Vestn Otorinolaringol
. 2020;85(2):67-72. doi: 10.17116/otorino20208502167.
[Viral Co-Infection With Head and Neck Tumors]
[Article in Russian]
A M Pevzner 1, M M Tsyganov 1, M K Ibragimova 1, N V Litvyakov 1
Affiliations expand
PMID: 32476395 DOI: 10.17116/otorino20208502167
Abstract in English , Russian
The review is devoted to assessing the prevalence of human papillomavirus (HPV) in combination with other viral agents for head and neck tumors (HNT). HPV is recognized as an etiological factor in the development of cervical cancer, but there is evidence that it may be involved in carcinogenesis in other locations, in particular the upper respiratory tract. However, HPV is not the most important factor in tumor growth and progression. Recently, many researchers have reported the presence of concomitant co-infection, affecting tumor progression. Of all the studies analyzed, only 3 studies showed the absence or low rates of co-infection in HNT: from the Czech Republic (0%), China (0.6%) and Japan (3%). Most often, HPV infection was detected together with the Epstein-Barr virus (EBV) - from 12.5 to 34.1% of cases. In Russia, the prevailing combination of viral co-infection was a combination of EBV and cytomegalovirus (9.5%) and a combination of EBV and herpes simplex virus (6.7%). Thus, the degree of incidence of HPV in HNT varies greatly, and the mechanisms of coinfection are poorly understood, which raises the question of whether HPV and concomitant infection can be involved in tumor progression. This makes further research in this direction relevant and promising.

Keywords: co-infection; human papillomavirus; overview; tumors of the head and neck.

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2
Vestn Otorinolaringol
. 2020;85(3):48-51. doi: 10.17116/otorino20208503148.
[New Approach to Treatment of Polypous Rhinosinusitis]
[Article in Russian]
I B Popov 1 2, D A Shcherbakov 1 2, O B Tyryk 2, T A Aleksanyan 3
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PMID: 32628383 DOI: 10.17116/otorino20208503148
Abstract in English , Russian
Annotation: Polypous rhinosinusitis (PRS) is a hardly treatable disease due to the unknown etiology and recurrent course. Standard treatment regimens are aimed at removing polyps and reducing the activity of inflammation, while little attention is paid to pathogenesis factors such as oxidative stress and mucociliary insufficiency.

Objective: To improve the combined treatment of PRS.

Material and methods: The study involved 98 patients (50 people - the study group, 48 people - control group). The structure of the comorbid pathology of patients in the control group was selected so as to correspond to the pathology in the study group. Patients of both groups received combined treatment, including surgical treatment in accordance with the FESS principles, followed by the prescription of 200 mcg mometasone furoate in each half of the nose for 6 months. The treatment of patients of the study group also included the drug N-acetylcysteine - 3 ml (300 mg) in each maxillary sinus intrasurgicaly, then 600 mg orally in the morning after meals for 6 months. Survey methods included a questionnaire survey using the SNOT-22 questionnaire, the prevalence of the polypous process was assessed by endoscopy (Claus Bachert scale) and CT (Lund-Mackay scale), and mucociliary function was also evaluated by performing a saccharin test. The results were compared with each other before surgery and after 6, 12 and 24 months after surgery.

Results: Patients who have been taking N-acetylcysteine for a long time have a more pronounced and long-term improvement in their general condition (according to SNOT-22, an average by 1.7 times, p<0.05) compared with patients in the control group. Also, the frequency of relapses decreases and the effectiveness of surgical treatment increases (according to the Lund-Mackey scale - 5.02 in the experimental group and 10.75 in the control; according to S. Bachert - 1 point and 3 points, respectively).

Conclusions: Long-term use of N-acetylcysteine in PRS increases the effectiveness of surgical treatment, reduces the frequency of relapses, and also improves the general condition of patients.

Keywords: N-acetylcysteine; polypous rhinosinusitis; secondary mucociliary dysfunction.

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3
Vestn Otorinolaringol
. 2020;85(2):78-83. doi: 10.17116/otorino20208502178.
[Etiopathogenetic Factors of Wound Healing in Chronic Post-Intubation Cicatricial Stenosis of the Larynx and Trachea]
[Article in Russian]
V V Vavin 1, D A Kuznetsova 2, I I Nazhmudinov 1, Kh Sh Davudov 1
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PMID: 32476397 DOI: 10.17116/otorino20208502178
Abstract in English , Russian
Despite the existing modern high-tech methods of examination and a variety of surgical treatment methods, the problem of diagnosis, treatment and rehabilitation of patients with chronic post-intubation cicatricial stenosis of the larynx and trachea still requires further study. Improving the understanding and correction of cellular, molecular genetic and biochemical disorders in a chronic wound is a key condition for increasing the efficiency of diagnosis, individual prognosis of the clinical course and the conduct of adequate therapeutic and preventive measures for post-intubation cicatricial laryngotracheal stenoses. In this regard, it seemed appropriate to analyze the existing etiopathogenetic factors of pathological wound healing in chronic post-intubation cicatricial stenosis of the larynx and trachea. Our attempt to summarize the available literature data demonstrated that laryngotracheal scars are a fibro-proliferative disease caused by aberrant wound healing after a damaging effect on the tissues of the larynx and trachea. The article describes the most pathogenetically significant healing, repair, and scarring factors in post-intubation laryngotracheal stenoses, including transforming growth factor β1, vascular growth factor A, type I and III collagen, and matrix metalloproteinases. An assessment of the features of the diagnostic and prognostic significance of these markers will increase the effectiveness of the treatment of patients with chronic cicatricial stenosis of the larynx and trachea, and will also serve as a prerequisite for the development of strategies for diagnostic, treatment, prophylactic and rehabilitation measures that will improve the quality of medical care and the quality of life of patients with chronic cicatricial stenosis of the larynx and trachea.

Keywords: MMR-2; MMR-9; TGF-β1; VEGF-A; chronic post-intubational scar stenosis of the larynx and trachea; collagen types I and III.

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4
Vestn Otorinolaringol
. 2020;85(3):64-67. doi: 10.17116/otorino20208503164.
[Bioregulatory Drugs in the Prevention of Complications in the Early Postoperative Period in Patients After Septoplasty and FESS]
[Article in Russian]
I M Kirichenko 1
Affiliations expand
PMID: 32628386 DOI: 10.17116/otorino20208503164
Abstract in English , Russian
Objective: To evaluate the effectiveness of the use of bioregulatory drugs for the prevention of complications in the early postoperative period in patients after septoplasty and FESS.

