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Abstract Tracheal rupture is an urgent life-threatening complication that relates to complex and poorly understood areas of trauma surgery. The article presents a review of modern world and domestic literature on instrumental tracheal ruptures, the Relevance of early diagnosis and various treatment methods. Based on an analysis of modern literature data, the article describes the issues of conservative and surgical treatment methods, as well as an assessment of their results. The problem of the diagnostic algorithm and the choice of conservative, surgical treatment has not been solved and remains relevant. The issues of treating patients with a defect in the membranous wall of the trachea in intensive care and in need of artificial ventilation in clinical practice remain unresolved. All of the above indicates the Relevance of the study.Aim of the study To present data from domestic and foreign literature on the diagnosis and treatment of instrumental tracheal ruptures.Material and methods A review of the literature was carried out for the period from 1993 to 2024 in Russian and English, available on the databases Pubmed, Medline, UpTodate, Scopus, E-library, on topics such as post-intubation tracheal rupture, iatrogenic tracheal rupture, diagnosis and treatment of instrumental tracheal ruptures, closed tracheal injury.Results The concept of the classification system, risk factors, etiopathogenesis is outlined. Information is provided on the diagnostic significance of computed tomography and tracheobronchoscopy. Close attention is paid to the methods and choice of treatment tactics, the principles of intraoperative tactics, and the strategy of conservative treatment. A comparative assessment of treatment Results and their complications with a conservative or surgical treatment approach is given.Conclusion Thus, an analysis of domestic and foreign literature indicates that the issues of diagnosis and treatment of iatrogenic tracheal injuries remain largely unresolved. There is no generally accepted algorithm for instrumental diagnosis of tracheal ruptures. There are no uniform approaches to determining indications and contraindications for conservative and surgical treatment of tracheal injuries. There are diametrically opposed opinions regarding the choice of treatment tactics. These contradictions create significant difficulties in assessing the Results of treatment of this complex category of patients.

. To date, the blood vessels in allergic diseases of the respiratory system are an acting problem. It is known that the full functioning of tissues and organs depends on the state of vessels of a hemomicrocirculatory bed. The purpose of the work is to study morphological changes in the vessels of the hemomicrocirculatory channel of the guinea pig trachea with experimental ovalbumin-induced allergic inflammation. Material and methods. With the help of histological, morphometric and statistical methods studied the trachea of 48 male guinea pigs in conditions of experimental ovalbumin-induced allergic inflammation, which was modeled by subcutaneous sensitization and the subsequent inhalation of ovalbumin. To determine the structural and functional adjustment of arterioles, venules and blood capillaries, the outer diameter, diameter of the lumen, the thickness of the middle membrane and the cereal index of arterioles, the diameter of the lumen of venules and capillaries were determined. The results. It has been found that in all study groups, the size of the outer diameter of arterioles is increased (P */**

Background. Violation of the regeneration of the tracheal wall after undergoing reconstructive surgeries remains an urgent problem of modern surgery. One of the reasons for the violation of the regeneration processes is insufficient blood supply to the organ. Finding new ways to improve blood flow is a promising area of research.Aim. To evaluate the effectiveness of VEGF effect on the regeneration of the anterior tracheal surface in the early postoperative period.Materials and methods. The study included 60 male Wistar rats at the age of 10 months. All animals underwent tracheal reconstructive surgery; the animals were divided into three groups: group 1 – without medicinal film, group 2 – with prolonged-release medicinal film, group 3 – with prolonged-release medicinal film containing VEGF. The sampling of histological material was carried out on days 3, 7 and 21 of the study, using morphometry to determine the thickness of the tracheal wall, the thickness of the postoperative scar, the area of the surgical intervention zone, the area of the vessels, the ratio of the thickness of the postoperative scar to the wall thickness trachea and the ratio of the area of the vessels to the area of the surgical intervention zone.Results. It was revealed that when exposed to a long-acting medicinal film containing VEGF, significant histological changes occurred on day 7 of the study. In groups 1 and 2, healing occurred by day 21 and was accompanied by defects of the mucous membrane and cartilage. On day 7 in group 3, there was a complete epithelialization of the tracheal wall, an increase in the number of newly formed vessels and glands in the area of surgical intervention. Healing was carried out with a thin postoperative scar without defects in all layers of the tracheal wall.Conclusion. The results obtained indicate the stimulating effect of VEGF on the regeneration of the tracheal wall in the early postoperative period after undergoing reconstructive surgery. The use of VEGF reduces the time of postoperative wound healing and preserves the anatomical structure of the tracheal wall.

