[Mastoid osteoma]. / Osteoma sostsevidnogo otrostka.

Osteomas of the temporal bone are rare, especially osteomas originating from the mastoid process. Most often occur in women aged 20-30 years. The maximum growth rate is observed during puberty. Usually, the neoplasm becomes an accidental finding on X-rays or CT scans. The clinic of osteoma depends on its location and size. The patient may complain of a cosmetic defect, headache, discomfort and a feeling of heaviness in the area of the neoplasm. In this clinical case, a long-term asymptomatic course of osteoma of the temporal bone is described. CT examination was used for its visualization, and treatment was carried out surgically using a drill.

[Application of allogenous dural membrane (brefotissue DM) in surgical treatment of retraction pockets of the tympanic membrane]. / Primenenie allogennoi tverdoi mozgovoi obolochki (brefotkan' tverdoi mozgovoi obolochki) pri khirurgicheskom lechenii retraktsionnykh karmanov barabannoi pereponki.

INTRODUCTION: The tactics of treating patients with retraction pockets of the tympanic membrane is still debatable. When choosing surgical treatment, preference is given to the removal of the retraction pocket with simultaneous reconstruction of the posterior-upper wall of the external auditory canal (retraction area) with a cartilage or fascial flap, autologous bone, or a combination of the above tissues. Considering the well-known negative aspects of the use of all the mentioned grafts, there is a need to find new types of tissues to strengthen the retraction pocket. For example, dura mater brefotissue has good plastic properties, resistance to infection, is easy to prepare, store, and is cheaper than many allografts. AIM: Evaluation of the possibility of using dura mater brefotissue in the surgical treatment of patients with retraction pockets of the tympanic membrane. MATERIALS AND METHODS: The study included 52 patients who underwent surgery to eliminate the retraction pocket. All of them were divided into 2 groups. In the first - the main (n=25) cartilage of the auricle was used to seal the relaxed part of the tympanic membrane, in the second - the control (n=27) applied tissue of the dura mater. After 1, 3, 6 and 12 months, to assess the result of the intervention, all patients underwent otomicroscopy, audiometry with the calculation of the average sound conduction index for speech frequencies. RESEARCH RESULTS: Fewer cases (4 patients out of 27) had difficulty in graft placement with the use of dura mater compared to the group where cartilage was used (9 patients out of 25). The average duration of graft placement was 8±0.5 minutes in the control group and 2±0.3 minutes in the main group. A stable morphological result was obtained in the group with the use of brefotissue in 26 patients (96%) and only in 20 patients (80%) with the use of cartilage. It is important to note that in the group with the use of brefotissue, in the early postoperative period, there was an increase in the air-bone interval, and 1 month after the operation, the average values increased by 10±0.5 dB. 12 months after the operation, the above parameters returned to preoperative. CONCLUSION: The conducted study indicates that the dura mater brefotissue, having sufficient strength, the convenience of forming a given shape and placing it in the desired position, can be successfully used in the surgical treatment of patients with retraction pockets of the tympanic membrane.

[The influence of signs of dysmorphophobia on the evaluation of the result of rhinoplasty]. / Vliyanie priznakov dismorfofobii na otsenku rezul'tata rinoplastiki.

The object of the clinical research was 367 patients after rhinoplasty. All patients before the operation fill in a special questionnaire, allowing to evaluate quantify the signs of dysmorphophobia. Patients with low index of dysmorphophobia (within 5-6 points) adequately estimated the result of the operation because their opinion coincided with the opinion of the doctor and in some cases they didn't notice even insignificant defects the doctor saw. The total number of these results satisfying the patient and the doctor composed 93% (341 patients). The patients who attaches great importance to insignificant defect of their appearance the index of desmorphophobia was high (16 patients - the average index of dysmorphophobia - 15). Questionnaires containing questions that allows to expose the signs of dysmorphophobia may be useful in the time of selection of patients for plastic surgery, in particular rhinoplasty. According to the questionnaire worked out by us, the index of dysmorphophobia of 5 points and below allows to count up on an adequate evaluation. The importance of index from 6 to 10 points may require psychological support of the patient who will much evaluate the result.

[The use of retinoids to stimulate the regenerative process in trepanation cavity after "open" sanitizing surgery on the middle ear]. / Primenenie retinoidov dlya stimulyatsii regenerativnogo protsessa v trepanatsionnoi polosti posle «otkrytoi¼ saniruyushchei operatsii na srednem ukhe.

