[Mastoid obliteration during last 5 years]. / Mastoidoplastika: tendentsii poslednikh 5 let.

The article presents modern approaches to mastoid obliteration in cases of chronic purulent otitis media with cholesteatoma, published in peer-reviewed russian and foreign journals from 2017 to 2021. The review tells us about effect of mastoid cavity obliteration on reducing the recurrence of cholesteatoma, improving the quality of life of patients according to the results of international questionnaires and the effect of surgery on hearing in the long-term postoperative period. An analysis of the use of autologous and biocompatible materials in middle ear surgery is presented. Their safety and ease of use during surgical intervention were evaluated.

EPIDEMIOLOGIC AND DEMOGRAPHIC FEATURES OF INTRACRANIAL OTO- AND RHINOSINUSOGENIC PYOINFLAMMATORY COMPLICATIONS IN RUSSIAN FEDERATION.

An analysis of demographic and epidemiologic situation was made in cases of otogenic and rhinosinusogenic intracranial complications on the area of 32 regions of Russian Federation at the period from 2009 to 2014. The state of ENT-service of examined subject is characterized by reduction of provision of during ENT-beds and lower level of hospitalization of population over indicated period. There was revealed a reliable correlated dependence of the main medical statistical indices from the intracranial complications with climatic and demographic factors, the rate of morbidity and activities of ENT-service in the area of this region.

COOPERATIVE MANAGEMENT OF NEUROSURGEON AND OTOLARYNGOLOGIST IN TREATMENT OF CHILDREN WITH OTORHINOGENIC SUPPURATIVE-INFAMMATORY BRAIN DISEASES.

This work analyzed 47 cases of oto- and rhinosinusogenic suppurative meningoencephalitis, abscesses and empyemas of the brain in children at the age from 3 months to 17 years old. The article presents the treatment strategy, results and the volume of diagnostic measures. On the basis of this research, the authors came to conclusion, that care of the children with otogenic and rhinosinusogenic suppurative diseases of the brain required an interdisciplinary approach and effective cooperation of a neurosurgeon, otolaryngologist, pediatrician, resuscitation specialist, infectionist and a clinical pharmacologist.

[The specific clinical features of otogenic intracranial complications: the current views].

The objective of the present study was to elucidate the specific clinical features of otogenic intracranial complications (ICC) encountered in the current otorhinolaryngological practice. The work is based on the results of the retrospective analysis of 106 adult patients presenting with otogenic intracranial complications admitted for the treatment to multidisciplinary clinics of Sankt-Peterburg and Krasnoyarsk. Forty six (42.5%) patients presented with acute otitis media. 90% of them had suppurative destructive mastoiditis. In sixty (56.6%) patients, chronic suppurative otitis media (epitympanophonia) was associated with the extensive destructive process spreading toward dura mater of the medial and posterior cranial fossae and onto the sigmoid sinus. The prevalence of intracranial complications among the adult patients suffering from suppurative otitis media and treated in the otorhinolaryngological clinics amounted to 3.17%. The overall structure of otogenic intracranial complications was as follows: meningitis 42.5%, brain and cerebellum abscess 24.5%, suppurative meningoencephalitis 19.8%, sinus thrombosis 5.7%, epidural and subdural empyemas 4.7%, the combined suppurative brain lesions 2.8%. Systemic inflammatory response syndrome (sepsis) was diagnosed in 33 (31%) patients with otogenic ICC. The high intrahospital mortality rate among the patients with this condition (20.8%) is emphasized. The main causes of the fatal outcome in the patients with otogenic intracranial complications are supposed to be brain oedema with the concomitant development of dyslocation syndrome and sepsis.

[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.

[The modern epidemiological characteristics of oto- and rhinosinusogenic intracranial complications].

The objective of the present study was to survey epidemiology of oto- and rhinosinusogenic intracranial complications that are currently diagnosed at the territory of the Russian Federation. The work was based on the analysis of the official statistical reports together with the data obtained from the chief specialists responsible for the otorhinolaryngological services in 32 subjects of the Russian Federation during the period from 2009 to 2014. It was shown that the state of the otorhinolaryngological service in the period covered by the study was characterized by the reduction in the number of beds available for the patients presenting with ENT pathology by 14.0% and the lowering of the hospitalization rate for the general population by 6.3%. The frequency of oto- and rhinosinusogenic intracranial complications among the patients hospitalized to occupy the beds intended for the care of the patients suffering from ENT diseases was estimated at 0.03% and intrahospital lethality at 21.2%. The prevalence of pyogenic intracranial complications associated with the inflammatyory pathology affecting ENT was 0.61 per 100.000 population per year, with the mortality rate amounting to 0.17 fatal outcomes per 100.000 population per year. The study revealed significant correlation of the principal medico-statistical characteristics of high-frequency oscillatory ventilation (HFOV)---?? between themselves and with the parameters of ENT morbidity and activities of the otorhinolaryngological services at the territory of a given administrative territory. It is concluded that the improvement of the quality of healthcare for the population presenting with intracranial complications and inflammatory ENT diseases is possible only on the baseis of the combined and interdisciplinary approach to the solution of the problem.

