Dysosmia is a frequent symptom in acute rhinosinusitis. Post-infectious dysosmia has a large share in the structure of olfactory disorders. The most common is postviral dysosmia. The sense of smell in acute rhinosinusitis can change both in the conductive and sensorineural types, but most often it is of a mixed nature, has an acute beginning and a favorable prognosis. There is also a transformation of the olfactory epithelium into a multilayer flat or respiratory epithelium. The pathogenesis of acute rhinosinusitis is based on an increase in edema of the mucous membrane of the upper respiratory tract and, as a result, the block of the natural sinuses of the paranasal sinuses, which leads to a violation of their ventilation and stagnation of secretions in the sinus cavity. For the treatment of acute rhinosinusitis, antibacterial, vasoconstrictive drugs, elimination and irrigation therapy are used.it is important to restore mucociliary transport, and therefore it is necessary to prescribe mucoactive and secretolytic drugs. A special role among these medicines is played by herbal preparations, among which one of the most effective and well-studied is a combined herbal preparation that includes Gentiana lutea, Primula veris, Rumex acetosa, Sambucus nigra, Verbena officinalis. Due to the anti-inflammatory and secretolytic effects, treatment regimens that include this drug provide high efficiency and optimal treatment times for patients with acute rhinosinusitis. Studies have shown that this drug has shown inhibitory activity in vitro against respiratory viruses, including respiratory syncytial virus, adenovirus and parainfluenza. In addition, it has been proven that when using this drug, a pronounced anti-inflammatory effect develops in the form of a decrease in prostaglandin E2 levels, cyclooxygenase-2 expression, tumor necrosis factor, and especially interleukin. In addition, the inclusion of this drug in the complex therapy of acute rhinosinusitis contributes to the restoration of olfactory function in the form of reducing the threshold of smell, increasing the ability to distinguish and identify odors. Data from the studies presented in the article demonstrate high efficacy and good tolerance of this drug.

Introduction. At the present moment, the healthcare system has faced significant problems in terms of infectious safety: an unprecedented increase in the spectrum of pathogenic microorganisms, the annual appearance of 1-2 “new” infectious diseases, an increase in the proportion of emergent infections, especially of viral etiology, against which there are no effective drugs, and the spread drug-resistant microorganisms, as well as the establishment of a direct etiological or trigger role of microbial agents in the development of somatic human pathology.

The aim of our work was to evaluate the topical preparation (amylmetacresol and dichlorobenzyl alcohol) used to stop the inflammatory process and eliminate pain in patients with pharyngeal diseases.

Patients and methods. We studied the antimicrobial, antiviral and anti-inflammatory effect of a fixed combination of 2,4-dichlorobenzyl alcohol 1.2 mg, amylmethacresol 0.6 mg. 20 patients with manifestations of inflammatory changes in the pharyngeal cavity underwent treatment with Strepsils resorption tablets according to the scheme. The control group consisted of 10 patients who received therapy according to the usual scheme.

Results and discussion. As a result of the therapy, sore throat in patients in the first group completely disappeared amongst 15 patients, and its intensity significantly decreased amongst 5 patients. Patients noted that the use of Strepsils resorption tablets reduces the sensation of a foreign body, irritation in the pharynx and oral cavity; eliminates pain, tickle, feeling of soreness in the throat. The analgesic effect of the drug manifested itself after about 5 minutes and lasted up to 2 hours. By the end of the treatment, all patients from this group had unpleasant sensations and discomfort completely stopped.

Conclusion. Amylmethacresol/Dichlorobenzyl Absorption Tablets is a well-tolerated and effective over-the-counter treatment offering functional, sensory and emotional benefits for patients with acute sore throat, providing a quick onset of effect and may be more relevant and suitable than antibiotics when pharyngitis associated with viral infections of the upper respiratory tract.

The article highlights that rhinitis is the most common disease, it is divided into 3 main phenotypes: infectious (IR), allergic (AR) and non-infectious non-allergic (NAR). There are also combined forms.

