Introduction. The use of standardized medicines with multidirectional mechanisms of action, which correspond to phytoprepa­rations containing standardized myrtol, limonene, cineol and alpha-pinene, is of great importance in the treatment of acute sinusitis in puberty children.

Aim. To increase the effectiveness of conservative treatment of acute sinusitis in puberty patients using a phytopreparation with multidirectional mechanisms of action.

Materials and methods. A simple controlled clinical trial with randomization involved 36 patients with acute sinusitis aged 10 to 18 years on the background of acute respiratory infection. The clinical effectiveness of the use of a phytopreparation containing standardized myrtol in complex therapy relative to generally accepted treatment regimens was evaluated. The main objectives were to evaluate the safety of the drug, the effect on the recovery time and patient adherence. The severity of clinical manifestations of acute rhinosinusitis was studied using the SNOT-22 questionnaire. The effect of therapy on the quality of life of patients, cognitive functions, fatigue in school and other parameters were conducted using the SF-36 life questionnaire.

Results and discussion. Acute sinusitis in puberty patients with acute respiratory viral infection is more severe. This is due not only to aggressive infectious contamination of the mucous membranes, but also to the immunological resistance of adolescents in tran­sition. The use of a standardized myrtol-containing drug in the complex therapy of acute sinusitis has demonstrated better effective­ness in relieving symptoms of the disease, improving quality of life and school learning relative to conventional treatment regimens.

Conclusions. The clinical manifestations of acute sinusitis against the background of acute respiratory viral infection, due to the peculiarities of the restructuring of the body at puberty, differ in their variability. In stopping the cascade of symptoms of the disease, the standardized myrtol-containing drug Resper Myrtol has demonstrated greater effectiveness and safety relative to generally accepted regimens.

Introduction. The clinical manifestations of acute tonsillopharyngitis (ATP) are varied, the combined use of topical medications with synergistic and complementary mechanisms of action in various dosage forms is of practical interest.

Aim. To study the effectiveness of combination topical therapy for ATP in adults and children using ambazon and benzydamine.

Materials and methods. From March to May 2025, a multicenter clinical observational study was conducted in Samara among patients who sought medical attention from an otolaryngologist complaining of sore throat. To exclude the possible etiology of ATP due to Group A beta-hemolytic streptococcus, the otolaryngologist performed a rapid diagnostic procedure at the initial consultation. The study group included 30 patients, 13 children and 17 adults (mean age 24.9 ± 15.1 years). All patients received a combination of ambazon and benzydamine at the recommended dosage.

Results and discussion. Treatment effectiveness was assessed on days 2, 3, and 5 of treatment, as well as 2 days after the end of the treatment period. By day 2, sore throat was completely relieved in 10% of patients, and another 40% of patients expe­rienced a reduction in throat pain intensity. The VAS score was 3.8 ± 2.3 points, compared to the baseline of 6.7 ± 2.6 points (p < 0.001). By the end of treatment, sore throat was completely relieved in 50% of patients, and the pain intensity score for another 50% was 0.6 ± 0.6 points. A patient survey on day 7 revealed that 96.7% (n = 29) of patients had no sore throat.

Conclusions. The obtained data on a significant regression of objective and subjective signs of ATP, including a reduction in inflammatory changes in the pharyngeal mucosa, indicate the feasibility of using the studied combination in the compre­hensive treatment of ATP in adults and children.

Introduction. Improving the effectiveness of conservative treatment of secretory otitis media (SOM) in children remains an urgent problem because of the multifactorial etiology of the disease and the continued reliance on surgical intervention. The article presents the collective experience of monitoring the course of SOM after ARI with therapy aimed at various links in the pathogenesis of the disease.

Aim. To evaluate the clinical efficacy of intranasal azoximer bromide (Polyoxidonium ® , Petrovax, Russia) versus combination therapy with a mucoregulator, topical antibacterial agents, and a decongestant for the treatment of secretory otitis media in children after acute respiratory viral infection.