Patients and methods: We performed surgical treatment of 25 patients with chronic rhinosinusitis with frequent exacerbations without polyps. The extent of operation was septoplasty and FESS (polysinusotomy). In the postoperative period after septoplasty and functional endoscopic surgery on the paranasal sinuses (PNSs), along with systemic antibiotic therapy, irrigation therapy and nasal cavity cleaning under the endoscope control, Traumeel S in tablets was used 1 tablet 3 times a day 15 minutes before meals for 10 days. In the nasal cavity, after washing with a normalized solution of sea salt, Euphorbium Compositum Nazentropfen S, 1-2 spray 3 times a day for 10 days, was used as monotherapy. The control group included 25 patients with chronic rhinosinusitis with frequent exacerbations without polyps, comparable in age, sex, duration of the disease and the extent of surgery with the main group.

Results: Accelerating the processes of wound healing, re-epithelialization, reducing reactive changes in the mucous membranes of PNSs, reducing postoperative edema with the use of naturally occurring drugs Euphorbium Compositum Nazentropfen S and Traumeel S helps minimize pathological effects on the epithelium of PNSs and the nasal cavity, accelerates the regeneration time of the ciliary epithelium and improves mucus function.

Conclusion: The bioregulatory drugs Euphorbium Compositum with Nazentropfen S and Traumeel S can be effectively used in the treatment of patients after rhinosurgical interventions in order to accelerate reparative processes and restore the function of the ciliated epithelium, do not cause addiction and "withdrawal syndrome" and do not have an irritating effect on the nasal mucosa and PNSs.

Keywords: bioregulatory drugs; chronic rhinosinusitis; postoperative period.

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5
Vestn Otorinolaringol
. 2020;85(2):6-13. doi: 10.17116/otorino2020850216.
[Exudative Otitis Media as a Manifestation of Spontaneous Otoliquorrhea]
[Article in Russian]
A I Kryukov 1, E V Garov 1, E I Zelikovich 1, M V Tardov 1, O V Fedorova 1, T G Martirosyan 1
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PMID: 32476382 DOI: 10.17116/otorino2020850216
Abstract in English , Russian
Spontaneous otoliquorrhea (SOL) often mimics the picture of exudative otitis media (EOM), which leads to delayed diagnosis of the underlying disease.

Purpose of study: Is to evaluate causes, clinical features and diagnostic algorithm for patients with SOL.

Patients and research methods: From 2007 to 2018, 33 patients with SOL underwent examination and treatment in the Department of Ear Microsurgery of the Institute. At the preoperative stage, all patients underwent a complete examination, including examination of ENT organs, anthropometric, biochemical, audiological, ultrasound and radiological tests, which made it possible to make the correct diagnosis.

Results: SOL was more likely to occur in women over 50 who are obese (69.7%, stage II-III). The disease onset in 51.6% of patients was preceded by conditions accompanied by a short-term or prolonged increase in intracranial pressure. SOL was manifested by the clinical picture of EOM in 72.7% of cases, only in 45.5% of cases was accompanied by release from the ear and nose, was often intermittent and complicated by meningitis in 12.1% of patients. Difficulties in diagnosing the disease are caused by clinical manifestations of exudative or acute otitis media in the absence of a causative factor, which led to the verification of SOL from 1 to 4 years in 81.9% of patients who received long-term treatment for other ENT diseases.

Conclusion: The master factors in the diagnosis of SOL are otomicroscopy and endoscopy of the nasopharynx, Halo test and screening determination of glucose level in the obtained discharge, as well as high-resolution CT of the temporal bone, which allows to localize the cerebrospinal fluid fistula and to determine the size of the defect.

Keywords: diagnosis; exudative otitis media; spontaneous otoliquorrhea.

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6
Vestn Otorinolaringol
. 2020;85(2):73-77. doi: 10.17116/otorino20208502173.
[Damage to the Inner Ear With Syphilitic Infection]
[Article in Russian]
O M Doronina 1 2, A V Gurov 1 2, D V Zaslavsky 3, Yu S Egorova 3, D S Ogorodnikov 1
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PMID: 32476396 DOI: 10.17116/otorino20208502173
Abstract in English , Russian
The epidemiology of neurosyphilis is presented in article. The pathogenetic mechanisms of involvement in the syphilitic process are described already in the early stages of the disease of the central and peripheral nervous system and, in particular, of the auditory and vestibular analyzers. Described classical clinical forms of neurosyphilis. Statistical data on the incidence of syphilis in Russia from the 20-30s of the last century to the present are given. Presented analysis of the development of the incidence rate in Russia of syphilis and neurosyphilis, the main methods for the diagnosis of neurosyphilis. The changes in the structure of neurosyphilis disease that have occurred over the past 20 years, which are characterized by nonspecificity, course wear and inversion of typical clinical symptoms, as a result of pathomorphism, are described. The article describes the mechanism for the development of the pathological process in the inner ear with syphilitic infection. Described changes in the capillary wall of the vascular streak, leading to impaired hematolabyrinth barrier function and the development of the labyrinth hydrops. Literature data on the electron microscopic study of the vascular strip of the rabbit webbed snail infected with syphilis are presented. The article also collected literature data on indicators obtained by audiological and vestibulological studies of the inner ear in cases of early and late neurosyphilis. The article focuses on the possible only manifestation of neurosyphilis in the form of cochleovestibular symptoms.

Keywords: acoustic analyzer; neurosyphilis; syphilis; vestibular analyzer.

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7
Vestn Otorinolaringol
. 2020;85(3):43-47. doi: 10.17116/otorino20208503143.
[Expression of Pro- And Anti-Apoptotic Molecules in the Mucous Membrane of the Nasal Cavity With Polypous Rhinosinusitis]
[Article in Russian]
N Yu Matveeva 1, D G Pavlush 1, S G Kalinichenko 1
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PMID: 32628382 DOI: 10.17116/otorino20208503143
Abstract in English , Russian
Objective: To study the expression of proapoptotic (p53, p21) and antiapoptotic (MDM2) factors, as well as the distribution of proliferating PCNA-immunoreactive cells in the nasal mucosa in various types of polyposis rhinosinusitis (PRS).

Material and methods: We studied the immunolocalization of proapoptotic (p53, p21) and antiapoptotic (MDM2) factors, as well as the distribution of proliferating PCNA immunoreactive cells in the mucous membrane of the nasal cavity for various types of polypous rhinosinusitis.

Results and discussion: Comparing with the control group, increased expression of all factors is detected. The main portion of marked cells is located in the loose connective tissue of the lamina propria of mucous membrane, a relatively small number of cells are detected in the epithelial layer. The edematous, eosinophilic (allergic) type of PRS is characterized by the expression of p53 and PCNA and by the reduction of MDM2 immunoreactive cells, while the expression of p53 and p21 is reduced in fibroinflammatory (neutrophilic) type.

Conclusion: PRS is accompanied by epithelial metaplasia, by formation of inflammatory cell infiltrates, fibrosis and edema. The results are discussed in connection with the data on the regulatory role of apoptosis in the pathomorphism of chronic productive inflammation.

Keywords: MDM2; PCNA; apoptosis; metaplasia; p21; p53; productive mucosal inflammation.