IR is a viral disease. Its clinical picture is described, the frequent failure of patients to consult a doctor for this disease is noted, which contributes to the development of complications and its chronization.

The authors described the characteristic features of the AR clinic with “oral Allergy syndrome“.

It is noted that NAR is a heterogeneous disease, which is divided into at least 6 subphenotypes: drug, taste, hormonal, atrophic, idiopathic and rhinitis of older people. The authors analyze the reasons for their occurrence. There is also a professional form of rhinitis.

All these phenotypes are United by the symptom of difficult nasal breathing, which also occurs in chronic rhinosinusitis and “empty nose“ syndrome.

Other causes of nasal breathing disorders are also mentioned.

In the treatment of patients with almost any of the rhinitis phenotypes, the main ones are irrigation-elimination therapy and the appointment of topical decongestants (TD). An important role is played by avoiding the causes that activate the course of rhinitis, and educating the population to properly organize the individual treatment process.

The larynx is the first part of the respiratory and digestive tract and it performs vital functions. The air stream, passing through the throat and coming into contact with its mucous membrane, is moistened, warmed up and purified. Due to the anatomical structure of the mouth cavity and pharynx, it creates conditions for entry, presence and inactivation of microorganisms, viruses and fungi. Under normal conditions, due to effective protective mechanisms (mucociliary and immune), pathogens are trapped in the upper respiratory tract while the lower sections remain «clean». Acute pharyngitis is a widespread, polyetiological disease of the upper respiratory tract. There are quite a few preconditions for its development. A favorable background for local inflammation is the reduction of specific and non-specific protection factors, which may be observed in the existing chronic inflammation and worsened in diabetes mellitus and metabolic syndrome, with prolonged use of cytostatics and/or glucocorticosteroids and many other immunocompromised conditions. Due to the prevalence of pharyngitis, the development of effective screening and treatment methods is particularly relevant. Given the localized nature of inflammatory process in the pharynx and the possibility of side effects, general anti-inflammatory drugs are used less and less frequently, and local non-steroidal anti-inflammatory drugs are increasingly drawing the attention of physicians. The article discusses the possibilities and effectiveness of the medication based on benzidamine hydrochloride in treating pharyngitis of diverse etiology. The article presents the studies of foreign scientists, as well as dosages and peculiarities of the medication application. Treatment of acute tonsillipharyngitis with local non-steroidal anti-inflammatory drugs is commonly accepted and widely used in the practice of pediatricians, therapists and otorhinolaryngologists and allows to achieve rapid relief of the patient’s condition.

The article presents our own research data on systemic immunity status in patients with chronic tonsillitis (CT) and microbiological profile of the flora isolated from the tonsils in CT. The study showed that phagocytic index in neutrophils decreased by 81.9% and the phagocytosis in neutrophils reduced by 67.2% in patients with CT. We studied microbial flora of the tonsils and its persistent properties in CT. The steps for that were as follows: we evaluated the antilysocyme (ALA), anti-interferon (AIA), anticomplementary (ACA) activities of the isolated microorganisms as possible ways to stand against the oxygen-independent mechanism of phagocytosis. Most strains of Staphylococcus aureus had ALA, AIA and AСA, while most strains of Streptococcus pyogenes had ALA, less frequently AСA and did not show AIA. We found antibacterial polyresistance in 56.0% of pathogens among the selected strains in the examined patients with CT. A comparative analysis of species antibiotic resistance showed that the largest number of multiresistant strains were S.aureus - 62.0%. The set of revealed persistent properties of chronic tonsillitis pathogens serves as underlying rationale for the search for new methods of therapy using drugs of non-antibacterial origin, affecting the factors of bacteria resistance to inborn and acquired immunity. It is possible, and necessary that attention be paid to phytotherapy in the search for such new methods. Tonsilgon N is one of the complex phytotherapeutic products, which efficacy and safety has been proven in clinical trials, and the main pharmacological properties are confirmed in in vitro and in vivo preclinical studies. It contains marshmallow root, chamomile flowers, horsetail grass, walnut leaves, yarrow grass, oak bark, and dandelion grass. The clinical studies revealed that it has positive effect on the dynamics of both clinical and microbiological, immunological parameters in patients with chronic tonsillitis. All these things allow us to recommend that this complex herbal product be more often included into the comprehensive treatment of chronic tonsillitis. 

