Anomalii kostnogo otdela slukhovoi truby.

Reports of congenital anomalies of the Eustachian tube are scare. These anomalies are usually associated with chromosomal abnormalities, most often in oculoauriculovertebral spectrum. We present a case of completely bony widened Eustachian tube, entering the cells of sphenoid sinus lateral recess. No wall defect between the sphenoid sinus and the tube was found, nevertheless the tube and middle ear had normal pneumatisation. The anatomy of the outer ear, otoscopy and hearing thresholds were normal on the ipsilateral side. At the same time, there were microtia, atresia of the external auditory canal, underdeveloped tympanic cavity and cochlea hypoplasia and deafness on the contralateral side, although the majority of previous published cases described ipsilateral temporal bone anomalies. The patient had no facial asymmetry and was not given a syndrome diagnosis.

[Traumatic perilymphatic fistula with the luxation of the stapes into vestibule]. / Travmaticheskaia perilimfaticheskaia fistula s liuksatsiei stremeni v preddverie.

A case of perilymphatic fistula with the luxation of the stapes into vestibule was described, which was caused by a direct damage of the eardrum (the patient cleaned the right ear with a cotton swab and received a strong blow to the arm). The moment of injury was characterized by severe pain, a significant hearing loss, the appearance of tympanophonia and vertigo. Clinical examination revealed the eardrum rupture. After perforation healing the hearing did not improve, a high degree of mixed sensorineural hearing loss remained with a bone-air interval of up to 50 dB throughout the tone scale. CT of the temporal bones showed a pneumolabirinth and a change in the malleus position, which made it possible to suggest the presence of a perilymphatic fistula with the luxation of the stapes. The extent of damage was confirmed by surgery. The stapes was removed and the perilymphatic fistula was closed.

[Factors influencing the remote patency of distal shunts in patients with atherosclerosis of lower extremity arteries]. / Faktory, vliiaiushchie na otdalënnuiu prokhodimost' distal'nykh shuntov u bol'nykh aterosklerozom arterii nizhnikh konechnostei.

Under study was the prognostic value of local risk factors of the development of late reocclusion of distal shunts in 149 patients with critical ischemia of lower extremities. It was found that the greatest influence on the remote patency of transplants is exerted by the state of the arterial wall in the area of the distal and in less degree of the proximal anastomoses. In a less degree the duration of functioning of the shunt depended on its length, position in soft tissues, transplant material and the level of the proximal anastomosis. The distal anastomosis level, the history of the simultaneous or previously made aorto-femoral shunt, geometry of the proximal and distal anastomoses did not have any reliable influence on the distal shunt patency.