INTRODUCTION: One of the methods of surgical treatment of patients with chronic purulent otitis media is an "open" sanitizing surgery on the middle ear. One of its important features is the formation of a wound surface that communicates with the external environment, which subsequently leads to infection, lengthening the time for epithelization, and in 13-30% of cases, the latter is incomplete with the development of a "trepanation cavity disease". OBJECTIVE: To establish the nature of the effect of retinoid-based drugs on the severity of the inflammatory process and the regeneration processes in the tissues of the trepanation cavity after sanitizing operations on the middle ear. MATERIAL AND METHODS: The subjects of the study were 78 patients who underwent the first "open" sanitizing operation on the middle ear. At the final stage, turunda with a 1% dioxin solution in combination with a sterile ointment of 13-cis-retinoic acid, concentration 0.05% was injected into the postsurgery cavity. 30 patients additionally took 13-cis-retinoic acid in tablet form. In the control group, retinoids were not used. CONCLUSION: The obtained data allow us to recommend the use of retinoid-based drugs as a means of suppressing the inflammatory reaction and stimulating the regeneration process in the trepanation cavity after an "open" sanitizing surgery on the middle ear.

[Application of bone-plastic materials for mastoidoplasty]. / Primenenie kostno-plasticheskikh materialov dlia mastoidoplastiki.

The aim of this study is comparative assessment of of different bone-plastic materials for mastoidoplasty. The study included 30 patients who underwent 'canal wall down' mastoid surgery with mastoidoplasty. The following criteria were used for comparing: 1) simplicity of modeling of the material 2) the wound healing process 3) osteointegration - the process of formation of 'new bone' tissue (CT of temporal bones 6 and 12 months after oreretion). It was confirmed that the main groups of bone-plastic material (bioglass, composite materials and ß-tricalcium phosphate) is suitable for mastoidoplasty after 'canal wall down' mastoid surgery.

[The influence of biological compatibility of the cyanoacrylate glue on regeneration of the cartilaginous tissue]. / Vliianie biosovmestimogo kleia na osnove tsianakrilata na regeneratsiiu khriashchevoi tkani.

The objective of the present study was to evaluate the possibility of the application of the cyanoacrylate-based glue for the strengthening of the reconstructed elements of the middle ear and its influence on the regeneration of the cartilaginous tissue. We used the cartilaginous tissue from the auricles of the male California rabbits as a model. The cartilage was destroyed in a standard press. Half of the cartilage thus fragmented was implanted into the left auricle. The remaining part was mixed up with the cyanoacrylate glue and implanted into the right auricle of the same animal. The implanted material was used for the morphological study on day 10, within 1 and 2 months after the beginning of the experiment. The results of the study confirm the absence of the toxic action of the biologically compatible cyanoacrylate-based glue on the regeneration of the cartilaginous and connective tissues which suggests the possibility of its application for the surgical treatment of the diseases of the middle ear.

[The influence of retinoids on the regeneration of an open osteal wound]. / Vliianie retinoidov na regeneratsiiu otkrytoi kostnoi rany.

The objective of the present study was to elucidate the influence of retinoid-based pharmaceutical products on the process of regeneration of the tissues surrounding an open osteal wound under the experimental conditions. The experiments were carried out using 20 'Sovetskaya shinshilla' rabbits (12 males and 8 females). The animals with the modelled open osteal wound underwent daily treatment by the placement of the dressings impregnated with a mixture of dioxo-methyltetrahydropyrimidine and chloramphenicol ointments supplemented by 0.05% retinoic acid (1:1:1). The rabbits of the control group were treated using the dressings impregnated only with a mixture of dioxo-methyltetrahydropyrimidine and chloramphenicol ointments containing no retinoic acid. The study has demonstrated that the application of the retinoid-based medications for the treatment of the open osteal wound resulted in the well apparent positive dynamics of the wound process in comparison with that in the control animals. It is concluded that the data obtained give evidence that retinoid-based preparations can be used as an adjuvant treatment for the acceleration and promotion of the wound healing process in the trepanation cavity following sanation surgery on the middle ear.

[The application of the biologically compatible cyanacrylate-based glue for ossiculoplasty in the patients presenting with chronic otitis media]. / Primenenie biosovmestimogo kleya na osnove tsianakrilata pri ossikuloplastike u bol'nykh khronicheskim gnoinym srednim otitom.

The objective of the study was to improve the functional outcomes of the treatment in the patients presenting with chronic otitis media by means of the combined application of platelet-enriched plasma and the biologically compatible cyanacrylate-based glue for the fixation of the reconstructed auditory ossicular chain. The functional results of the surgery were evaluated within 1, 3, and12 months after the intervention making use of tonal threshold audiometry. It was shown that the use of the platelet-enriched plasma with its subsequent fixation by the biologically compatible cyanacrylate-based glue enhances stability of the implanted prosthetic elements, reduces the risk of their displacement during the postoperative period due to the formation of the cicatrical tissue between the structural components of the middle ear. This approach improves the functional result of the described treatment and decreases the frequency of relapses associated with poor stability of the reconstructed sound-conducting system.