Pharyngalgia is one of the most common complaints in both children and adults seeking medical advice. The causes of throat discomfort and pain vary and are explained by anatomo-physiological characteristics of pharynx. The lesion of pharyngeal mucosa and mucosal associated lymphoid tissue develops in 80% of acute respiratory disease cases. Detailed history taking and additional tests are required to confirm the etiology of pharyngalgia that is not related to respiratory infection and to provide appropriate treatment for the patient. Fixed topical combination with complex effectiveness established itself as a leading choice of inflammatory pharynx diseases treatment. Such treatment has the following advantages: the precise point of drug effect, minimal amount of side effects or its complete absence and risk reduction of general micro biome affection. The treatment should also be able to reach hard-to-reach areas and have good sensory properties. The purpose of topical treatment in patients with pharyngeal pathology is to relieve pain quickly, to reduce the inflammation and to prevent secondary infection of mucosa. The drug containing tyrothricin as antibiotic, benzocaine as antiseptic provides antibacterial and benzalkonium chloride as antiseptic, antiviral and analgetic effects. Not only do the early diagnosis and treatment meet the need of the patient to relieve the symptoms quickly but also have a positive impact on disease course and prevent the development of complications.

In this article, the authors provide an overview of existing data on the use of topical antibacterial drugs in acute rhinosinusitis in children. General information on the etiology of acute rhinosinusitis is given. Indications for systemic and topical antibiotic therapy in acute rhinosinusitis are noted, indicated in Russian and international consensus documents. The advantages of using the combined preparation of thiamphenicol and N-acetylcysteine in acute rhinosinusitis in children and adults are considered separately. It is concluded that the topical antibacterial therapy of acute rhinosinusitis, despite all its advantages, is not an equivalent substitute for systemic antibacterial therapy in the treatment of severe and, especially, complicated forms of acute rhinosinusitis. The practitioner should be guided by the indications for systemic and topical antibacterial therapy adopted in Russian consensus documents. If there are indications for systemic antibiotic therapy, local remedies are only ancillary treatment, the action of which is aimed at enhancing the effect of systemic antibiotics. In the case of monotherapy with local drugs containing antibacterial components, it is mandatory to re-evaluate the patient’s condition and the dynamics of the symptoms of the disease for 2–3 days of treatment, and in the absence of positive changes, reconsider the need for systemic antibacterial therapy. More promising is the use of combined drugs that, in addition to affecting the causative agent of the disease, achieve anti-inflammatory, decongestion or mucolytic effects. It is convenient and rational to use nasal sprays, however, in order to improve the delivery of the active substance to the site of inflammation in acute rhinosinusitis, the use of nebulizer is justified.

Introduction. A biofilm is a community of bacteria embedded in a matrix consisting of polysaccharides, nucleic acids, and proteins. Biofilms are resistant to antibiotics, antiseptics, and immune defense factors of the human body. Currently, the role of bacterial biofilms in the pathogenesis of chronic infections is known. There are a lot of articles confirming the detection of biofilms in diseases of the upper respiratory tract and ear: adenoiditis, recurrent and chronic otitis, laryngitis.

Biofilms and Chronic Rhinosinusitis (CRS). Biofilms can play a significant role in prolonging inflammation in the paranasal sinuses. Biofilms are found in 76.7% of patients with CRS. This fact can serve as one of the explanations for the refractoriness of drug therapy and recurrent inflammations after surgical treatment.

