Rhinosinusitis is one of the most common human nosologies. Treatment of acute forms of rhinosinusitis should be comprehensive and directed, first of all, to the eradication of the infectious agent, as well as to restore aeration of the sinuses and drainage function of the anastomosis. With the development of bacterial inflammation, it is necessary to decide the feasibility of systemic antimicrobial therapy. With starting empirical therapy, the drug of choice is amoxicillin, but at the risk of antibiotic resistance, as well as the ineffectiveness of starting therapy, it is recommended to use protected aminopenicillins or cephditoren. Spectraceph (cephditoren) is effective in the therapy of patients acute purulent rhinosinusitis, including with prolonged, recurrent course.

Acute rhinosinusitis is a common inflammation of the nose and paranasal sinuses. The sinusitis diagnosis is based on a combination of clinical data with examination, data of instrumental studies. Viral ARS accounts for more than 90 per cent of cases. The bacterial etiology of sinusitis occurs in around 55–65% of cases. The purpose of the treatment of the acute RS is to eliminate the focus of infection, restore the ostiomeatal complex, regulate a drainage function, reduce inflammation and alleviate symptoms such as pain and nasal congestion. The main areas of treatment are antibacterial therapy, irrigation, anti-inflammatory therapy. Topical corticosteroids – first line drugs, along with irrigation. They can be used both as monotherapy as well as in addition to antibacterial  therapy. In the light forms of ARS mometazone at a dosage of 400 μg per day was much more efficient than placebo and amoxicillin. And the addition of topical corticosteroids  (MF) to the standard course of system antibiotic therapy (amoxicillin/clavulanate, cefuroxime) was much faster than the placebo to facilitate the symptoms of the acute RS and accelerated recovery. Intranasal steroids help in the treatment of daytime cough. When compared to treatment by other inhalation  corticosieroids  mometasone  has  higher  efficiency, safety,  better  resolution  of  symptoms, lower  cost  of  treatment. Mometasone can be used by pregnant women without fear of systemic manifestations.

Excessive accumulation of mucous secretions in the nasal cavity and paranasal sinuses is key drivers in the pathogenesis  of rhinosinusitis. Mucoactive drugs are actively used to combat this phenomenon. Mucoactive drugs promote mucosal secretion clearance due to increase of ciliary beat frequency in ciliated epithelium and decrease in the viscosity of secretion by means of hydrolysis of disulfide bonds and increased mucus moisture. The lack of clinical trials that meet the requirements of evidencebased medicine did not allow to include this class of drugs in the official guidelines for a long time.  However, thanks to the latest results, phytopreparations including a mucoactive plant preparation Myrtol standardized have been introduced into the European position paper on rhinosinusitis and nasal polyps (EPOS 2012). A large randomized double-blind multicenter study involving more than 300 patients with acute rhinosinusitis showed that administration of Mirtol standardized facilitates acceleration of the regression of the disease symptoms, reduces the need for antibiotic therapy and reduces the period of disability as compared to taking placebo. The results of this and other clinical studies allowed Myrtol to take a rightful place in the international and domestic guidelines.

200  children aged 4 to 12 years diagnosed with grade 3 adenoids, chronic adenoiditis, admitted for routine surgical intervention – adenoidectomy, have been examined and treated in the Pediatric ENT-pathology Department of the Moscow Department of Health L.I. Sverzhevskiy Otorhinolaryngology Healthcare Research Institute.

2 groups of patients were formed depending on the treatment performed in the postoperative period. Group  I (active treatment): 100 children who underwent conservative treatment after adenoidectomy, including: tested/investigational drug – Umckalor solution (per os), dosing regimen: children aged from 4 to 6 years – 5–10 drops 3 times a day, aged from 6 to 12 years – 10 to 20 drops 3 times a day; topical decongestants (in the age-related dosage); silver proteinate (nasal drops in age-specific doses); secondand third-generation antihistamines (in the age-specific  doses). Group   II (control): 100  children, who received conservative therapy after adenoidectomy, including: antibacterial therapy (in the age-specific doses) (third-generation cephalosporins); topical decongestants (in the age-specific doses); silver proteinate (nasal drops in age-specific doses); secondand third-generation antihistamines (in the age-specific doses). In both groups, the course of postoperative therapy amounted to 7 days. The clinical studies have shown that in the early postoperative period the clinical efficacy of Umckalor as part of combined therapy in children, who underwent adenoidectomy, involves reducing the duration of reactive events, accelerating the healing of the postoperative nasopharynx wound. The combined antiviral, antibacterial, immunomodulatory, anti-inflammatory, mucolytic and secretory-motor effect of the drug allows Umckalor to be used as an alternative to antibacterial drugs as part of combined therapy in children who underwent adenoidectomy.

