Infections of the upper respiratory tract are widespread in the modern world. Treatment of these diseases is performed by both otolaryngologists and general practitioners. Сompetent diagnostics and proper selection of antibacterial therapy is the key to successful treatment of patients with pathology of ENT organs. Medicine of the third generation group of cephalosporins (Pancef®) currently are well represented on the market. They have proven to be an effective therapy of the pathogenic microflora.

Federal State Funded Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University under the Ministry of Health of the Russian Federation (I.M. Sechenov First MSMU) Acute rhinosinusitis is a common disease with worldwide prevalence. It is a disease that leads to the temporary disability and associates with decrease of quality of life. Patients with acute rhinosinusitis seek a medical care not only at otorhinolaryngologist but also to general practitioner, physician and pediatrician of the outpatient departments. Acute bacterial rhinosinusitis (ABRS) usually comes from acute viral upper respiratory infections or acute viral rhinosinusitis. Distinguishing acute viral rhinosinusitis and acute bacterial rhinosinusitis is a frequent challenge to the primary care clinician because of the lack of reliable criteria. So, the diagnosis of acute bacterial rhinosinusitis is most appropriately made on the basis of the medical history, length of the disease and clinical features. The treatment of ABRS should be complex, because despite the infectious etiology of the disease the necessity of antibiotics is still the point at issue. The main required effects of treatment of the acute bacterial rhinosinusitis are anti-inflammatory, mucolytic and anciliary. Phytotherapy is recommended for ABRS treatment by European, American and Russian guidelines.

Acute inflammatory diseases of the pharynx are frequent enough pathology of a person, especially in childhood and young age. Etiotropic factors of tonsillopharyngitis in most cases are viruses. Determination of the pathogen and the type of pathological process plays a key role in the choice of tactics of patient management. The introduction of new rapid diagnostic methods into clinical practice is relevant for clinical medicine. Topical medicines for the treatment of patients with pharyngeal pathology are effective and safe. It is preferable to use combination drugs containing several components acting on different parts of the pathological process.

The article reflects the issues of the management of patients with external ear inflammatory diseases. Authors describe the pathogenetic and etiological factors of this pathology development. In the article the principles of conservative treatment and the possibility of using measures that prevent relapses are described, depending on the severity and nature of the pathological process. The paper consists a brief review of clinical studies on the effectiveness of a complex drug with antibacterial, antiinflammatory and antiedematous action based on neomycin, polymyxin B and dexamethasone is reviewed.

 

Today, one of the most frequent causes for visiting paediatricians, general practitioners, ENT specialists are infectious inflammatory diseases of the pharynx [1]. Acute pharyngitis is a common manifestation of various acute respiratory viral and bacterial infections [2]. The drugs to be used for the local treatment of pharyngitis should meet the following requirements: have a broad spectrum of antibacterial activity, no toxic or irritating effects on the mucous membrane, low absorption rate and low allergenicity.

Chronic suppurative otitis media (CSOM) remains one of the main causes of severe hearing loss in children and people of working age, which makes it socially significant. According to domestic and foreign authors, the prevalence of this disease in global population is 1,5 to 4%.

The article highlights the problem of acute tonsillopharyngitis and chronic tonsillitis – epidemiology, clinical picture, diagnosis, principles of treatment, including the possibility of using drugs with target action. Data on the practical effectiveness and safety of Tonsilotren® are presented on the basis of data from Russian and foreign literature.

 

Inflammatory diseases of the middle ear are found in all age groups. Acute otitis media is diagnosed in 20–30% of cases among the total number of patients with various diseases of ENT organs. The disease usually lasts no more than three weeks, but the development of a prolonged or recurrent acute otitis media, which can lead to persistent changes in the middle ear and hearing loss, may occur. The recurrent course of acute otitis media leads to the development of chronic inflammatory pathology of the middle ear, to a progressive decrease in hearing, causing a disruption in the formation of speech and general development in young children. Timely diagnosis and adequate treatment of acute otitis media prevent the development of possible menacing complications.

The article presents modern data on antibacterial therapy for acute infectious and inflammatory diseases of the upper respiratory tract and ear, provides a overview of the most commonly used antibiotics in the practice of ENT, as well as clinical studies devoted to the study of the efficacy and safety of the drug Spectracef – a representative of the cephalosporin group.

 

Noninvasive fungal sinusitis is a widespread disease of the top respiratory tracts. The disease can proceed a long time asymptomatically or have a clinical demonstration with a dominance of a neurologic and ophthalmologic symptomatology. This pathology is surgical disease and successfully responds to treatment. However, unlike a noninvasive mycotic affection of maxillary sinus, when the starting mechanism of mitsetoma grow is invasion of foreign body after stomatologic manipulations, the pathogenesis of the isolated fungal sphenoiditis remains diskutabelny. By analogy, it is suggested about a drift into the sphenoidal sinus under certain conditions of foreign substance, which becomes the trigger of development of a fungal body in a sinus. Based on the analysis of clinical cases we established the reference cliniko-anatomic features, which are defining in a pathogenesis of this disease and can be taken as a basis at differential diagnostics chronic bacteriemic and noninvasive fungalc sphenoiditis. In a pathogenesis deviations of a nasal septum, hypoplasia of nasal turbinates and also considerably oversize of the ostium of a sphenoid sinus have a basic meaning.