Methods for Controlling Biofilms. Is there a Way Out? As part of the strategy of removing biofilm, it is important to destroy its structure to planktonic forms, which will allow for the process of managing CRS progress. Antibiotic therapy alone is considered insufficient. Nasal irrigation can provide a violation of the biofilm integrity due to the mechanical destruction of its matrix and have a significant impact on the outcome of the disease. The nasal irrigation preparation containing isotonic sea water solution added with carbon dioxide (CO₂-0.4%) has such an effect. In an experimental study, it was shown that 98% of the bacteria were non-viable when processing Staphylococus aureus biofilm.

Conclusion. The impact on biofilms should be complex, including medication, physical means, irrigation of the nasal cavity.

Intriduction. Chronic rhinitis and rhinosinusitis noticeably deteriorate the patients’ quality of life and lead to the accompanying upper airway pathology development. The main purpose of treatment of this group of patients is to decrease severity of symptoms and the second one to prevent complications. The optimal therapy will help patients to maintain their lifestyle. Intranasal glucocorticosteroids are first-line drugs to treat acute rhinosinusitis or exacerbations of chronic rhinosinusitis in adults (including the elderly) and adolescents aged 12 years and older as an auxiliary therapeutic agent if treated by antibiotics, and to treat acute rhinosinusitis with mild to moderate symptoms without signs of severe bacterial infection. In the number of trials, mometasone furoate effectiveness in regard to decreasing of prominent symptoms with no side effects development has been shown.

Objective: this article reviews available data on the effectiveness of intranasal corticosteroids – mometasone furoate – in the treatment of different forms of chronic inflammatory diseases of the nose and paranasal sinuses.

Methods: information for this review was identified through a RISC and MEDLINE databases applying key words.

Conclusions: based on the available data, treatment of chronic rhinosinusites and rhinitis should be initiated by conservative therapy. Summarizing information from the available literature we can conclude that treatment by mometasone furoate improve quality of life decreasing clinical symptoms of chronic rhinosinusitis and rhinitis.

The article discusses the main aspects of diagnosis and treatment of dysphonia at the present stage and provides best practice guidelines. There is a vast array of pathologies that can give rise to dysphonia. Neoplastic processes and neoplasms, which late diagnosis leads to higher mortality, are considered alarming in this context. If dysphonia persists for more than 4 weeks, it is required to make laryngoscopy to exclude serious larynx diseases. People whose work involves using their voice are the most susceptible to the development of dysphonia. It is important to identify risk factors in patients, which include recent operations in the head, neck and chest area, recent endotracheal intubation, the presence of neck lesion, voice and speech profession, smoking history, signs of respiratory failure. Treatment for dysphonia depends on the cause of the pathological process and may include management of the underlying disease, pharmacotherapy, non-drug treatment and surgical intervention. There are extremely few products among the health aids of allopathic medicine that specifically improve the quality of voice function. In this regard, homeopathic medicines play a large role in the treatment of voice disorders. Clinical studies showed the efficacy of these medicines, which have a wide range of indications and a minimal number of side effects. However, the use of traditional homeopathic medicines is limited by the need for homeopathy expertise. Complex homeopathic medicines have been developed to optimize the treatment of these patients. Any specialist without homeopathy expertise may use a combination of these medicines and conventional treatment.

The article highlights the urgent problem of modern medicine - allergic diseases. Over the past decades, there has been a significant increase in the prevalence of this pathology, the share of which in the general structure of the incidence of the population remains high to this day. The statistics are staggering. According to various sources, various manifestations of allergies affect from 10% to 40% of the world’s population. According to conservative estimates, more than 500 million people in the world. According to epidemiological studies, the amount of atopy is growing by 5-6% every year. The disease has a huge impact on the quality of life of the patient. Needless to say, an allergic disease can be accompanied by complications, including life-threatening. The big financial burden on the budget of our country is the economic costs of combating allergies and its complications. Therefore, the treatment of this nasology is one of the key issues both in the global and in Russian healthcare.

