[Our experience with the application of collagen-based preparations in reconstructive surgery of the middle ear].

This paper summarizes our experience with the application of collagen-based preparations for reconstructive surgery of the middle ear. The best morphological results (88.46%) were obtained by the closure of extensive defects with the Oblecolum membrane as a temporary supporting structure and the outer atraumatic dressing for the tympanic transplant (in 30 patients) or by the use of the compact-porous explants from the "Sanguicol" preparation as an overlay on the transplant (in 22 patients). Twenty seven patients presenting with the so-called "operated ear disease" underwent mastoidoplasty with the use of the compact-porous preparation "Stimul-oss" as a supporting structure to induce the ingrowth of the bone tissue and the subsequent substitution of the defect. This treatment ensured the reduction of the volume of the bony trepanation cavity. In addition, we have obtained preliminary encouraging results of the application of collagene preparations for the surgical intervention on the stirrup in the patients suffering otosclerosis.

[Experience with the use of surgical lasers for the treatment of patients with upper respiratory tract and ear diseases].

The objective of this study was to analyse the efficiency and safety of the use of a holmium- YAG laser (wave length 2.09 mcm) and an erbium-activated glass-based fiber laser scalpel (wave length 1.56 mcm) in ENT-surgery. Priority methods for the surgical intervention in the nasal cavity, paranasal sinuses, and middle ear were developed to treat patients with distorted nasal septa, vasomotor rhinitis, polypous rhinosinusitis, Eustachian tube dysfunction, and various forms of chronic suppurative otitis media. Long-term observations demonstrated fairly good stability of beneficial outcomes of the treatment with the above methods in the majority of the patients. It is concluded that surgical technologies with the use of modern medical lasers provide extensive possibilities for a great variety of interventions in patients with upper respiratory tract and ear diseases.

[Vestibular disorders in patients with otosclerosis: prevalence, diagnostic and therapeutic options].

A total of 177 patients with otosclerosis were selected for this study. Vestibular disorders were diagnosed in 40 (22.6%) of them. The patients were allocated to 2 groups comprising 11 and 18 subjects respectively. Patients of group 1 were given surgical treatment during the current hospitalization. Patients of group 2 were treated by conservative therapy following stapedoplasty performed 1 year or more earlier. The study included analysis of vestibular symptoms and evaluation of clinical effectiveness of the combined treatment in the form of therapy with betahistine dihydrochloride (betaserk) during 2 months and a course of 10-12 sessions of game exercises at a stabilographic complex. The patients of both groups enjoyed reduced severity of subjective and objective vestibular symptoms and statistically significant improvement of the equilibrium function assessed from statokinesigrams. It is concluded that combined vestibuloadaptive therapy is an effective method of preparation for stapedoplasty and correction of postoperative complications.

[Holmium laser in chondrology: potentials and prospects]. / Vozmozhnosti i perspektivy primeneniia gol'mievogo lazera v khondrologii.

To study the mechanism of simulation of a cartilage, to define the optimum parameters and laser radiation regimens, the authors made a complex of in vitro experiments on the cartilages of the nasal septum in man and domestic animals and in vivo experiments on those of the concha in rabbits and pigs. Holmium laser radiation is shown to be the most suitable tool for formation of a cartilage. Evidence is provided for the possibility of irreversibly altering the shape of a cartilage during laser radiation. A procedure has been developed for non-invasive correction of the septum of the nose for its curvature. Restored or improved nasal respiration was observed in more than two thirds of the patients. Laser surgery is not of age-limited application, it is noninvasive, can be performed in the outpatient settings and requires no drug treatment in the postoperative treatment.

[Clinical efficacy of cefixime (results of multicenter trials)]. / Klinicheskaia éffektivnost' tsefiksima (rezultaty mul'titsentrovykh ispytanii.

Multicentre trials of cefixime (Cefspan, Fujisawa Pharmaceutical Co., Ltd., Japan) were performed in 1992. The trials involved 137 children and 269 adult patients with inflammatory infections of the respiratory organs and urinary tracts and otorhinolaryngologic affections. Positive clinical and bacteriological results of the trials were stated in 76-90 per cent of the cases. The adverse reactions such as skin eruption and dyspepsia were rare and did not require the specific treatment.