Materials and methods. A randomized, open-label, prospective, comparative clinical study was conducted in 49 children aged 4–7 years with SOM after ARI. The study group included 23 patients who received intranasal azoximer bromide, 3 drops in each nostril three times daily for two weeks. The control group comprised 26 patients who received combination therapy: an intranasal spray containing neomycin, polymyxin, dexamethasone metabenzoate, and phenylephrine (one administration per nostril three times daily for 10 days) plus oral carbocysteine at an age-appropriate dose for two weeks.

Results. During azoximer bromide treatment, the dynamics of intratympanic pressure recovery were not inferior to those with standard therapy, and SOM relapses were less frequent at 3 and 6 months.

Conclusions. Age-related characteristics of local immunity in children aged 4-7 years may underlie chronic catarrhal inflammation of the mucous membrane of the auditory tube and tympanic cavity after acute respiratory viral infection. Intranasal immunocorrection with azoximer bromide resolves catarrhal inflammation of the tympanic cavity and auditory tube during SOM developing after acute respiratory viral infection.

Acute respiratory viral infections (ARVIs) remain one of the leading causes of morbidity and temporary disability worldwide. Bacterial complications such as sinusitis, bronchitis, and pneumonia significantly worsen prognosis and increase the burden on healthcare systems. The rising resistance of microorganisms to antibacterial therapy highlights the need for alternative therapeutic strategies, including plant-derived agents with proven antimicrobial and immunomodulatory activity. Pelargonium sidoides DC root extract has demonstrated efficacy in reducing the risk of complications and improving outcomes in respiratory tract infections. We present a clinical case illustrating the use of a preparation based on Pelargonium sidoides root extract in a patient diagnosed with ARVI and a history of recurrent sinusitis. The administration of the phytotherapeutic preparation was associated with favorable clinical dynamics, including symptomatic improvement and prevention of bacterial complications. Pelargonium sidoides root extract may represent a valuable therapeutic option in the management of ARVIs, particularly for patients at risk of bacterial complications. The results obtained are consistent with the literature data showing that the herbal medicine exhibits a pronounced adjuvant effect in upper respiratory infections, improves mucociliary clearance, and reduces the risk of bacterial complications.

One of the determining factors of the effectiveness of treatment of upper respiratory tract infections is the immunological reactivity of the mucous membranes. In this context, understanding the individual pathophysiological mechanisms of disease development and their clinical course, depending on the state of general and local immunity, will allow improving treatment tactics and achieving positive results at an earlier date. To substantiate the prospects of using a multicomponent phytonerating drug with a multidirectional effect in the treatment of inflammatory diseases of the upper respiratory tract with an emphasis on unique pharmacokinetic parameters and pharmacodynamic parameters. The analysis of literature sources highlighting topical issues of etiopathogenetic mechanisms of upper respiratory tract infections, clinical features, and the expe­rience of researchers using phytoniringovyh drugs and their own observations. Databases of literature data were used: RSCI, Web of Science, PubMed, Google Scholar, Scopus, etc., according to keywords, ENT infections, upper respiratory tract infection, immunity, immunoglobulins, herbal medicines, phytotherapy, with a search depth of more than ten years. Among the reasons for seeking specialized otorhinolaryngological care, upper respiratory tract infections occupy a leading place. The key pathogens are RNA-containing viruses of four families and DNA-containing viruses of two families. The main effector of adaptive immunity, protection of the mucous membranes of the upper respiratory tract, is secretory class A immunoglobulin. There is a tendency to decrease the content of IFN-a and sIdA in the first days of the disease, which can be explained by a decrease in infectious protection, therefore, the search for drugs capable of affecting the local immune response is justified, and the medicinal phy­topreparation Tonsilgon N. meets these requirements. The inclusion of the medicinal phytopreparation in the basic therapy of upper respiratory tract infections will achieve high results in relieving clinical symptoms by enhancing the local immune response of the oropharyngeal mucosa.

