Infectious and inflammatory diseases of the ENT organs are the most common and usually have a viral etiology. Combined lesions are predominantly nasopharyngitis, pharyngotonsillitis, laryngotracheitis. Lesions of the nose and paranasal sinuses are often combined with otitis media. The onset of the disease is aggressive, with pronounced symptoms – impaired nasal breathing, rhinorrhea, cough, headache, etc. All this requires timely medical care of a wide range of action, capable of alleviating the patient’s suffering at an early stage. Analysis of literary data showed that timely treatment not only improves the clinical picture of the disease, but also prevents further spread of the infectious process and the development of complications. Such a drug is Respero Myrtol, an effective and safe herbal preparation obtained from essential oils of plants such as eucalyptus, lime and pine, mainly consisting of monoterpenes such as d-limonene, 1,8-cineole and alpha-pinene. It has been proven that it is not only well tolerated, but also a safe alternative to antibiotics for the treatment of respiratory infections with post-viral complications without the use of specific microbial agents. The high safety profile makes it suitable for both adults and pediatric practice. Thus, the use of herbal preparations has undoubted practical significance for the treatment of infectious and inflammatory diseases of the ENT organs. The use of such a natural remedy as Respero Myrtol is effective and safe both as monotherapy and in combination with other drugs. Its multifaceted action – improving mucus drainage, reducing inflammation, providing antioxidant protection and antimicrobial action – makes it a valuable therapeutic agent for the treatment of respiratory diseases.

Acute bacterial rhinosinusitis is about 0.5–2% of the total number of acute rhinosinusitis. Most often the etiological agents are Streptococcus pneumoniae, Moraxella Catarrhalis and Haemophilus Influenzae. Amoxicillin is most often used as antibacterial therapy of the first line. The growth of S. pneumoniae resistance to penicillins is increasing. Penicillin’s not working. It is necessary to find a viable alternative antibacterial treatment. It should be considered as an initial treatment of the third-generation cephalosporins, in particular Cefixime. A clinical case of patient treatment is presented sought medical care at the clinic of the ear, throat and nose diseases. The patient complained of а purulent nasal discharge, postnasal drip, hyposmia, unpleasant odor from the nose, temperature of 37.6 °C, discomfort in the projection of both maxillary sinuses, swelling in the area of the upper eyelid of the right eye. Аn additional examination was carried out and the diagnosis of “Acute bacterial rhinosinusitis” was established. The patient was on outpatient treatment. The initial antibacterial therapy was the Cefixime in the form of dispersed tablets 400 mg once a day for 7 days. Positive dynamics was already noted on the 3^rd day of treatment, the complete relief of clinical symptoms was achieved by the tenth day. On the NOSE scale, the patient scored 80 points on the day of circulation, on 3 days – 40 points, on the 7^th day – 20 points. The results of a microbiological examination were obtained seven days after the start of treatment. It detected the growth of S. Pneumoniae 10^6 sensitive to all antibacterial drugs. The presented clinical case demonstrates the high response of the outpatient medicine. The Cefixime can be recommended as the drug of choice in causal treatment of the acute bacterial rhinosinusitis, especially in the case of resistance or allergy to penicillin.

In recent years, there has been a significant increase in the incidence of various viral infections among the adult population. These infections pose a serious threat to human health, as they can lead to the development of severe complications and even death. Antiviral therapy is a key element in the fight against these diseases, but existing drugs are often not effective enough. Therefore, the development of new, more effective and safe drugs is an urgent task of modern medicine. In this regard, the search for new approaches to the treatment of viral infections is becoming relevant, one of which may be the use of riamilovir as part of complex antiviral therapy. Riamilovir is an antiviral etiotropic drug that was developed specifically to combat RNA viral infections. It has a broad spectrum of action and is able to suppress the replication of viruses, thereby preventing their spread in the body. Riamilovir acts by blocking the enzymes necessary for the reproduction of the virus. This mechanism helps prevent further spread of the infection and speed up the patient’s recovery. The drug is well tolerated, and side effects are minimal, which makes it safe for use in patients with various concomitant pathologies. However, it is important to consider contraindications, such as individual intolerance to the components of the drug. The article provides a brief review of scientific literature devoted to the study of the effectiveness of antiviral complex therapy using the drug Riamilovir, and also presents a clinical observation of a patient with rapid relief of acute respiratory infection against the background of timely treatment.

Acute inflammatory diseases of the larynx are a group of the most common diseases among both adults and children, which are caused by a number of infectious and non-infectious factors. Despite the fact that most cases of acute inflammatory diseases of the larynx are viral in nature, treatment often involves unjustified prescribing of systemic antibiotics, which contributes to the development of the problem of antibiotic resistance. The purpose of this article is to conduct an analytical review of existing methods of complex treatment for acute inflammatory diseases of the larynx and new drugs of complex action, the use of which can reduce the need for irrational antibiotic therapy. Immunostimulants boost the innate and acquired immunity, act on both cellular and humoral immunity, activate nonspecific defences and help to develop specific immune response. Bacterial lysates, mixtures of antigens derived from inactivated bacteria representing the most common pathogens, are the most effective group of immunostimulants. The administration of combination immunostimulants may help in enhancing a relief of symptoms of acute inflammatory diseases of the larynx, improve recovery times for patients, reduce systemic antibiotics prescribing rates and decrease the incidence of acute respiratory infections by expanding body’s resistance to various respiratory disease agents.