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8
Vestn Otorinolaringol
. 2020;85(2):26-30. doi: 10.17116/otorino20208502126.
[A Meta-Analysis of Clinical Studies in Otorhinolaryngology]
[Article in Russian]
A A Korneenkov 1, Yu K Yanov 1, S V Ryazantsev 1, E E Vyazemskaya 1, S V Astashchenko 1, E S Ryazantseva 1
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PMID: 32476385 DOI: 10.17116/otorino20208502126
Abstract in English , Russian
The objective: Of the work was to describe the basics of a meta-analysis with features for evaluating models with fixed and random effects, to present principles for interpreting the graphical results of a meta-analysis (forest plot or blobogram) of comparative reviews of randomized clinical trials (RCTs).

Material and methods: To illustrate the possibility of efficient use of the R software environment for meta-analysis, we used the results of RCTs of various tonsillectomy methods already published in the Cochrane Database review.

Results: The article provides explanations for the calculation of effect size, heterogeneity statistic, and other meta-analysis statistics and their interpretation for evaluating RCTs and recommendations for choosing a model depending on the on the general research concept.

Conclusion: The described method allows meta-analysis and gives an idea of the principles for preparing the results of clinical trials with the expectation of their subsequent use in systematic reviews and meta-analysis.

Keywords: R software environment; R-language; blobogram; chronic tonsillitis; effect model; forest plot; meta-analysis; randomized controlled studies; relative risk; systematic review.

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9
Vestn Otorinolaringol
. 2020;85(3):75-82. doi: 10.17116/otorino20208503175.
[Rhinitis Medicamentosa]
[Article in Russian]
O D Ostroumova 1 2, E V Shikh 1, E V Rebrova 1, A Yu Ryazanova 3
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PMID: 32628388 DOI: 10.17116/otorino20208503175
Abstract in English , Russian
One type of non-allergic non-infectious rhinitis is represented by a heterogeneous group of rhinitis medicamentosa, which can be divided into several pathogenetic types. The most common rebound nasal congestion associated with the use of topical decongestants. Excessive use of intranasal decongestants leads to a decrease in the number of alpha-adrenoreceptors on the surface of cell membranes and uncoupling their connection with the G-protein and the development of tachyphylaxis. To prevent the development of rebound nasal congestion caused by topical decongestants, it is important to limit the frequency of their use. In most cases, the duration of the use of vasoconstrictor drugs should be limited to 5-7 days, according to Patient information leaflets for the drugs. However, in patients who have had a history of episodes of rebound nasal congestion, which develops including the previously indicated periods, the duration of decongestant therapy should be limited to 3 days. Rhinitis associated with local inflammation is caused by the intake of acetylsalicylic acid (ASA) or other non-steroidal anti-inflammatory drugs. Currently, the so-called "aspirin triad" is well known - a combination of bronchial asthma, rhinosinusitis (often polyposis) and intolerance to ASA. Neurogenic rhinitis develops due to the use of drugs that violate vascular tone, for example, antihypertensive drugs or type 5 phosphodiesterase inhibitors. Drug-induced rhinitis has a significant impact on the patient's quality of life: nasal congestion, rhinorrhea, secondary night apnea, insomnia as a result of nasal breathing disturbances, headaches, irritability, weakness after sleepless nights disturb patients to a large extent. Timely diagnosis and withdrawal of a provocative drug, the use of topical corticosteroids in case of severe rhinitis are the basis of the treatment of rhinitis medicamentosa. In severe cases, there is a need, including surgical treatment, such as, for example, submucosal laser destruction of the lower nasal concha.

Keywords: adverse drug reactions; rebound nasal congestion; rhinitis; rhinitis medicamentosa.

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10
Vestn Otorinolaringol
. 2020;85(2):14-20. doi: 10.17116/otorino20208502114.
[Hearing Loss Due to Mutations or Lack of the Gene Coding Protein Stereocillin]
[Article in Russian]
T G Markova 1 2, N N Alekseeva 1 2, O L Mironovich 3, E A Bliznets 3, M R Lalayants 1 2, A V Polyakov 3, G A Tavartkiladze 1 2
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PMID: 32476383 DOI: 10.17116/otorino20208502114
Abstract in English , Russian
Objective: The description of a clinical picture and audiological features at the hearing loss caused by changes of a STRC gene, coding protein stereocillin (MIM: 606440). Mutations in the numerous genes responsible for the inner ear proteins are the reason for congenital sensorineural hearing loss. The main cause of congenital bilateral sensorineural hearing loss in the Russian Federation are mutations in GJB2 gene it reaches up 68% of cases identified in infancy. GJB2 gene tests already became routine around the world. Possibilities of new methods based on sequencing of new generation (NGS, next generation sequencing) allow to conduct a research of more rare genes connected with a hearing impairment. The most often among GJB2 negative patients reveal mutations and deletion of a gene of STRC.

Patients and methods: Full audiological examination of 5 children and one adult with a hearing loss from 2 unrelated families is provided. Mutations in STRC gene were identified. All children are examined aged before 8 years, and 3 children failed universal audiological screening in maternity hospital, to two children screening was not carried out as they were born till 2009.

Results: The children with the sensorineural hearing loss connected with mutations and deletion of STRC gene failed hearing screening in maternity hospital because of the OAE is not registered, what indicates the congenital nature of a hearing loss. Recently it could not be noticed earlier because of slight increase of hearing thresholds and was regarded only as the early onset. Our data emphasize that the of thresholds from 35 to 60 dB in frequencies 0,5-4 kHz is common for mutations/deletions of STRC gene.

Conclusion: The development of molecular genetics methods confirms the hereditary causes of GJB2-negative patients and expands indications for family counseling. Special approach for child with hearing loss so early revealed is necessary and the consultation of parents frightened of screening results is very important.

Keywords: STRC gene; congenital hearing loss; mild-to-moderate hearing loss; nonsyndromal sensorineural hearing loss.

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11
Vestn Otorinolaringol
. 2020;85(2):49-52. doi: 10.17116/otorino20208502149.
[Bilateral Temporal Bone Xanthoma Associated With Hyperlipidemia]
[Article in Russian]
M V Subbotina 1, O V Kanya 2
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PMID: 32476390 DOI: 10.17116/otorino20208502149
Abstract in English , Russian
Presented clinical observation of a 42-year-old patient with bilateral xanthoma of the temporal bone, who has been treated for a long time for bilateral external otitis media, repeatedly mastoiditis. In this case, hyperlipidemia was detected only after the diagnosis of xanthoma was established. In this case, histological and clinical data helped to diagnose xanthomas and exclude chronic otitis media: the preservation of the auditory ossicles and hearing despite a large destruction of the temporal bone; satisfactory condition of the patient for many years in the presence of volumetric formations in both temporal areas extending into the cranial cavity, spreaded from the brain substance and not accumulating contrast according to computer and magnetic resonance imaging; normalization of hearing against the background of prolonged heating of the body - 'melting' of fats and opening the ear canal. Fistulas, through which a yellowish secret stood out either in the external auditory canal or in the behind-the-ear area, served as a kind of 'whisper valve', which made it possible to stop the pain syndrome and did not lead to the development of cerebral symptoms.