[Cochlear implantation with implant Combi 40+ produced by MED-El]. / Opyt operatsii kokhlearnoi implantatsii s implantom Combi 40+ firmy "MED-El".

The paper reports three cases of cochlear implantation using implant Combi 40+ produced by Med-El (Austria). Short-term postoperative testing results demonstrate an appreciable progress in hearing. Changes in speech discrimination and speech production are evaluated.

[Approaches to surgical treatment of snoring and sleep apnea]. / Varianty khirurgicheskogo lecheniia bol'nykh s khrapom i sindromom sonnogo apnoé.

Examination and treatment data on 186 patients suffering from snoring and sleep apnea and surgical methods to manage these pathological conditions are reviewed. The stages of the surgical treatment of snoring and sleep apnea are the following: correction of nasal breathing, surgical intervention on the palatine using different tools (laser, scalpel, loop, electric knife). Effectiveness of the treatment methods, complications, postoperative developments are compared.

[Finger test as a prognostic criterion in the assessment of the effectiveness of treatment of patients with tinnitus]. / Pal'tse-pal'tsevoi test kak prognosticheskii kriterii éffektivnosti lecheniia bol'nykh s ushnym shumom.

ENT specialists of the Moscow Sechenov Medical University have developed and tried a variant of the pointed test permitting prognostication of the results which could be obtained at treatment of patients with noise in the ears of different etiology. The test was performed in 263 patients with neurosensory, mixed-type and conductive hypoacusis. High informative potential, convenience in performance for physician and the patient who can be taught to conduct in independently make the test valuable in practical otorhinolaryngology.

[Objective assessment of the olfactory analyzer function based on recording of olfacto-vegetative and olfacto-vestibular reactions]. / Ob"ektivnaia otsenka funktsii oboniatel'nogo analizatora na osnove registratsii ol'fakto-vegetativnykh i ol'fakto-vestibuliarnykh reaktsii.

To register objectively olfactory defects and to assess them qualitatively and quantitatively, the authors propose to use olfactometric techniques reflecting olfactovegetative and olfactovestibular manifestations. Automatic pupillographic complex APK-OI provides speed, time and amplitude parameters of the pupillary and nyctating reflexes. 600 pupillograms and records of the nictation reflex proved high diagnostic significance of these methods. 104 stabilographic examinations (ST-02 unit) illustrated the changes in 12 vestibular parameters prior to and after olfactory impact. The results give grounds for application of olfactovestibular reactions registration as an objective olfactometric test.

[Use of gaseous ozone and ozonized solutions in the treatment of chronic suppurative otitis media]. / Primenenie gazoobraznogo ozona i ozonirovannykh rastvorov pri lechenii khronicheskikh gnoinykh srednikh otitov.

Ozone as gas and ozonized solutions were employed as treatment modalities in 28 patients with acute and chronic inflammatory diseases of the middle ear. Basing on otoscopy, bacteriological tests of the discharge from the middle ear cavity, number of washings before disappearance of the purulent discharge the conclusion was made that cure of patients on ozone therapy occurs 3-5 days earlier than in ozone-untreated patients. Ozone therapy is a beneficial adjuvant in combined treatment of otitis media.

[The role of pathology of the ORL organs in the etiology of facial pain]. / Rol' patologii LOR-organov v étiologii litsevykh bolei.

An ENT practitioner often deals with facial pain. This problem has been widely discussed in the literature but the major issues of its etiology, pathogenesis and clinical development still remain unclear. Facial pain of different localization may be caused by ear, nose or throat inflammation, tumors, anatomic deviations of ENT organs, their traumatic lesions or surgical interventions or may be of psychogenic origin. Acute and chronic inflammatory diseases of ENT organs in patients suffering from prosopalgias suggest that they may be associated with ENT pathologies. However, the relationship between ENT pathologies and prosopalgias have been inadequately investigated by both otorhinolaryngology and neurology, clinical observations have not been properly reviewed, and reliable conclusions have not been made. There are essentially no publications discussing the question as to the cases in which ENT pathologies do or do not cause prosopalgias. Study of prosopalgias and identification of the role of ENT pathologies in their genesis are very important. For all practical purposes it seems necessary to invite an ENT doctor to participate in the diagnosis and treatment of prosopalgias.

