Despite the extensive accumulated clinical experience, inflammatory diseases of the upper respiratory tract and ear still remain an important problem in the field of otorhinolaryngology, especially pediatric practice, since these diseases are associated with the risk of complications. One of the reasons for the ineffectiveness of conservative treatment is the incorrect initial antibacterial therapy. Errors in antimicrobial therapy are associated with both insufficient knowledge of clinical pharmacology by doctors and incorrect interpretation of anamnestic and clinical data, which leads to incorrect treatment of CCA. The aim of the work is to analyze the use of azithromycin in the treatment of upper respiratory tract and ear infections in children, based on pharmacological characteristics, as well as to consider current methods of antibiotic therapy in pediatric practice. An analysis of the literature and our own observations allows us to conclude that azithromycin is an effective antibacterial drug. Taking into account the low toxicity and good bioavailability, azithromycin continues to be one of the main drugs in the arsenal of doctors for the treatment of various infections, including respiratory diseases and infectious processes of ENT organs in children caused by both typical and atypical bacterial pathogens. The convenient dosage form and simple dosage regimen make this drug a popular choice in outpatient pediatric practice, which confirms the widespread use and trust in this antibacterial drug among both doctors and parents.

High incidence of acute rhinosinusitis in a population remains one of the topical issues in practical otolaryngology. Statistical data show an increasing trend towards transition of acute rhinosinusitis in patients into chronic rhinosinusitis. According to literary sources, the emergence of bacterial resistance to antibiotics is as a rule the major reason of protracted course of the disease. Unreasonable antibiotics prescription, irrational use and uncontrolled intake result in the rapid development of antibiotic resistance. In this context, the use of herbal medicines having not only antibacterial, but also mucolytic, fungicidal, antioxidant effects in the complex therapy is a modern solution for disease management. Respero Myrtol, a standardized myrtol-based medicine, has taken its rightful place in the therapy. This article is aimed to investigate the possibilities of the effective use of medicine containing standardized myrtol as its main ingredient in the treatment of acute rhinosinusitis (based on the review of literature). Research materials included scientific articles on aspects of acute rhinosinusitis in otorhinolaryngology practice that were published in domestic specialized periodicals of eLIBRARY and scientific databases Scopus, Web of Science, Medline from 2014 to 2024. The published literature was analysed using the cause-and-effect technique. A clinical example was dis-cussed. With regard to the analysis of scientific literature, a brief overview of the epidemiology, etiology, predisposing factors for the development, diagnosis and treatment of acute rhinosinusitis was provided. The article addresses relevant socio-economic issues related to acute rhinosinusitis, the problem of antibiotic resistance. The issues of improving acute rhinosinusitis treatments using a standardized myrtol medicine in complex therapy as an alternative to antibiotic therapy were brought to attention. As a result, the authors concluded that the use of Respero Myrtol contributes to the rapid relief of clinical symptoms of acute rhinosinusitis, improves the patient’s quality of life, and can be advised as an alternative to antibiotic therapy in uncomplicated course of the disease.

Despite medical advances, infectious and inflammatory upper respiratory diseases are the most common groups of diseases among outpatients. Viruses induce acute respiratory diseases in most patients; however, bacterial and “atypical” pathogens can cause exacerbations of chronic diseases such as adenoiditis, tonsillitis, pharyngitis and others. Prescribing etiotropic drugs to patients with infectious and inflammatory diseases of the pharynx can reduce the effectiveness of the therapy due to the growth of antimicrobial resistance. Increasing etiotropic drug resistance of some pathogens requires the selection of alternative agents for patients with infectious and inflammatory diseases of the pharynx. The non-specific prophylaxis of the latter is aimed to activate inner defense mechanisms using bacterial lysates (BL). Based on a review of the literature, the article discusses the features of the use and clinical effectiveness of topical BL in infectious and inflammatory diseases of the pharynx. BL are an important supplementation to the standard therapy regimen for inflammatory upper respiratory diseases, which contributes to the restoration of the immune response autoregulation, a reliable decrease in the frequency and duration of acute forms and exacerbations of chronic upper respiratory diseases, and reduced use of antibiotics and antipyretics. Evidence of possible mechanisms to correct immunity in infectious and inflammatory diseases of the pharynx, as well as a review of the clinical effectiveness of the medicine was demonstrated by example of Imudon. Its beneficial use to treat disease in the acute period is associated with its focal action on the infectious and inflammatory lesions. The drug is effective at any stage of the disease and can be used for prophylactic purposes due to activation of mucosal immunity in the respiratory tract. The high efficiency of Imudon is determined by its ability to activate phagocytosis and production of specific immunoglobulins by plasma cells, which reduces the risk of relapses and chronicity of the disease.