Keywords: differential diagnosis of mastoiditis; hypercholesterolemia; temporal bone xanthoma.

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12
Vestn Otorinolaringol
. 2020;85(3):23-27. doi: 10.17116/otorino.
[Characteristics of Diagnosis and Surgical Treatment of Various Forms of Congenital Temporal Bone Cholesteatoma]
[Article in Russian]
I A Anikin 1, N N Khamgushkeeva 1, A D Knyazev 1, O I Konoplev 1
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PMID: 32628378 DOI: 10.17116/otorino
Abstract in English , Russian
Objective: To conduct a retro- and prospective analysis of the clinical characteristics and results of surgical treatment of patients with congenital temporal bone cholesteatoma.

Patients and methods: On the basis of the SPb Scientific Research Institute of ENT of the Ministry of Health of Russia 23 patients were diagnosed with congenital temporal bone cholesteatoma for the period from 2011 to 2018. There were 11 men (47.8%), 12 women (52.2%), the age of patients - from 2 to 44 years. The M.J. Levenson criteria were used to verify congenital middle ear cholesteatoma. (1986). According to intrasurgery findings, we identified congenital cholesteatoma of the middle ear stages according to the ChOLE classification. Other types of congenital temporal bone cholesteatoma included the patients with congenital atresia of the external auditory opening, combined with congenital temporal bone cholesteatoma; we found a patient with exostoses obstructing the external auditory canal combined with congenital cholesteatoma of the middle ear; and a patient with congenital cholesteatoma of the temporal bone pyramid.

Results: An increase in the incidence of congenital temporal bone cholesteatoma was noted, which is probably due to increased awareness of specialists and the wider use of imaging research methods. A relationship was revealed between the stage of congenital cholesteatoma according to the ChOLE classification and the necessary volume of surgical intervention. Of the total number of cases of congenital temporal bone cholesteatoma, 26.1% were the patients with anomalies in the development of the outer and middle ear.

Conclusions: All patients with suspected congenital temporal bone cholesteatoma require a temporal bone MSCT and middle ear MRI in DWI mode.

Keywords: cholesteatoma; cholesteatoma classification; congenital atresia of the external auditory canal; congenital cholesteatoma; congenital cholesteatoma of the middle ear; surgical tactics; temporal bone; temporal bone pyramid cholesteatoma.

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13
Vestn Otorinolaringol
. 2020;85(2):21-25. doi: 10.17116/otorino20208502121.
[OTOF-related Auditory Neuropathy Spectrum Disorder]
[Article in Russian]
M R Lalayants 1, O L Mironovich 2, E A Bliznets 2, T G Markova 1 3, A V Polyakov 2, G A Tavartkiladze 1 3
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PMID: 32476384 DOI: 10.17116/otorino20208502121
Abstract in English , Russian
Otoferlin (OTOF) gene mutations are the most common cause of hereditary ANSD according to investigations in several countries.

The aim: Of this study was to estimate the prevalence of OTOF mutations in Russian children with ANSD and evaluate audiological and clinical features of OTOF-related ANSD.

Patients and methods: 28 children with bilateral ANSDwere enrolled in the investigation. Two step genetic testing was performed: first step - GJB2 gene testing to exclude GJB2-related hearing loss; second step - NGS-based sequencing to explore another 35 hearing loss genes (including OTOF).

Results: OTOF mutations, including 6 new variants, were found in 5 children with ANSD (18%). All 5 children had no risk factors for hearing loss and passed hearing screening. OAE and cochlear microphonics were present till the last testing at the age of 4-5 years. ABR were not detectable. The ASSR were measurable bilaterally at all frequencies in all cases, but they did not correlate with behavioral thresholds that revealed severe hearing loss. Hearing thresholds were stable during follow up period. 3 children underwent cochlear implantation. After cochlear implantation auditory nerve action potentials to electric stimulation were detected within normal range.

Conclusion: Genetic testing of children with ANSD and first of all OTOF testing enables to reveal hearing loss etiology and provide the optimal rehabilitation approach, including cochlear implantation, as early as possible.

Keywords: auditory neuropathy; cochlear implantation; hereditary hearing loss; otoferlin.

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14
Vestn Otorinolaringol
. 2020;85(3):18-22. doi: 10.17116/otorino20208503118.
[Comparative Cytological Analysis of the Middle Ear Exudate in Different Children's Groups]
[Article in Russian]
V N Krasnozhen 1, A V Shakhov 2, I G Andreeva 1 3, A A Ayzenshtadt 4, A V Gatina 3, E R Murtazina 3, M V Bogoroditskaya 4, P P Suzaeva 2
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PMID: 32628377 DOI: 10.17116/otorino20208503118
Abstract in English , Russian
The purpose: to compare the types of cytograms of exudate from the middle ear between patients with exudative otitis media (EOM) with congenital clefts of the lip/palate (CCLP) and without CCLP, determining the stages of chronic disease and the significance of surgery on the middle ear.

Patients and methods: Two clinics was parallel conducted a cytological examination of exudate of the middle ear in children. The first group consisted of 30 patients aged 2 to 17 years with EOM without CCLP (n=54 ears). The 2nd group included 17 patients aged 1 year 4 months to 10 years with EOM with CCLP (n=34 ears).

Results: In the 1st group, in 61% of cases (n=33), an inflammatory-regenerative type of cytogram was detected, in 39% (n=21) - a regenerative, inflammatory type of cytogram was not detected. In the 2nd group, in 82.4% of cases (n=28), an inflammatory type of cytogram was observed, in 14.7% (n=5) - an inflammatory-regenerative type, in 2.9% (n=1 ear) - a regenerative type.

Conclusion: With CCLP, the inflammatory nature of the cytogram of the resulting exudate from the middle ear is more common, which is characterized by signs of destruction of the mucous membrane, decay and degradation of the basal and cell membranes. Patients with CCLP often suffer from EOM. They are more likely to development of chronic purulent otitis media, including with cholesteatoma. Destructive changes in the mucous membrane of the middle ear are found in children of different ages. Taking into account the analysis of cytograms of the exudate of the middle ear with CCLP, the imposition of long-term ventilation tubes is justified.

Keywords: children; congenital cleft lip and palate; cytology; exudate; exudative otitis media.