Background. The development of new methods for delivering biologically active substances to the surgical site is a promising area of modern surgery. One of the biologically active substances used to stimulate regeneration is the vascular endothelial growth factor (VEGF). The search for ways to gradually and over a long period of time deliver VEGF to the surgical site is a promising area of research.Aim. To develop a method for delivering VEGF to the surgical site and to assess its elimination in the early postoperative period.Materials and methods. The study included 78 male Wistar rats at the age of 10 months. All animals underwent reconstructive surgery on the trachea, the animals were divided into 3 groups: group 1 – without a medicinal film, group 2 – with a medicinal film of prolonged action, group 3 – with a medicinal film of prolonged action containing VEGF. Blood sampling was carried out on days 1, 3, and 21 of the study, using the method of enzyme-linked immunosorbent assay to determine the level of VEGF in blood plasma, the unit of measurement was pg/ml.Results. A long-acting medicinal film containing VEGF has been developed. It was revealed that the use of a medicinal film containing VEGF significantly increases the VEGF index in blood plasma by 26 times starting from the first day of the study and remained high throughout the study.Conclusion. The results obtained indicate the effectiveness of the developed medicinal film of prolonged action. Elimination of VEGF starts from the first day of the study and lasts up to 21 days. High VEGF indices, according to the authors, are associated with the exogenous introduction of VEGF into the animal organism in the form of a prolonged-action film and the induction of endogenous VEGF in rats.

The treatment of patients with chronic stenosis of the larynx and trachea is a laborious long process that requires special attention to the choice of surgical tactics and conservative therapy. The effectiveness of the performed surgical treatment largely depends on the course of the postoperative wound process, which explains the need for an individual approach to patient management in order to prevent the development of bacterial complications. One of the factors contributing to the occurrence of these complications are transient microorganisms that colonize the mucous membrane of the respiratory tract, represented mainly by Streptococci, Staphylococci and Neisseria, as well as Acinetobacter, Moraxella, Corinebacterium, Escherichia, Klebsiella. In order to prevent postoperative complications, it is necessary to carry out antibacterial prophylaxis with I–II generation cephalosporins (cefazolin, cefuroxime) or inhibitor-protected aminopenicillins (amoxicillin/clavulanate, ampicillin/sulbactam) during clean surgical interventions. In cases where a bacteriological examination reveals hospital strains of microorganisms, it is necessary to carry out antibacterial therapy aimed at eradication of the bacterial pathogen. In case of “dirty” surgical interventions in patients in cases where a bacteriological examination does not reveal pathogenic strains of microorganisms, it is recommended to carry out antibacterial therapy with broad-spectrum antibiotics, within 7–10 days after the surgery. Irrigation and inhalation therapy occupies a special place in the treatment of patients with chronic stenosis of the larynx and trachea. At the final stages of the operation, irrigation of the surgical area with solutions of glucocorticosteroids and anesthetics is used, and inhalation therapy is used starting from the early postoperative period, continuing throughout the entire period of inpatient treatment, as well as at the outpatient stage. Among the inhalation drugs used topic antibiotics, glucocorticosteroids, mineral water, mucolytics, and bacteriophages are most often used.

Objective: to assess the potentials of using indocyanine green fluorescence angiography in evaluating revascularization of tissue-engineered construct that was obtained from the decellularized biological matrix of primate trachea, including using mesenchymal stem cells, after heterotopic tracheal allotransplantation. Material and methods. Tracheas were obtained from two male hamadryas baboons. After decellularization, 4 cm segments of tracheas were implanted under the lateral part of the latissimus dorsi in two healthy primates, one after recellularization with mesenchymal stem cells (animal 1), and the second without recellularization (animal 2). Immunosuppressive therapy was not performed. Blood flow in the transplanted segment of the trachea was evaluated 60 days after transplantation by surgical isolation of the flap of the latissimus dorsi with the transplanted segment of the trachea, while maintaining blood flow through the thoracodorsal artery. Indocyanine green near-infrared fluorescence angiography was visualized using a FLUM-808 multispectral fluorescence organoscope. Results. Sixty days after implantation, the tracheal cartilaginous framework macroscopically appeared to be intact in both animals, tightly integrated into the muscle tissue. The framework retained its natural color. After intravenous injection of indocyanine green, the tracheal vessels were visualized in both animals. Intercartilaginous vessels and portions of the cartilaginous semi-rings devoid of vessels were clearly distinguished. The entire implanted segment was almost uniformly vascularized. No local disruptions in blood supply were observed. The fluorescence brightness of the tracheal vessels was 193 ± 17 cu and 198 ± 10 cu in animals 1 and 2, respectively. The average muscle brightness in the implantation zone was 159 ± 9 cu and 116 ± 8 cu in animals 1 and 2, respectively. Conclusion. Indocyanine green fluorescence angiography is characterized by high-contrast images and high sensitivity. This facilitates vascular patency visualization and allows to assess the degree of neoangiogenesis after experimental transplantation of the tracheal segment, at different stages of experiment, without euthanizing the animal.