Introduction. The aggravation of the comorbid background of patients with ARVI is the main reason for the addition of secondary pathogenic and conditionally pathogenic bacterial flora and, as a result, the development of local and general complications.

Aim. To conduct a clinical assessment of the efficacy and safety of the drug Triazavirin based on riamilovir in the treatment of acute respiratory viral infections. 

Materials and methods. The study conducted on the basis of the medical center of the Federal State Budgetary Educational Institution of the Russian Ministry of Health involved 56 patients with acute recurrent viral infection. Regarding the prescribed therapy, the patients were divided into 2 groups: group 1 (n = 27) from day 2, triazavirin was taken as an antiviral drug (riamilovir) 250 mg (1 capsule) 3 times a day for 5 days; group 2 (n = 29) as an antiviral drug, Kagocel took 2 tablets 3 times a day for 2 days, then 1 tablet 3 times a day for 5 days. The effect of the therapy was assessed by the severity of intoxication syndrome, rhinorrhea, difficulty in nasal breathing, decreased olfactory function, pain syndrome localized in the nasopharynx and throat, cough severity and laboratory results.

Results. In patients with 7 days of therapy, the indicator of psychological health increased by 34.7 points in the first group, by 28.8 points in the second group. Vital activity increased by 33.7 points in patients of group 1 and by 23.8 points in the second group. Physical activity tended to increase by 19.5 points and 6.0 points in the first and second groups, respectively.

Conclusions. The analysis of changes in the severity of clinical symptoms affecting the quality of life of patients confirmed the effectiveness and safety of the drug Triazavirin.

Acute purulent otitis media is an inflammation of the mucous membrane of the middle ear, a disease often encountered both in pediatric practice and in adult patients. The prerequisite for the development of this pathology is a violation of the function of the auditory tube, often occurring in inflammatory diseases of the upper respiratory tract, as well as in conditions of hypertrophy of the pharyngeal tonsil. Bacterial microflora, represented in most clinical cases by S. pneumoniae and H. influenzae, traditionally acts as an etiological factor of acute purulent otitis media. The authors of the article discuss the features of the clinical course of the disease, the causes of frequent recurrent course and the risk of developing purulent complications. The article highlights current problems of diagnosis and treatment of acute otitis media at different stages, including rational and justified use of antibacterial drugs. The authors consider the possibility of using topical anti-inflammatory and analgesic drugs as an alternative to the systemic use of non-steroidal anti-inflammatory drugs (NSAIDs) for rapid relief of the main symptoms of the disease. The authors conclude that ear drops containing lidocaine and phenazone, due to their combined action, are effective as a symptomatic treatment for acute otitis media, including its recurrent course, help reduce the frequency of prescribing antibacterial drugs, effectively relieve pain, reduce the duration of the disease and significantly improve the patient’s quality of life. Due to the high safety profile and the possibility of using ear drops with phenazone and lidocaine from birth, this dosage form finds its successful application in pediatric practice.

Introduction. Primary referral for infectious and inflammatory diseases of the pharynx reaches 30%.

Aim. To study the effectiveness of ambazon in patients with acute tonsillopharyngitis.

Materials and methods. The study was conducted at the SCDC Clinics of the Samara State Medical University and the CDC “Persona-Med” LLC in 75 patients (45.9 ± 11.2 years old) with acute tonsillopharyngitis (ATP). The main group (Group I, n = 48) additionally received ambazon, 1 tablet for resorption 15 minutes after meals 4 times a day for 4 days. The control group (Group II, n = 27) received symptomatic therapy. On the 1st, 2nd and 4th day, the complaint of sore throat was assessed using a visual analogue scale (VAS), the frequency of additional complaints, and the pharyngoscopic picture using a 4-point scale.