[Possibilities of computerized tomography in destructive bone changes in patients with polypous rhinosinusopathy]. / Vozmozhnosti komp'iuternoi tomografii pri kostnykh destruktivnykh izmeneniiakh u bol'nykh polipoznoi rinosinusopatiei.

The authors made a CT investigation of 15 patients (11 men and 4 women) suffering from polypous rhinosinusopathy. Thirteen patients prior to it underwent polypectomy of the nose. Ophthalmocele was observed in 7 patients. The results of CT investigation made it possible to define the spreading of the destructive process in the accessory nasal sinuses in its polypous lesion and reject a tumor process.

[Possibilities of helium-neon lasers in olfactory disorders]. / Vozmozhnosti gelii-neonogo lazera pri narushenii obonianiia.

310 patients with olfactory analyzer dysfunction have been examined. Of them 40 patients received laser radiation on the olfactory zone. The course comprised 10 sessions. A response occurred in 26 patients who exhibited neither side effects nor allergy. The conclusion is made on validity of using helium-neon laser in perspective olfactory defects.

[Role of computerized tomography in the diagnosis of osteomas of the sphenoid sinus with intracranial extension]. / Rol' komp'iuternoi tomografii v diagnostike osteom klinovidnykh pazukh v vnutricherepnym rasprostraneniem.

The paper reports two rare cases of sphenoidal osteoma which occur statistically in 1.9% of sphenoidal osteomas. Two women underwent computed tomography because of complaints of progressive headaches. The patients had recurrent unilateral exudative otitis media. CT localized the tumor spread into the cerebral cranium and promoted further treatment design. The authors state that indications to CT diagnosis in patients with headaches should be increased. It is also suggested to make CT-diagnosis more frequently in cases of recurrent unilateral exudative otitis.

[Total sequestration of the labyrinth]. / Total'naia sekvestratsiia labirintov.

At present total sequestration of the labyrinth in the case of purulent epitympanitis and cholesteatoma is a rare pathology. This paper describes data from the literature and two observations by the present authors. They offer an efficient method for arresting labyrinthectomy-induced liquorrhea by means of a flap of the lip mucous membrane. They maintain that computer tomography combined with traditional tomography is an informative method for diagnosing labyrinth destruction. They assert that continuous destruction of the labyrinth during prolonged pyorrhea and progressive development of cholesteatoma can be stimulated by functional changes of the body, e.g. pregnancy. They also suggest that the vestibular apparatus has high compensatory potentials under the conditions of a complete destruction of the vestibule and semicircular canals as a result of extended inflammation of the middle and internal ear.

[Acute sensorineural hearing loss (data of the otorhinolaryngologic clinic of the I.M. Sechenov Moscow Medical Academy)]. / Ostraia neirosensornaia tugoukhost' (po materialam kliniki boleznei ukha, gorla i nosa MMA im. I.M. Sechenova).

The authors review the history of the research on acute neurosensory hypoacusis performed at the chair of ENT diseases of the I. M. Sechenov Moscow Medical Institute in 1916-1995. Etiological, pathogenetic, clinical, therapeutic and prophylactic aspects are considered. The investigators have developed and introduced into practice combined treatment of acute neurosensory hypoacusis the primary components of which are immediate hospitalization, chemotherapy in line with hyperbaric oxygenation and reflex therapy.

[Use of spectral luminescent analysis for objective evaluation of the state of tissues in surgical and laser effects]. / Primenenie metoda spektral'nogo liuminestsentnogo analiza kak ob"ektivnogo sposoba otsenki sostoianiia tkanei pri khirurgicheskom i lazernom vozdeistviiakh.

An optic spectral multichannel analyzer demonstrated a stimulating effect of He-Ne laser on repair processes. For the first time the spectral luminescent analysis was used to determine viability of the transplanted tissue (temporal muscle fascia)in tympanoplasty. Spectral measurements gave grounds for designing policy of the post-tympanoplasty patients' management. The paper presents spectral characteristics of different tissues of the external and middle ear.