Improving the effectiveness of treatment of patients with acute infectious and inflammatory pharyngeal diseases remains one of the topical issues facing the modern healthcare practice covering otorhinolaryngology, paediatrics and internal medicine sectors. The authors described the clinical picture of acute tonsillopharyngitis of various origin, and pharyngeal presentations in novel coronavirus infection. The article summarizes the modern principles of topical and systemic therapy in infectious and inflammatory pharyngeal pathology according to different etiological factors. Expedience of using topical antiseptic drugs as symptomatic therapy has been substantiated. The article examines in detail topical drugs that allow to achieve the maximum active substance concentration of the site of inflammation without systemic effect on the patient. The therapeutic options of topical antiseptic drugs are demonstrated using the example of Faringazon (active substance – ambazon) with local bacteriostatic effects against gram-positive microorganisms: Streptococcus haemolyticus, Streptococcus viridans, Pneumococcus. Most patients with inflammatory pharyngeal diseases do not require systemic antimicrobial therapy, therefore the local effect that can relieve local symptoms of the disease, return the pharyngoscopic picture to normal and improve patients’ general well-being is the main method of treatment. Symptomatic topical therapy as a component of care bundle for acute infectious and inflammatory pharyngeal diseases can significantly ease patients’ condition, reduce the intensity of pain syndrome and accelerate the eradication of pathogens. The use of Faringazon in wide clinical practice is justified owing to its efficiency and ease of administration. It is necessary to emphasize that Faringazon does not cause GI side effects. Exceptions are cases when the patients have individual intolerance to the active substance.

Introduction. Polyethologicity of otitis externa with inflammation of the auricle, ear canal and outer layer of the eardrum, persistent course and high probability of recurrence necessitates improved treatment.

Aim. To evaluate the effectiveness of the use and the impact on the quality of life of combined ear drops with antimicrobial and local anesthetic effects.

Materials and methods. A simple randomized controlled clinical trial involved 56 people, including 25 women and 31 men aged 32 to 56 years, suffering from acute diffuse otitis externa. Clinical efficacy, recovery time and impact on quality of life were evaluated in two groups: groups 1 (n = 27), patients receiving ear drops containing choline acetate as local therapy, with group 2 (n = 29) taking a multicomponent drug containing polymyxin B sulfate 1,000,000 IU, neomycin sulfate 0.5 g (375,000 IU) and lidocaine hydrochloride in the form of ear drops. The assessment of otalgia, hearing loss and discharge from the external auditory canal was carried out on the VAS, quality of life scale using the SF-36 general questionnaires.

Results and discussion. There was a positive dynamic of clinical manifestations and restoration of quality-of-life indicators in a shorter period (3rd, 5th day) with the disappearance of all the main clinical symptoms (7th day) with good tolerability and absence of side effects in the second group of patients taking the multicomponent drug.

Conclusions. The use of ear drops containing a combination of topical antimicrobial drugs with an anesthetic in the complex therapy of otitis externa significantly improved the clinical symptoms and quality of life of patients.

Introduction. The therapy to treat acute infectious diseases of the nose and paranasal sinuses aims to improve the quality of life throughout the disease course and prevent its complications. Acute rhinosinusitis follows a mild to moderate clinical course in most cases, which entails low medical aid appealability.

Aim. To analyse health-related quality of life (HRQoL) of patients throughout acute viral rhinosinusitis course and within 2 weeks after illness.

Materials and methods. A SF-36 survey was conducted 2 weeks after the date of recovery specified in the out-patient medical records, i.e., a 4-week period of life during which a patient experienced acute viral rhinosinusitis was to be assessed. The division into groups was carried out according to a retrospective analysis of the treatment regimen used. The test data were processed using Z-statistics. The Mann-Whitney U test was used to compare differences between the groups.

