[Exudative otitis media. Modern concepts and the importance of the problem].

The objective of the present work was to analyse current concepts of etiology, pathogenesis, and classification of exudative otitis medium (EOM) in conjunction with the methods for the treatment of this pathology. Views of the problem expressed by different authors (both Russian-speaking and foreign) are discussed. Complications of the disease developing as a result of the untimely or inadequate treatment are described.

[Epidemiological characteristic of the patients presenting with cochleovestibular disorders associated with labyrinthine hydrops]. / Épidemiologicheskaia kharakteristika bol'nykh, stradaiushchikh kokhleovestibuliarnymi narusheniiami pri gidropse labirinta.

A total of 1,067 patients complaining of hearing impairment, dizziness, and tympanophony were admitted for the treatment to the Surdological Department of N.I. Pirogov City Clinical Hospital No 1 during the period from 2000 to 2010. As many as 326 (30.5%) patients were preliminarily diagnosed with Meniere's disease based on their medical histories, clinical condition, and the results of questionnaire studies. All of them were subjected to comprehensive audiologic and vestibulogic examination with the use of up-to-date techniques. The data thus obtained allowed to reveal labyrinthine hydrops in 275 (84%) patients. It is concluded that 101 (9.5%) patients presenting with the typical symptoms of Meniere's disease had labyrinthine hydrops.

[The application of supravascular laser irradiation of blood for the treatment of cochleovestibular disorders].

A total of 165 patients presenting with neurosensory impairement of hearing and Meniere's disease were treated by supravascular (extracorporeal) laser irradiation of blood. The study undertaken to evaluate the efficacy of this treatment confirmed its beneficial effect in patients with acute hearing disorders. It was equally effective as regards elimination of labyrinthine hydropsis in patients presenting with Meniere's disease. The method proved less efficacious for the management of long-standing hearing impairement and chronic loss of hearing, but it can be used to prevent the development of these conditions.

[The importance of psychic personality traits and emotional state for diagnostics and treatment of the patient].

It is very important for a physician to be aware not only of objective changes in the somatic status of the patient but also of his or her subjective emotional experience in connection with a given pathology. In everyday life and work, we frequently encounter people differing in psychic traits and emotional status. In the present paper, we describe certain personality types, their characteristic features and types of behaviour in response to the developing pathology. The most common reaction is the feeling of apprehension. Recommendations are proposed on the application of the methods for reducing manifestations of apprehension with the use of psychotherapeutic modalities and pharmaceuticals.

[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).

[Assessment of functioning of the internal ear in patients with labyrinthine hydrops and in normal subjects by means of phase audiometry].

A method for the diagnosis of labyrinthine hydrops is proposed that takes advantage of specific physiological features of internal ear functioning. Namely, the basal membrane of the inner ear exposed to a low-frequency tone undergoes synchronous sinusoidal oscillations along its entire length; simultaneously, sensitivity of the organ of Corti changes periodically. Under normal conditions, perception of 1,000 Hz tonal signals at the background of a low-frequency masker varied substantially depending on the phase during which the signal came. In the maximum discharging phase that corresponded to a 270 degree deviation of the basal membrane from its initial position, it was maximally displaced towards the vestibule staircase, and perception of the test tone was most affected. Patients with hydrops of the internal ear exhibited phase-independent constant perception of high-frequency tonal signals against the background test tone. It is concluded that the method of phase audiometry can be used in large research centres for the comprehensive evaluation of cochlear-vestibular function during hydrops formation.

[Psychosomatic status of patients with cochleovestibular disorders. Correction methods].

Psychosomatic status was studied in 106 patients aged 18-65 years with acute and chronic cochleovestibular disorders. Hearing problems, noise in the ears and vestibular disorders have a negative psychogenic effect in patients with cochleovestibulopathy. The majority of the patients need psychological and psychopharmacological care to relieve anxiety and form adequate attitude to the disease. Correction of psychosomatic disorders raises efficacy of the treatment of cochleovestibular diseases.

[Erespal effectiveness in exudative otitis media]. / Effektivnost' érespala pri ékssudativnom srednem otite.

Standard conservative treatment of exudative otitis media (EOM) was performed in 82 patients, but 44 of them received adjuvant fenspiride (erespal) in a dose 80 mg per os 3 times a day for 10 days. Dynamic pure tone audiometry, tympanometry and subjective response demonstrated higher treatment efficiency in the erespal group. Therefore, it is recommended to include erespal in combined conventional therapy of EOM.