Objective: to study the viability of a tissue-engineered graft (TEG) based on a devitalized tracheal scaffold (DTS) seeded with mesenchymal stromal and epithelial cells in an experiment on rabbits with assessment of cytocompatibility and biocompatibility in vivo. Materials and methods. Syngeneic mesenchymal stromal bone marrow cells (MSBMCs) and syngeneic lung epithelial cells of rabbit were obtained. The morphology and phenotype of the MSBMC culture were confirmed via immunofluorescence staining for CD90 and CD271 markers. Pulmonary epithelial cells obtained by enzymatic treatment of minced rabbit lung tissue were stained with CKPan, CK8/18 and CK14 markers characteristic of epithelial cells. The donor trachea was devitalized in three successive freezethawing cycles. Double-layer cell seeding of DTS was performed under static and dynamic culturing. Orthotopic implantation of TEGs was performed at the site of the anterolateral wall defect in the rabbit that was formed as a result of tracheal resection over four rings. Results were evaluated by computed tomography, histological and immunohistochemical analyzes. Results. A TEG implant, based on DTS, with bilayer colonization by cell cultures of rabbit MSBMC and epithelial cells was obtained. Three months after implantation, TEG engraftment was noted, no tracheal wall stenosis was observed. However, slight narrowing of the lumen in the implantation site was noted. Six months after implantation, viability of TEG was confirmed by histological method. Epithelialization and vascularization of the tracheal wall, absence of signs of purulent inflammation and aseptic necrosis were shown. The small narrowing of the lumen of trachea was found to have been caused by chronic inflammation due to irritation of the mucous membrane with suture material. Conclusion. A new model for assessing the viability of a tissue engineering implant when closing a critical airway defect was created. The developed TEG – based on DTS seeded (bilayer) by lung epithelial cells and BMSCs – was successfully used to replace non-extended tracheal defects in an in vivo experiment. The use of tracheal tissue-engineered graft for orthotopic implantation showed biocompatibility with minimal tissue response.

Aim. To experimentally test a new method for plastic surgery of a critical defect in the tracheal wall using a cell engineering construction and a stent. Materials and methods. The object of the experiment was 13 Oryctolagus Chinchilla rabbits. To determine the critical size of the tracheal defect, a “Defects Group” (n=11) was created, divided into two subgroups depending on the width of the mucous and submucosal defect, the length of the defect was standard - 15 mm. Subgroup 1 included animals with a defect width of

The article presents the data of pathomorphology of chicken organs for infectious bronchitis. The authors found that the lesions of the organs for infectious bronchitis of chickens are systemic in nature and manifests itself depending on the age of the bird and the form of the disease: in the respiratory form, the lungs are most affected in chickens of 20-day age; in the nephroso-nephritis form – kidneys at 40, 90-day age; in the reproductive form – ovaries and ovaries at 285-day age. In this case, the respiratory form of infectious bronchitis in the lungs of chickens was observed hyperemia and edema of stroma, in pnevmocapillar and around the vessel contains a transudate. A significant number of pneumocapillars filled desquamated epithelium and lymphocytes. Some parts of the lung tissue and the tissue around the vessels are impregnated with transudate. In the lumen of parabronchus the presence of desquamated epithelium, lymphocytes, and muco-serous exudate noted. There were large areas of atelectasis, which bordered on areas of compensatory emphysema. The disease was accompanied by catarrhal-hemorrhagic, croup inflammation of the bronchus. In many cases, hyperemia and hemorrhages on the mucous membrane of the trachea, often catarrhal bronchitis, were observed. For nephroso-nephritis forms of infectious bronchitis in the kidneys of chickens for infectious bronchitis, hyperemia and hemorrhages in the stroma, granular dystrophy, necrosis and desquamation of tubular epithelial cells were recorded, in the lumen of which the accumulation of protein mass was detected, as well as blood filling of the capillary plexus of the vascular glomerulus. According to the reproductive form of infectious bronchitis in the oviduct, the presence of cysts was noted, especially in the anterior part of it. The posterior part of the oviduct was predominantly atrophied. The ovary was significantly reduced and covered with yellow bodies. In the future, atresia and degenerative changes in the egg follicles occurred.