Results and discussion. Health-related quality of life depends on the disease treatment strategy applied. An observational approach comprising on-demand use of nasal decongestants and nasal moisturisers was associated with a physical health level of 30.55 ± 2.74 scores and a mental health of 32.59 ± 1.47 scores out of 100 scores possible. In patients receiving nasal decongestants and nasal moisturisers, antiviral drugs (regardless of the route of administration), and expectorants, the physical health level was determined as 34.76 ± 2.78 scores, whereas the mental health level as 33.26 ± 2.52 scores. The patients who used decongestants, nasal moisturisers and herbal medicines with anti-inflammatory and mucolytic properties for the treatment showed the highest scores in physical (39.02 ± 2.23 points) and mental health (34.35 ± 2.34 points).

Conclusion. Acute viral rhinosinusitis significantly impairs the patient’s quality of life both during the illness and over the following 2 weeks. The deterioration of the physical health component is accompanied by a comparable level of deterioration of mental health. In addition to nasal congestion, the subjective symptom complex in acute viral rhinosinusitis includes a physical weakness combined with pain and feeling of oppression.

Introduction. Acute laryngotracheitis occurs at any age and is a complication of acute respiratory infection with a frequency of up to 40%. One of the main clinical symptoms is an unproductive paroxysmal cough. According to the literature, phytotherapy is a safe and effective part of conservative therapy and is included in clinical recommendations.

Aim. To evaluate the effectiveness of the use of mucolytic phytopreparations in the treatment of acute respiratory infection complicated by laryngotracheitis.

Materials and methods. A randomized simple controlled clinical trial was conducted in which 74 patients aged 18 to 45 years with acute laryngitis complicated by laryngotracheitis participated. All patients were randomly divided into 3 groups: group 1 (n = 24) received standard conservative therapy without mucolytic expectorants; group 2 (n = 25) – standard conservative therapy and acetylcysteine; group 3 (n = 25) – standard therapy using a herbal preparation based on ivy leaf extract in the form of syrup. Assessment of the severity of the main clinical symptoms and quality of life was carried out on the 5^th, 7^th and 10^th day of therapy.

Conclusions. The use of ivy leaf extract, which has a mucolytic and expectorant effect in complex therapy in patients with acute laryngotracheitis against the background of acute respiratory viral infection, allowed us to obtain stable positive dynamics in a shorter time (5^th day of treatment) with the disappearance of all the main clinical symptoms on the 7^th day.

Introduction. The prevalence of acute and chronic rhinitis determines the socio-economic side of the issue and requires effective treatment and improvement of patients’ quality of life.

Aim. To study the effectiveness of the Rinofluimucil® in patients with acute and chronic catarrhal rhinitis at the outpatient stage of treatment.

Materials and methods. The study was conducted in a group of 82 patients aged 18 to 59 years (average age 37,7 ± 13,1 years) diagnosed with acute rhinitis and chronic catarrhal rhinitis. Two groups were identified: the main group (21 patients with acute rhinitis and 20 patients with chronic rhinitis) and the control group (20 patients with acute rhinitis and 21 patients with chronic rhinitis). The control group received elimination and symptomatic therapy, the main group received endonasal monotherapy with Rinofluimucil®, one dose 3 times a day for 7 days. The effectiveness of the treatment was determined by the dynamics of subjective and objective symptoms.

Results and discussion. In patients with acute rhinitis in the main group, the assessment of the amount of nasal discharge and concentration of attention changed by 12,3 and 10,5 times, respectively. In patients with chronic rhinitis, the assessment of the amount of nasal discharge and concentration in the main group changed by 3,3 and 2,6 times, respectively. Restoration of mucociliary clearance to normal with the use of the Rinofluimucil® was observed in patients with both acute rhinitis (18,1 ± 0,4 s) and chronic catarrhal rhinitis (21,3 ± 0,2 s). According to the PARM data, by the 7th day of observation there was an improvement in the average value of the total volumetric flow of nasal breathing in patients with acute and chronic rhinitis in the main group by 1,9 and 2 times, respectively.

Conclusions. The data obtained indicate the importance of using the Rinofluimucil® in patients with acute and chronic rhinitis in clinical practice.