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15
Vestn Otorinolaringol
. 2020;85(3):6-10. doi: 10.17116/otorino2020850316.
[Modern Aspects of Pathogenetic Treatment of Sensorineural Hearing Loss]
[Article in Russian]
T V Zolotova 1, N V Dubinskaya 1, A P Davydova 1
Affiliations expand
PMID: 32628375 DOI: 10.17116/otorino2020850316
Abstract in English , Russian
Objective: Optimization of the treatment of sensorineural hearing loss (SHL) using a calcium channel blocker - nimodipine.

Material and methods: The study consists of experimental and clinical sections. The experiment involved 42 white outbred rats, which were used for modeling SHL according to the original method and treatment with nimodipine followed by histological control. The clinical study involved 115 patients with chronic SHL. Calcium metabolism was evaluated by quantifying the mineral density of bone tissue during osteodensitometry of the radial bones of patients.

Results and discussion: Histological studies after rats were removed from the experiment showed that modeling SHL by noise exposure against the background of immobilization of experimental animals is effective and is accompanied by early signs of apoptosis of the external hair and auxiliary cells, degenerative changes in spiral ganglion neurocytes. The role of calcium metabolism disorders in the initiation of the described disorders is shown. The use of nimodipine in experimental animals reduces the severity of histological changes. When examining patients with SHL, signs of impaired calcium metabolism in bone tissue were detected in 60% of the examined patients.

Conclusion: The obtained data determine the special role of disorders in the ratios of micro-elements in the body, especially calcium, in the development of SHL, and dictate the need for their correction using calcium channel blockers. The clinical use of nimodipine is possible both for prevention and for the treatment of sensorineural hearing loss.

Keywords: experimental modeling of hearing loss in animals; noise exposure in animals; osteodensitometry in patients with hearing loss; sensorineural hearing loss.

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16
Vestn Otorinolaringol
. 2020;85(3):57-63. doi: 10.17116/otorino20208503157.
[Hypertrophy of Palatine Tonsils - Possible Treatment Approaches]
[Article in Russian]
E P Karpova 1, L V Gankovskaya 2, O V Vozgoment 1 3, Ya S Avalyan 1, I Yu Kulikova 4, E D Merkusheva 2, E M Khasanova 2
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PMID: 32628385 DOI: 10.17116/otorino20208503157
Abstract in English , Russian
Objective: To evaluate the effectiveness of different approaches to the treatment of patients with hypertrophy of the palatine tonsils (HPT).

Material and methods: 90 children with HPT of II-III degree and 20 healthy children (group 1) aged from 3 to 7 years were included in the study. Children with HPT were divided into three groups: group 2 - children who underwent tonsillotomy (n=30), group 3 - children who underwent conservative treatment, including only topical use of Polyoxidonium (n=30), group 4 - children who underwent complex treatment (tonsillotomy with subsequent local use of Polyoxidonium), (n=30). The severity of nasal breathing disturbances on a visual analogue scale, the average number of acute respiratory viral infections 6 months before and after treatment, the level of gene expression of antimicrobial peptides before and after treatment, the degree of hypertrophy of the palatine tonsils and spleen with an assessment of the echostructure and determination of the spleen mass coefficient using Ultrasound were evaluated in the study.

Results: In children receiving only Polyoxidonium, there was a decrease in the severity of nasal breathing disorders, a decrease in the frequency of acute respiratory viral infections, an increase in the expression of antimicrobial peptide genes compared to the initial level of these indicators. Comprehensive treatment of children with HPT (group 4) showed a significant decrease in the severity of nasal breathing disorders, a decrease in the average number of acute respiratory infections within 6 months, an increase in the expression of antimicrobial peptide genes compared to children who underwent only tonsillotomy (group 2) or only conservative therapy (group 3).

Conclusion: It is proved that the use of Polyoxidonium in the complex treatment of HPT is clinically effective and safe.

Keywords: Polyoxidonium; antimicrobial peptides; hypertrophy of palatine tonsils; ultrasound.

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17
Vestn Otorinolaringol
. 2020;85(2):37-40. doi: 10.17116/otorino20208502137.
[Modification of the Method for Closing the Defect of the Medial Wall of the Maxillary Sinus]
[Article in Russian]
D A Shcherbakov 1, A S Krotova 2, T A Aleksanyan 3
Affiliations expand
PMID: 32476387 DOI: 10.17116/otorino20208502137
Abstract in English , Russian
Pathological ventilation of the maxillary sinus (MS) is one of the risk factors for the formation of chronic maxillary sinusitis.

Purpose of study: Is to evaluate the effectiveness of the method of restoring the medial wall of the MS with an autograft - a quadrangular cartilage of the nasal septum using the butterfly technique (Patent Application No. 2018140468, priority of 11/19/2018).

Material and methods: The study included patients who underwent septoplasty, endoscopic surgery on the MS with plasty of the medial wall of the MS (1st, main group, n=136), as well as patients who underwent surgery according to Caldwell-Luc with the formation of persistent nasoantral anastomosis in the lower nasal passage (2nd, control group, n=56). The criteria for the inclusion of patients in the study were as follows: the presence of MS fungal body; inverted papilloma with lesions of the MS; cysts and/or a foreign body of the MS with localization in the alveolar bay without involving the natural anastomosis in the pathological process; concomitant 3rd or 4th, or 5th or 6th types of curvature of the nasal septum according to R. Mladina (1987). An objective assessment of the condition of the patients was carried out using the SNOT-22 clinical questionnaire, and for analysis the state of aerodynamics of the nasal cavity and MS in patients of various groups after surgical treatment used the method of computational aerodynamics.

Results: In patients with nasoantral ostium in the lower nasal meatus, the pathological maxillary sinus aeration one was observed. It is recommended to close the nasoantral ostium to prevent violations of the aerodynamics of the nasal cavity and the maxillary sinus during surgery through the lower nasal meatus.

Conclusion: Our proposed method for closing a defect in the lower nasal passage is effective. The autograft is well established, contributes to the speedy restoration of normal sinus aerodynamics.

Keywords: endoscopic surgery; maxillary sinus; nasoantral anastomosis; quadrangular cartilage.

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18
Vestn Otorinolaringol
. 2020;85(3):95-99. doi: 10.17116/otorino20208503195.
[Artificial Temporal Bone]
[Article in Russian]
A I Kryukov 1, E V Garov 1, V N Zelenkova 1, E I Zelikovich 1, G V Kurilenkov 1, G Yu Tsarapkin 1, V V Mishchenko 1, F A Tomilov 1, T G Martirosyan 1, K G Romanova 2
Affiliations expand
PMID: 32628392 DOI: 10.17116/otorino20208503195
Abstract in English , Russian
This article presents assembly technology and the main stages of dissection on artificial temporal bone. This sample of artificial temporal bone is a domestic product. The use of this material makes it possible to develop basic dissection skills, such as anthromastoidotomy, posterior tympanotomy, and facial nerve decompression. Artificial temporal bone can be used as a teaching tool for students, residents and postgraduate students who train otosurgical skills in the form of basic stages of dissection work on complex structures of the temporal bone.