Results and discussion. On the 2nd day, the severity of sore throat according to VAS in group I was 3.5 ± 0.2 points, in group II 4.9 ± 0.3 points (p < 0.05). On the 4th day, the severity of sore throat in group I had lower values 1.1 ± 0.1 points, in group II 2.9 ± 0.1 points (p < 0.05). On the 2nd day, complaints of a sensation of a foreign body in the oropharynx and discomfort when swallowing in group I amounted to 27.1% and 45.8%, and in group II 77.8% and 66.7%, respectively. The pharyngoscopic picture in group I was characterized by a decrease in the severity of edema and hyperemia of the pharyngeal mucosa (score of 1.3 ± 0.3 points and 1.1 ± 0.2 points), in group II 2.1 ± 0.3 points and 2.9 ± 0.4 points, respectively. On the 4th day, the pharyngoscopic picture in group I returned to normal, while in group II, hyperemia and edema of the mucosa and an increase in regional lymph nodes persisted.

Conclusions. The use of ambazon in the treatment of ATP allows to reduce the severity of the pain symptom, reduce the frequency of additional complaints and normalize the pharyngoscopic picture.

Introduction. Anatomical and topographic features of abundant pharyngeal innervation, causing pronounced symptoms of exacerbations of tonsillopharyngitis and significantly reducing the well-being of patients, will determine the improvement of treatment.

Aim. To evaluate the possibility of using a nonsteroidal anti-inflammatory drug with the flurbiprofen in complex exacerbations of chronic tonsillopharyngitis.

Materials and methods. The clinical observation of 117 patients with exacerbation of chronic tonsillopharyngitis was carried out. By random sampling, all patients were divided into 2 groups, where persons of the main group (n = 61) for standard conservative therapy took a tableted nonsteroidal anti-inflammatory drug with the active substance flurbiprofen 1 tablet with a 3-6-hour time interval during.

Results and discussion. On day 3 of the therapy, a more pronounced improvement in both the severity of clinical complaints and pharyngoscopy data was noted to a greater extent in patients of the main group: a decrease in the severity of edema of the palatine tonsils by 1.6 points, vascular injection by 1.8 points, edema of the palatine arches by 2.2 points, hyperemia of the mucous membrane by 3.7 points. In the Conrol group (n = 56), there was a decrease in the severity of edema of the palatine tonsils by 1.4 points, vascular injection by 1.2 points, edema of the palatine arches by 1.7 points, hyperemia of the mucous membrane by 2.4 points. During the 7-day course of treatment, psychological health was restored by 24.8 points in the control group and by 32.3 points in the main group. An increase in vital activity was noted by 18.7 points in the control group and by 34.2 points in the main group, a clear increase in physical activity by 19.6 points and 7.6 points in the main and control groups, respectively.

Conclusions. Earlier relief of inflammatory symptoms of exacerbations of tonsillopharyngitis and restoration of patient well-being when a nonsteroidal anti-inflammatory drug was included in complex therapy confirmed its good efficacy and safety.

Introduction. The most dangerous local complication of acute and exacerbations of chronic inflammatory diseases of the pharynx is the formation of abscesses in the structure of the cellular spaces of the neck. Paratonsillar abscess (PTA) is the most common abscessing lesion. In turn, parapharyngeal abscess (PFA) is often found in patients with PTA as its complication.

Aim. To study the clinical, microbiological and pathomorphological features of parapharyngeal complications in patients with PTA.

Materials and methods. The analysis of medical records of 50 patients with diagnoses of parathonsillar and parapharyngeal abscesses who underwent inpatient treatment at the otorhinolaryngological department of the N.I. Pirogov State Clinical Hospital No. 1 in the period from September 2021 to April 2023 was carried out. The studied patients were divided into 2 groups. In group 2 of patients (n = 25; F 10, M 15; average age -37.2 years ± 10.8 years) an isolated PTA was diagnosed. In the 2 group of patients (n = 25; F 10, M 15, the average age was 44.6 years ± 14.8 years) PTA was complicated by the development of PFA.