[An experimental study of the coagulating properties of a laser beam applied to fix titanium prostheses of auditory ossicles with the use of platelet-rich plasma].

The displacement of prostheses of auditory ossicles at the concluding stage of surgery and in the early postoperative period is one of the factors influencing the functional outcome of stapedoplasty. The objective of the present experimental study was to estimate the effectiveness of the use of platelet-rich plasma as an alloy for the laser welding in order to improve fixation of titanium prostheses employed in ossiculoplastic surgery. The results of a series of experiments undertaken to assess the possibility of stabilization of titanium prostheses in the desired position with the help of laser welding indicate that this technique with the use of platelet-rich plasma as an alloy may be a reliable method for the fixation of the reconstructed chain of ossicles in the desired position.

[Analgesic effect of TES therapy in the early postoperative period in patients who underwent tonsillectomy].

The objective of the present work was to study peculiarities of the analgesic action of therapeutic electrical stimulation (TES therapy) in the early postoperative period in the patients who underwent tonsillectomy. A total of 60 patients admitted for this surgery to the specialized otorhinolaryngological department were available for observation. They were divided into two groups depending on the pain relief strategy. The patients of the study group (n=30) underwent courses of transcranial electrical stimulation on a daily basis (from the onset of hospitalization) in addition to the administration of a standard analgetic. The standard dose of tramadol (2.0 ml) was given to the patients of the control group (n=30) who complained of strong pain. The results of the objective and subjective estimations indicate that the degree of pharyngeal pain in the patients treated with TES therapy and the standard analgetic was significantly different. The patients receiving TES therapy could sooner resume their habitual diet and required smaller amounts of the analgetic which makes this modality a cost-effective supplement to the standard postoperative treatment.

[The treatment of the patients presenting with chronic inflammation of the trepanation cavity with a preparation containing silver nanoparticles following sanitation surgery of the open type].

The objective of the present study was to estimate the efficacy of argovit used for the treatment of relapses of chronic suppurative otitis medium (CSOM) developing in the patients who underwent the sanitation surgical procedure. The study carried out between January 2011 and November 2011 included 35 patients aged from 12 to 69 years presenting with CSOM after surgical intervention on the tympanic cavity of the middle ear. The treatment resulted in the rapid elimination of clinical symptoms and positive dynamics of the objective signs of the disease, such as reduction or termination of pathological exudation and stimulation of the epidermization processes. The majority of the treated patients had stable remission within 6 months after the termination of the treatment.

[A new method for the fixation of sound-conducting elements of the middle ear during ossiculoplasty].

The objective of the present work was to estimate the possibilities of the application of platelet-enriched plasma as a filtering material for ossiculoplasty. The results of surgical interventions on 120 patients presenting with chronic suppurative otitis media are reported. All the patients underwent closed-type sanation surgery (differential atticoanthrotomy) including either complete or partial restoration of the sound conduction mechanism in the middle ear. Platelet-enriched plasma was applied into the tympanic cavity of 55 patients as a fixing material for the reconstruction of the chain of the auditory ossicles. Ossiculoplasty without additional fixation was performed in 65 patients comprising the control group. The results of the study indicate that a clot of platelet-enriched plasma may be a good fixing material for the reconstruction of the entire chain of auditory ossicles and can be used for all types of ossiculopasty.

[Symptoms and signs of maxillary cysts].

The objective of the present investigation was to reveal clinical symptoms significantly associated with the cysts in the maxillary sinuses (MS). The study included 67 consecutive patients with the roentgenologically confirmed diagnosis of maxillary cysts in the absence of concomitant pathological changes in the nasal cavity and paranasal sinuses. Each patient was interviewed twice: first time before surgery when they were asked to fill a questionnaire and specify the disturbing symptoms, the second time postoperatively, i.e. during the follow-up examination within 4-6 months after the treatment. The statistical analysis demonstrated that MS cysts may be a cause of such symptoms as headache in the frontal region, feeling of pressure in the affected sinus, mucous rhinorrhoea, nasal obstruction, and probably coughing in the morning hours as a manifestation of postnasal drip syndrome.

[Morphological and functional changes in the tympanic cavity after its filling with platelet-enriched plasma (an experimental study)]. / Morfologicheskie i funktsional'nye izmeneniia v barabannoi polosti posle zapolneniia ee obogashchennoi trombotsitami plazmoi (éksperimental'noe issledovanie).