Intranasal (topical) corticosteroids (IKS) are the drug of choice in the treatment of patients diagnosed with allergic rhinitis (AR). However, ICS are widely used in clinical practice and in the treatment of other diseases of the nose and paranasal sinuses. Depending on the nature of the pathological process, the duration of the drug can vary widely: from two weeks to several months or years. The purpose of this work is to systematize relevant publications and analyze possible uses for this group of drugs. The article reflects the issues of epidemiology, etiopathogenesis of allergic rhinitis. Consistently considered modern methods of treatment, in particular the use of (ICS) in therapy regimens. The results of international multicenter randomized controlled clinical trials are presented, the purpose of which was to determine and evaluate the efficacy and tolerability of ICS, in particular fluticasone propionate. It is concluded that fluticasone propionate is a modern and effective agent for the pathogenetic treatment of patients with not only allergic but also non-allergic rhinitis and can be recommended in the modern treatment regimen for both allergic and non-allergic rhinitis.

Introduction. Sudden sensorineural hearing loss is the most common pathology of polyethological sound perception. Systemic glucocorticosteroid therapy has long been considered the main treatment method. In recent years, topical therapy has been of great interest. However, intratympanic injections cause considerable discomfort to the patient and require about 1 hour per day to perform the procedure.

Materials. In order to modernize and reduce the time spent on delivering steroids into tympanic cavity, this article considers the experience of managing 41 patients with sudden unilateral sensorineural hearing loss. Patients of the first group received dexamethasone 4 mg / ml in a volume of 1 ml by catheterization of the auditory tube, followed by introduction into the tympanic cavity. Patients of the second group were divided into 2 subgroups: in the first subgroup, dexamethasone 4 mg / ml in a volume of 0.5 ml was administered into tympanic cavity through a pre-imposed hole in the eardrum using a radio-wave device, and patients of the second subgroup received a classic intratympanic injection of dexamethasone 4mg / ml 0.5 ml after application anesthesia of the eardrum. The audiometry was performed before treatment, after 1, 2 weeks, 1 and 6 months.

Results. The average time spent in the clinic of patients of the first group was 30 minutes, while patients of the first subgroup of the second group had 20 minutes a day. The longest time in the clinic was 2 subgroup of patients from 2 groups-about 1 hour.

Conclusions. Radio-wave myringotomy is the safest and most convenient method. The smallest amount of time spent on the patient was observed in the subgroup of intratympanic injections that performed radio-wave miringotomy. It has been proved that the methods of topical treatment are not inferior in efficiency to each other.

Allergic rhinitis is a common allergic disease that have a substantially negative impact on the patients’ quality of life. Pharmacotherapy is essential to the treatment of allergic rhinitis, including the use of antihistamines, leukotriene receptor antagonists, topical steroids, decongestants, cromones, anticholinergics and their various combinations. Antihistamines are commonly prescribed drugs to treat mild, moderate, and severe disease. The article discusses the mechanisms of action of first- and second-generation antihistamines and compares the potential side effects and drug interactions.
First-generation antihistamines differ in their significant sedative and hypnotic effect, mainly due to their pronounced lipophilic properties and ability to transverse the blood–brain barrier and bind to H1-histamine receptors in the central nervous system. Due to low selectivity of the first-generation antihistamines, they may interact with other receptors and develop adverse side effects, including dry mouth, nasopharynx, more rarely pupillary dilation, increased intraocular  pressure, tachycardia, and urine retention. Bilastine is a highly selective second-generation antihistamine that has a  rapid onset and a prolonged action. This drug does not interact with the P450 cytochrome system or undergo significant metabolism in the human body, and therefore the drug has low potential for drug-drug interactions. Bilastine is excreted almost completely unchanged and therefore does not require dose adjustment in patients with renal or hepatic impairment. Bilastine demonstrated similar efficacy in seasonal allergic rhinitis compared to cetirizine and desloratadine, as well as similar efficacy and safety in long-term treatment of patients with perennial rhinitis compared to cetirizine. Bilastine is well tolerated both at standard and at supratherapeutic doses, appears to have less sedative potential than other second-generation antihistamines, and has no cardiotoxicity. 