Introduction. In conditions of widespread resistance of pathogens to traditional antimicrobial drugs, active attention is paid to the development of topical antimicrobial drugs for the effective treatment of inflammatory pathology of the middle ear.

Aim. To study the efficacy and safety of a new dosage form of the drug Dioxydin® (2.5 mg/ml ear drops) in the treatment of patients with acute purulent otitis media and exacerbation of chronic purulent otitis media in comparison with ear drops containing 0.3% ciprofloxacin solution.

Materials and methods. A multicenter randomized comparative clinical trial included adults with acute purulent otitis media or exacerbation of chronic purulent otitis media and during 6 face-to-face visits (days 1^st, 3^rd, 6^th, 9^th, as well as a therapy completion visit and a follow-up visit), the effect of drugs was evaluated according to examination, otoscopy, microbiological and audiometric examinations. Safety was assessed by the frequency of adverse events and the results of blood, urine tests and vital signs.

Results. The achievement of the primary criteria was evaluated among 164 participants randomized into 2 groups: the proportion of patients with no indications for systemic antibacterial therapy at Visit 2 and with no ear pain at Visit 4, Dioxydin® ear drops had no less effectiveness than the comparison drug (64.6 and 89.9% versus 68.3 and 87.3%, respectively). In terms of the frequency of elimination of the pathogen and improvement of air conduction, the compared drugs also had no statistically significant differences, and according to some secondary criteria, Dioxydin® significantly exceeded 0.3% ciprofloxacin solution (the proportion of patients with a pronounced decrease in pain and congestion in the ear, as well as hyperemia of the eardrum). According to the safety criteria, the compared drugs had no significant differences.

Conclusions. The results of the study confirmed the high efficacy and safety of Dioxydin® ear drops in the treatment of otitis media in adults.

Acute respiratory infection (ARI) of the upper respiratory tract with incomplete epithelialization of the nasopharynx after surgery of the pharyngeal tonsil using cold sodium plasma is a little-studied problem.

Aim. To evaluate the clinical efficacy and adequacy of topical therapy of acute viral rhinosinusitis with 2% silver proteinate (Sialor® preparation, tablets for preparation of a solution for topical use, 200 mg, in a bottle with a spray nozzle) instead of using systemic and local antibiotic therapy in the period of incomplete epithelialization of an operating wound after surgical treatment of chronic adenoiditis associated with hypertrophy of the pharyngeal tonsil, by physical factors of destruction of lymphadenoid tissue.

Materials and methods. We observed 64 patients who underwent surgical intervention in the site of the pharyngeal tonsil using different techniques. The epithelization status of the surgical wound in the nasopharynx was visualized using 2.4 mm flexible rhino-laryngo fiberscope examination of the nasopharynx performed on postoperative days 10, 20 and 30. We assessed the frequency rates of ARI during the first month follow-up period and the features of the clinical course of ARI according to the patient’s diary. The treatment included on-demand topical therapy with decongestants and Sialor (2% silver proteinate). Results and discussion. The duration of ARI and the severity of nasal symptoms are comparable to the course of mild to moderate ARI in children with preserved pharyngeal tonsil.

Conclusion. Sialor topical therapy is an adequate choice instead of local and systemic antibiotic therapy to suppress the pathogenic microflora activity in ARI, to provide a local anti-inflammatory effect during the long-term period of pharyngeal tonsil surgery with incomplete epithelization. The incomplete epithelization of the nasopharynx is not an indication to administer systemic antibiotics in the presence of signs of ARI of the upper respiratory tract after pharyngeal tonsil surgery.

Introduction. The prevalence of acute and chronic rhinitis determines the socio-economic side of the issue and requires effective treatment and improvement of patients’ quality of life.