This experimental study had the objective to estimate the functional state of the sound-conducting system of the middle ear and morphological changes in the tympanic cavity after its filling with platelet-enriched plasma (PEP) obtained by one-step centrifugation of the whole venous blood. The experiments were made on 6 pigs of the Large White breed. Tympanotomy performed under general anesthesia was followed by the introduction of a clot of platelet-enriched plasma into the tympanic cavity. The results of the study indicate that the ventilation function of the pharyngotympanic tube was fully preserved. The PEP clot was completely eliminated from the tympanic cavity within the first month after filling. Neither scars nor adhesions were recorded after the treatment with PEP. The study confirms the beneficial effect of using PEP for the support of the sound-conducting structures of the middle ear and stimulation of the regeneration processes after tympanoplasty.

[Application of platelet-enriched plasma for the prevention of cochleovestibular disorders associated with piston stapedoplasty].

The present study was designed to evaluate the influence of sealing the labyrinthine vestibule with platelet-enriched plasma (PEP) on the development of cochleovestibular complications following piston stapedoplasty. The platelet-rich plasma was prepared by single-step centrifugation of the whole venous blood. Analysis of the data obtained showed that the use of PEP for sealing the periprosthetic space after stapedoplasty reduces the risk of development of sensorineural hearing impairment compared with the application of fatty tissue for the same purpose or a freely positioned prosthesis. Moreover, the use of PEP decreases the probability of the development of tympanophonia and its intensity after piston stapedoplasty.

[Evaluation of clinical efficiency of viferon gel for the treatment of acute rhinopharyngitis].

Because numerous studies have demonstrated that the majority of acute inflammatory diseases of the upper respiratory tract are associated with viral infection, interferon-based medicines are being extensively developed for non-specific therapy and prevention of acute respiratory viral infections (ARVI). The objective of the present study was to evaluate the efficiency of local application of viferon gel for the treatment of acute rhinopharyngitis from the results of examination and treatment of a group of outpatients with this pathology (n = 90). Viferon gel was introduced into each half of the nose at a dose of 0.5 ml 4-5 times daily. It was shown that timely prescription of this preparation accelerates the achievement of positive results of AVRI therapy and thereby reduces duration of the disease and prevents the development of bacterial complications in the upper respiratory tract.

[Advantages and disadvantages of the application of endoscopic techniques at different stages of tympanoplasty].

The objective of this work was to evaluate advantages and disadvantages of selected tympanoplastic stages under the endoscopic control during the surgical treatment of 93 patients presenting with chronic otitis media. The endoscopic techniques has indisputable advantages over traditional surgical microscopy when applied to elucidate the character and extent of the pathological process in the middle ear. This method allows to reveal granulation and cholesteatoma in difficult of access pockets and folds of the middle ear without enlargement of the extent of surgical intervention, to evaluate the "continuity" of the chain of auditory ossicles, etc. At the same time the use of an endoscope during performance of the majority of tympanoplastic procedures creates some difficulties related to the necessity of regular cleaning of the instrument and the impossibility of application of the bimanual technique.

[Usage of platelet-enriched plasma as hemostatic and analgenic medication in tonsillectomy].

The rate of posttonsillectomy hemorrhage, pain severity were assessed in the study group (80 tonsillar niches) and in the control group (110 tonsillar niches). Treatment of postoperative tonsillar niches with platelet-enriched plasma (PEP) was performed in the study group and was not performed in the controls. No hemorrhage was registered in the study group and 9 cases of hemorrhage occurred in the control group. Swallowing test and analysis of the visual-analogue scales demonstrated that pain after tonsillectomy was less severe after local use of PEP. Thus, usage of PEP in the region of the postoperative wound is effective in prevention of hemorrhage and pharyngeal pain attenuation after tonsillectomy.

[Effects of middle-ear surgical interventions of different types on peripheral audio reproduction part of the acoustic analyzer in patients with otitis media purulenta chronica].

Different operations on the middle ear were performed in 86 patients with otitis media purulenta chronica (OMPC). Mean bone hearing thresholds in the high-pitched area (10,000-16,000 Hz) were determined and suprathreshold tests were made in 86 patients on day 10 and 6 months after surgery. Minimal changes seen only in early postoperative period occurred in canal wall up operations with tympanoplasty of type I-II. Canal wall down type of surgery had a negative effect on the function of the cochlear receptor system in the early postoperative period. All "open" types of ear surgery, even with tympanoplasty, provoked hearing deterioration with maximum elevation of the hearing thresholds in the high-pitched area (10,000-16,000 Hz). Middle ear surgery without forming a new tympanic cavity results in progressive deterioration of the peripheral part of the hearing receptor system.