Keywords: anthromastoidotomy; facial nerve decompression; posterior tympanotomy; temporal bone.

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19
Vestn Otorinolaringol
. 2020;85(3):36-42. doi: 10.17116/otorino20208503136.
[Argumentation for Use of Laser Fluorescence Spectrometry in Identification of Inflammatory Diseases of Pharynx]
[Article in Russian]
A B Timurzieva 1, G N Nikiforova 1, V M Svistushkin 1, A N Gerasimov 1, M T Alexandrov 1
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PMID: 32628381 DOI: 10.17116/otorino20208503136
Abstract in English , Russian
Objective: The article demonstrates the experience of using laser fluorescence spectrometry (LFS) in the diagnosis of inflammatory diseases of pharynx, describes a method for recording spectra of pharyngeal tissues using the EnSpectr L405 hardware-software complex operating on the basis of laser radiation with a wavelength of 405 nm, and identifies characteristic features of spectral curves.

Patients and methods: The authors presented the characteristics of the spectra from the surface of the pharynx tissue of healthy volunteers, patients with chronic tonsillitis and granular pharyngitis.

Results: The most informative parameters of the spectral curves were calculated, analyzing which it is possible to identify the morphometric, metabolic, functional features of the tissue of the tonsils and posterior pharyngeal wall in normal and pathological conditions.

Conclusion: The article illustrates the importance of developing highly sensitive and highly specific methods for the rapid diagnosis of inflammatory diseases of the pharynx. The presented technology can be used in clinical practice in future.

Keywords: chronic tonsillitis; express- diagnosis; granular pharyngitis; inflammatory diseases of pharynx; laser fluorescence spectrometry.

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20
Vestn Otorinolaringol
. 2020;85(2):31-36. doi: 10.17116/otorino20208502131.
[The State of Regional Lymph Nodes in Chronic Tonsillitis According to Ultrasound]
[Article in Russian]
D V Trukhin 1 2, I A Kim 1 2, E V Nosulya 3, A I Kryukov 2 3, I V Rychkova 2, Sh G Gadzhiibragimov 3, K G Romanova 4
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PMID: 32476386 DOI: 10.17116/otorino20208502131
Abstract in English , Russian
Despite the variety of chronic tonsillitis clinical symptoms, none of the known signs of this disease is typical for it.

Purpose of study: Is development of a method for differential diagnosis of complicated (toxic-allergic) and uncomplicated (simple) forms of chronic tonsillitis.

Methods: 147 patients were divided into 2 groups: 1) 61 (42%) - with a simple form and 2) 86 (58%) - with a toxic-allergic form of chronic tonsillitis of the II degree. Patients underwent ultrasound examination of regional lymph nodes, to determine their localization, quantity (single, multiple), shape, size and structure.

Results: According to ultrasound data, it was revealed that for the simple form of chronic tonsillitis the following characteristics of the lymph nodes were typical - bean-like form, single, clear contours, homogeneous central parts and reduced vascularization; for the toxic-allergic form of chronic tonsillitis, the following characteristics of lymph nodes were revealed - oval shape, lymph nodes conglomerates, hypoechoic central parts, increased vascularization and irregular shape of the gates.

Conclusion: The proposed method allows to quickly and efficiently conduct differential diagnosis of chronic tonsillitis. This technique is easily reproducible in the conditions of any (outpatient, inpatient) medical facility using standard equipment for ultrasound examination, does not require the use of any drugs.

Keywords: chronic tonsillitis; diagnisis; lymph nodes; ultrasound.

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21
Vestn Otorinolaringol
. 2020;85(3):11-17. doi: 10.17116/otorino20208503111.
[Psychoacoustic Methods in Diagnosis of Central Auditory Processing Disorders in Prematurely Born Children]
[Article in Russian]
I V Savenko 1, E S Garbaruk 1 2, M Yu Boboshko 1 3
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PMID: 32628376 DOI: 10.17116/otorino20208503111
Abstract in English , Russian
Introduction: The presence of numerous perinatal risk factors and comorbid pathology in prematurely born children, even in the absence of peripheral auditory deficit, can lead to disruptions in the processes of higher nervous sound information processing with the formation of central auditory disorders.

Objective: Audiological assessment of the functional state of auditory system central parts in prematurely born children.

Material and methods: The study involved 54 deeply premature born infants, which were divided into 3 groups depending on age (6-7, 8-9, and 10-11 years), 18 subjects in each group, and 70 healthy, term-born children of the corresponding age. In addition to the traditional audiological examination, all children underwent an assessment of functional state of the central parts of auditory system through a pause detection test (Random Gap Detection Test, RGDT); the perception of fast rhythmic sequences of stimuli, monaural low excess speech testing, binaural interaction test in alternating binaural speech format (ABS ), dichotic presentation of pairs of single digits, single digits and monosyllables, two-digit numerals, Russian matrix phrasal test in noise (RUMatrix) were studied.

Results: Prematurely born infants of all age groups were significantly worse compared to control group (p<0.01) while having RGDT, a test for assessing the perception of fast rhythmic sequences of stimuli and dichotic binaural integration tests. Monaural intelligibility of monosyllabic words in silence in children of all three groups did not differ from normal values, but it suffered from contralateral use of noise interference in children aged 6-7. According to the RUMatrix test, legibility of phrases in noise was impaired in 65% of subjects. Test results in the ABS format revealed a significant violation of speech intelligibility (p<0.01) only in children of the younger age group.

Conclusion: In prematurely born children, there is a dysfunction of the central parts of the auditory system, which is multilevel in nature, partially leveling as children grow older. Moreover, the processes of temporary processing of acoustic information suffer to the greatest extent, not being compensated up to adolescence.

Keywords: central auditory disorders; central auditory processing; hearing loss; prematurely born infants.

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22
Vestn Otorinolaringol
. 2020;85(2):53-54. doi: 10.17116/otorino20208502153.
[Keloid of the External Auditory Canal]
[Article in Russian]
R V Reznikov 1
Affiliations expand
PMID: 32476391 DOI: 10.17116/otorino20208502153
Abstract in English , Russian
Own clinical observation of the keloid of the external auditory canal is reported. This is a very rare variant of the localization of this tumor. A description of this neoplasm is rare in domestic and foreign literature.

Keywords: external auditory canal; keloid; tumor.

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23
Vestn Otorinolaringol
. 2020;85(3):32-35. doi: 10.17116/otorino20208503132.
[Etiology and Clinical Symptoms of Bilateral Vestibulopathy]
[Article in Russian]
N L Kunelskaya 1 2, E V Baybakova 1, A L Guseva 2, M A Chugunova 1, E A Kulakova 1
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PMID: 32628380 DOI: 10.17116/otorino20208503132
Abstract in English , Russian
Objective: To identify etiology, clinical symptoms of bilateral vestibulopathy (BV) depending on etiology.

