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Introduction. Adenoid hypertrophy (pharyngeal tonsil hypertrophy) is considered as one of the most common diseases of the ENT organs.Aim. To study the polymorphism of the IL-10 gene (interleukin 10) and infections caused by human herpesvirus 6 (HHV6), cytomegalovirus (CMV) and Epstein-Barr virus (EBV) in children with AH.Materials and methods. The study included 106 children with adenoid hypertrophy and 38 healthy children aged 2 to 11 years. All children with adenoid hypertrophy were divided into three subgroups depending on the size of the pharyngeal tonsil. Viruses were determined by real-time quantitative polymerase chain reaction (PCR).Results. In patients with AH, HHV6 was detected more often than in CMV and EBV. Among the three subgroups of children with HGM, HHV6 and EBV infections prevailed in children with the maximum degree of pharyngeal tonsil hypertrophy. The frequency of the GG genotype was higher in the control group of children. Significantly higher frequencies of the G allele and GG and GA genotypes for IL-10 rs1800896 were found in the subgroup of children with the smallest size of the pharyngeal tonsil compared to other subgroups.Discussions. The frequencies of HHV-6 and CMV in the control group are significantly different. HHV-6 was the most frequently detected virus in patients with HGM compared with CMV and EBV. The frequency of the GG genotype was in the control group of children. A significantly higher frequency of the G allele and GG genotypes was found in the first subgroup of children compared to the second and exclusive subgroups. We found a lower frequency of the G allele and GG and GA genotypes in a significant subgroup of children compared to the second subgroup. Previous studies show a significant increase in the frequency of the A allele and the AA and IL-10 genotypes (rs1800896-1082G/A) in patients resistant to HHV-6 and CMV infections compared to those infected.Conclusions. The presence of HHV-6 and CMV infections contributes to the development of pharyngeal tonsil hypertrophy, and HHV-6 and EBV may contribute to the size of the pharyngeal tonsil.

Acute otitis externa is a common disease in the pediatric population, characterized by diffuse inflammation of the external auditory canal. Typical symptoms of acute otitis externa include otology, itching, congestion, and a feeling of fullness in the sore ear. In the case of active inflammation, the process can go to the tympanic membrane, and acute otitis media will join the external one. Primary therapy for diffuse uncomplicated acute otitis externa should include a local antimicrobial drug, without systemic antibiotic therapy. Topical therapy with antibacterial drugs in combination with anesthetics is the most rational. A clinical case of a 12-year-old patient with acute diffuse otitis externa and otitis media with effusion; acute nasopharyngitis; and adenoiditis, which was established based on anamnesis and clinical data is presented. Complex therapy was prescribed, which included local antibiotic therapy with a complex topical drug for the treatment of imperforated otitis externa and imperforated otitis media. At reexamination 5 days later, the patient demonstrated positive dynamics, pain in the left ear was eliminated. In cases of uncomplicated diffuse otitis externa, as well as in cases of its combination with otitis media with effusion, topical antibiotic therapy is a major priority. It should be borne in mind that the topical medication is more effective with the cleansing of the external auditory canal from inflammatory secretion. If it is used correctly, it would provide positive dynamics without systemic antibiotic prescription. It preserves the microbiome and mobilizes the body’s defenses. The application of complex topical antibiotic drugs can be widely recommended in pediatric practice.

Currently the issue of antibiotic resistance is urgent due to the unreasonable prescription of systemic antibiotics in the treatment of the upper respiratory tract infections. Frequent use of systemic antibiotic therapy in childhood leads to disruption of the microbiota and the development of secondary immunodeficiency. Alternative topical antibiotic therapy together with mucolytics allows the antibiotic to penetrate directly to the inflammation site and destroy biofilms. The article outlines the use of thiamphenicol glycinate acetylcysteinate in children with prolonged adenoiditis. In Russia this antibiotic is presented by Fluimucil® IT; it is manufactured in the form of a lyophilisate for both injectable solutions and solutions for inhalations and irrigation of mucous membranes. Thiamphenicol glycinate acetylcysteinate helps to improve the course of the disease, in some cases, to avoid invasive procedures and reduce the use of systemic antibiotics.