Introduction. Тhe search for drugs that accelerate the process of resolving post-traumatic reactive changes, which have both sufficient anti-edema and anti-inflammatory effects, and reparative properties, is relevant.

Goal of reserch. The purpose of this review is to find a means to speed wound healing after nasal traumas.

Materials and methods. The researchers conducted an analysis of scientific research data to evaluate the efficacy of naturopathic mountain arnica-based remedies for the treatment of patients with an external nose trauma accompanied by the formation of edema, hematoma of lateral nasal wall and/or skin abrasions of external nose.

Results. This work shows that topical plant remedies based on Аrnicamontana has a pronounced anti-inflammatory and antiedema effect, comparable to the traditionally used for this purpose heparin-containing ointments and gels. However, unlike the latter, products based on Arnica montana have a pronounced wound- healing effect, which allows to significantly reduce the time to resolve traumatic injuries of the skin of the external nose. The analysis of the work also demonstrates the absence of adverse reactions when using this drug.

Conclusion. The obtained data allow us to recommend topical naturpathic remedies based on Arnicamontana for use as a firstchoice drug for wound healing after nasal traumas. In addition, the drug is effective in the complex treatment of patients with nasal trauma requiring surgical intervention: at the preoperative stage - to reduce post-traumatic reactions and prepare for surgery, and at the postoperative stage - for the early recovery, reducing edema and inflammation.

The incidence of allergic rhinitis has been increasing rapidly worldwide in recent years. About 40% of the world’s population suffer from allergic inflammation of the nasal mucous membrane. Clinical manifestations of allergic rhinitis are absence or difficulty of nasal breathing, itching, sneezing, nasal congestion and rhinorrhoea, as well as swelling of the face, the presence of dermatitis in the region of the nasal wings, general malaise, smell disturbance. Manifestations of allergies by ENT organs in most cases do not pose a threat to life, but they can cause the development of other pathological processes, bad sleep, irritability, decreased efficiency, mood swings, which, in turn, adversely affects human health and reduces the quality of life. The pathogenesis of allergic rhinitis is based on an immediate hypersensitivity. According to the modern classification, depending on the nature of the course of the disease it is common to identify intermittent and persistent forms.

At present, the drugs of choice in the treatment of patients with allergic rhinitis are intranasal glucocorticosteroids. However, the presence of a concomitant pathology of the nasal cavity in the patient, such as deviated septum, not only significantly impairs the course of nasal inflammatory process, but also creates obstacles to adequate delivery of topical drugs to all parts of the nasal cavity, which, in turn, reduces their effectiveness.

For patients suffering from allergic rhinitis in combination with other pathology of the nasal cavity, combined oral medications may be a good alternative to intranasal sprays. Certain interest for doctors is caused by the appearance of a combined antihistamine drug on the Russian market, which includes a blocker of leukotrienes and H1-histamine receptors of the second generation – montelukast and levocetirizine. The drug can be used both in adults and children from 15 years old for treatment of intermittent and persistent forms of allergic rhinitis.

Timely and properly performed therapy of allergic rhinitis allows to eliminate symptoms of the disease and prevent the development of complications.

The aim of the review is to identify current possibilities of carbon dioxide laser application in microsurgical treatment of chronic laryngeal cicatricial stenoses. Currently, laser endolaryngeal surgeries are one of the main standards in surgical treatment of patients with this laryngeal pathology, including when providing high-tech assistance. Various types of lasers and methods of surgical treatment of the larynx are used. The choice of these methods is primarily determined by the opinion of the operating surgeon. The review highlights the principles of laser surgery in general, and when using carbon dioxide laser in particular. The use of micromanipulators makes it possible to combine the work of carbon dioxide laser with the operating microscope, affecting target tissues noninvasively with maximum precision. This technology makes it possible to expand the range of surgical manipulations in endolaryngeal surgeries. The main operating modes of the carbon dioxide laser, applicable for different clinical situations, such as power, impulse, laser power density (PD) are considered. In addition, the combination of a micromanipulator with an operating microscope allows the use of additional techniques aimed at preventing restenosis, such as the use of microflaps, submucosal laryngeal cicatricial tissue vaporization. The possibilities of the recurrence of cicatricial stenosis by different variants of stenting are presented. The risk of complications of this technique is not higher than in other types of larynx laser surgeries, and with proper preventive measures can be minimized. In the review, possible complications, both early and late, measures of their prophylaxis, as well as ways to eliminate their consequences are analyzed in detail.