Aim. To study the effectiveness of the drug Strepsils® Intensive in patients with acute tonsillopharyngitis in different age groups. Materials and methods. 143 patients were examined, of whom 36 adolescents (mean age 14.7 ± 3.4 years) and 34 adults (mean age 29.9 ± 7.1 years) were selected. All patients included in the study received Strepsils® Intensive for resorption, one tablet every 3–6 hours (5 tablets per day) for 3 days. To assess the dynamics of complaints, a 10-point visual analogue scale (VAS) was used; additional assessment included mesopharyngoscopy data on the 1st, 2nd and 3rd days of observation. Patient satisfaction with treatment and the occurrence of adverse reactions were studied.

Results and discussion. Evaluation of treatment results using a 10-point VAS showed a significantly significant (p < 0.05) improvement in the well-being of patients in both groups when prescribed the drug Strepsils® Intensive. By the 1st day of treatment with Strepsils® Intensive, sore throat in adult patients decreased by 46% (4.1 ± 0.3 points) (p < 0.05). The dynamics of the severity of sore throat in the group of adolescents decreased by 60.2% (5.3 ± 0.1 points). There was a decrease in difficulty swallowing by 50% in adults and by 60.5% in adolescents. By the end of the observation, the pharyngoscopy picture was normalized in both groups in 97% of cases. Patient satisfaction with the effectiveness of treatment was rated as excellent in 95.7% (n = 67), and as average in 4.3% (n = 3).

Conclusions. The use of the drug Strepsils® Intensive is advisable in the treatment of acute tonsillopharyngitis in adolescents and adults against the background of ARVI as an effective means of relieving the severity of symptoms.

Nasal irrigation is one of the most common recommendations for the treatment of patients with a wide variety of rhinologic diseases. First described in ancient Indian Ayurvedic papers, rinsing the nasal cavity with saline solutions remains relevant today with all the variety of available modern medications for local use. Nasal irrigation is a safe and effective method for the treatment and prevention of acute respiratory viral infections. The preventive use of nasal saline is especially important during the seasonal rise in the incidence of acute respiratory viral infections and influenza. Nasal irrigation reduces the viscosity of mucus and promotes its faster elimination along with pathogens fixed in it. Moreover, the use of isotonic saline solutions increases the effectiveness of the mucociliary clearance and reduces the concentration of local inflammatory mediators and cytokines. Acute upper respiratory tract infections, including common cold and acute rhinosinusitis, are common diseases that cause significant discomfort and are a common cause of temporary disability during periods of increased incidence of acute respiratory viral infections. Despite the fact that treatment of acute upper respiratory tract infections in most cases involves only symptomatic therapy the use of antipyretic drugs, sufficient fluid intake, local elimination and irrigation therapy is often used as adjuvant therapy in this group of patients. At the same time, it is quite difficult to assess the effectiveness of nasal lavage in clinical practice from the standpoint of evidence-based medicine. The purpose of this review is to analyze modern clinical studies and topical reviews assessing the effectiveness of nasal irrigation for various pathologies with a more detailed analysis of the effectiveness of this method for the treatment of patients with acute upper respiratory tract infections and as a preventive measure during the season of epidemic rise in the incidence of acute upper respiratory tract infections.

The prevalence of the acute sinusitis in ENT practice is very high. The current prevalence in Russian Federation is roughly estimated at 6 to 15%, and accounts for about 10 million cases a year. The incidence of acute sinusitis increases in autumn and early spring and decreases in the summer. Most cases of acute sinusitis are of a viral etiology, but it can also arise from bacterial infection, allergies, or injuries. The disease is characterized by swelling of the nasal mucous membrane, nasal blockage and discharge. Typically, the duration of acute inflammation of the paranasal sinuses averages about 4 weeks. In case of the inappropriate treatment, the inflammatory process can spread to adjacent anatomical structures – to the orbit, ear, or brain, resulting in serious, sometimes life-threatening complications. Over the last 10 years, the resistance of pathogenic flora to antimicrobial agents has greatly increased due to the unjustifiability and irrationality of their use. The purpose of this review was to analyze the effectiveness and safety of the antibiotic therapy for acute rhinosinusitis. The paper discusses the etiology, pathogenesis, and characteristics of the acute sinusitis. It presents the features of the most used drugs, with special attention to the comparative assessment of their therapeutic effectiveness compared to other antibiotics, as well as determining the optimal schemes for their use within the framework of modern clinical protocols. A description of a clinical case of acute sinusitis and a treatment regimen with Cefixime EXPRESS is presented.