Introduction. The issue of timely diagnosis, treatment and prevention of acute respiratory viral infections (ARVI) and their complications is relevant.

Aim. Тo evaluate the effectiveness of treatment of acute nasopharyngitis with the inclusion of a drug with the active substance silver proteinate in complex therapy.

Materials and methods. The study was conducted with the participation of 67 children of the younger age group of 7–10 years, including girls (n = 33) and boys (n = 34), with a verified diagnosis of acute nasopharyngitis (runny nose), J-00, who were divided into two groups. In addition to the standard treatment, children in the main group (n = 35) received a drug with antimicrobial and anti-inflammatory effects with an active substance in silver proteinate for 7 days, and children in the control group (n = 32) received standard treatment for acute nasopharyngitis, according to clinical recommendations. The complaints raised the coefficient of poor living conditions for patients, according to the results of the PSOM-31 questionnaire. The control points were on the 5^th and 7^th day after the start of treatment.

Results and discussion. In patients of both groups, there was a decrease in the severity of subjective and objective symptoms of the disease, and to a greater extent in children who additionally took the drug with silver proteinate content. The best indicators of relief of nasopharyngeal symptoms by the 7^th day of treatment were recorded in individuals of the first group: a decrease in rhinorrhea by 26% and postnasal congestion by 65.5%. On day 7, the “general symptoms” worried the patients of the second group to a greater extent than those of the first group and were equal to 7.4 and 14.9 points according to the results of the PSOM-31 questionnaire, respectively. Patients of both groups receiving conservative therapy did not register any manifestations of allergies and side effects.

Conclusion. The topical use of silver proteinate in the complex therapy of acute nasopharyngitis reduces local inflammatory manifestations in the nasopharynx, promotes an earlier recovery period, and is well tolerated by patients.

Introduction. The main mechanism of the pathological process in polypous rhinosinusitis involves mucous membrane remodelling due to alterations followed by the formation of polypous vegetations that are likely to relapse.

Aim. To conduct a clinical evaluation of the efficacy of the use of seawater spray with silver ions as part of the elimination therapy of polypous sinusitis.

Materials and methods. We conducted a prospective randomized clinical trial involving 66 patients aged 20 to 46 years on an outpatient basis. The inclusion criterion included a diagnosis of chronic polypous rhinosinusitis in the exacerbation phase with attachment of a bacterial infection. All patients were randomly divided into 2 groups. The efficacy and safety of the use of seawater spray with silver ions was assessed on Days 3, 5 and 7 of treatment in Group 1 (n = 32) as compared to Group 2 (n = 34) which used the standard seawater spay.

Results and discussion. On Day 7, the nasal breathing improved in 96.5% of patients in Group 1 and in 45% of patients in Group 2. 97.5% of patients in Group 1 reported the absence of nasal discharge on Day 7 as compare with 56.5% of patients in Group 2. The absence of postnasal drip was noted on Day 7 of therapy in 98.5% of patients in Group 1 and in 2.5% of patients in Group 2, respectively. The SF-36 QoL trend scores showed a more significant improvement of the patients’ health status on Day 7 of the therapy from 89.4 to 98.9 scores and from 84.6 to 91.1 points in patients of Groups 1 and 2, respectively.

Conclusions. The clinical assessment of the efficacy of the use of seawater spray with silver ions as part of the elimination therapy of polypous sinusitis discovered a significant reduction in clinical symptoms.

Infectious and inflammatory diseases of the upper respiratory tract occupy one of the leading positions in the overall morbidity structure of the population worldwide. Among these diseases, the pharynx, nasal cavity and paranasal sinuses are most often affected. Against this background, the resistance of certain pathogens to etiotropic drugs is growing and the arsenal of pathogenetic therapies is insufficient, which creates the need to find alternative medicines. One of the possible alternative therapy options is a group of immunomodulatory drugs, among which bacterial lysates are the most popular. There is already sufficient evidence in the modern literature on the efficacy and safety of bacterial lysate preparations. Topical bacterial lysates have a stimulating effect on various links of specific and nonspecific immunity. They act directly in the focus of the disease, do not harm the body’s own microbiome, combine well with other medicines and can be used in patients of any age. Bacterial lysates are considered as an effective component of therapy of infectious and inflammatory diseases of the upper respiratory tract. They lead to the elimination of pathogenic pathogens, stimulate the body’s own defense mechanisms, and also contribute to the restoration of autoregulation of the local immune response. The use of bacterial lysate preparations leads to the activation of mucosal immunity and a decrease in the incidence of infectious diseases. Topical immunomodulators also have a preventive effect, preventing the occurrence of possible respiratory infections and improving the quality of life of patients. The use of drugs bacterial lysates show good clinical results, they contribute to improving the effectiveness of therapy and preventive measures.