Pharynx and pharyngeal lymphadenoid elements possess  diverse protective mechanisms, however, are often involved in the inflammatory process. Lysozyme is important natural factor in the maintenance of normal pharyngeal microbiome. The article presents the data about the efficient use of factors of natural protection of lysozyme and pyridoxine for the treatment of acute inflammatory diseases with lesions of the mucous membrane of the pharynx and lymphadenoid pharyngeal ring.

The vast majority of acute respiratory infections have a viral etiology. Streptococcus pneumoniae, Hemophilus influenza and Moraxella catarrhalis are the major bacterial pathogens responsible for the development of acute sinusitis and acute otitis media. The article presents clinical signs of bacterial paranasal sinuses and ear infections and indications for systemic antibacterial therapy. The issues of choice of antibacterial drugs for the treatment of acute bacterial sinusitis and acute otitis media are reviewed. The niche of third generation cephalosporins in the treatment of this pathology is also examined in this article. The article provides an overview of clinical trials of the efficacy and safety of cefixime in patients with URT and ear diseases.

Objective. To determine the clinical and morphological  criteria of chronic inflammation development in the middle ear mucosa and the study of local immunity.

Material and methods. 67 patients  aged from 19 to 67 years (men-28,  women-39) with complaints of pain, congestion in the ear, constant or intermittent  mucopurulent discharge from the ear, and hearing loss were examined. The disease  duration ranged from 3 days to 20 years or more. We have investigated the mucosa of the pathologically changed parts of the tympanic cavity. The sections were  stained  with hematoxylin  and eosin,  and trichromatic color by Mallory. For the  immunohistochemical  study monoclonal antibodies  to T lymphocytes  (CD4 T-lymphocytes-helper cells, CD8 T-lymphocytes-suppressors), B-lymphocytes  (CD20) were used. The calculation of the immunohistochemical  reaction was performed with a standard increase of 40 in 12 fields of view.

Conclusions. On Week 3 of the disease is a clear imbalance in the local immune defense occurs, which is a turning point in the course of the disease. In the period since 6 months and suppression of the immune response was detected. Thus, we believe that in conditions of a purulent inflammatory process the beginning of the process of chronic inflammation (development of granulation tissue) in the mucous membrane of the middle ear occurs on Week 3 from the onset of the disease, which is by 2–2.5  times later than in aseptic conditions.

Acute inflammatory diseases of the oropharynx dominate the medical aid appealability among all age categories. Such diseases are characterized by poly-ethiology and may form a mixed infection with bacteria and respiratory viruses. Components of bacterial cell walls, toxins, decay products of tissues during cytolysis or apoptosis of cells as a result of massive output of mature virions induce epithelial cells and macrophages for active synthesis of chemokines MCP-1, MCP-3, RANTES, IL-8, which leads to increased inflow of polymorphonuclear leukocytesin to the flammatory focus and a mass release of biogenic amines, lysosomal enzymes, cationic proteins, the release of arachidonic acid, which gradually turns into eicosanoids. Systemic use of NSAIDs can cause NSAID-associated gastropathies. Good accessibility of the target organ in diseases of the oropharynx allows target organspecific delivery of local treatment. Benzidamine hydrochloride (Tantum® Verde) refers to the group of anti-inflammatory suppressor of cytokines and also has a pronounced analgesic effect. The article provides data of the follow-up study of the efficacy of Tantum Verde® in the treatment of acute tonsillopharyngitis in outpatient settings.

The article presents a differentiated approach to the therapy of nasal obstruction syndrome. The authors discuss the physiological aspects of nasal breathing, the need for mucociliary clearance of the mucous layer lining the nasal epithelium, the factors of nasal resistance, and the concept of nasal cycle.

The article deals with the most common causes of breathing problems such as acute infectious and allergic rhinitis and provides detailed description of the etiology, pathogenesis and role of various microorganisms in the routine evaluation of acute rhinitis. Classifications of rhinitis including allergic one are presented. The paper reviews features of seasonal and year-round disease, pathogenesis of allergic inflammation.

The authors suggest that topical decongestants are used for reliable relief of nasal obstruction  syndrome. In case of abundant rhinorrhoea, the combined nasal spray Otrivin Complex containing xylometazoline and ipratropium bromide is advised. If nasal secretions are combined with congestion, the authors recommend using Vibrocil containing phenylephrine and dimethindene maleate.