Impaired mucociliary clearance is the main mechanism of pathogenesis of acute and chronic diseases of the nose and paranasal sinuses. Viral infections have a negative impact on the condition of the mucous membranes of the upper respiratory tract, increasing the secretion of mucus by goblet cells, increasing its viscosity and reducing the intensity of the beating of cilia, making it difficult to remove mucus from the lumen of the respiratory tract and sinuses. The article discusses approaches to the treatment of acute and chronic sinusitis from the perspective of improving the functioning of mucociliary transport. Up-to-date requirements for drug therapy of both acute and chronic diseases of the nose and paranasal sinuses first necessitate a reasonable, evidence-based approach to the prescription of antibacterial agents, as the bacterial diseases account for no more than 2% of clinical cases in the sinusitis pattern, and even in this group, antibiotic therapy can only be prescribed in case of chronic, severe or complicated course of the disease. However, as most episodes of inflammatory diseases of the nose and paranasal sinuses are directly or indirectly associated with viral infection and post-viral changes, the next challenge facing the clinician is the choice of optimal therapy targeting the main link in the pathogenesis of the disease – correction of impaired mucociliary clearance. And the third issue that needs to be solved in planning drug therapy is the effectiveness and safety of the prescribed drug with the aim to minimize the risk of side effects. The authors of the article point to the effectiveness of the use of the herbal medicine Respero Myrtol, which has a mucolytic, anti-inflammatory and antibacterial effect, in the treatment of acute and chronic sinusitis, as well as protracted forms of rhinitis

Introduction. All acute respiratory infections are characterized by damage to the mucous membrane of the respiratory tract, a decrease in local immune defense and a weakening of nonspecific protective factors.

Aim. To characterize the clinical effectiveness of the use of the immunocorrective drug in frequently ill children.

Materials and methods. The article assessed the microbiological spectrum of the rhinopharyngeal landscape in 65 children: 33 children took an immunocorrective drug in addition to conventional therapy – the main group; 32 children received conventional therapy (the comparison group), and also investigated the possibility of regulating their polypathogenic microbiota using topical bacterial lysates.

Results and discussion. The result of the therapy was a clinical improvement characterized by the relief of pharyngoscopic signs of chronic tonsillitis in children while taking topical bacterial lysates in form of lozenges. Analysis of the microbiota of the oropharyngeal mucosa in the studied patients of both groups before the start of therapy revealed the species diversity of opportunistic flora, among which Streptococcus pyogenes, Staphylococcus aureus, the family Enterobacteriaceae and Candida albicans were identified in all patients in diagnostic significant titers of 10⁵–10¹⁰. After treatment in the main group, the ratio of the microbiota of the nasopharynx significantly changed, stimulation of the production of local immunity components was noted, which was confirmed by a decrease in the intensity of contamination of microbiota with polypathogenic functions to diagnostically insignificant titers. When comparing the species composition of the microbiota in the studied groups after treatment with topical bacterial lysates, a statistically significant positive effect was found without additional use of antibacterial drugs.

Conclusions. It has been shown that the immunocorrective drug eliminates pharyngoscopic signs of rhinopharyngeal dysbiosis in children who are often and long-term ill.

Introduction. One of the most pressing issues of modern otorhinolaryngology is the problem of the formation of persistent defects of the vocal cords and tympanic membrane. This state of affairs is due to the variety of reasons that cause the development of these conditions, as well as the fact that the treatment of these processes, as a rule, is a technically complex task and is not always effective.

Aim. Experimental evaluation of the possibility of using bioengineered implants based on MSCs, PEG-fibrin gel and collagen matrix to restore defects in vibrating tissues of ENT organs – vocal folds and tympanic membrane.