Acute rhinosinusitis is a common pathological condition characterized by inflammatory changes in the nasal mucosa and paranasal sinuses. This inflammation leads to the development of a variety of clinical symptoms that can significantly impair the quality of life of patients. In recent years, there has been a growing interest in the pathogenesis of this condition, which Underlines the need for an integrated approach to its diagnosis and therapy: the use of herbal medicines is becoming an increasingly relevant area in the treatment of rhinosinusitis. Ivy leaf extract appears as a promising phytotherapeutic agent with the potential for effective treatment of acute infectious and inflammatory diseases of the upper respiratory tract. This herbal extract contains a wide range of biologically active compounds, including saponins, flavonoids and glycosides, which largely determine its therapeutic properties and mechanism of action. According to extensive scientific literature data, ivy leaf extract preparations demonstrate the ability to effectively reduce the clinical manifestations of acute rhinosinusitis. The article presents a clinical observation of a patient with acute rhinosinusitis. Complex therapy with the inclusion of a herbal preparation was prescribed. There were observed good tolerability of the treatment and the absence of adverse drug effects.

Introduction. Inflammatory ear, nose, and throat (ENT) diseases account for a significant proportion in the respiratory disease profile. The causative agents of these diseases may include atypical infections along with other viral and bacterial agents.

Aim. To determine the seasonal incidence of Chlamidia pneumoniae and Mycoplasma pneumoniae infections in acute respiratory infection (ARI) outpatients with otolaryngological manifestations; to evaluate the most common symptoms to establish a relationship between clinical symptoms and laboratory findings of patients.

Materials and methods. 284 acute respiratory infection (ARI) patients aged 3 to 17 years underwent routine examination of ENT and lower airways, PCR assay for the detection of C. pneumoniae and M. pneumoniae in epithelial cell scrapings obtained from the nasopharynx and oropharynx, chlamydia and mycoplasma IgA/IgG/IgM ELISA, bacteriological analysis. Statistical data processing was conducted.

Results. Acute sinusitis (82.4%) and pharyngitis (21.8%) were the most common clinical manifestations of respiratory mycoplasmosis and chlamydia in patients. M. pneumoniae IgM positivity was found in 53.3% of patients aged 3 to 6 years, similar data were obtained regarding C. pneumoniae. The frequency of positivity rates for C. pneumoniae IgM, IgG and IgA and M. pneumoniae IgM was found to be significantly higher in autumn as compared to other seasons (p < 0.05).

Conclusions. Respiratory mycoplasmosis is common in preschool and primary school children in the autumn-winter period. ENT atypical microflora manifests itself as acute rhinosinusitis, in which mycoplasma-chlamydial infection is detected in 31.7% of cases. The classic clinical presentations of respiratory mycoplasmosis include productive cough along with nasal breathing difficulty and discharge from the nasal cavity.

Introduction. Acute inflammatory diseases of the paranasal sinuses (PNS) have a high frequency, risks of transition to chronic forms and occurrence of various complications.

Aim. To increase the effectiveness of complex therapy of acute sinusitis by influencing the etiopathogenetic mechanisms of the disease with a herbal medicinal product Sinupret extract.

Materials and methods. 72 patients aged 19 to 54 years participated in the study, including males (n = 42) and females (n = 30), with a diagnosis of acute sinusitis (J01). The patients were randomly divided into two groups. Patients of the 1st main group (n = 37), in addition to the standard treatment, received a herbal medicinal product with pronounced anti-inflammatory and secretolytic effects for 7 days, and persons of the 2nd control group (n = 35) received treatment according to the latest clinical recommendations. According to the SF-36 questionnaire, the coefficient of poor quality of life of patients was determined. The clinical condition of the patients was assessed on the on the 3rd, 5th and 7th day after the start of treatment.

Results and discussion. A decrease in the severity of subjective and objective symptoms of acute sinusitis during treatment was observed in both groups, but in patients of the main group who additionally took a multicomponent phytoniringovy drug, they were achieved faster, starting from 3rd day of therapy. By the end of treatment (7th day), nasal breathing improved significantly and amounted to 95.8% in the 1st group patients, while in the 2nd group patients this indicator was only 67%. Similar indicators were noted earlier for postnasal congestion, dysosmia, cephalgia, rhinorrhea, and restoration of mucociliary clearance.

Conclusions. The use of a multicomponent phytonoring drug in the complex therapy of acute sinusitis at an earlier stage reduces the severity of clinical symptoms and inflammatory manifestations, is well tolerated by patients, and accelerates recovery time.

Introduction. Chronic rhinosinusitis accompanied by nasal breathing difficulty, nasal discharge, hyposmia and facial pain is a common disease.