Results and discussion. Associations of facultative anaerobic and obligate anaerobic microorganisms were found in all pus aspirates obtained from PTA and PFA. Monocultures of microorganisms were not isolated in any case. The detection of Fusobacterium necrophorum was associated with pronounced necrotic changes in the tissues of the tonsils and surrounding structures; Peptostreptococcus anaerobius with purulent melting of fiber tissue; Veillonella dispar with pronounced infiltrative processes in tissues combined with oral pathology in patients.

Conclusions. The most common microorganisms in patients with PTA and PFA were Streptococcus pyogenes and Fusobacterium necrophorum. The activity of Fusobacterium necrophorum is associated with a more severe course of the inflammatory process in the near-pharyngeal space.

In childhood, the occurrence and steady growth of diseases of the nasopharyngeal tonsils, often acquiring a chronic course and occurring with exacerbations and complications, is facilitated by a number of factors. Etiological factors of adenotonsillar diseases in children are both bacterial and viral pathogens, among which respiratory viruses are among the most significant. Herpes virus infections (HVI) play an important role in the development of chronic upper respiratory tract pathology, especially in the cohort of frequently ill children. Representatives of the herpes virus family are characterized by lymphotropic action, long-term persistence in the body, and a tendency to reproduce in cells, leading to a violation of the immune status. The incidence of relapses in the postoperative period during surgical interventions in the ENT organs in children remains high. Herpesvirus etiology of recurrent infectious and inflammatory diseases of the URT (upper respiratory tract) is the leading factor in the ineffectiveness of tonsillotomy, adenotomy, and repeated proliferation of lymphoid tissue in the postoperative period in preschool children. The use of a drug from the group of bacterial lysates before surgery is justified in the treatment of frequently and long-term ill children with adenotonsillar hypertrophy.

Introduction. Seasonal allergic rhinitis continues to be one of the most common chronic diseases, affecting up to 24% of the adult population of the Russian Federation.

Aim. To evaluate the effectiveness of the drug mometasone furoate (Nozefrin Allergy) in patients with seasonal allergic rhinitis in outpatient practice.

Materials and methods. The study was conducted in a group of 42 patients aged 18 to 73 years (average age 39.0 ± 15.5 years) diagnosed with seasonal allergic rhinitis. All patients received monotherapy with Nozefrin Allergy, 2 injections (50 mcg of mometasone furoate each) into each nostril once a day for 30 days. The effectiveness of the treatment was determined on the 7^th, 14^th, 30^th day of treatment and on the 60th day.

Results and discussion. During the use of the drug Nozefrin Allergy, by the 7^th day there was a significant decrease in complaints of impaired smell by 3.6 times, sneezing by 2.4 times, discharge from the nasal cavity decreased by 2.3 times, and nasal congestion by 2.3 times. 2.1 times. After 14 days, nasal congestion disappeared in 64.3%, nasal discharge and itching in the nasal cavity were absent in 69.0% and 88.1% of patients. According to the SST-12 test, already by the 7th day of using the drug Nozefrin Allergy, there was an increase in the average total score to 10.1 ± 1.9 points, which corresponds to normosmia. At days 14, 30, and 60, the mean total SST-12 score remained stable at 10.6 ± 0.9 points, 10.9 ± 1.1 points, and 11.1 ± 0.5 points, respectively. The dynamics of respiratory function at the end of the course of treatment was characterized by an improvement

in the total volumetric flow to 783.4 ± 162.7 cm³/s and a decrease in nasal resistance to 0.2 ± 0.1 cPa/ml. The total rTNSS scale score by the 7th day decreased to 9.1 ± 0.4 points, the severity of the assessed complaints was moderate.

Conclusion. The data obtained indicate the effectiveness of using the drug Nozefrin Allergy in patients with seasonal allergic rhinitis in outpatient clinical practice.

Introduction. One of the few ways to rehabilitate profound hearing loss in elderly patients is cochlear implantation. A number of studies have been published assessing the effect of unilateral cochlear implantation on cognitive function in elderly patients, but the results have been mixed.