Materials and methods. For the experiment on vocal fold restoration, 6 rabbits were selected, divided equally into 2 groups. After the formation of the vocal fold scar, a bioequivalent was implanted: spheroids based on MSCs + PEG-fibrin gel (group – VF-spheroids, n = 3) in a volume of 0.5 ml, for the control group, the role of bioequivalent was performed by saline solution (VF-control group, n = 3). For the eardrum repair experiment, 6 chinchillas were selected, divided equally into 2 groups. At the first stage, a persistent chronic perforation was created, on which either no intervention was carried out (ED-control group, n = 3), or the perforation was closed using a bioequivalent based on MSC spheroids, PEG-fibrin gel and collagen matrix (ED-spheroid group, n = 3).

Results and discussion. Endoscopic and morphological examination revealed a more complete restoration of tissue structure in the treatment groups compared to the control groups.

Conclusion. Implantation of the developed bioequivalents in the sites of vocal fold and tympanic membrane injury leads to the formation of tissue morphologically similar to the structure of intact structures.

Introduction. Endoscopic rhinosinus surgery stands out for its reduced complications and marked symptomatic improvement compared to open surgical approaches. However, local bleeding challenges may compromise the efficacy of minimally invasive procedures. Exploring terlipressin’s application in endoscopic rhinosinus surgery is a promising avenue, given its mechanism of action and successful use in obstetric and other medical practices.

Aim. This study aimed to assess terlipressin’s efficacy in reducing intraoperative bleeding during endoscopic rhinosinus surgical interventions under general anesthesia.

Materials and methods. A prospective randomized cohort study included 170 cases of endoscopic rhinosinus surgical interventions. The BT group (n = 89) received no terlipressin, while the T group (n = 81) had 200 mcg of terlipressin during surgery. Bleeding intensity was assessed on a 6-point scale. Heart rate, blood pressure, perfusion index, and bleeding intensity were recorded at 10th, 30th, and 60th minute into the operation (study points). Bleeding intensity ≥2 points was considered significant. Results. In the T group, mean BP was significantly higher at all study points than in the BT group. Perfusion index values in the terlipressin group were significantly lower throughout. ROC analysis highlighted perfusion index’s prognostic value at 30th and 60th minutes for predicting significant bleeding. Threshold perfusion index values associated with increased bleeding probability were 4.520 at 30th minutes and 5.040 at 60th minute. Multifactorial analysis linked intraoperative terlipressin administration to a lower likelihood of significant intraoperative bleeding.

Conclusion. Intravenous terlipressin (200 mcg) effectively reduces intraoperative bleeding intensity without lowering arterial pressure during endoscopic rhinosinus surgical interventions under general anesthesia.

Introduction. Optimization of preoperative preparation protocols in otosurgery can reduce intraand postoperative infectious complications, improve surgical outcomes, which is important for the rehabilitation of patients with ear diseases.

Aim. To determine the effectiveness of antiseptic and hygienic preoperative preparation of the surgical field during endaural otosurgical interventions.

Materials and methods. The randomized study included 183 patients who underwent surgery via the endaural approach. The first part of the study evaluated the effect of 10% povidone-iodine solution treatment on the skin microbiome; the second part evaluated the need for ear canal depilation and before surgery and compared the methods.

Results. Examination of skin microbiota of the external auditory canal in 85% revealed the growth of microorganisms:

Staphylococcus – 115 (85.5%), fungal growth – 6 (4.4%), Corynebacterium – 8 (5.9%), etc. Microbial growth was not detected in 15%. Antiseptic treatment with 10% Povidone-iodine solution with endaural access reduces the degree of contamination and suppresses the growth of microorganisms in more than one third of patients. Inflammatory changes of the postoperative wound correspond to the degree of inflammation IA in both control and study groups. After depilation, visualization was assessed as optimal in 100% of cases and no inflammatory reactions were found. Average depilation time with scissors 113 sec, with an ear trimmer 32 sec.