Results: Idiopathic BV was identifies in one third of patients. The most common identified reasons are Meniere's disease, meningitis and ototoxicity. BV develops more often without incidental hearing loss in case of idiopathic, autoimmune etiology, ototoxicity and bilateral vestibular neuronitis. BV after neuroinfection is characterized by prompt symptoms development, bilateral severe hearing loss, Gain reduction in vHIT lower 0.4 and loss of more than 8 lines in DVA test.

Conclusion: BV after bilateral Meniere's disease is characterized by Gain higher than 0.4 and typical clinical picture of the primary disease.

Keywords: Meniere’s disease; bilateral vestibulopathy; dynamic visual acuity test; vestibular hypofunction; video head impulse test.

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24
Vestn Otorinolaringol
. 2020;85(2):55-57. doi: 10.17116/otorino20208502155.
[Giant Temporal Bone Cholesteatoma]
[Article in Russian]
E N Pligina 1, N M Kostakova 1, V M Kurochkina 1
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PMID: 32476392 DOI: 10.17116/otorino20208502155
Abstract in English , Russian
Presented clinical observation of a patient with exacerbation of left-sided chronic purulent otitis media complicated by extradural brain abscess, temporal bone osteomyelitis. The patient underwent a sanitizing operation on the left temporal bone with plastic closure of the defect in the postoperative cavity with a muscular-fascial flap. Described the postoperative management of the patient and presented the results of treatment 2 months after surgery.

Keywords: cholesteatoma; extradural abscess; otogenic intracranial complications.

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25
Vestn Otorinolaringol
. 2020;85(3):28-31. doi: 10.17116/otorino20208503128.
[The Use of Retinoids to Stimulate the Regenerative Process in Trepanation Cavity After "Open" Sanitizing Surgery on the Middle Ear]
[Article in Russian]
F V Semenov 1, G K Leonov 1
Affiliations expand
PMID: 32628379 DOI: 10.17116/otorino20208503128
Abstract in English , Russian
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.

Keywords: chronic otitis media; regeneration; retinoids; trepanation cavity.

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26
Vestn Otorinolaringol
. 2020;85(3):88-90. doi: 10.17116/otorino20208503188.
[Disorder of Mobility of Vocal Folds on the Background of Hypoparathyroidism at Patient After Subtotal Resection of Thyroid Gland]
[Article in Russian]
V M Svistushkin 1, O Yu Karpova 1, A V Zolotova 1, P S Artamonova 1
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PMID: 32628390 DOI: 10.17116/otorino20208503188
Abstract in English , Russian
During surgery on the thyroid gland, injury to the recurrent nerve is possible with the development of a clinical picture due to impaired mobility of the vocal fold. A disturbance of the mobility of the opposite vocal fold in the form of a paradoxical spasm may join these manifestations if the parathyroid glands were affected during surgery, followed by a decrease in the level of ionized calcium in the blood. Management of such patients presents certain difficulties. A clinical case of examination and treatment of a patient with bilateral impairment of mobility of the vocal folds resulting from thyroid surgery is presented. The peculiarity of this observation is that because of our treatment, we managed to stop the spasm of one vocal fold, and then restore the mobility of the other vocal fold, due to which a complete restoration of the respiratory and vocal function was achieved.

Keywords: hypoparathyroidism; paresis of the vocal folds; violation of the mobility of the vocal folds.

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27
Vestn Otorinolaringol
. 2020;85(2):58-62. doi: 10.17116/otorino20208502158.
[Dynamic Monitoring of Patients With Chronic Rhinosinusitis With Nasal Polyps]
[Article in Russian]
Yu P Moiseeva 1, G Z Piskunov 1
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PMID: 32476393 DOI: 10.17116/otorino20208502158
Abstract in English , Russian
In connection with the prevalence and tendency to relapse, chronic rhinosinusitis with nasal polyps is an urgent problem not only for otorhinolaryngologists, but also for specialists whose therapeutic activity is somehow related to the respiratory system. Based on clinical observations, 5 phenotypes of this pathology were identified, each of which requires an individual approach to treatment and prevention. As a rule, the first stage is functional endoscopic rhinosinus surgery, the volume of which is determined depending on the phenotype. But even with a carefully performed operation, the result of surgical treatment may be unsatisfactory if there was no adequate care in the early inpatient and outpatient periods. This paper highlights the features of dynamic monitoring of patients with different phenotypes of chronic rhinosinusitis with nasal polyps.

Keywords: chronic rhinosinusitis with nasal polyps; dynamic observation; phenotype; postoperative care.

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28
Vestn Otorinolaringol
. 2020;85(3):68-74. doi: 10.17116/otorino20208503168.
[Overview of Modern Methods for the Diagnosis of Exudative Otitis Media]
[Article in Russian]
A A Novozhilov 1 2, P A Shilyagin 2, A V Shakhov 1 2 3, V M Gelikonov 2
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PMID: 32628387 DOI: 10.17116/otorino20208503168
Abstract in English , Russian
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.

Keywords: diagnostic methods; exudative otitis media; optical coherence tomography.

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29
Vestn Otorinolaringol
. 2020;85(2):63-66. doi: 10.17116/otorino20208502163.
[Otorhinolaryngological Aspects of the Disease Course in Children Infected With SARS-CoV-2 Virus]
[Article in Russian]
Yu Yu Rusetsky 1, I Yu MeYtel 1, A R Babayan 1, U S Malyavina 1
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PMID: 32476394 DOI: 10.17116/otorino20208502163
Abstract in English , Russian
Recently, almost all over the world attention of doctors and scientists is focused on a new coronavirus infection, the source of which was the causative agent SARS-CoV-2. In this regard, early diagnosis, including on the basis of symptoms from ENT organs, is crucial. A brief analysis of the available literature on the peculiarities of ENT organs manifestations in patients with SARS-CoV-2 is given. It was found out that to date there is very little data on the state of loro organs in patients with SARS-CoV-2 and no data on anosmia in the pediatric population. However, it is in children in the epidemic aspect that early diagnosis of infection and understanding of its key symptoms is of utmost importance.

Keywords: ENT; SARS-CoV-2; anosmia; children; coronavirus.

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30
Vestn Otorinolaringol
. 2020;85(3):52-56. doi: 10.17116/otorino20208503152.
[The Role of Secretory Immunoglobulin E in the Differential Diagnosis of Rhinitis During Pregnancy]
[Article in Russian]
M A Ryabova 1, N A Shumilova 1, L V Georgieva 1
Affiliations expand
PMID: 32628384 DOI: 10.17116/otorino20208503152
Abstract in English , Russian
Objective: To evaluate the role of secretory immunoglobulin E in the differential diagnosis of rhinitis in pregnant women.