Aim. Evaluation of the impact of unilateral cochlear implantation on auditory and non-auditory functions in elderly patients.

Materials and methods. The study included 50 elderly and senile patients (mean age 67.16 ± 3.5 years). RBANS-H, HI-MoCA tests were used to assess cognitive function. Quality of life, depression and anxiety levels were assessed by HADS, SF-36. Auditory function was assessed by pure tone audiometry, speech audiometry, SSQ, HISQUI19.

Results. The study showed improvement in cognitive function in patients with and without residual hearing. There was also an improvement in quality of life, a decrease in depression and anxiety in both study groups. When assessing the auditory function, statistically significant differences between the study groups remained during the study for the sound quality indicator (SSQ test), while other parameters did not have a statistically significant difference at the end of the study. In addition, the study did not reveal a statistically significant effect of vestibular dysfunction on cognitive function in patients.

Conclusions. Unilateral CI as a method of rehabilitation of profound impairments of auditory function in elderly and senile patients has demonstrated its high effectiveness.

A case of residual temporal bone cholesteatoma in a patient with granulomatosis with polyangiitis (Wegener) (GPA) is presented. At the onset of the disease, the patient developed a symptom complex, which included, along with sinonasal manifestations, left-sided purulent otitis media, refractory to traditional therapy. A separate atticoanthrotomy on the left temporal bone, performed in the active phase, before the diagnosis of vasculitis, did not lead to a clinical improvement in the condition of the middle ear. Despite the subsequent implementation of adequate immunosuppressive therapy and drug remission of GPA, the continuously recurrent course of purulent otitis media of the operated ear contributed to the development of residual cholesteatoma of the temporal bone with the spread of the process to surrounding structures. The presence of cholesteatoma was confirmed by MRI of the temporal bones in the non-EPI DWI mode. During the period of drug remission of GPA, repeated sanitizing surgery was performed on the middle ear with tympanoplasty and obliteration of the parathympanic spaces, which made it possible to achieve remission of purulent otitis media. The development of residual middle ear cholesteatoma in a patient with GPA could be due to the untimely initial diagnosis, the late onset of specific immunotherapy, the rapidly progressive and recurrent nature of the course of the disease, and surgical treatment in the phase of high disease activity. The insufficient volume of primary surgical treatment contributed to the formation of laced cavities and the development of residual cholesteatoma of the temporal bone. The use of MRI in the non-EPI DWI mode for diagnosis made it possible to identify the development of cholesteatoma of the left temporal bone in a patient with GPA and track the results of surgical treatment in the postoperative period. The non-EPI DWI MRI method proved effective both for detecting temporal bone cholesteatoma and tracking changes in the postoperative period of a patient with GPA. Tympanoplasty with surgical obliteration of the parathympanic spaces allowed to stop the inflammation of the middle ear in a patient with a systemic autoimmune disease.

Introduction. Currently, the most common method of surgical treatment of patients suffering from chronic decompensated tonsillitis is bilateral extracapsular tonsillectomy (ТЕ). The most dangerous and common complication of this surgical method is postoperative bleeding from the area of the surgical wound, leading to repeated medical treatment and the development of hemodynamic disorders. The frequency of postoperative bleeding after TE is estimated by the authors in a different range depending on the research methodology and can reach 21.8%

Aim. To search for additional factors determining the frequency and timing of bleeding after bilateral tonsillectomy performed for chronic decompensated tonsillitis.

Materials and methods. The study was conducted in the format of a retrospective cohort analysis (over 3 years) with the participation of 51 patients, as well as two control groups: a group of patients who underwent bilateral tonsillectomy (404 patients), and a group of patients with nosebleeds of various etiologies (1548 patients). The article presents generalized data on the timing of bleeding, indicators of blood loss, gender and age composition of patients and other parameters.

Results. The inverse dependence of bleeding time on age and body mass index (p < 0.05) was revealed, a direct dependence on the number of tonsillectomies performed, the same distribution of bleeding frequencies after tonsillectomies and nosebleeds over the observed period, as well as a significant association of the frequency of nosebleeds with various atmospheric and geophysical phenomena (p < 0.01).