Aim. To study the corrective role of 0.08% sodium hypochlorite and 2.1% hypertonic solution in relieving symptoms of exacerbation of chronic rhinosinusitis and improving the patients’ quality of life.

Materials and methods. A total of 79 patients (aged 18 to 63 years) diagnosed with chronic rhinosinusitis, exacerbation (ICD-10 code: J32) were enrolled in the study. The patients were divided into two groups. The control group received a standard treatment for exacerbations of chronic rhinosinusitis based on clinical guidelines. In addition to the course of conservative therapy, patients of the treatment group received an antiseptic nasal spray containing sodium hypochlorite at a concentration of ≤ 0.08%, 2.1% sodium chloride, 0.05% lithium magnesium sodium silicate and purified water. The patients’ life distress index was assessed based on data collected using the PSOM-31 questionnaire. The follow-up visits were Days 5 and Day 10 of treatment.

Results and discussion. The patients of Group 2 reported the greatest changes in the severity of nasal symptoms at Day 10 of treatment, which amounted to 6.2 scores, whereas in Group 1 they amounted to 10.7 scores. At Day 10, the most disturbing general symptoms were reported by the patients of Group 1 as compared to the patients of Group 2: 16 vs 18.3 scores, respectively. Emotional deficiencies were less pronounced on Day 10 in patients of Group 2 (7 scores) as compared to Group 1 (8.7 scores).

Conclusion. Addition of a sodium hypochlorite-based agent containing 2.1% hypertonic sodium chloride solution to the standard therapy for exacerbations of chronic rhinosinusitis improves the patients’ well-being indices. Assessment of the survey results using the PSOM-31 questionnaire shows the maximal reduction in symptom severity and improvement of well-being indices on Day 10 of treatment, which confirms the accumulation of therapeutic effects of the antiseptic agent.

Acute upper respiratory infections are common among children and are often accompanied by inflammation of the mucous membrane of the nose and paranasal sinuses. Vasoconstrictive decongestants are one of the key methods of symptomatic therapy in inflammatory ear, throat, and nose (ENT) diseases. This research explores the pharmacology of decongestants, their classification, mechanism of action, features of administration in pediatric practice, and potential side effects. The safety of drugs in terms of their chemical structure, age groups and duration of use are given special attention. The article provides a review of current guidelines on the prescription of decongestants, including international standards for the treatment of rhinitis and rhinosinusitis in children, as well as the advantages of the fixed combination of phenylephrine and dimethindene over other vasoconstrictors. Nasal dosage forms of the fixed combination of phenylephrine and dimethindene have many advantages and are considered to be the safest in pediatric practice. A comparative analysis of drugs of different pharmacological groups shows that intranasal decongestants are the most effective and virtually non-competitive drugs used in a range of inflammatory ETN diseases that are accompanied by nasal obstruction: acute rhinitis (including acute respiratory viral infections), chronic rhinitis, allergic rhinitis, acute and chronic sinusitis, acute otitis media (as an adjuvant treatment). They are indispensable in the preparation for nasal surgical interventions, swelling of the mucous membrane of the nose and paranasal sinuses after surgical interventions and in other circumstances when it is pathogenetically and symptomatically necessary to reduce the swelling of the mucous membrane of the nasal cavity and paranasal sinuses in a faster way.

Acute sinusitis is an acute inflammation of the nasal mucosa and paranasal sinuses lasting less than 12 weeks. The disease is often included in the symptom complex of acute respiratory disease, the addition of bacterial pathogens was noted in 2% of clinical cases in adults and in 7–8% in children. The causative agents of acute purulent sinusitis in 70–75% of cases are Streptococcus pneumoniae and Haemophilus influenzae, in 15–20% – Streptococcus pyogenes, Moraxella catarrhalis, Staphylococcus aureus, anaerobes and others. The clinical manifestations of this pathology suggest that the symptoms of the disease persist for more than 10 days without significant improvement. In moderate to severe cases, systemic antibiotic therapy is prescribed empirically in accordance with the clinical recommendations of the National Medical Association of Otorhinolaryngologists, approved by the Russian Ministry of Health. To date, due to the emerging problem of microbial antibiotic resistance, the risk of chronic disease and complications due to the irrational use of systemic antibacterial drugs is increasing. The revision of the criteria for prescribing existing antibiotics leads to an increase in the dose of the most highly effective ones in order to completely eradicate the pathogen and prevent the selection of resistant strains. Empirical systemic antibacterial therapy for purulent-inflammatory diseases of the paranasal sinuses stops the inflammatory process, prevents the risks of intracranial and orbital complications. In 97.3–95% of cases, the results of microbiological studies show a high sensitivity of the most significant pathogens of respiratory infections to Amoxicillin, which is the drug of choice for inflammatory diseases of the sinuses in Russia and abroad. The presented clinical observation shows the need to comply with modern principles of rational antibiotic therapy in acute bacterial sinusitis.

Introduction. To this day, chronic tonsillitis is considered an urgent research issue in otorhinolaryngological practice, as it is characterized by a complex course and the risk of complications.