Scleroma is a chronic infectious disease characterized by developing inflammation nye granulomas, mainly of the upper respiratory tract, with subsequent scarring. The reasons for the development of scleroma remain unclear, but it is generally accepted that the gram-negative coccal bacterium Klebsiella rhinoscleromatis (pas-Volkovich's loch - Frisch) is the causative agent of this disease. Endemic in the spread of scleroma is considered There are tropical and temperate zones such as Africa, Asia, Eastern Europe, South America and Central America. Features of development scleroma in the present case and the complexity of the diagnosis caused by atypical, the rapid development of the disease, the greater prevalence of the process (including the orbit), with the transition to the soft tissues of the cheek bone and upper jaw, which is not typical for scleroma. The process was primarily localized in the left maxillary sinus and mimicked sinusitis. The presence of radicular cysts and darkening of the left maxillary sinus on radiographs, taking into account the clinical picture of the disease, were interpreted incorrectly, which led to the establishment of an incorrect diagnosis and subsequent surgical interventions. More targeted and consistent examination of histo-the logical material obtained after three surgical interventions made it possible to identify the characteristic signs scleroma, establish the correct diagnosis and prescribe effective treatment. In our case, we applied Ciprofloxacin course for 3 months at a maximum daily dose of 2000 mg in combination with probiotics. During treatment, it was noted a significant improvement in the patient's well-being, facial pains became less intense, a decrease in the volume of ma tissues of the left cheek and improved nasal breathing.Склерома представляет собой хроническое инфекционное заболевание, характеризующееся формированием воспалительных гранулем, преимущественно верхних дыхательных путей, с последующим рубцеванием. Причины развития склеромы остаются невыясненными, но принято считать, что грамотрицательная кокковая бактерия

The purpose of the study. To establish the effectiveness of symptom reduction and preventive action of the herbal drug Tonsilgon N (HD) as monotherapy for exacerbations of chronic tonsillitis/pharyngitis in adult patients.The study included 60 adult male and female patients aged 18 to 60 years with an established diagnosis of acute tonsillopharyngitis. In total, each patient underwent 5 visits. Visit 1 - enrollment in the study and beginning of HD monotherapy, Visit 2 - on Day 7, Visit 3 - on Day 14 and completion of HD monotherapy, Visit 4 - on Day 60 and Visit 5 - on Day 180. The diagnosis of the disease and the examination of the patient was carried out on the basis of anamnesis, general clinical and ENT examination, palpation of regional lymph nodes. The severity of the clinical signs was evaluated on the basis of the symptom score. The general condition of the patient was also evaluated using a visual analogue scale (VAS) and the number of exacerbations of tonsillopharyngitis during the observation period.The number of exacerbations of chronic tonsillitis and episodes of ATP for 6 months after the end of treatment decreased 4.8 times compared to the previous period. During the course of treatment (14 days), complaints of patients with ATP (general health and/or fatigue, pain when swallowing, headache, cough, burning sensation, a lump in the throat, hoarseness, pain and dryness in the throat, difficulty swallowing) had a pronounced tendency to regression. Improvement was also noted on examination and clinical evaluation. According to the results of the analysis of the evaluation of general condition according to the VAS (according to the standard technique in cm), there was a significant improvement both during the treatment period by 2.2 times, and during the observation period (180 days) from the period of Visit 2 to Visit 4 by 31.3 times.The use of HD as monotherapy for non-streptococcal ATP has shown its high efficiency. The possibility of using Tonsilgon N was shown as a prophylactic agent that reduces the number of exacerbations of inflammatory diseases in the pharynx during the period after the treatment course.Установить эффективность снижения симптоматики и профилактического действия растительного лекарственного препарата Тонзилгон Н (РЛП) в качестве монотерапии при обострениях хронического тонзиллита/фарингита у взрослых больных.В исследование были включены 60 взрослых пациентов мужского и женского пола в возрасте от 18 до 60 лет с установленным диагнозом «острый тонзиллофарингит». Всего каждый пациент прошел 5 визитов. Визит 1 — включение в исследование и начало монотерапии РЛП, Визит 2 — на День 7, Визит 3 — День 14 и завершение монотерапии РЛП, Визит 4 — День 60 и Визит 5 — День 180. Диагностику заболевания и оценку пациента проводили на основании сбора анамнеза, общеклинического и ЛОР-осмотра, пальпации региональных лимфоузлов, выраженность и тяжесть клиники заболевания — на основании балльной оценки симптомов. Также оценивалось общее состояние пациента по визуально-аналоговой шкале (ВАШ) и количество обострений тонзиллофарингита за период наблюдения.Количество обострений хронического тонзиллита и эпизодов ОТФ за 6 мес после окончания лечения снизилось в 4,8 раза по сравнению с прошлым периодом. В процессе курса лечения (14 дней) жалобы пациентов с ОТФ (общее самочувствие и/или усталость/утомляемость, боль при глотании, головная боль, кашель, жжение, комок в глотке, осиплость/охриплость, боль и сухость в глотке, затруднение глотания) имели выраженную тенденцию к регрессу. Также отмечалось улучшение по данным осмотра и оценки клинической симптоматики. По результатам анализа оценки общего самочувствия по ВАШ (по стандартной методике в см), отмечалось достоверное улучшение как в период лечения в 2,2 раза, так и в период наблюдения (180 дней) с периода Визита 2 до Визита 4 в 31,3 раза.Применение РЛП в качестве монотерапии ОТФ нестрептококковой природы показало его высокую эффективность. Была показана возможность использования Тонзилгон Н в качестве профилактического средства, снижающего количество обострений воспалительных заболеваний в глотке в период после лечебного курса.