Conclusion. Summarizing the data from several centers where bleeding after TE was recorded by increasing the study sample may help identify additional risk factors for the development of this complication.

Introduction. Recently, a significant breakthrough has been noted in the surgery of congenital choanal atresia in children: new approaches, various modifications of surgical techniques of choanoplasty have reduced the percentage of complications along with achieving good clinical results in restoring nasal breathing. The outcome of surgery largely depends on adequate hemostasis. Thus, increasing its effectiveness remains relevant.

Aim. Evaluation of the effectiveness of intraoperative hemostasis during choanoplasty in patients with congenital choanal atresia (CCA).

Materials and methods. The study included 63 children diagnosed with CCA treated at the Veltischev Institute (Moscow). The patients were divided into 2 groups: the main group and the control group. In the main group, hemostasis was carried out by using a bipolar coagulator (power 18 W), periodic irrigation of the surgical field with 1-2 ml of 1% solution of incomplete silver salt of polyacrylic acid (total volume 10-20 ml), in combination with intravenous administration of tranexamic acid in a single dose of 15 mg/kg body weight at a rate of 1 ml/min. In the control group, only coagulation and tranexamic acid were used.

Results and discussion. In the main group, the use of incomplete silver salt of polyacrylic acid reduced the average volume of blood loss by 1.3 times compared with the control group.

Conclusion. The study showed that the use of incomplete silver salt of polyacrylic acid in hemostasis during choanoplasty in children with CCA is effective.

One of the most common complications following surgical interventions in nasal cavity is synechiae and scarring, which often leads to restenosis, particularly in cases of choanal atresia. Laser technologies, especially blue laser (wavelength 445 nm), represent a promising opportunity in rhinology for addressing these complications. Objective: to study the effectiveness and safety of blue laser for nasal synechiae and stenosis surgery in patients with congenital choanal atresia after multiple surgical interventions. In ENT department of Veltishev Institute 4 children have undergone choanal reconstruction following multiple attempts of choanoplasty. A clinical case of a 6-year-old girl diagnosed with bilateral complete choanal atresia, who underwent six surgical interventions within two years and was admitted with complete choanal restenosis is presented. The most common cause of restenosis after surgery for hoan atresia is the formation of synechiae in the surgical area. Traditional dissection of the synechiae in most cases leads to repeated stenosis. To reduce the recurrence rate in the patient, the authors used a blue laser. The blue laser demonstrated high effectiveness in the surgical treatment of postop restenosis, minimizing surgical trauma, preventing recurrences, and improving the patient’s quality of life. The results confirm the feasibility of using lasers in rhinology as a preferred method for treating restenosis and enhancing respiratory function.

A number of factors contribute to the occurrence of chronic otolaryngological diseases in children at an early age, which often acquire a long, undulating course with exacerbations, relapses and complications. The increasing aggressiveness of environmental factors, the growth of allergization of the population, the formation of strains of microorganisms resistant to the action of medicines, lead to a steady increase in diseases of the nasopharyngeal tonsils and a worsening of their course, especially among children, both in our country and abroad. At the same time, the adenotonsillar problem has long gone beyond ENT pathology and attracts the attention of a wide range of medical resea. The aim of the work: to analyze the literature data on clinical manifestations, laboratory and instrumental diagnostic methods and the prevalence of OSA in children. The analysis of publications using PubMed, EMBASE and Web of Science search engines in the period from January 1970 to March 2024 related to research on epidemiological, pathogenetic, clinical and laboratory aspects of OSA in children and adults was carried out. rchers. Sleep respiratory disorder is a term covering various clinical diagnoses from primary snoring to obstructive sleep apnea. This clinical symptom is registered in at least one in nine children, which makes it one of the most frequently diagnosed sleep disorders and puts it in the category of serious social problems. The most compelling evidence relates to hyperactivity, inattention, and social problems: decreased social competence, increased problematic behavior, and decreased memory scores. Despite the growing body of evidence suggesting cognitive impairment in children with snoring, many results have been contradictory. The availability of pediatric sleep laboratories, even in countries with advanced health systems, is limited, which encourages the search for less complex and more convenient testing methods. Timely detection of the development of the disease allows you to prevent complications and improve the quality of life. The article also describes clinical cases of late diagnosis of obstructive sleep apnea in children.