The article presents the analysis of the existing literature on the use of fiberoptic facilities during challenging tracheal intubation. Awake fiberoptic intubation is the «gold standard» for difficult intubation cases in selective surgery. However, in emergency cases there is no clear rule for particular fiberoptic bronchoscope intubation method (awake, under anaesthesia with neuroomuscular relaxants or without them). Moreover, fiberoptic bronchoscope intubation technique is not described and valid enough. This is why further shared and generalized experience of fiberoptic tracheal intubation is needed, primarily for anesthetic management of emergency operations.

The experience of plasty of the pharynx and esophagus with graft of the free small intestine segment was presented in 12 children after burn stricture by the potassium permanganate. The technical aspects of operation using methods of the reconstructive vascular surgery were described. Good short-term result was obtained in all the patients. The long-term results were investigated during 15 years. It was observed, that the graft diverticulum developed by 4–7 years in 3 patients, whom repeated operation should be performed. According to the authors, the regional plasty of the esophagus by free revasculizated small intestine graft was really effective surgical supply and could be considered as the method of choice in limited scarry lesions of the pharynx and cervical esophagus, but the method should be improved.

The treatment of cicatrical stenosis of the trachea was performed in 193 patients at the age 8–65 years (132 of men and 61 women). The length of cicatrical stenosis shaped mainly by growth of granulation tissue and its different combinations consisted of 0,5 to 2,5 cm, getting 3,0 cm and more in 74 cases. The peculiar features of such cicatrical changes were characterized differently depending on its dominating localization on the length of the trachea — in the area of the neck or in the range of the mediastinum. Respiratory distresses, which were the main clinical manifestation of the disease, depended on the degree of stenisis of the trachea opening with the cicatrical process in each case. The decrease of size of the trachea opening with respect to natural size on1/3 was considered as the first degree of stenosis, on2/3 — II degree, more than on2/3 — III degree. The efficiency of endoscopic methods of treatment was the most significant in cicatrical stenosis of trachea with the length not more than 0,5–1,5 сm and dramatically decreased with the increase of length. The cicatrical stenosis of trachea with the length more than 3,5–3,0 сm should be considered as the indication for radical surgical intervention such as resection and plasty of trachea with forming of intertracheal or laryngotracheal anastomosis.

The article presents the results of diagnostics and treatment of 6 patients, whom the trachea-esophageal stenting was performed (5 men, 1 woman). The age of patients was from 49 to 78 years old. The indication to stent implantation was in cases of esophageal cancer in 4 patients. Metastatic lesions of the lymph nodes of the mediastinum was the reason of esophageal stenosis after previously performed surgery (type of Lewes operation) in one case. Another reason of surgery was central cancer of the right lung with invasion to the mediastinum, trachea and esophagus compression in one patient. Treatment management was determined by presence of respiratory failure and dysphagia evidence. The trachea stenting was carried out as the first stage of treatment in case of respiratory failure. The esophageal stenting was made in case of dysphagia. There weren’t any complications. The trachea-esophageal patency was restored.

The authors present a case study: an unusual foreign body (sewing needle) in the trachea. Despite the large size and unusual shape of a foreign body, we managed to remove it through the airways with rigid upper traheobronchoscopy, avoiding complications.

The number of permanent cannula wearers - has increased recently [1, 9]. Etiological factors contributing to an increase in the number of patients with tracheostomas are concomitant injuries to hollow neck organs, postintubation tracheal or laryngeal stenosis, surgical interventions on the neck, cancer of the upper respiratory tract, severe somatic diseases deteriorating the vital functions - breathing and food passage, which require repair surgery on the respiratory and digestive tracts. Despite successes in laryngotracheal surgery, failed or inefficient restorative surgical treatment requires a significant number of patients to wear a cannula on permanent basis [4-6]. Tracheostoma is a risk for the patient, while failure to provide adequate medical care and monitoring by the doctor can be life-threatening [8, 10, 11].

The original techniques of bronchus stump closure, modeling and disjunction of non-neoplastic tracheoesophageal fistula, replacement of postresectional defects of the trachea, pericardium, diaphragm and the thoracic wall using titanium nickelide implants have been developed and tested. It was ascertained that these methods were highly effective and simplified and standardized surgical procedures, provided anatomic and physiologic reconstruction of the injured area.