Introduction. Chronic suppurative otitis media (CSOM) is a chronic inflammation of the middle ear cavities, resulting in per­sistent perforation or retraction of the eardrum of varying size and location. Exacerbation of CSOM is a major public health problem, which is aggravated by the rise of antibiotic resistance of key pathogens (S. aureus, P. aeruginosa). Phage therapy is considered to be a promising alternative or complement to the traditional treatment.

Aim. To evaluate the efficacy and safety of Sextaphage^® (pyobacteriophage polyvalent) as monotherapy and combination ther­apy in exacerbated CSOM.

Materials and methods. An interim data cut was performed of the clinical trial with total 33 patients with exacerbated CSOM included. The patients were divided into 3 groups (11 patients each): 1) standard topical antibacterial therapy (ciprofloxacin); 2) monotherapy by transtympanic delivery of polyvalent pyobacteriophage; 3) combination therapy (pyobacteriophage polyva­lent + ciprofloxacin). Treatment lasted 10 days.

Results and discussion. The clinical resolution of otorrhea was achieved in 90.9% of patients in groups 1 and 3 and in 72.7% of thosed in group 2 by Day 10. The polyvalent pyobacteriophage therapy demonstrated significant clinical and bacteri­olytic efficacy against key pathogens. Combination therapy demonstrated high efficacy (90.9%). Treatment was well tolerated, with no adverse events reported in the study.

Conclusion. The use of polyvalent pyobacteriophage in the integrated treatment of exacerbated chronic otitis media has demonstrated high efficacy and safety, confirming its value in the fight against antibiotic resistance and in improving disease outcomes.

Introduction. A sore throat is one of the most common symptoms of acute respiratory viral infections (ARVI).

Aim. To evaluate the clinical efficacy of Miramistin as part of combination therapy in patients with a sore throat associated with ARVI.

Materials and methods. The study was conducted in a sample of 57 patients (mean age 36.6 ± 8.0 years) with documented acute tonsillopharyngitis due to ARVI. The treatment group (28 patients, mean age 39.5 ± 6.4 years) was treated by irritation of the oropharynx with benzyldimethyl-myristoylamino-propylammonium spray, 4-fold pressing 4 times a day for 5 days. The control group (29 patients, mean age 33.9 ± 8.4 years) was prescribed standard ARVI therapy with antiviral and antipyretic drugs. The general and local symptoms of the disease were assessed using a 3-point scale and the pharyngoscopic view of patients was monitored. In addition, the outcomes of treatment were assessed by the doctor and the patients using integral scales (IMPSS, IMOS).

Results and discussion. On day 5, the number of patients with complete sore throat relief was 85.7% in the treatment group and 69.0% in the control group; complaints of discomfort in swallowing were completely resolved in 85.7% of patients in the treatment group and in 72.4% of patients in the control group. On day 5, all patients in the treatment group showed significant improvement and minimal changes in their pharyngoscopic view as compared to the control group, which had persistent hyperemia, swelling of the oropharyngeal mucosa, and the presence of reddish lymphoid follicles on the posterior pharyngeal wall.

Conclusions. The data obtained indicate the importance of using antiseptic drugs as part of the combination ARVI therapy.

Introduction. Various forms of chronic pharyngitis are of the greatest interest for practical otorhinolaryngology. This is due to the prevalence of nosological forms, the peculiarities of the etiopathogenetic mechanisms of the disease, and the variability of the clinical course. The irrational use of drugs with antibacterial and local anti-inflammatory effects often leads to the devel­opment of resistance of many pathogenic microorganisms, changes in the composition of the normal microbiota of the lymphat­ic formations of the pharyngeal ring and the formation of local dysbiosis, which can be avoided by using immunomodulatory drugs based on bacterial cell lysates.

Aim. To investigate the clinical efficacy and safety of bacterial lysates in the treatment and prevention of acute and exacerba­tions of chronic pharyngitis.