Chronic tonsillitis creates conditions for the functional disorders of the voice and deterioration of its acoustic characteristics. The study of larynx functional state (video laryngostroboscopy, acoustic analysis of the voice using the LingWaves Voice Program program, and the Voice Handicap Index) in 40 patients with vocal-speech professions with simple and toxico-allergic 1 forms of chronic tonsillitis. After the course of palatine tonsils lacunaes sanation, the positive dynamics of the average values of the vibratory insufficiency index from 18 to 14 points and the DSI index from 29 to 385 points were noted. Chronic tonsillitis should be considered as one of the reasons for the development of functional dysphonia. Sanitation of lacunae of palatine tonsils improves the functional state of the vocal apparatus, which is confirmed by the results of acoustic analysis of the voice, by video laryngostroscope and VHI questionnaire.

According to WHO, allergic diseases will rank the second most prevalent in the world during the 21st century. On top of that, it also includes aggravation of allergic inflammation, the development of polysensitization, the attachment of various infectious complications. All this applies fully to the allergic rhinitis, which represents a particular problem in paediatrics. In many cases, the diagnosis of allergic rhinitis remains unrecognized, and children receive a wide variety of medications that aggravate allergic sensitization. Yuri L. Soldatsky, MD, Professor, Head of the ENT service of the Morozov Children’s City Clinical Hospital said in an interview about modern effective and safe approaches to the treatment of allergic rhinitis in children.

Allergic rhinitis is one of the most widespread human diseases. The article presents the modern classification of allergic rhinitis, the main approaches to treatment. The indications for carrying out hyposensitizing therapy for this disease have been determined, the effectiveness of nonspecific hyposensitizing therapy, conducted with the antihistamines of the second generation, which have a high affinity for H1 receptors. Also demonstrated the possibilities of the original drug bilastin (Nixar) – a representative of a group of antihistamines.

Treatment of allergic rhinitis (AR) is an important medical and social problem. Priority in choosing the tactics of managing patients with this pathology is the appointment of intranasal corticosteroids in the form of basic AR therapy and as part of combined schemes.

The issue of chronic rhinosinusitis (CRS) treatment is currently important. Wide variety of CRS clinical forms can be defined by multiple etiological factors, comprising genetic, environmental, infectious, allergic, immune contravention and systemic diseases. Cases when CRS occurs in patient with concomitant allergic rhinitis (AR) are not rare. Considering multifactorial etiology of CRS the therapy approach must be individual and complex especially in patients with concomitant AR. Usually surgical treatment is indicated, but in case of concomitant AR it requires additional pred- and postoperative therapy.

The purpose of the study was to improve the surgical stage of CI, taking into account the analysis of its complications. Materials and methods: During the period 2014-2017 in the Federal Research Clinical Center of Otorhinolaryngology and the State Hospital of the Ministry of Internal Affairs of Azerbaijan Republic named after A. Heydarov in 847 patients were performed 967 CI. The majority of patients were children aged 1–4 years (n = 540). Operations performed under the guidance of an experienced surgeon. In the postoperative period, follow-up visits were made every 3 months. Various variations of minor complications and the timing of their manifestation after CI were noted. Results. The incidence of minor complications was 1.6%. Of these, 0.5% were temporal hematoma, 0.8% dizziness, 0.1% seizure, 0.2% otitis media. Conclusion. The number of minor complications after CI is very low and does not always depend on the experience of the surgical team. In most cases, timely correction of minor complications of CI is the prevention of major complications.

This article presents the new method of plastics of larynx and trachea defect. The method is based on expiremental research and it will allow to restore an anatomical integrity of airways at the final stage of surgical treatment. Personal clinical observation is presented.

Reinke’s edema is a form of chronic hypertrophic laryngitis. Conservative treatment includes IPP in case of concomitant refux esophagitis, phonopedic and anti-inflammatory local treatment. It’s strongly recommended to give up smoking to all patients. Unseccessful conservative therapy, laryngeal stenosis and severe hoarseness are indications for surgical treatment. In ENT Department of IM Sechenov First Moscow State Medical University 10 adult patients (female) with Reike’s edema were treated. In 7 patients surgery performed by K.Storz «cold-steel» instruments, in other 3 cases semiconductor laser was used. Results assessed by laryngostroboscopy and acoustic voice analyses data. Patients were observed upon 1 month after surgery. In «laser» group of patients shorter rehabilitation time has been noticed.

This article describes the literature review on the prevalence, etiopathogenetic mechanisms, clinical picture and diagnostic methods and treatment of acute viral rhinosinusitis. Coryzalia, according to its pharmacological properties, can be used both in monotherapy and complex treatment of acute rhinosinusitis.

Acute rhinitis (ICD-X, acute nasopharyngitis, runny nose – J00) and acute sinusitis (J01) make up a larger proportion of all acute upper respiratory tract diseases (J00-J06). The prescription of antibacterial drugs for the treatment of virus diseases in the ENT area and the unproven or unconfirmed bacterial disease is considered erroneous and dangerous. In this regard, the role of pathogenetically justified therapy in the treatment of ARS increases. When choosing the medicines for ARS, particular attention is given to the use of herbal medicines with combination effect, which found its way into legislation – a group of herbal medicines is included in the list of ARS treatment medicines in adults in the EPOS-2012 document, and methodological recommendations approved by the National Medical Association of Otorhinolaryngologists.

The prevalence of allergic diseases has increased worldwide over the past decades. Despite significant progress in understanding the causes and mechanisms of allergic inflammation, and the development of approaches to the treatment of allergic diseases, the real practice of providing medical care to patients with allergic diseases remains far from perfect. The problem was addressed at the symposium «The Many Faces of Allergy: What are We Doing Wrong?» held within the framework of the AllRussian Conference «Clinical Immunology and Allergology to Practical Health Care».