Objective: to study the nature of the complications in the experiment (in prosthesis concerning trachea and lungs) in lavsan tracheal prosthesis. Materials and methods: An experimental study was carried out on 27 mongrel dogs, divided into groups: the first group was replaced with lavsan prosthesis of 1h1sm tracheal defect (n = 9); in the second group cartilage defect of half-rings of the trachea 4 * 1,5 cm (n = 9) was replaced; in the third group circular tracheal defect was replaced with removing of three half-rings (1.5 cm) (n = 9). The dynamics of change in clinic in animals after surgery was evaluated. All the animals were performed in the dynamics tracheoscopy At autopsy after the period of 2, 4 and 8 weeks changes in the nature of tracheal prostheses and lungs were evaluated. Results: In all the animals of the first group there were no postoperative complications, the prosthesis was covered with mucous from the lumen of the trachea, lung lesions were not observed. Animals of the second and the third group were observed. Coughing on the second day after surgery, the prosthesis deformity of varying severity, lung lesions typical to pneumonia were revealed. Conclusion: Lavsan tracheal prosthesis is acceptable only if it has small defects.

The results of treatment of 9 patients with mechanical injury of trachea and of 22 patients with cicatricial stenoses of trachea are presented, in this article. 18 patients had. staged, reconstructive and plastic operations at the cicatricial stenosis, 2 patients had. endoscopic recanalization of tracheal lumen and. 2 patients had. sleeve resection of trachea with, anastomosis. An. original medical complex including argon-plasmatic, cryosurgical and. lymphotropic technologies. In all cases we managed, to recover respiratory tract integrity and. to provide adequate breath through, natural respiratory tract.

Cicatricial stenosis is caused by pathological processes in the larynx and trachea leading to a narrowing of the lumen and resulting respiratory failure [10]. One of the main causes of cicatricial stenosis of the larynx and trachea is long-term mechanical ventilation via endotracheal and tracheostomy tube [2, 3, 4, 6, 9, 11].

The article discusses the main, modern provisions of the programs of medical and social rehabilitation of patients with occupational diseases of the ENT organs. The criteria of the degree of loss of professional ability to work in hearing loss and malignant neoplasms of the upper respiratory tract are presented. Rehabilitation programs and forms are developed taking into account the needs of the victim in medical, social and vocational rehabilitation, taking into account the potential capabilities and abilities of the victim to carry out professional, domestic and social activities.

Despite the technical achievements of recent years in medicine, the problem of frequent recurrent stricture formation of the lumen of larynx and cervical trachea remains urgent. The etiology and pathogenesis of development of scar stenosis of the larynx and trachea were considered, and the analysis of the drugs' use for topical therapy in the comprehensive treatment of this pathology was conducted in the presented review. Special attention was paid to plasma enriched with platelets, its use in otorhinolaryngology, in particular in the treatment of laryngeal diseases. Positive and negative sides of the adjuvant therapy use have been identified. The search for means helping to prevent recurrent stricture formation of laryngeal lumen and cervical trachea determines the interest of the considered problem.

Spruce branch is a rare radiolucent bronchial foreign body. Despite modern imaging tests and endoscopic examination, this foreign body is often detected only intraoperatively. This study enrolled 4 patients with spruce branch aspiration. In the 4 th case, spruce branch was removed during rigid bronchoscopy that was associated with «lodging» type of foreign body. In two cases, spruce branch migrated to peripheral bronchial segments («extrusive» type) that required surgical treatment (thoracoscopy with resection of the right basal pyramid segments and wedge resection of the right lower lobe). The 3 rd case was the most interesting. Initially, the foreign body was «underlying», but it migrated after partial endoscopic removal that finally required right-sided lower lobectomy. This report describes the peculiarities of clinical course and management of patients with a rare type of radiolucent bronchial foreign body - spruce branch.

The article presents a literature review, that analyzes the use of implantation materials in reconstructive plastic surgery of the larynx and trachea in patients with local and extended laryngeal-tracheal stenosis, including lumen obliteration. 48 literature sources were studied. The positive and negative aspects of biological and synthetic implant materials use have been determined. The choice of an implantation material that meets all the demands for the complete restoration of the respiratory tract determines the relevance of the problem raised.