Aim. To determine the role of immunity in children with chronic tonsillitis of a toxic-allergic form against the background of the use of a complex herbal preparation.

Materials and methods. The study included 38 children with chronic toxic-allergic tonsillitis, who, depending on the type of treatment, were divided into 2 groups. Group 1 (n = 18) – standard treatment was performed. Group 2 (n = 20 – traditional therapy + combined herbal medicinal product Tonsilgon® N. The research methods included biochemical methods – assessment of the degree of intoxication, activity of lipid peroxidation processes, liver function, intensification of the immune system, intensification of the hemostasis system.

Results. It was found that the development of chronic toxic-allergic tonsillitis is characterized by significant disturbances in the activity of the immune system. An increase in the activity of the pro-inflammatory link of the immune system and depression of the anti-inflammatory component were noted. These changes led to the progression of tonsillitis in the form of endogenous intoxication and oxidative stress, on the one hand, and the development of complications – hepatic depression and hemostatic disorders. The ineffectiveness of traditional therapy in chronic tonsillitis is due to the lack of specific administration complex anti-inflammatory agent, which leads to the resort to surgical intervention. The nature of the above violations was persistent and irreversible against the background of standard treatment, and reversible with complex therapy. The inclusion of complex anti-inflammatory agent from the early stages of the disease led to a decrease in endotoxicosis, lipoperoxidation activity, restoration of immune, hepatic, and hemostatic activity for 10 days.

Conclusion. The immunological component plays an important role in the pathogenetic process of the toxic-allergic form of chronic tonsillitis, requiring the inclusion of a combined herbal medicinal product.

The problem of snoring and the obstructive sleep apnea syndrome, which was first described in medicine in 1980, remains relevant today. And, despite the existing various conservative treatment methods, surgery for snoring and obstructive sleep apnea syndrome continues to develop. Topical diagnostics, including sleep video endoscopic examination, is of the most important for determining the correct treatment method. The most common operation in the pharynx for the treatment of snoring and obstructive sleep apnea syndrome is uvulopalatoplasty with bilateral tonsillectomy, although other operations have been proposed: in particular, anterior palatoplasty, lateral pharyngoplasty, suture correction of the soft palate using barb-sutures. In this regard, the problem of sore throat after pharyngeal surgeries remains relevant, which is intense and rather long-lasting, which is caused by the rich innervation of the pharynx, the constant work of the pharyngeal muscles, as a crossroad of the respiratory and digestive sistems. Along with systemic therapy, these patients also need local anesthetic, antibacterial therapy. The article is devoted to these two urgent problems and for illustration is given a clinical example of treatment of a patient with snoring and obstructive sleep apnea syndrome and its postoperative administration.

Ronchopathy is a complex polyethological disease that has a multifactorial negative effect on the cardiovascular, respiratory and other systems of the body. Mortality in this terrible disease, most often from vascular causes and, especially, in the presence of obstructive sleep apnea syndrome, ranges from 6 to 11%, and the consequences of various complications associated with this disease increase it to 37%. The effectiveness of surgical methods of treating patients with ronchopathy is still clearly unsatisfactory, and does not allow most of them to achieve a guaranteed recovery. At the same time, the growing number of such patients, who are in dire need of effective treatment and reliable prevention of complications of this disease, encourages specialists to further search for surgical treatment methods. Surgical interventions on the soft palate in patients with ronchopathy and obstructive sleep apnea syndrome are based on the principle of injury to the palatine curtain of varying intensity (surgical, thermal, radiofrequency, laser, chemical), independent of the methods of exposure. At the same time, depending on the intensity of exposure, inflammation, necrosis or partial tissue rejection are noted and, as a result, scarring, compaaction and a decrease in the volume of the palate. At the same time, the mobility of the palatine curtain should decrease, and the intensity of snoring should decrease. However, injury caused primarily to the velopharyngeal muscles often leads to hypo- and atrophy, hypotension and significant sagging of the palate, and, subsequently, to a recurrence of the disease and increased snoring. This significantly reduces the effectiveness of surgical treatment of these patients. Increasing the effectiveness of uvulopalatoplasty is one of the tasks of modern otorhinolaryngology. Ways to increase the effectiveness of uvulopalatoplasty lie in the following directions: qualitative and adequate selection for the upcoming operation; accurate determination of the level(s) of obstruction, shape and degree of collapse of the soft tissues of the upper respiratory tract; careful consideration of the structural features of the soft palate and pharynx of each individual patient; maximum reduction of surgical trauma to the tissues of the palatine curtain during surgery.

Introduction. The article addresses the issue of selecting effective materials for tympanoplasty – the surgical restoration of the integrity of the tympanic membrane in cases of chronic purulent tubotympanic middle otitis. The challenge of choosing an effective plastic material (graft) remains unresolved among otosurgeons globally. The primary reason for this issue is that there are no tissues in the human body analogous in structure to the tympanic membrane.