[Cleft palate surgery with ENT-pathology correction].

The article presents the cases of cleft palate surgical treatment with simultaneous intervention in ENT organs (bypass of the tympanic cavity, segmental or total adenotomy, etc.) with the restoration of vomer anatomy and hard palate reconstruction by means of super-elastic low-profile nickel titanium implant. The article describes the advantages of the method in comparison with the conventional ones.

[Characteristics of cell-mediated and humoral components of the immune response in the children presenting with chronic adenoiditis].

The objective of the present study was to determine the magnitude of characteristics of immunity and estimate the immunological status of the children presenting with chronic adenoiditis (CA) at the stage of remission. The valid sample (n=158) was used to analyse the blood cellular spectrum and humoral characteristics in the children at the age from 2.5 to 10 years residing in the city of Krasnoyarsk. It was shown that the development of CA was associated with the activation of non-specific protective factors and consistent with the general physiological patterns. The total T-lymphocyte population significantly increased which excluded the T-cellular immunodepressive state. The reduction in the absolute and relative number of B-lymphocytes suggested insufficiency of the B cell-dependent component of the immune system in the children that was especially well-pronounced in the younger age group.

[Organization of remote long-term support of the patients with cochlear implants in distant regions].

The concept of remote long-term support of the patients with cochlear implants is suggested to cope with the problem of the increasingly growing number of patients with cochlear pathology. The authors deem it necessary to provide intraoperative support and postoperative follow-up technologies for the patients living far from the cochlear implantation centres. A scheme for the remote selection of patients and their intraoperative monitoring is proposed with the use of implant telemetry, electrical stapedial reflex (eSRT) testing, auditory response telemetry (ART), and surgical on-line counseling. Remote follow-up and rehabilitation should include cochlear implant tuning, speech therapy, and on-line workshops for the patients and/or specialists. The choice and the use of software and hardware for this purpose are discussed. The concept of remote long-term support turned out to be an efficacious, reliable, time-saving, and cost-effective tool for providing high-tech medical aid to patients with ENT diseases in the Krasnoyarsk kray (territory).

[The role of environmental factors in the development of pathology of the lymphadenoid pharyngeal ring in children].

The authors present the analysis of the prevalence and structure of pathology of the lymphadenoid pharyngeal ring in children living in the districts of the city of Krasnoyarsk differing in terms of atmospheric pollution. It is shown that that pharyngeal adenoid hypertrophy occurs significantly more frequently in the children from the districts exposed to an extremely high level of atmospheric pollution than in those residing under more favourable environmental conditions.

[Dynamics of immunological characteristics and investigation of apoptosis of palatal tonsillar lymphocytes in patients presenting with chronic tonsillitis and treated by conservative therapy].

The enhanced amount of viable lymphocytes and the decreased number of apoptotic cells as well as the reduced levels of IgA and IgM and the elevated concentration of sIgA in lacunar secretion are considered to be the reliable criteria for the efficacy of the conservative treatment of chronic tonsillitis. Combined therapy of this condition including irrigation of the palatal tonsillar lacunae with a miramistin solution, their contact ultrasonic treatment, and application of imudon makes it possible to maintain the optimal ratio of viable to apoptotic lymphocytes during a period of up to 6-7 months.

[Specific microendoscopic characteristics of intranasal mucosa in patients presenting with chronic rhinosinusitis and treated with sinuforte].

The objective of the present work was to assess the efficacy of the treatment of chronic rhinosinusitis (CR) in the patients treated with sinuforte using the contact microendoscpic technique. This randomized open clinical and instrumental study included 30 patients presenting with chronic rhinosinusitis. All of them were treated with sinuforte as monotherapy at a dose of 1.3 mg per procedure given once daily during 7 consecutive days. The efficacy of the treatment was evaluated by means of endoscopic and microendoscopic examination supplemented by functional tests on days 1, 2, 4, 6, and 8 after the beginning of therapy. In addition, a questionnaire study was carried out. It was demonstrated that the use of sinuforte for the treatment of the patients with chronic rhinjsinusitis is safe and efficacious as confirmed by the morphological picture revealed by contact microendoscopy.

[Use of current radiation techniques in the diagnosis and treatment of juvenile angiofibromas of the nasopharynx]. / Primenenie sovremennykh luchevykh metodov v diagnostike i lechenii iunosheskikh angiofibrom nosoglotki.

In 1992-2001 seventeen patients with juvenile nasopharyngeal angiofibromas (JNAs) were treated at Krasnoyarsk Territorial Clinical Hospital. The patients underwent a comprehensive diagnosis involving computed tomography (CT), magnetic resonance imaging (MRI), and angiography, followed by tumor vascular embolization. Later on JNAs were surgically removed in 14 patients, a course of radiation therapy was performed. In suspected JNA, the authors consider it necessary to concomitantly use CT, MRI, and angiography, which provides the most complete diagnostic picture of a pathological focus. X-ray endovascular occlusion considerably lowers blood loss, facilitates a complete angiofibroma removal, and affects the tolerability of radiation therapy in inoperable cases.