Treatment of cicatricial tracheal stenosis combined with postoperative sternal instability is a difficult objective. A 53-year-old patient with multiple previous tracheostomies and compensated tracheal stenosis underwent surgical correction of congenital heart disease in childhood. Heart failure progression occurred in 2017. The patient was examined. Mitral and tricuspid valve defect was diagnosed. Mitral valve replacement and tricuspid valve annuloplasty with radiofrequency ablation (RFA) of the right atrium were scheduled. To provide anesthesia, the patient underwent repeated tracheostomy that was complicated by atrial fibrillation. After stabilization of clinical condition, mitral valve replacement and tricuspid valve annuloplasty with radiofrequency ablation were performed. Postoperative period was complicated by cicatricial tracheal stenosis and total chest instability. A two-stage surgical treatment including circular tracheal resection with anastomosis and repeated sternal osteosynthesis with a titanium implant was performed. This approach ensured favorable functional outcome. In these patients, treatment strategy cannot be standardized and requires a personalized approach together with appropriate surgical experience.

The authors report acute neck injury followed by damage to larynx, trachea and pharynx. Features of treatment of this lesion are analyzed.

Objective: To analyze the long-term postoperative outcomes in patients with cicatricial tracheal stenosis and to determine the indications for various surgical strategies., Material and Methods: There were 976 patients with benign cicatricial tracheal stenosis for the period 2001-2017. Tracheal stenosis occurred after mechanical ventilation and tracheostomy in 910 (93.2%) patients. Other causes were neck trauma, burns, previous surgery or tuberculosis. Idiopathic stenosis was observed in 41 (4.2%) patients. Multiple-stage reconstructive treatment was possible due to benign nature of disease. There were 2.4 operations per a patient, and 976 patients underwent 2327 procedures. Circular tracheal resection was preferred ( n =396)., Results: Surgical complications occurred in 107 (4.6%) cases, mortality rate - 0.3%. In long-term period, 42 patients died for various causes. In most cases ( n =34, 80.9%), mortality was associated with concomitant diseases or consequences of trauma rather cicatricial tracheal stenosis or its treatment. Eight patients died from cicatricial tracheal stenosis or its treatment (7 patients after staged repair, 1 after circular tracheal resection). Four patients died due to asphyxia following T-tube obturation with a tracheobronchial secret or unjustified decannulation. For various reasons, 41 (6.2%) patients continued their treatment in other hospitals (4 patients died). Mortality rate in this group was 9.8%. Favorable long-term outcome was observed in 90.1% of patients, good and unsatisfactory results - in 7.2% and 1.8% of patients, respectively. Circular tracheal resection ensured better functional outcome., Conclusion: Surgical treatment of cicatricial tracheal stenosis is associated with low incidence of postoperative complications and mortality. However, further improvement in long-term results is associated with advanced rehabilitation programs for concomitant diseases. Treatment of cicatricial tracheal stenosis should be carried out at specialized hospitals.

Occupational diseases of the upper respiratory tract (URT) represent a significant section of occupational pathology of the respiratory system, since the mucous membrane of the nasal cavity and paranasal sinuses is the outpost that first comes into contact with inhaled agents (pollutants), including professional aerosols. The pathogenesis of occupational diseases of URT is based on long-term contact of pollutants with cells of the scintillating epithelium and violation of the function of the mucociliary system of URT. Occupational diseases of URT include: chronic catarrhal, subatrophic, atrophic, hypertrophic rhinitis, rhinopharyngolaryngitis; all forms of laryngitis, laryngotracheobronchitis, allergic diseases. Treatment and prevention of these diseases should be comprehensive with the use of personal respiratory protection equipment, mandatory preventive examinations and various local effects (inhalation, instillation, lavage, herbal medicine, etc.).

Neoplasms of the upper respiratory tract and ear are tumors of visual localization; however, patients often go to specialized medical institutions in the presence of a widespread tumor process. This paper presents a brief overview of the most common benign and malignant tumors with localization in the oropharynx, nasopharynx, larynx and ear. The clinical picture, diagnosis and various treatment options are presented. Attention is paid to early diagnosis and the need for timely consultation with an oncologist and doctors of related specialties.

Objective: To analyze the long-term outcomes of local resections in patients with carcinoid tumors of bronchopulmonary system., Material and Methods: There were 52 patients with tracheal and bronchopulmonary carcinoid for the period 2013-2019. The sample included 21 men and 31 women. Age of patients ranged from 20 to 82 years (mean 62 years). Typical carcinoid was diagnosed in 34 cases, atypical carcinoid - in 18 cases. Central tumor was diagnosed in 26 patients. Tracheal neoplasm was found in 2 patients. Another patient had mediastinal tumor. Five patients underwent resection with broncho- or tracheobronchoplastic reconstruction., Results: Surgical approach for carcinoid is determined by its differentiation, localization and lung tissue lesion following a long-standing tumor. These operations are quite safe. Complications occurred after 4 (7.7%) surgeries. Long-term results were followed-up for the period from 8 months to 7 years. There were no signs of recurrence and disease progression after organ-sparing bronchial resection. Local resection with bronchoplasty is advisable for typical carcinoid.