Conclusions. Preoperative antiseptic preparation reduces microbial contamination of the skin via endaural access, with no significant impact on wound healing process in the postoperative period. Depilation improved the view of the operative field in 100% of cases. Depilation with an ear trimmer is 3.5 times faster than with scissors.

Chronic nonspecific pharyngitis (CNP) is an extremely common pathology, but there are no consensus documents regulating the diagnosis and treatment of CNP. We compiled a questionnaire with a list of questions on the problem of CNF, distributed a google form among practitioners and conducted a survey with subsequent analysis of the answers. Then, a search and analysis of scientific works on this topic was carried out on the platforms PubMed, eLibrary.Ru, CyberLeninka, as well as in other open Internet sources. The data of the survey of specialists are compared with the results of the literature review. Therapeutic and diagnostic approaches in CNF are largely determined by the traditional ways of life of a medical institution. This fact, as well as the lack of regulatory documents on the problem of CNF, makes it difficult to competently diagnose and choose an adequate treatment tactics for this disease. The results of the study suggest that CF should be considered as a multifactorial disease, paying attention to the comorbid profile of the patient. The vast majority of respondents consider gastroesophageal reflux and other gastroenterological diseases to be the main predisposing factors. This is confirmed by the literature, and the specialists interviewed by us suggest that the main bias should be made to the assessment of complaints, anamnesis, and pharyngoscopy. Therapy of CNF with the use of only topical drugs is prescribed everywhere, but does not give the desired result. It is necessary to have a multi-stage treatment aimed at eliminating predisposing factors and correcting local changes with the involvement of not only otorhinolaryngologists, but also doctors of other specialties (gastroenterologists, endocrinologists, psychiatrists and neurologists).

Introduction. Chronic otitis media with effusion (COME) is a middle ear disease, characterized by mucous effusion accumulation in its structures. One of the important COME formation mechanism is gastric reflux. Gastric contents reflux into the tympanic cavity which contributes to the irreversible transformation of its mucous membrane.

Aim. To substantiate the significance of the gastric reflux in the middle ear mucosa fibrous remodeling.

Materials and methods. The study included 96 people diagnosed with COME and concomitant gastroesophageal reflux disease (GERD), 54 women and 42 men, in the age range from 18 to 65 years (mean age 51.4 years). All patients underwent tympanostomy tube installation and supervised by an otolaryngologist during 12 months. Patients were divided into 2 groups depending on their consent to GERD therapy. The conservative treatment of COME and GERD was carried out in accordance with established and current medical care standards and clinical guidelines for the relevant nosology.

Results and discussion. 14 days after the tympanostomy, the otorrhea decrease was noted in 31 (75.6%) of the main group and 31 (56.6%) participants in the comparison group (n = 96).

By the end of 12 months observation a positive disease outcome such as exudation reduction and complete tympanic membrane repair was recorded in 35 (83.3%) and 25 (62.5%) patients of both groups respectively (n = 82).

Patients with a mixed 34 (35.4%) and non-acid 11 (11.5%) types of reflux showed worse disease outcome rates, just like in patients with COME who delayed GERD treatment 8 (8.3%).

Conclusions. The combination of infectious agent exposure causes an active mucous membrane exudation in the disease early stages with mixed and non-acid gastric reflux leads to mucous membrane middle ear fibrous remodeling. It has also been established that an unsuccessful COME treatment duration aggravates the outcome of the disease in the absence of GERD therapy.