Chronic rhinitis is a common condition characterized by inflammation of the mucous membrane of the nose. It can lead to troublesome symptoms like itching, runny nose, nasal congestion, sneezing and irritation. Rhinitis can significantly lower the quality of life, have a detrimental effect on productivity and negatively affect social communications. Therefore, it is important to diagnose and treat this disease in due time. There are two main types of rhinitis: allergic rhinitis and non-allergic rhinitis. Non-allergic rhinitis refers to patients who have nasal symptoms, but skin tests do not show any allergic reactions. In this case, additional tests are necessary before making an accurate diagnosis. In turn, several subgroups of non-allergic rhinitis can be distinguished according to the causes and mechanisms of its development. The article discusses the features of the treatment of rhinitis medicamentosa. The use of different drugs can cause nasal symptoms, including nasal congestion. Rhinitis medicamentosa can be divided into two subgroups: rhinitis caused by adverse effects of systemic drugs and rhinitis due to overuse of antioedemic nasal therapy. Topically active vasoconstrictors are used to relieve nasal congestion caused by various reasons. However, the long-term use of such drugs can lead to the development of rhinitis medicamentosa and other adverse reactions. There are several hypotheses as to why rhinitis medicamentosa occurs. They include activation of beta-adrenergic receptors, the decreased production of presynaptic endogenous norepinephrine, and the development of tachyphylaxis. The overuse of topical nasal decongestants can bring on vicious cycle: the more frequently the patients use the drugs, the more likely thery are to get increased adverse effects. It is important to understand the potential risks and limitations of using topical nasal decongestants. If symptoms of nasal congestion or other adverse effects develop, it is necessary to consult a doctor to adjust the treatment.

Tinnitus is currently a serious problem of rhinolaryngology, leads to a significant decrease in the quality of human life, limits his ability to household, social and professional activities. It has a high prevalence and occurs in 10-15% of the adult population, while in 1-3% of cases a severe form of the disease is observed. There are more than 60 treatments for ear noise in the world. These include drug therapy; physiotherapeutic effects that allow stimulating various parts of the auditory pathway from the hair cells of the cochlea, the nuclei of the brain stem, the medulla oblongata, the temporal gyri of the cerebral cortex; sound therapy, as well as the use of technical means audio maskers, hearing aids, implants. The aim of this review is to highlight the current state of the issue, to analyze the sound-activating methods of rehabilitation of patients with tinnitus proposed in world practice. Such a variety of techniques is due to the polyethological nature of the factors causing tinnitus and the empirical approach to treatment. A significant arsenal of medications and surgical interventions used to treat pathological auditory sensations often turns out to be far from universal and often ineffective. It should be noted that with an increase in the prescription of subjective tinnitus, the effectiveness of drug therapy decreases and, in turn, the importance of rehabilitation therapies increases. Most modern methods of treating this pathology are based on the principles of neuroplasticity the ability of the central nervous system to structurally and functionally reorganize. Recently, much attention has been paid to non-drug treatment methods, including the method of reeducation (sound therapy).

Acute respiratory viral infections are among the most common diseases affecting the health of the population and often leading to complications from the upper respiratory tract. Medical treatment of acute respiratory viral infection is often complemented by hardware therapies that help reduce the risk of complications and accelerate recovery. This paper describes modern hardware methods for the treatment of acute respiratory viral infections, including low-frequency ultrasound cavitation, photochromotherapy, ultraviolet irradiation and UHF therapy. The clinical efficacy was evaluated in comparison with drug-based approaches. The possibilities of using these methods both in medical institutions and at home using the MULTILOR device were also investigated. Data analysis has shown that the use of hardware treatment methods significantly reduces the severity of symptoms of acute respiratory viral infections, shortens the duration of the disease and reduces the risk of complications. It is important to note that devices such as MULTILOR allow for treatment at home, increasing the availability of therapy. Hardware treatment of acute respiratory viral infections (ARVI) of the upper respiratory tract is a promising direction in modern medical practice, due to its proven effectiveness, safety and variety of technologies used. The inclusion in therapeutic regimens of such methods as low-frequency ultrasonic cavitation, ultraviolet irradiation (UVF), as well as UHF therapy, allows not only to significantly accelerate the regression of clinical symptoms, but also prevents the development of complications often associated with acute respiratory viral infections. The combined effect of these methods contributes to a significant reduction in symptoms, improvement of the condition of the mucous membranes and prevention of disease recurrence.

