[On the problem of rational antibacterial therapy of inflammatory diseases of the upper respiratory tract].

The objective of the present study was to estimate the effectiveness and safety of the treatment of exacerbations of chronic tonsillitis with zitrolid forte given during 3 days. This antibiotic was prescribed to the patients presenting with a confirmed inflammatory process of coccal etiology less than 3 days in duration. The effectiveness of zitrolid was evaluated based on the results of dynamic clinical studies, laboratory analysis, and pharyngoscopic data. The study has demonstrated the effectiveness and safety of zitrolid forte as a medicine for empirical therapy of tonsillitis and exacerbations of chronic laryngitis.

[About the role of chronic viral infection in etiology of proliferative diseases of the ENT organs]. / K voprosu o roli khronicheskoi virusnoi infektsii v étiologii proliferativnykh zabolevanii LOR-organov.

The role of certain viruses (human papilloma virus, Epstein-Barr virus, cytomegalovirus, and herpes virus) in the development and malignization of some pre-cancer conditions in human ENT organs is considered. The results of genetic (with the use of PCR) and histological studies of tissue biopsies and surgical specimens are presented. A total of 107 patients presenting with prolifertaive diseases of ENT organ mucosa were available for tissue sampling along with 30 other patients with histologically verified cancer of the larynx, pharynx, nasal cavity, and paranasal sinuses. The clinical data obtained are discussed.

[Not Available]. / Éndoskopicheskaia khirurgiia divertikula Tsenkera s pomoshch'iu poluprovodnikovogo lazera.

Zeneker's diverticulum (pharyngeal diverticulum) is a pathological sac-like protrusion of the mucous membrane at the posterior nasopharyngeal wall. Surgical operation is the principal method for the treatment of this rather rare disease. In the present paper, two cases of its successful management by means of laser-assisted endoscopic diverticulotomy are described. Both operations were made at the otorhinolaryngological clinic of Sankt-Peterburg State Medical University. Contact laser surgery was for the first time performed for the purpose.

[The treatment of polypous suppurative rhinosinusitis in the patients presenting with the severe and moderate aspirin triad]. / Lechenie polipozno-gnoinogo rinosinusita u bol'nykh s aspirinovoi triadoi tiazheloi i srednei stepeni tiazhesti.

The present study inluded 22 patients presenting either with very severe or moderately severe aspirin triad 17 of whom suffered exacerbation of chronic polypous suppurative rhinosinusitis. The reference group comprised 10 patients with exacerbation of chronic polypous suppurative rhinosinusitis in the absence of concomitant bronchial asthma. The control group included 25 practically healthy subjects having neither chronic somatic diseases nor ENT organ pathology. Conventional otorhinolaryngological examination of the patients was supplemented by cytological studies of the secretion from maxillary sinuses (MS) and inranasal mucosa, measurement of viscosity and pH of MS secretion. It was shown that eosinophil count in the MS secretion was several-fold higher than that in the secretion from nasal cavity mucosa . Polypotomy in the nasal cavity was performed after the preoperative treatment of the patients using sparing procedures, such as laser irradiation and a radiofrequency loop. This approach allowed to reduce the probability of enhancement of bronchial resistance during surgery and in the immediate postoperative period; moreover, it made it possible to continue puncture therapy of patients experiencing exacerbation of the chronic inflammatory process in the maxillary sinuses.

[The potential of photodynamic therapy for the treatment of recurrent respiratory papillomatosis]. / Vozmozhnosti fotodinamicheskoi terapii v lechenii retsidiviruiushchego respiratornogo papillomatoza.

The problem of recurrent respiratory papillomatosis (RRP) thus far remains unresolved despite a large number of surgical and conservative methods proposed to address it. Photodynamic therapy is an up-to-date tool for the treatment of various neoplasms based on the interaction between the light and a photosensitizing agent (PA) that gives rise to active oxygen species and causes the death of cells. The potential of photodynamic therapy for the treatment of recurrent respiratory papillomatosis remains to be elucidated. A total of 8 seances of photodynamic therapy were undertaken at the Department of Otorhinolaryngology, I.P. Pavlov Sankt-Peterburg State Medical University, during the period between 2006 and 2010 for the treatment of patients with laryngeal and tracheal lesion, two of them under local anesthesia and the remaining ones under general narcosis. Complete and partial regression of the disease was achieved in 2 and 5 cases respectively. One patient failed to benefit from the treatment. Photodynamic therapy was well tolerated by the patients and produced good functional results; none of them developed adverse effects, there were no signs of refractoriness to the treatment.

[The use of eurespal for the treatment of chronic laryngitis].

The author provides a rationale for the use of eurespal for the treatment of chronic laryngitis based on the pathogenetic concept of pathological condition. The results of a clinical study designed to evaluate the efficiency and safety of eurespal therapy in patients with chronic laryngitis are presented.