Objective: Analysis and comparison of clinical guidelines (CG) on malignant neoplasms of the respiratory system, placed in the CG rubricator of the Ministry of Health of Russia, for the information they contain on the role of factors and working conditions of the working environment in the etiology of respiratory diseases, including the upper respiratory tract, and comparison this information with published and regularly updated data from the International Agency for Research on Cancer (IARC)., Material and Methods: Clinical recommendations from the heading of the Ministry of Health of Russia "Cancer of the laryngopharynx", "Cancer of the nasopharynx", "Cancer of the oropharynx", "Cancer of the nasal cavity and paranasal sinuses", "Cancer of the larynx", "Cancer of the trachea", "Cancer of the lung", and IARC data according to the List of Classifications by cancer sites with sufficient or limited evidence in humans dated 11/29/2019., Results: The low level of registration of occupational cancer of the upper respiratory tract in Russia is due to an inadequate system of criteria for detecting this form of occupational pathology, a long latency period of diseases, and insufficient assessment of the history of information on the potential role of occupational carcinogens. The CGs developed to optimize the diagnosis and treatment of malignant neoplasms of the respiratory system do not contain up-to-date information on the role of professional potential carcinogens in the genesis of malignant neoplasms., Conclusion: Recognition of the professional nature of malignant neoplasms of the respiratory system implies, firstly, strengthening the role of otorhinolaryngologists in early diagnosis and rehabilitation of patients, and secondly, it has a pronounced preventive focus in the form of tasks facing the employer to reduce the carcinogenic load and develop preventive measures aimed to reduce and prevent the development of malignant tumors in workers, including the respiratory system.

Acute bacterial rhinosinusitis (ABRS) is one of the most common diseases in outpatient practice with a steady tendency to increase of complicated forms in recent years. The risk of antibiotic resistance makes it necessary to search for effective pathogenetic methods of ABRS treatment., Objective: To evaluate the efficacy of inhalation therapy with compressor nebulizer using Fluimucil Antibiotic IT in the treatment of ABRS and acute laryngotracheitis in outpatient practice., Material and Methods: Patients with ABRS were divided into two sex- and age-matched groups of 26 people each. The first group was treated with 250 mg of Fluimucil Antibiotic IT inhalations by the use of Norditalia HI-NEB compressor nebulizer once a day. The second group was treated with amoxicillin/clavulanate 875 mg + 125 mg orally two times a day., Results: In the first group, the cough disappeared significantly earlier (on day 5-6) than in the second group (on day 7-8). In the first group, nasal congestion also disappeared significantly earlier (on day 3-5) than in the second group (on day 4-6). There was no significant difference in the reduction of intoxication syndrome and nasal secretions in both groups., Conclusion: Local antibacterial and mucolytic therapy in the initial stages of ABRS and acute laryngotracheitis reduces rhinological symptoms and coughing, similar to systemic antibacterial therapy. The use of Fluimucil Antibiotic IT in the early stages of the treatment provides an opportunity to avoid systemic antibiotics, which reduces the risk of antibiotic resistance as well as side effects in patients.

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.

Objective: To study neurological status and structural changes in the tracheal lymphoid tissue in rats with different resistance to emotional stress in experimental hemorrhagic stroke., Material and Methods: Evaluation of neurological deficit on the Menzies scale and a histological study of structural features of tracheal lymphoid tissue were performed on days 1, 3 and 7 of experimental hemorrhagic stroke in 98 Wistar male rats with different resistance to emotional stress. Stroke simulation was preceded by animal testing to determine individual stress resistance., Results and Conclusion: Neurological disorders are more pronounced in non-stress-resistant animals during all periods of observation. Lymphoid nodules of the tracheal wall of rats react with destruction of lymphoid cells and depletion of small lymphocytes observed in stress-resistant rats already on the 1 st day of a stroke. On the 3 rd day, the neurological deficit and changes in the cellular composition of the lymphoid formations of the trachea are most pronounced in both groups of rats. By the 7 th day, a positive trend towards the restoration of the structure of tracheal lymphoid tissue and normal neurological status is detected only in rats resistant to emotional stress.