Material and methods: The study involved 97 pregnant women with rhinitis symptoms and 23 healthy pregnant women without rhinitis symptoms. The first group of the study included 37 pregnant women with previously confirmed (anamnestically and immunologically) allergic rhinitis (AR), the 2nd group of the study included 30 pregnant women with suspected beginning of the AR, the 3rd group of the study was 30 women with pregnant women's rhinitis, diagnosed on the base of follow-up study. The study included: anamnesis taking, routine examination of ENT organs, general clinical examination, study of the level of total IgE in blood, nasal secretion cytology study, secretory IgE level in nasal secretion analysis, follow-up telephone gathered catamnestic data analysis.

Results and discussion: When analyzing laboratory data, an increase in the average number of eosinophils in the blood was not detected in any group. When examining secretory immunoglobulin E of the nasal secretion in the group of patients with previously confirmed AR, this indicator averaged 2.9±0.7 kE/L, in the group with AR beginning - 5.5±2.6 kE/L, which exceeded the value in the control group (1.2±0.6 kE/l, p<0.05). In the group of patients with pregnant women's rhinitis, the indices of nasal IgE did not differ significantly from the control group (1.9±0.3 and 1.2±0.6 kE/L, respectively, p<0.05).

Conclusion: The level of secretory nasal immunoglobulin E can be used in the differential diagnosis of rhinitis in pregnancy.

Keywords: allergy; nasal immunoglobulin E; pregnancy; rhinitis.

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31
Vestn Otorinolaringol
. 2020;85(3):91-94. doi: 10.17116/otorino20208503191.
[Reflections on Some Issues of the Combined Pathology of the Upper and Lower Respiratory Tract]
[Article in Russian]
G A Gadzhimirzaev 1, R G Gadzhimirzaeva 1
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PMID: 32628391 DOI: 10.17116/otorino20208503191
Abstract in English , Russian
The purpose of this work is to generalize and critically evaluate current literature data on the state of problem of the relationship between acute and chronic diseases of upper and lower respiratory tract. Modern ideas about the mechanisms of relationship of pathological processes of ENT organs with bronchopulmonary pathology are considered. A number of organizational issues are discussed in order to optimize the medical diagnostic process in the pathology of respiratory system.

Keywords: Keewords: diseases of the upper and lower respiratory tract; clinical characteristics; interconnection; organizational issues; problems.

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32
Vestn Otorinolaringol
. 2020;85(3):83-87. doi: 10.17116/otorino20208503183.
[Conducting Bilateral Tonsillectomy in Patients After Kidney Transplantation. Clinical Observation]
[Article in Russian]
S A Karpishchenko 1, O M Kolesnikova 1, Yu V Legkova 1
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PMID: 32628389 DOI: 10.17116/otorino20208503183
Abstract in English , Russian
The experience of performing bilateral tonsillectomy under general anesthesia for two patients with a transplanted kidney receiving immunosuppressive therapy is presented. In both patients after surgery, pain and inflammatory changes in the postsurgery wound were minimal. However, in the postsurgery period, infection was observed in patients, this required the prescription of systemic antibacterial drugs. On the background of immunosuppressive therapy, the clinical course of chronic tonsillitis proceeded without severe symptoms, despite the decompensation of the chronic process in the tonsils. Due to severe concomitant renal pathology and with a transplanted kidney, such patients need to be examined and treated in a multidisciplinary hospital. Indications for surgical treatment of these patients should be substantiated together with nephrologists, otolaryngologists and anesthetists.

Keywords: chronic tonsillitis; kidney transplantation; tonsillectomy.

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33
Vestn Otorinolaringol
. 2020;85(2):45-48. doi: 10.17116/otorino20208502145.
[Proteus Syndrome in the Practice of an Otorhinolaryngologist: A Clinical Case]
[Article in Russian]
I V Stozhkova 1, E V Pchelenok 1, S Ya Kosyakov 1
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PMID: 32476389 DOI: 10.17116/otorino20208502145
Abstract in English , Russian
Described a rare clinical observation of a patient aged 18 years with chronic left-sided otitis media against Proteus syndrome. By this age, the patient underwent a large number of operations regarding the removal of lymphangiomas, hemlimfangiomas, angiokeratitis of the body, as well as several sanitizing surgery on the left ear. A review of domestic and foreign literature showed that this case can be considered unique.

Keywords: Proteus syndrome; cholesteatoma; overgrowth.

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34
Vestn Otorinolaringol
. 2020;85(3):100-103. doi: 10.17116/otorino202085031100.
[Scientific and Practical Contribution of Professor M.F. Tsytovich in the Development of Domestic Otorhinolaryngology (To the 150th Anniversary From His Birth)]
[Article in Russian]
O V Mareev 1, A I Zavyalov 1
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PMID: 32628393 DOI: 10.17116/otorino202085031100
Abstract in English , Russian
The article presents biographical information about Professor M.F. Tsytovich, reflecting his scientific and practical contribution to the formation and development of domestic otorhinolaryngology, to the training of scientific and pedagogical personnel, as well as characterizing his social activities in the first half of the twentieth century.

Keywords: Professor M.F. Tsytovich; Saratov Medical University; otorhinolaryngology.

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35
Vestn Otorinolaringol
. 2020;85(2):41-44. doi: 10.17116/otorino20208502141.
[Conservative Treatment of Exacerbation of Chronic Purulent Otitis Media]
[Article in Russian]
S A Karpishchenko 1, O N Sopko 2, A N Bervinova 2
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PMID: 32476388 DOI: 10.17116/otorino20208502141
Abstract in English , Russian
The purpose of the work: Is to study the efficacy of treatment of exacerbation of chronic tubotympanic purulent otitis media with Otofa drug with the active substance Rifamycin.

Material and methods: Performed a retrospective analysis of 37 medical histories of patients who applied to the otorhinolaryngology clinic with a diagnosis of exacerbation of chronic purulent tubotympanic otitis media in the period from January 2019 to December 2019.

Results: Noted relief of symptoms such as throbbing noise and pain in patients receiving the topical Otofa drug (active ingredient Rifamycin) by the 3th day of therapy. Otofa also reduced otorrhea by the 5th day of therapy.

Conclusion: The study showed the high clinical efficacy of Otofa ear drops containing the Rifamycin antibiotic.

Keywords: Otofa; Rifamycin; chronic purulent otitis media; mesotympanitis.

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36
Vestn Otorinolaringol
. 2020;85(2):84-87. doi: 10.17116/otorino20208502184.
[Traditional and Innovative Technologies of the Pedagogical Process in Medical Universities]
[Article in Russian]
A I Izvin 1
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PMID: 32476398 DOI: 10.17116/otorino20208502184
Abstract in English , Russian
The article discusses a set of innovative forms of teaching the pedagogical process in the form of business games, round tables, webinars, distance learning, a module-rating system and the use of Internet resources designed to improve the training of specialists in medical universities.

Keywords: competency-based approach; innovative learning technologies; pedagogical process; quality education.

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