Aim. To conduct a literature review on materials used in tympanoplasty for the closure of tympanic membrane perforations and the formation of a neotympanic membrane, as well as a comparative analysis of their characteristics and properties. Materials and methods. A literature review on tympanic membrane surgery was conducted. The review includes data from surgical guidelines on middle ear surgery.

Results and discussion. Various types of grafts are discussed: autografts (such as the fascia of the temporal muscle and perichondrium of the tragus), allografts (including the dermal matrix AlloDerm), xenografts (such as bovine and equine pericardium), and other non-biological materials. A critical part of the study involves comparing different materials concerning their physical and anatomical properties similar to those of the tympanic membrane. The advantages and disadvantages are analyzed. The article discusses engraftment, mechanical compatibility with the tympanic membrane, provides comparative statistics on the long-term outcomes of tympanoplasty using various types of grafts, and the possibility of their use in complex clinical cases.

Conclusion. The authors emphasize the need for further research to determine the most effective and safe materials for tympanoplasty, which will enable sustainable results in hearing restoration and prevent disease recurrence. Thus, the article presents a comprehensive analysis of the problem of selecting materials for tympanoplasty, substantiating the need for an individualized approach in each clinical case, with a focus on the biological, physical, and functional aspects of the materials used.

Introduction. The negative impact of chronic tonsillitis on the reproductive system of women has been established. Prolonged persistence of infectious agents leads to disruption of blood supply to the endometrium and prevents normal implantation of the trophoblast. Some unexplained reproductive losses may be caused by immune causes, including those associated with chronic tonsillitis.

Aim. To study the prevalence of various forms of chronic tonsillitis and the state of humoral immunity in women with habitual miscarriage, to evaluate pregnancy outcomes after treatment of chronic tonsillitis in this group of patients.

Materials and methods. The main group consisted of 45 patients with a history of miscarriages and chronic tonsillitis who were treated for chronic tonsillitis before planning pregnancy. The control group consisted of 41 patients with spontaneous miscarriages and chronic tonsillitis who were not treated for chronic tonsillitis before planning pregnancy. The treatment included flushing of the tonsillar lacunae and physiotherapy. The immunological study included a spectrum of antiphospholipid antibodies by solid-phase enzyme immunoassay (ELISA).

Results. In the study of humoral immunity in the main group, elevated levels of aß2-GP-I were noted in 25 (55.6%), anti–HCG in 22 (48.9%), aCL in 17 (37.7%), aPT in 12 (26.7%), and aAnV in 10 (22.2%), aFS – in 8 (17.8%) patients. All patients in the main group underwent a course of treatment for chronic tonsillitis before planning pregnancy. A month after treatment, a decrease in the level of antiphospholipid antibodies was noted. Spontaneous termination of pregnancy in the early stages occurred in 2 (4.4%) women of the main group and in 8 (19.5%) patients of the comparison group (p = 0.043).

Conclusions. Clinical studies have proven the relationship of bacterial and viral infections with early miscarriages and premature birth. Infections accompanied by increased production of pro-inflammatory cytokines play an important role in miscarriage. Reducing autoimmune activity and reducing autoantibody levels after CT treatment helps reduce the incidence of pregnancy complications.

Introduction. The opacification of the unilateral sphenoidal sinus (USS) in computed tomography is caused by various diseases, including inflammation and infectious sinusitis, benign and malignant tumors and encephalocles. Symptoms of isolated lesions of this sinus are varied and nonspecific. This symptom includes retrobulbar pain, which does not occur with other paranasal spasms. This makes this symptom diagnostically valuable.

Aim. Тo consider the relationship between the presence of retrobulbar pain in patients with isolated sphenoiditis and the nature of pathological changes in the sinus.

Materials and methods. A retrospective cohort study of multiple institutions was conducted on all patients with USS from 2017 to 2024. The demographics of the patients, symptoms, findings of nasal endoscopy and CT scans were recorded. For categorical features, the obtained data were analyzed using statistical methods.

Results. Based on the analysis, it was found that retroorbital pain was more often detected in patients with fungal formation of the sphenoid sinus in the association with or without purulent fundus (p = 0.01), and was also more often observed in client patients. Moreover, no correlation was observed between diplopia and inflammatory pathology.

Conclusion. Thus, retroorbital pain is a predictor of sinus chronic inflammation, requiring surgical intervention in short time, pathological changes in the sinus.