The aim of this article is to demonstrate ENT specialists, neurologists and general practitioners how to examine and treat patients with acute vertiginous complaints. Traditional otoneurologic testing that carried out for accurate topic diagnostics of acute vestibular dysfunction is described as available «Vestibular passport». Clinical diagnosis can be achieved after thorough assessment of patient’s complaints as well as history of the present illness. Gaze tests and posture control trials are demonstrated in details. Diagnostic value of each probe is shown from the viewpoint of differential diagnostics of peripheral and central vestibular dysfunction. High diagnostic value of registration and analysis of oculogyric reactions is presented by history cases of acute labyrinthopathy and acute vestibular neuronitis. In these cases absence of saccadic and pursuit gaze disturbances rule out central vestibular system dysfunction. The salient feature of these two variants of peripheral vestibular dysfunction is spontaneous nystagmus that revealed by Frenzel glasses. This significant oculomotor symptom as well as disturbances of static and dynamic postural control confirm patient’s vestibular complaints in objective way. Revelation of decompensation signs of vestibular dysfunction needs urgent medicine vertigo therapy and spare vestibular rehabilitation. Actually, medications of choice are sedative drugs with antiemetic effect, non-loop diuretics and glucocorticoids. 

The article presents the different grafts for chronic tympanic membrane perforation closure. The types of surgical treatment of chronic otitis media are described in a historical aspect. The initially proposed vascularized skin grafts were quickly replaced by a range of connective tissue autografts. Authors indicated a few studies in which fascia lata, venous wall, periosteum were used for myringoplasty. However, these tissues are not widely used in otosurgery. The special attention is given to the comparative studies on the outcomes of closure with fascial and cartilage grafts. The last ones are currently most commonly used for myringoplasty. Nonetheless, the use of each of these grafts is associated with indicated in the literature advantages and disadvantages. The cartilaginous grafts allow to close rather big perforations, but with lack of flexibility and pliability. On the other hand, flexible perichondrium and fascia improve the mechanical properties of neotympanic membrane yet increasing the risk of retraction and reperforation. Therefore, the search of alternative treatment for chronic tympanic membrane perforation is lasting at present. There are many studies on regenerative medicine in foreign literature. The tissue engineering approach allows to repair the damaged tissue due to proliferation of pluripotent cells and activation of their migration. The tympanic membrane regenerative potential eliminates the need for external stem cells and allows to use less complicated “in situ” tissue engineering technique. The key of this technique is the combination of the regeneration regulating factors with temporary supporting scaffolds. The authors also describe the advantages of the modern tissue engineering approach and prospects for its further application to clinical practice. 

Introduction. Chronic nasal congestion caused by edema of inferior turbinate affect 20% of population and strongly influences their quality of life. Pharmacological treatment of chronic rhinitis is considered to be the first line therapy. However, if conservative treatment is not effective and clinical signs are not disappearing the question about relevant surgical treatment is arising. Nowadays there are many methods of exposure on mucosa of the inferior turbinate. Considering high incidence of the pathology surgical treatment is of current importance in modern otorhinolaryngology.

Objective. Assessment of the effectiveness and comparison of the period of rehabilitation after submucosal laser destruction by laser beam with wavelength 1,56 and after submucosal destruction by radiosurgical instruments Ellman Surgitron with a frequency of 4 MHz in patients with chronic rhinitis.