The objective of the present study was the analysis of the application of the hydrogel-based medicinal compositions for the treatment of the patients presenting with pathological changes in the nasal cavity and paranasal sinuses during the postoperative period. A total of 25 patients at the age from 18 to 60 years with the diseases of the nasal cavity and paranasal sinuses were available for the examination including 12 ones with polypous polysinusitis and 13 patients having benign neoplasms in the nasal cavity, paranasal sinuses, and the base of the skull. All these patients underwent endoscopic endonasal polysinusotomy. After the surgical intervention was completed, the postoperative cavities were filled up with a gel containing sodium alginate, sodium hyaluronate, and dioxydin. This procedure was followed by the tamponade with the use of the silicone oil tampons in conformity with the standard method. The application of the polyfunctional depot-materials in the combination with the physiotherapeutic treatment modalities made it possible to accelerate the wound healing processes including epithelization, changes in the mucous membrane of the paranasal sinuses, and the reduction of the postoperative oedema.Цель исследования - анализ использования гидрогелевых лечебных материалов в послеоперационном периоде у пациентов с патологией полости носа и околоносовых пазух. 25 пациентам в возрасте от 18 до 60 лет с заболеваниями полости носа и околоносовых пазух (из них 12 пациентов с полипозным полисинуситом и 13 - с доброкачественным новообразованием полости носа, околоносовых пазух и основания черепа) были выполнены эндоскопические эндоназальные полисинусотомии. После выполнения хирургического этапа интраоперационно послеоперационные полости заполнялись гелем на основе альгината натрия, гиалуроната натрия и диоксидина, производилась тампонада силиконовыми тампонами по стандартизованной методике. Использование полифункциональных депо-материалов на гидрогелевой основе в сочетании с физиотерапевтическим воздействием позволило ускорить процессы заживления раны, эпителизацию, снизить реактивные изменения слизистой оболочки околоносовых пазух, уменьшить послеоперационный отек.

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.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.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.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.Оценить эффективность применения биорегуляторных препаратов для профилактики осложнений в раннем послеоперационном периоде у пациентов после септопластики и FESS.Нами проведено хирургическое лечение 25 больных хроническим риносинуситом с частыми обострениями без полипов в объеме септопластики и FESS (полисинусотомии). В послеоперационном периоде после септопластики и функциональных эндоскопических операций на околоносовых пазухах (ОНП) наряду с системной антибиотикотерапией, ирригационной терапией и туалетом полости носа под контролем эндоскопа применяли таблетированную форму препарата «Траумель С» по 1 таблетке 3 раза в день за 15 мин до еды в течение 10 дней. В полости носа после промывания нормализованным раствором морской соли применяли в качестве монотерапии спрей «Эуфорбиум композитум Назентропфен C» по 1—2 впрыскивания 3 раза в день 10 дней. В группу контроля включили 25 пациентов с хроническим риносинуситом с частыми обострениями без полипов, сопоставимых по возрасту, полу, длительности течения заболевания и объему хирургического лечения с основной группой.Ускорение процессов ранозаживления, реэпителизации, снижение реактивных изменений слизистых оболочек ОНП, уменьшение послеоперационного отека при применении препаратов природного происхождения «Эуфорбиум композитум Назентропфен C» и «Траумель С» способствуют минимизации патологических воздействий на эпителий ОНП и полости носа, сокращают время регенерации реснитчатого эпителия и улучшают мукоцилиарную функцию.Биорегуляторные препараты «Эуфорбиум композитум Назентропфен C» и «Траумель С» могут эффективно использоваться в лечении пациентов после ринохирургических вмешательств с целью ускорения репаративных процессов и восстановления функции мерцательного эпителия, не вызывают привыкания и «синдрома отмены» и не обладают раздражающим действием на слизистую оболочку носа и ОНП.