Acute purulent inflammatory processes of the soft tissues of the external nose deserve special attention in clinical practice, considering their potential for diverse clinical manifestations such as furuncles, carbuncles, abscesses, cellulitis, and erysipelas. These pathologies are associated with an elevated risk of generalized infection, which can lead to life-threatening complications including intracranial and orbital complications, Lemierre’s syndrome, sepsis, and septic embolism. The article describes the mechanism of complication development related to septic emboli, the stepwise progression of symptoms, and the possible challenges in diagnosis and treatment that may be encountered based on a clinical case study. The article describes a clinical case of a 43-year-old patient who developed a nasal phlegmon complicated by septic embolic pneumonia with multiple lung abscesses and bilateral pleuritis after self-removal of a pustule on the wing of his nose. The development of such a complication in an otherwise healthy individual highlights the significance of topographic-anatomical features of this region and the high likelihood of systemic complications when medical assistance is delayed. Despite initial treatment, symptom progression and the emergence of secondary foci of purulent infection following changes in therapeutic strategy and successful surgical debridement of the primary infection site emphasize the need for a multidisciplinary approach, dynamic assessment of clinical and laboratory data, and additional diagnostic methods to ensure timely detection of complications. This case underscores the danger of self-intervention in facial skin infections and the necessity of early medical consultation. Timely diagnosis, adequate antibiotic therapy, and surgical intervention are key factors for successful treatment and prevention of life-threatening complications.

Introduction. Hearing loss affects 1 to 2 out of every 1000 newborns. Detecting anomalies in the inner ear is a challenging task even for experienced specialists.

Aim. To develop a fully automated sequence of commands with a pipeline data transfer for the classification of inner ear defects and processing of CT images of inner ear anomalies in patients using this program data.

Materials and мethods. This study presents the first automated method for classifying congenital inner ear anomalies. In the experimental part, a 3D cochlear structure network was developed for 346 standard and 121 atypical structures using a common segmentation scheme trained exclusively on normal anatomy. From 2018 to 2024, 98 patients were examined at the Federal State Budgetary Institution of Science, Otolaryngology, Federal Medical and Biological Agency of Russia, including 54 (55.5%) boys and 44 (44.5%) girls aged from 8 months to 6 years (average age 2.5 years) with inner ear developmental anomalies and severe hearing impairments, who subsequently underwent cochlear implantation.

Results. We achieved a generalized average accuracy of 77% across 7 different pathological subgroups of disorders compared to the professional diagnosis of an otolaryngologist specializing in congenital inner ear defects.

Discussion. Although automatic detection of various types of inner ear anomalies is essentially a classification task, the lack of representative and heterogeneous datasets that accurately represent the diversity of these congenital developmental defects necessitates the use of a parametric approach. This method is employed with standard data to extract implicit information that could potentially detect anomalies in a non-controlled manner.

Conclusions. We proposed the first method for the automatic detection of congenital anomalies of the inner ear and demonstrated that the use of 3D information about the shape of the cochlea, extracted using a model trained exclusively on standard structures, is sufficient for classifying developmental defects.

Introduction. Despite the development of diagnostic capabilities in otorhinolaryngology, the mechanisms of development of subjective ear noise, and in many cases etiological factors, are not sufficiently studied. To date, many hypotheses of pathogenesis have been proposed, one of which is dysfunction of the auditory tubes. At the moment, there is no “gold standard” for assessing the condition of the auditory tubes, since dysfunction has various manifestations on standard tests, has a type A tympanogram and has positive and sometimes normal pressure in the tympanic cavity, appearing only with the ETF stress test (Eustachian Tube Function).

Aim. To identify an objective relationship between auditory tube dysfunction and tinnitus in a group of patients with subjective tinnitus

Materials and methods. We examined 26 patients with complaints of hearing loss. Exclusion criteria were: absence of acute and chronic ENT pathology, surgical interventions on ENT organs, complaints of impaired nasal breathing. The patients were divided into 2 groups: 16 patients with tinnitus (61.6%) and 10 patients with no tinnitus (38.4%).

Results. In the majority of patients in the group with tinnitus (81%), dysfunction of the auditory tube was detected. Also, analysis of peak compliance indicators showed a decrease in its level in the group of patients with tinnitus.

Conclusion. The results obtained indicate the paramount importance of assessing the condition of the middle ear in patients with tinnitus. Studying the function of the auditory tube allows us to identify dysfunctions that are not always obvious during the initial otorhinolaryngological examination and adjust the diagnostic and treatment plan for this category of patients.

Introduction. Voice disorders occur in approximately 30% of the country’s population. The most studied characteristics of the voice include fundamental frequency, pitch and amplitude, harmonic-to-noise ratio, cepstral peak severity, acoustic quality index of voice, maximum phonation time, variations in fundamental frequency and number of pauses in speech signals.

Aim. Literature review assessing the possibility of acoustic voice analysis in patients with dysphonia.

Materials and methods. The authors searched for publications in the electronic databases PubMed, Web of Science, Google Scholar and ELibrary. The search was carried out using the following keywords: “voice acoustic analysis”, “voice disorder”, “artificial neural network”, “dysphonia”, “standard deviation of fundamental frequency”, “voice quality”, “acoustic voice analysis”.