Diseases of the nose, paranasal sinuses and upper respiratory tract occupy a leading place in the structure of acute pathology in children of all ages. This also applies to adenotonsillar problems in children. Oncological diseases in children are quite rare, especially those localized in the ENT organs. It must be remembered that under the guise of acute ENT pathology and adenotonsillar problems, quite rare diseases, including cancer, can be hidden. A complaint of difficulty in nasal breathing may be the only manifestation of this pathology. The doctor’s task is to identify cancer pathology at the earliest possible stage. The main methods for differential diagnosis are x-ray and endoscopic examination, regardless of age. Neurofibromatosis (NF) is a group of systemic diseases that are inherited. Refers to phakomatoses. Features include disturbances in the formation of systems of ectodermal and mesodermal origin. The skin, nervous and skeletal systems are most often affected. The formation of the development of malignant neoplasms is characteristic. The disease is rare but results in a greater cancer burden on the nervous system than any other neoplastic disease. In this regard, tumor formations may have different localization and clinical manifestations. The disease affects multiple systems with cutaneous, neurological and orthopedic manifestations that lead to disability or mortality of the patient. The purpose of our study was to demonstrate a rare oncological disease – neurofibromatosis, the first manifestations of which were manifestations in the ENT organs of a 6-year-old child with a family history. The interest of the presented clinical case lies in the rare localization of neurofibroma with localization in the structures of the neck with the involvement of the pharynx, larynx, mediastinum, and neck vessels.

Introduction. The COVID-19 pandemic has modified the information needs of participants in the public health management system and identified a lack of information for making management and health decisions during the pandemic.

Aim. To summarize and provide a general description of information and data that should be available in the health information system of otorhinolaryngological health facilities for decision-making in epidemic settings based on the results of conducted studies.

Materials and methods. In this study we used our own experience in addressing information challenges on optimization of otorhinolaryngological care both at the height of pandemic and after renewal of scheduled visits and hospital admissions. We considered studies under the auspices of WHO on assessment of the effectiveness of health information systems as a whole and individual works that were carried out to analyse the impact of the pandemic on provision of otorhinolaryngological care.

Results and discussion. The content of data used for decision-making in a pandemic has been substantiated in the following areas: 1) provision of health care should be organized as close as possible to the patient’s personalized care plan with due account for temporal and spatial factors – it is proposed to use patient’s geographic data, patient’s health characteristics indicating the date and time they were registered; 2) health care facilities personnel should be ready to provide medical care – it is proposed to use the results of periodic surveys of health care facilities personnel with regard to their awareness of an epidemic, concern about different risks, working conditions satisfaction, motivation, and emotional status; 3) provision of health care should be simulated, and the optimal option for organizing and distributing the workload should be verified and selected – it is proposed to use service algorithms and necessary resources.

Introduction. There is a clear need to discuss separate issues related to acute rhinosinusitis. The rationale is that prevalence rates of the disease remain high. At the same time, the incidence rates are growing globally, including Russia, Europe, the USA and Asia. Apart from that, acute rhinosinusitis significantly deteriorates the patients’ quality of life, causing physical, emotional and professional malaise. Moreover, the complications of acute rhinosinusitis may have serious consequences, and the economic costs to society are significant, including both explicit and implicit costs.

Aim. To raise the level of awareness of otolaryngologists about current issues of acute rhinosinusitis based on the analysis and synthesis of literary sources.

Materials and methods. An analysis of the published literature on the cause-and-effect relationship between the development and features of acute rhinosinusitis in the specialized academic research databases RSCI, eLibrary.Ru, Scopus, Web of Science, Medline over the last ten-year period was carried out.

Results and discussion. We presented a brief overview of the etiology, epidemiology, risk factors, and diagnostic methods of acute rhinosinusitis based on the results of scientific literature review. The issues of treatment and prevention strategies, problems of antibiotic resistance are considered. The article brings to the fore the issues related to risk factors, among which it highlights an increasing incidence of acute respiratory viral infections, environmental and lifestyle influences. Modern diagnostic methods are addressed. We also emphasized the issues of improvement of clinical guidelines with a focus on recent research, stressed the importance of an individual approach to each patient, taking into account the severity and features of the course of the disease in individual patients.

Conclusions. The paper considers a conceptual solution for providing medical care to patients with acute rhinosinusitis, which is based on the principles of evidence-based medicine and is regulated by legitimate clinical guidelines, both issued before and currently in force, including international ones.