Methods. 60 patients were included into the study aged from 18 to 80 years old with chronic rhinitis. All the patients were admitted to the department to perform surgical treatment. Semiconducted laser with wavelength 1,56 and radiosurgical instrument Ellman Surgitron with frequency of 4 MHz were applied to the treatment. We assessed SNOT20 score, endoscopic features, anterior active rhinomanometry and saccharin test results in all patients following the surgery.

Conclusions. The data we have obtained provide the basis for choosing semiconductor laser as more effective and safe technique for the treatment of patients with chronic rhinitis.

Introduction. Despite significant progress achieved in the surgical treatment of cicatricial laryngeal stenosis and cervical trachea in recent decades, this issue appears relevant, especially among people of young and working age.

Aim of the study: To develop tactics for surgical treatment of post-intubation laryngeal stenosis using a CO₂-laser.

Materials and methods: During the period from 2015 to 2019, surgical treatment was performed for 105 patients with post-intubation cicatricial stenosis of the larynx using microsurgical techniques and a CO₂-laser, provided that the cartilage frame of the larynx was preserved, which was determined in a preoperative examination.

Results and discussion: In the postoperative period, patients were monitored from 6 months to 3 years. Localization of cicatricial post-intubation laryngeal stenosis in the vestibular region is quite rare. According to the results of the study, achievement of a stable functional result was obtained in 20 (84%) of 24 patients with lesions of the vocal section of the larynx, in one case a cicatricial membrane of this section of the larynx was required to be excised after one year, and laryngoplasty with extra laryngeal access in four cases. Post-intubation stenosis of sub-folded localization is most widespread, and in our observations they amounted to 79%. The use of endolaryngeal access using a CO₂-laser made it possible to achieve a good functional result in 66% of cases, reconstruction of the larynx by extra-laryngeal access was required in 33%, and laryngotracheal resection in 1%.

Conclusion: It is shown that the use of a CO₂-laser in the surgical treatment of chronic post-intubation laryngeal stenosis significantly expands operational capabilities due to the high accuracy and low level of damage to surrounding tissues. This method allows the formation of minimal wound surfaces by submucosal excision of scar tissue and makes it possible to cover the wound with microlosks of the mucous membrane, reducing the time of epithelization in the intervention area, which is an important prevention of repeated stenosis. In the surgical treatment of extended stenosis of the middle part of the larynx, there are prerequisites for repeated wound replacement with scar tissue, which in our observations was avoided by using endoprostheses. The defeat of the sub-follicular part of the larynx is prone to restenosis even in the absence of data for the defeat of the cartilaginous framework of the larynx.

Introduction. The purpose of the study was learning diagnostic tools of Eustachian tube pathology and define the highly specific prognostic test. The Eustachian tube is a specific structure that is difficult to visualize and manipulate due to its location and anatomical features. Maintaining adequate aeration and physiological pressure in the tympanic cavity is extremely important for middle ear function. The preoperative assessment of the auditory tube function is still important. A lot of studies demonstrate majority methods of evaluation tube function. However, there is no gold standard for diagnosing tubular dysfunction.

Goal of reserch. The purpose of this review is to analyze methods for studying the function of the auditory tube as a preoperative preparation for hearing-enhancing operations, namely tympanoplasty.

Materials and methods. We analyzed the database related to modern methods of evaluation Eustachian tube function and tympanoplasty outcomes.

Results. Despite a large number of studies, the question of a priority and universal method for the preoperative assessment of the function of the Eustachian tube remains open. Each of the studies presented in this review has its own advantages and disadvantages associated with the complexity of the implementation or limitation of application. Endoscopic examination is the most informative for assessing the anatomical state of the auditory tube and nasopharynx. To assess the physiological function, a group of manometric tests, namely tubomanometry and the ETF-test, turned out to be more accurate, universal, and easily conducted.

Conclusion. The work of the auditory tube is of great prognostic value for conducting auditory-improving operations and determining treatment tactics. Identification of the “gold standard” of diagnosis will help improve the quality and increase the effectiveness of surgical treatment, and therefore, further research in this area is necessary.