[Efficacy of local use of recombinant interferon alpha-2 preparations in combined treatment of recurrent respiratory papillomatosis].

Clinical-immunological examination of 41 patients with recurrent respiratory papillomatosis (RRP) included determination of phenotype CD3, CD4, CD8, CD16, CD25, CD56, HLA-DR in peripheral blood by flow cytofluorimetry, the levels of IFN-gamma, TNF-alpha, GM-CSF, IL-2, IL-4, IL-5, IL-10, IL-12, IL-13 in the laryngeal secretion by multiplex immunoassay. Interferon inhalation therapy was conducted to prevent recurrence in 23 patients after surgical treatment and in 18 patients as monotherapy. The efficacy of the monotherapy was 45.5%. Treatment with IFN-alpha raised the levels of cytokines modulating an immune response by Th1-type (IFN-gamma, IL-12, IL-2) and GM-CSF, and reduced the levels of IL-4, IL-10 and IL-13. Local treatment with recombinant IFN-alpha is effective in aggressive RRP. As prognostic markers of the treatment efficacy may serve baseline high levels of TNF-alpha and IL-4/IFN-gamma index in laryngeal secretion. Treatment efficacy can be assessed by raise of IFN-gamma, IL-2 and IL-12 in combination with reduction of IL-4/IFN-gamma index.

[Choice of tools for ambulatory uvulopalatoplasty on the basis of experimental and clinical studies].

We studied interaction of a radiofrequency scalpel and a semiconductor laser with the tissue phantom. The heated part of the phantom can be easily removed and measured for size of the coagulated area. We investigated to what extent the width of the coagulation necrosis along the incision is influenced by the power and speed of each instrument used for incision. As for the laser, the width of the coagulation zone increased with rise of power and slowing of cutting velocity. For the scalpel, this relationship between incision velocity and coagulation effect was much weaker but had the same trend. We compared hemostasis efficiency during uvulopalatoplasty with both instruments. Much more potent hemostatic effect was registered in laser uvulopalatoplasty.

[Endoscopic laser surgery of laryngeal cancer]. / Endoskopicheskaia lazernaia khirurgiia zlokachestvennykh opukholei gortani.

The paper reviews the experience in application of YAG laser radiation for the treatment of early (T1 and T2) laryngeal cancer. In 1984-1999 the laser treatment was given to 248 patients with laryngeal cancer. The technique of the procedure, indications and contraindications are described. Good results in T1 and T2 were achieved while further studies are required in T3.

[Laser surgery of cicatricial laryngeal stenosis]. / Lazernaia khirurgiia rubtsovykh stenozov gortani.

The authors consider possibility of using surgical lasers for treatment of cicatricial laryngostenosis (CL); present classification of stenoses depending on the causes and location; emphasize advantages of high-energy laser vs conventional methods (reduced blood loss, no need in previous tracheotomy or laryngofissure, minimal reactive changes, rapid epithelization); describe the procedure of laser radiation and its variants depending on tumor location in the larynx.

[Comparative trial of 3-day azithromycin versus 10-day coamoxilav course efficacy in acute sinusitis]. / Sravnitel'noe issledovanie éffektivnosti lecheniia ostrogo sinusita azitromitsinom (3-dnevnyi kurs) i ko-amoksilavom (10-dnevnyi kurs).

AIM: To investigate the validity of a short-term course of azitromycin in acute sinusitis (AS). Comparison of clinical and bacteriological effects, tolerance of azitromycin and co-amoxiclav. MATERIALS AND METHODS: 50 AS patients were given a single 500 mg daily dose of axitromycin for 3 days and 50 such patients received co-amoxiclav 625 mg 3 times a day for 10 days. The examination performed before the treatment, 72 hours, 10-12 and 26-30 days after its beginning assessed the presence of fever, head ache, pain at palpation at the site of the sinuses projection, nasal breathing and discharge. X-ray examination and microbiological analysis of the puncture biopsy from the nasal sinuses were conducted before treatment and on its day 10-12. RESULTS: On the treatment hour 72 and day 10-12 azitromycin efficiency was significantly higher than that of co-amoxiclav. Recovery on the treatment day 10-12 was registered in 41(82%) and 26(52%) patients, improvement--in 6(12%) and 21(42%), no effect--in 3(6%) and 2(4%) patients, respectively, for azitromycin and co-amoxiklav. On the treatment days 26-30, 45 and 43 patients recovered, respectively. The causative agents were mainly S.aureus and Str.pyogenes. Eradication of the pathogens in response to azitromycin occurred in 29, to co-amoxiclav in 18 patients. The latter caused side effects more frequently. CONCLUSION: Azitromycin vs. co-amoxiclav provides cure in acute sinusitis for a shorter time, is better tolerated and less toxic.