[A case of the fracture of the temporal bone pyramid resulting in the fatal outcome]. / Nabliudenie pereloma piramidki visochnoi kosti, privedshego k letal'nomu iskhodu.

The authors report a clinical case of the fracture of the base of the skull with the concomitant damage to the sigmoid sinus, jugular vein, and internal carotid artery in the temporal bone pyramid. The injury was associated with massive bleeding from the external acoustic canal that resulted in the death of the patient.

URGENT X-RAY DIAGNOSTICS OF INTRACRANIAL PYOINFLAMMATORY OTORHINOSINUSOGENIC COMPLICATIONS.

An analysis of the results of X-ray CT and MR-imaging was made in 46 patients aged from 13 to 78 years old. The patients were admitted to multifield hospitals in Kursk at the period from 2005 to 2015. The research included the nasal cavity, paranasal sinuses, mastoid and pyramid of the temporal bones and the brain. The study could be repeated with bolus contrast medium infusion. The condition of the patients was evaluated in dynamics at intervals of 5-7 days and these data was associated with clinical picture. The authors presents a complex of symptoms and an algorithm of differentiated X-ray diagnostics of diseases of the ENT organs and the main nosological forms of pyoinflammatory diseases of arachnoid membrane and substances of the brain.

[FEATURES OF OTOGENIC INTRACRANIAL COMPLICATIONS AT THE PRESENT STAGE].

A retrospective analysis of treatment was made in 127 adult patients with acute and chronic otitis media complicated by suppurative-inflammatory pathology of the brain. Purulent meningitis was revealed in 52 (40.9%) of hospitalized patients. Meningoencephalitis was often diagnosed in the cases of acute otitis media (15.4%) and in cases of chronic otitis (22.7%). The otogenic brain abscess was detected in 13.5% of otitis media cases and it was noted to be twice frequent (33.3%) in cases of purulent otitis media. The patients 124 (97.6%) have been operated. An extended mastoidotomy and antromastoidotomy were performed in the acute purulent otitis media. An extended radical operation on the ear was applied in case of chronic otitis media. Performance of craniotomy and complete removal of the abscess using modern systems of neuronavigation showed a higher clinical efficacy as compared with transtemporal approach during sanitizing intervention on the ear including the opening and abscess drainage in surgery of otogenic abscesses of the brain.

[Variants of the anatomical structure of frontal sinuses based on the results of X-ray computed tomography].

The objective of the present work was to analyse computed tomograms of brain and paranasal sinuses obtained from 3,054 patients with a view to elucidating specific features of the latter's structure. The following structural variants were distinguished: agenesia, hypogenesia, and hypergenesia. Orbital, zygomatic, temporal, cock's comb, ethmoidal, and nasal recesses in the frontal sinuses were described. It is concluded that the marked structural variability of frontal sinuses is responsible for the great variety of clinical manifestations of frontitis.

[Clinical and roentgenological manifestations of the silent sinus syndrome].

Analysis of the results of the examination and treatment of four patients presenting with the silent sinus syndrome provided materials for the generalized characteristic of clinical and roentgenological manifestations of this condition.

[Water-soluble contrast media with increased viscosity for the diagnosis of diseases of the paranasal sinuses, bronchi and esophagus]. / Vodorastvorimye kontrastnye sredstva povyshennoi viazkosti dlia diagnostiki zabolevanii okolonosovykh pazukh, bronkhov i pishchevoda.

Water-soluble contrast agents with one of the polymers, cellulose derivatives or polyvinyl alcohol, were used in contrast examinations of paranasal sinuses, bronchi, and esophagus. Experiments have demonstrated the advantages of contrast agents basing on polymers as against the traditional oil-containing agents. Method for double-contrast examination of maxillary and frontal sinuses has been developed. Lowered concentrations of water-soluble contrast agents (i. e. diluted with distilled water) are recommended to be used, this permitting to save the reagents. A table of recommended dilutions of contrast media is presented. A total of 245 patients were examined, making use of contrast media of high viscosity.