Results and discussion. Fundamental frequency may be more sensitive to objective clinical assessment of voice than pitch and amplitude. The severity of the cepstral peak is an integral part of the acoustic analysis of the voice, helping to determine the differences between dysphonic and normal voices. Cepstral analysis is more sensitive to subtle dysphonic changes than vowel analysis methods. Despite the high analytical accuracy, ease of use of machine learning, as well as the promise of this approach in the diagnosis of dysphonia, the clinical application of this technology requires further research

Conclusions. Acoustic Analysis of Voice offers numerous advantages such as non-invasiveness, cost-effectiveness, and ease of use, facilitating the acquisition of objective data for evaluating the severity of voice disorders and serving as an indispensable tool for identifying pathologies associated with phonation disturbances. According to the literature, the most informative Acoustic Analysis of Voice parameters include fundamental frequency metrics, pitch and amplitude indices, cepstral peak prominence, voice quality index, maximum phonation time, and the relative noise level in the speech signal.

Introduction. Biologic therapy used for the treatment of chronic rhinosinusitis with nasal polyps (CRSwNP) effectively reduces symptom severity; however, its efficacy may depend on the histological type of polyps. The aim of this study was to assess the impact of nasal polyp type on the effectiveness of dupilumab in patients with CRSwNP and comorbid asthma.

Materials and methods. This cohort observational study included patients in whom previous surgical and pharmacological treatments had proven insufficient. Participants were categorized into three groups based on polyp histology (edematous, eosinophilic, fibrotic) and received dupilumab (300 mg subcutaneously every two weeks) for 52 weeks. Treatment efficacy was assessed at predefined time points using the Nasal Polyp Score (NPS) and the Lund-Mackay scale.

Results. Patients with edematous polyps exhibited the most pronounced improvement on the Lund-Mackay scale, with a mean reduction from 20.94 ± 3.36 to 5.44 ± 3.22 by week 52 (p < 0.001). In contrast, eosinophilic and fibrotic polyps showed less pronounced reductions, from 20.87 ± 2.74 to 7.17 ± 4.15 and from 20.86 ± 2.32 to 10.29 ± 3.24, respectively. Similarly, NPS scores decreased from 6.81 ± 0.83 to 2.00 ± 1.15 in edematous polyps, from 6.96 ± 0.93 to 2.65 ± 1.94 in eosinophilic polyps, and from 6.43 ± 0.85 to 2.50 ± 0.94 in fibrotic polyps by week 52.

Conclusions. The edematous polyp type is associated with the most pronounced response to biologic therapy, whereas fibrotic polyps demonstrate a less significant reduction in size.

The head area has a rich sensory innervation designed to protect one of the most important human organs, the brain. Headache is one of the main reasons for seeking medical help. Patients often turn to an otorhinolaryngologist on their own or in the direction of other doctors. Pain syndrome in the head area is usually characterized by a polymorphic clinical picture, characterized by polyethology, multifactorial nature and objective complexity in determining the etiological factors of its occurrence. Otalgia is a special case of headache or cephalgia. The purpose of this work was to highlight the problem of otalgia of unknown genesis. The classification of otalgia is considered. A brief review of the literature is given. Primary otalgia occurs as a result of a pathological condition of the ear and examination of the ear, as a rule, allows you to determine the cause. Secondary otalgia is diagnosed when the source of pain is not localized directly in the ear and an examination of the ear during otoscopy does not reveal an obvious pathology. Otalgia of unclear etiology is a collective term based on a common symptom – ear pain, but with a different etiology. Among the etiological factors, three large groups of causes can be distinguished. The first is an implicit, atypical pathology of the ear. The second is dental pathology, primarily of the temporomandibular joint (Kosten’s syndrome). The third most common group of causes is neurological pathology (neuralgia, osteochondrosis of the cervical spine, migraine). An algorithm for the actions of an otorhinolaryngologist in the diagnosis of “otalgia of unknown etiology” has been created. The results of their own developments are presented. It has been established that this problem is typical for older age groups (over 30 years old). In terms of gender, women predominate (more than 2 times). In addition to an otorhinolaryngologist, a dentist, a neurologist, and sometimes a psychiatrist, it is necessary to participate in the diagnosis and treatment of the nosology under discussion.

Position-dependent sleep breathing disorders, primarily positional obstructive sleep apnea (OSA), is a special type of the disease that has significant variability in the severity of breathing problems depending on body position. Based on data collected over the past few decades, it has been found that up to 60% of OSA patients exhibit significant positional dependency, while 20–30% of cases are recorded exclusively in a supine position (isolated positional OSA). The article explores in detail the current concepts of epidemiology, pathophysiology, clinical characteristics, and risk factors for position-dependent sleep-related breathing disorders. It also focuses on the role of position therapy (PT) as a potential treatment option, especially for patients with mild to moderate forms of the condition. The article presents data on the high efficiency and tolerance of modern vibrotactile devices for sleep apnea, which can significantly reduce the severity of the condition. The results of randomized controlled trials and meta-analyses confirm the comparability of PT with other treatments, such as positive airway pressure therapy (PAP) and orthodontic devices. The article discusses the prospects of a combined approach and the need for individualized therapy, as well as the importance of further research to achieve long-term clinical effects, improve adherence to therapy, and enhance the quality of life for patients. The article is useful for both sleep medicine doctors and specialists in related fields who encounter snoring and sleep breathing disorders in their practice.