[Non-contact optical coherence tomography - an effective method for visualizing the exudate of the middle ear]. / Beskontaktnaya opticheskaya kogerentnaya tomografiya ­ effektivnyi metod vizualizatsii ekssudata srednego ukha.

INTRODUCTION: Otitis media with effusion (OME) accounts for 15-17% of the total number of recorded diseases of the middle ear. Surgical methods have become much more common. One of the factors affecting the tactics and effectiveness of treatment OME is the degree of viscosity of the effusion. Modern diagnostic methods do not allow to reliably identify cases of OME with high effusion viscosity. OBJECTIVE: To study the possibilities of optical coherence tomography (OCT) in the diagnosis of OME and a non-invasive study of effusion viscosity. MATERIAL AND METHODS: An analysis of the results of the examination of 29 patients who underwent surgical treatment for OME - tympanostomy. A control group of 30 patients without middle ear pathology. The study used a spectral OCT with a non-contact probe designed specifically for studies of the structural middle ear. Quantitative analysis of the results using open source ImageJ. Objectification of the degree of viscosity of the effusion was carried out by means of viscometry. A comparative analysis of the intensity of the optical signal in the external auditory canal (EAC) and in the tympanic cavity (TC) was performed, as well as a comparison of the signal from viscous and fluid effusion. RESULTS: In all patients with OME, during the OCT study, an optical signal with a higher intensity was recorded in TC than in the EAC. In all cases, in the control group in the TC, an optical signal was recorded that was identical in intensity with the signal in the EAC. When measuring the degree of viscosity of the effusion, 17 cases of OME were characterized as effusion of a low degree of viscosity, 12 cases - effusion of extreme viscosity. When comparing the average intensity of the optical signal of the OCT images of viscous and liquid effusion, a statistically significant difference was revealed, p<0.001. DISCUSSION: OCT makes it possible to detect light scattering from large scatterers - cell structures characteristic of low viscosity effusion. In addition, OCT allows you to register an optical signal from small scatterers - high molecular weight structures that are present in large quantities in viscous effusion. A correlation was found between the intensity of the optical signal in the TC and the degree of viscosity of the middle ear effusion. CONCLUSIONS: Based on OCT data, it is possible to determine the indications for surgical treatment of OME by detecting viscous exudate.

[Overview of modern methods for the diagnosis of exudative otitis media]. / Obzor sovremennykh metodov diagnostiki ekssudativnogo srednego otita.

Modern methods for diagnosis of exudative otitis media (EOM) have great potential, however, the problem of diagnosis of EOM is still relevant. The article describes the methods of modern diagnostics that are widely used in the daily practice of an otolaryngologist. The basic principles, advantages and disadvantages of generally accepted diagnostic methods for EOM are presented. The method of optical coherence tomography (OCT) is described as a method of studying biological tissues, which is used in many fields of medicine. Information is provided on the possibilities of OCT in the diagnosis of diseases of the ENT organs and, in particular, of the middle ear. The results of studies of the tympanic cavity structures in various inflammatory conditions, the possibilities of intrasurgery use of OCT, as well as the possibilities and perspectives of introducing OCT into the practice of an otorhinolaryngologist in the diagnosis of exudative otitis media are described.

[A case of the late complication of stapedoplasty].

The authors report a case of the late complication of stapedoplasty that developed 1.5 years after the otherwise successful surgical intervention. Computed tomography revealed the displacement of the stapedial prosthesis into the internal ear. Upon revision, the prosthesis was replaced by a shorter one. Intraoperatively, the vestibular manifestations underwent complete regression. The substantial improvement of hearing was documented in the postoperative period.

[Some aspects of intensive care for severe forms of anaerobic non-sporeforming infections of soft tissues]. / Intensivnaia terapiia tiazhelykh form anaérobnoi neklostridial'noi infektsii miagkikh tkanei.

The results of treatment (in Hospital N.N. Burdenko) of 167 patients with anaerobic nonsporeforming ("nonclostridial") infection of soft tissues (ANIST) of various location are presented. Principal errors of intensive care in this category of patients, substantial difference in the course of infectious process in patients with ANIST depending the diseased area are shown. Programs of treatment for the patients with limited (up to 1600 cm2) and extended (over 1600 cm2) forms of ANIST are proposed. The effectiveness of such components of intensive care as ozonotherapy, correction of metabolic disturbances, HBO has been studied. Practical application of these programs allowed active influence on intoxication syndrome in ANIST which resulted in a decrease of lethality up to 10.2%.

[Modern aspects of wound sepsis in war surgical trauma]. / Sovremennye aspekty ranevogo sepsisa pri boevoi khirurgicheskoi travme.

The results of the treatment of 1020 wounded with symptoms of wound infection have been studied. The wounded were admitted with developed complications from the hospitals in Afghanistan. The syndrome of systemic inflammatory reaction detected in 239 (23.4%) wounded was the indication for application of the whole complex of antiseptic treatment. Sepsis in patients with complicated gunshot wounds was revealed only in 54 wounded, i.e. in 5.4%. Early diagnosis and multicomponent therapy resulted in a decrease of mortality rate in wound sepsis up to 9.3%.