The term «rhinitis» comprises a large heterogeneous group of diseases with different etiology and pathophysiological mechanisms. The latest consensual documents recommend that all rhinitis be classified into 3 main types: infectious, allergic (AR) and non-infectious and non-allergic with subsequent subdivision of each type into separate subtypes. In the Russian Federation, standards and clinical guidelines have been developed only for allergic rhinitis. The therapeutic agement of 779 patients with chronic rhinitis in outpatient settings have been analysed. When formulating the diagnosis, codes J31.0 and J30.0 and the terms «Hypertrophic rhinitis» and «Vasomotor rhinitis» were used for non-allergic rhinitis, while code J30.4 and the terms «Allergic rhinitis» or «Vasomotor-allergic rhinitis» were used for allergic genesis. The diagnosis «Intermittent AR» was indicated once, and severity was mentioned only in 2 patients. In AR group  (216 people), a comprehensive study was performed in 6.5% of cases, the diagnosis was established empirically in 52.7% of cases. Antihistamines were prescribed in 27.3% of cases, intranasal corticosteroids in 77.8%, montelukast in 9.7%, allergen-specific immunotherapy was performed in 1.9%. In non-allergic rhinitis (563 patients), 77.4% intranasal received corticosteroids, 7.5% received antihistamines, 3.7% – montelukast, 4.8% underwent surgical treatment. In both groups, original methods of therapy in the form of local antibiotics, homeopathic drugs, bacterial lysates were reported. In the AR group, a violation of the step-by-step therapy regimen was identified.

The article reflects the issues on etiopathogenesis and classification of immunodeficiency disorders. It also considered the aspects of administration of immunotropic therapy. Particular attention is paid to the immunomodulator  group. The article examines in detail and reviews the clinical efficacy of Polyoxidonium® immunomodulator. It describes its physicochemical structure and provides details of its administration in otorhinolaryngology on the basis of laboratory and clinical studies. This brings us to the conclusion that Polyoxidonium® can and should be considered as a modern and effective drug to be used in otorhinolaryngological practice.

The article presents the most common diseases of the upper respiratory tract in adults, the differential diagnostic criteria for acute respiratory infections, acute tonsillopharyngitis, acute and chronic rhinosinusitis. It discusses the need, the time frame for the indication of antibacterial therapy as well as the group of antibiotics and their dosage in these diseases.

The article addresses matters related to epidemiology, pathogenesis, clinical features and treatment of acute sinusitis. It also addresses in more detail the issues of secretolithic therapy of this disease, in particular, the use of the combination herbal drug Sinupret®. Here you can find the characteristics of this drug, its mechanism of action and its biological properties.

The article presents the results of clinical studies of the drug conducted by the Moscow State University of Medicine and Stomatology in 2011,  the Department of Otorhinolaryngology of the Medical Faculty of the FGBOU VPO  Russian Peoples’ Friendship University in 2011, and the studies conducted by the Italian and German scientists in 2015.

The following conclusions are drawn: a high safety profile and good efficacy of the drug allow us to recommend Sinupret® for the treatment of acute sinusitis in adults and children.

The article presents the published data about pathology of the middle ear: acute and chronic, modern methods of the medical therapy and features of surgical tactics choice.

Allergic rhinitis is one of most widespread human diseases associated with severe limitations in physical, psychological, and social aspects of life, which is the reason for the decline in quality of life. The drugs of first choice in patients with symptoms of seasonal and perennial allergic rhinitis of intermittent as well as of persistent courses are antihistamines of 2nd generation with high affinity to H1-receptors. The article is about a new representative of the above group of drugs, the original drug Niksar® (bilastine).

The article reflects the issues of epidemiology, etiology, pathogenesis and treatment of acute external otitis. A special emphasis in the work is made on the effectiveness of the modern combined drug Polidex in cupping this pathology.

The article presents the aspects of medical therapy of rhinosinusitis from the point of view of the disease pathogenesis. It is shown in which cases the indication of a systemic antibacterial therapy, the choice of optimal antibiotic given the current situation with antibiotic resistance and sensitivity is required. The author cites one recent study, which proved that the sensitivity of pneumococcus and Haemophilus influenzae to amoxicillin and amoxicillin/clavulanate is 100%, which defines their indication as first-line drugs for treatment of acute bacterial rhinosinusitis and acute exacerbation of chronic rhinosinusitis. The article provides information about clinical research in recent years and new trends of medical treatment of chronic rhinosinusitis with the use of corticosteroids, antileukotriene drugs and monoclonal antibodies.

Nasal polyps are known to mankind since ancient times. However, to this day, the polypoid vegetation processes remain insufficiently studied, and the problem of polypous rhinosinusitis is widespread.

According to the European Position Paper on Rhinosinusitis and Nasal Polyps EPOS-2012, thе pathology affects 2–4.3% of the Europe population [1]. The majority of domestic epidemiological studies show that nasal polyposis affects about 1% of the population in our country [2, 3]. From there, it can be assumed that polypous rhinosinusitis is an actual problem for at least 1.5 million citizens of our country [3]. Moreover, both domestic and foreign scientists agree that all available statistical data are strongly underestimated due to the large number of subclinical forms of this pathology and low incidence of outpatient visits [1, 2, 4, 5]. Average incidence of outpatient visits is 4.9 per 10 000  population in the Russian Federation. On top of that, the region-wise statistics vary little (3.7–5.8 per 10 000), which indicates that this type of pathology is spread uniformly [2].