The data obtained have shown that morphological aggravation of atherosclerosis in coronary arteries occurs with age; local hemodynamically significant lesions or their combination with occlusion are more widely spread, i.e. a greater number of basal branches of coronary arteries are affected. Age does not influence intravascular activation of platelets and lipid profile, but the ability of an organism to resist oxidative stress improves with age.

Complete vestibulometric, audiological and otoneurological examinations were made in 48 patients with multiple sclerosis (MS). Central cochlear-vestibular syndrome was diagnosed in all the examinees. The otoneurological examination and comparison of changes in the acoustic and vestibular functions revealed specific symptoms characteristic for demyelinating disease of the central parts of the cochleovestibular analyzer. MR-tomography visualization of the demyelination foci in the brain confirmed affection of the cochleovestibular analyzer.

To specify the character of vestibular cochlear disturbances in multiple sclerosis (MS) and mechanisms of their formation, the objective quantitative evaluation of experimental caloric nystagmus using the computer electronystagmographic method and a comparison of hearing impairment with asymmetry of vestibular reactions were conducted in 48 patients with MS. The peculiarities of vestibular disturbance found in the study suggest a predominance of central vestibular syndrome with both subtentorial and supratentorial traits. The influence of the heat stimulus of vestibular analyzer (hot water caloric test) in multiple sclerosis revealed during computer electronystagmography may have diagnostic value.

We studied characteristics of vestibular and acoustic disorders in patients with arterial hypertension, atherosclerosis and vascular dystonia; correlation between peripheral cochleovestibular syndromes (PCVS) and circulation in the major and intracranial arteries, central hemodynamics, organic changes in the brain. We discovered that anomalies and asymmetry in vertebral arteries diameters, stenoses, reduced stroke and minute blood volumes play an essential role in development of PCVS. The latter are rarely accompanied with ischemic foci in the brain. Medication of vascular vertigo consists in administration of an adequate drug. We believe that betaserk is most effective.

Roentgen computed tomography (RCT) and MR-imaging (MRI) were used in investigation of vertigo etiology and affection of the cochleovestibular analyzer in 130 patients aged 28 to 74 years with recurrent systemic rotatory vertigo or its other symptoms. All the patients have undergone comprehensive otoneurological examination, RCT and MRI which showed that peripheral cochleovestibular syndromes (PCVS) caused by arterial hypertension (AH), atherosclerosis (AS), vascular dystonia (VD) are rarely characterized by focal alterations in the brain. PCVS comparison with blood flow in the vertebral arteries (VA) detected most frequently anomalies and asymmetries of the diameters. MR-angiography plays an important role in verification of pathology of intracranial VA. In central cochleovestibular syndrome (CCVS) with AH, AS, VD, principal pathological changes were registered in the brain trunk and cerebellum by MRI. Vestibulometry and otoneurological method detect not only vascular cochleovestibular peripheral and central syndromes but also to make differential diagnosis. RCT and MRI verify cochleovestibular syndromes in patients with multiple encephalomyelitis, VIII nerve neurinoma and tumors of the posterior cranial fossa.

Diagnostic value of some audiological methods of investigation (pure-tone audiometry, tympanometry, noisimetry) has been determined on the basis of examination and treatment of 114 patients with chemodectoma and hemangioma of the middle ear. Tympanometric evidence directly correlated with primary location and dissemination of the tumor. Changes on tympanograms and noisimetries correlate with the results of the tests with pressure of the neck's vessels and elevation of airpressure in the external acoustic meatus. Audiological findings are comparable with those of CT and MRT of the temporal bones and visualization of the tumor in surgery. High significance of the above methods was proved.