Introduction. According to EPOS 2020, сhronic rhinosinusitis with nasal polypsis detected in 2–4.3% of the population, in Russia about 1.5 million people suffer from polyposis. In clinical practice, attention is most often paid to indicators of respiratory function. At the same time, the assessment of olfactory impairment characteristic of CRSwNP is carried out only by answering one of the 22 questions of the SNOT-22 questionnaire, and indicators of olfactory function are rarely taken into account when evaluating the results of objective research methods.

Aim. To study the features of the clinical and functional state of the nose in patients with chronic rhinosinusitis and impaired sense of smell.

Materials and methods. 50 patients with сhronic rhinosinusitis with nasal polypsis were examined. The study included an assessment of the sense of smell using Sniffin Stiks test-12, a study of respiratory function, performing a video endoscopy of the nose, computed tomography of the nose and paranasal sinuses. A comprehensive assessment of the condition was carried out using the SNOT-22 questionnaire.

Results. The subjective assessment of the sense of smell by patients with CRSwNP does not always coincide with the results of identification tests. The results of the SNOT-22 questionnaire often depend on the degree of olfactory impairment. Patients with CRSwNP and anosmia are more likely to complain of postnasal congestion, thick nasal discharge and cough than patients with hyposmia, which is consistent with objective research methods.

Conclusions. In patients with Ghronic rhinosinusitis with nasal polypsis and varying degrees of olfactory impairment, heterogeneity of the clinical and functional state of the nasal cavity and paranasal sinuses was noted. When interpreting the results of the SNOT-22 questionnaire, it is advisable to use factor analysis, taking into account the patient’s complaints. To plan individual management of patients with CRSwNP, a comprehensive assessment of the sense of smell is necessary, including identification tests, as well as an additional assessment of the results of computed tomography of the nose and paranasal sinuses and a video endoscopic picture of the nose according to generally recognized scales.

Introduction. Sensory organs help humans exist in the surrounding world, but the evaluation of olfaction remained “in the shadows” practically until the COVID-19 pandemic, although many questions are still insufficiently studied, such as the effect of intranasal medications on olfactory function.

Aim. To assess the olfactory function in healthy volunteers before and after a course of using an ectoine nasal solution.

Materials and methods. Under our observation were healthy volunteers (medical university students and healthcare workers aged 16 to 35 years) who, in addition to routine ENT examinations, underwent an assessment of their olfactory status using a professional set of odorants for olfactometry and subjectively using a self-assessment scale for olfaction before and after a course of ectoine nasal solution, as well as a self-assessment of its preventive effect. The collected data were recorded in Excel spreadsheets (Microsoft Office 365) for further statistical analysis.

Results and discussion. The results showed an average increase of 1 point in the self-assessment of olfaction in the observation group, as well as an increase in the number of “correct” responses when using the set of odorants. However, discrepancies were noted between self-assessment and the objective evaluation of olfaction. The extent of the preventive effect (based on the self-assessment by participants using a 10-point visual analog scale) was rated at 5 points.

Conclusions. 1. A one-month course of barrier therapy (ectoine nasal solution) does not cause any impairment in olfactory function, as evidenced by olfactometric testing (an average increase of 10% in correct responses across the group, with 80% of participants showing improvement) and olfaction self-assessment (an average increase of 1 point across the group, with 55% of participants showing improvement). 2. Self-assessment of olfaction cannot be considered a reliable measure of the actual olfactory function. 3. The use of barrier therapy (ectoine nasal solution) has a moderate preventive effect (5 points).