The purpose of the study is an experimental-theoretical study of the mechanisms of structuring the secretion of the nasal cavity, in the process of its dehydration in inflammatory diseases of the upper respiratory tract. The work shows the general patterns of dehydration of natural biological fluids and their model solutions. Simulation of dehydration of the secret allowed us to identify the most informative parameters of changes in its composition in pathology and to develop criteria for diagnosing the inflammatory process of the VDP using the wedge-shaped dehydration method. The study clarified the mechanisms of dehydration of biological fluid, which expanded the possibilities of diagnosing diseases of the VDP.

The article describes a rare clinical case of the development of angioedema of the larynx and pharynx in a patient during a surgery under endotracheal anesthesia. The authors of the article indicate that in the practice of clinic is 1 case for 32011 people, which is 0.003% of all hospitalized in the hospital for the elective surgical treatment of diseases of the upper respiratory tract. After removal of the tonsils and cyst of the nasopharynx, the surgeon noted a pronounced edema of the uvula, the mucous membrane of the soft palate, the lateral walls of the laryngopharynx and larynx. The patient was not taken out of the anesthesia. The mechanical ventilation was continued and the patient was transferred to the intensive care unit and intensive care unit where antiedematous and symptomatic therapy was conducted. On the 3rd day of treatment, the upper respiratory tract edema reduced, the patient was extubated. The authors present an algorithm for the examination and treatment of patients with angioedema.

The article provides a literarute review about the reconstructive surgery complications in patients with the larynx and trachea stenosis. The authors provide data on the etiology, pathogenetic features of the course of the larynx and trachea chronic stenosis, risk factors of the postoperative complication, and their prevention and therapy. Considered the methods of physiotherapeutic and pharmacological effects on the chronic inflammatory process in these patients and the experience of a number of researchers and the technical achievements of recent years.

After a retrospective study of the history of patients with a diagnosis of laryngeal cancer (2151 people), as well as the analysis of their own clinical materials, subglottic cancer was found in 103 patients, which was 4.8% of the total number of patients admitted to the hospital. One group of patients (n=39) underwent laryngectomy with subsequent irradiation, another group (n=64) was carried out by us developed and introduced into practice the method of the extended-combined laryngectomy. This method involves the mobilization and excision of the cervical tissue with lymph nodes located within it at the level VI level, the mobilization of the larynx and its removal at the level of the V-th or VI-th tracheal rings, as well as the dissection or thyroid share from the side of lesion in the unilateral localization, or complete dissection in the circular localization of the tumor. The comparative analysis was carried out on the frequency of metastasis in the pre- and paratracheal zones during the subglottic cancer of the larynx. A statistically significant (p<0.001) decrease in the incidence of metastases was observed in the advanced-combined laryngectomy (14.5%) compared with the traditional treatment (66.5%). If we consider that the main cause of death of patients with a tumor, both in subglottic cancer of the larynx and any other localization is metastasis, the development and introduction of new surgical methods that reduce the incidence of metastasis is a major breakthrough in practical oncology.

The present review of the literature is focused on the methods designed for the prevention of incompetent tracheorrhaphy. The main cause that dictates the necessity of strengthening the sutures is the risk of the development of the complications during the postoperative period following the surgical interventions. The incompetence of the tracheal anastomoses is known to occur in 3.6-26.3% of the patients which leads to the development of such complications as neck phlegmon, mediastinitis, and pleural empyema. The mortality rate amounts to 18.2%. The authors describe the methods employed for the prevention of incompetent tracheorrhaphy following the circular resections and suturing of the linear traumatic defects. The advantages and disadvantages of individual methods are discussed.

Aim: To reveal regularities of changes in cellular composition of lymphoid nodules in the tracheal wall in male Wistar rats resistant and not resistant to emotional stress in a model of hemorrhagic stroke., Material and Methods: Lymphoid formations of the tracheal wall (an area near the bifurcation of the organ) were investigated in 98 male Wistar rats using histological methods., Results and Conclusion: Significant changes in the cellular composition of lymphoid nodules were found. The pattern of changes depends on the stress resistance of rats and the period of the experiment. The active cell destruction in lymphoid nodules was noted both in stress resistant and stress susceptible animals. The changes in the structure of lymphoid nodules found in the experimental hemorrhagic stroke suggest a decrease in the local immune resistance, which is most pronounced in rats not resistant to stress, that may contribute to the development of severe inflammatory complications of stroke such as pneumonia.