Materials and methods. A total of 11 patients with a verified diagnosis of acute and exacerbation of chronic pharyngitis were examined. To achieve this goal, traditional therapy was supplemented with immunocorrection and the appointment of bacterial lysates. When choosing a medicinal product, literary sources were used that highlight topical issues of the development of acute and exacerbations of chronic pharyngitis, clinical manifestations, treatment prevention. Due to the small sample of patients, statistical processing was not carried out and is reflected in a subsequent publication with a larger sample of patients.

Results and discussion. It is noted that the use of bacterial cell lysates, allows achieving better results relative to traditional treat­ment methods. It was noted that the pronounced stimulating capabilities of local and systemic immunity, a drug based on bacterial cell lysates, restores the barrier functions of the mucous membranes at an early stage and reduces the frequency of exacerba­tions. Due to the existing difference in terminology and the most frequent use of the term “chronic tonsillopharyngitis” by foreign sources, the majority of the material is presented by domestic literature sources. The work is supported by two clinical examples.

Conclusions. The inclusion of bacterial lysates in the complex therapy of acute and exacerbations of chronic pharyngitis will make it possible to achieve recovery and improve the quality of life at an earlier date.

Introduction. Improvement of conservative therapy of polypous rhinosinusitis is important for scientific and practical otorhi­nolaryngology.

Aim. To study the therapeutic possibilities of a recombinant antibody to immunoglobulin E for polypous rhinosinusitis in patients with bronchial asthma with insufficient efficacy of intranasal glucocorticosteroid therapy.

Materials and methods. The study was performed with the participation of 78 patients out of 204 registered with pulmonol­ogists and otorhinolaryngologists aged 18-45 years, with an average weight of 60-90 kg. Inclusion criteria: the presence of polypous rhinosinusitis (J33) in combination with bronchial asthma with a predominance of the allergic component (J45.0), mild to moderate severity, persistent form, uncontrolled course. The effectiveness of recombinant antibody to immunoglobulin E was evaluated at 3^rd, 4^th and 5^th months compared with groups that received only standard basic complex therapy.

Results and discussion. In patients with polypous rhinosinusitis accompanied by bronchial asthma receiving the recombinant antibody to immunoglobulin IgE: nasal respiration was restored by 63%, 66.2% and 68.9%, olfactory improvement by 52%, 63.5% and 67.9% on the 3^rd, 4^th and 5^th month of therapy, respectively. According to CT data, at the end of the 5^th month of ther­apy, 70% of patients had a polypous process of 0-5 points, 30% of patients had values of 6-10 points of Lund-Mackay staging. According to the SF-36 questionnaire, normalization of quality-of-life indicators was recorded in the form of improved role functioning, vital activity and emotional state by 33.6, 33.3 and 30.2 points, respectively. The subjects receiving conservative therapy did not experience any allergic reactions or side effects during treatment.

Conclusions. The leading clinical manifestations of persistent atopic bronchial asthma, allergic rhinitis, nasal polyposis, and chronic idiopathic urticaria are nasal obstruction, rhinorrhea, hyperemia, and itching of the skin. These symptoms are caused by premature release of inflammatory mediators, the main one being histamine. The use of targeted therapy with humanized monoclonal antibodies is more likely to control the cascade of symptoms in patients with diseases refractory to H1 blockers.

Improving the effectiveness of perioperative therapy in children with pathology of the tonsils of the Pirogov-Waldeyer’s lymphoepithelial ring remains a priority task for practical otorhinolaryngology and related specialties. The article discusses the main epidemiological and etiopathogenetic aspects of the formation of pathological conditions of the lymphoepithelial pharyngeal ring. The well-founded and demanded principles of perioperative therapy using topical antiseptic and disinfectants are outlined, the most progressive of which are drugs with the main active ingredient ambazone. Special attention is paid to the mechanisms of achieving maximum therapeutic concentrations of the active substance with topical application, which make it possible to stop inflammation in a short time without exerting a systemic effect on the child’s body. The mechanisms of bacteriostatic action of an antiseptic drug against the most frequently verified microorganisms (Streptococcus haemolyticus, Streptococcus viridans, Pneumococcus) are described in detail. The rationale and prospects for the use of antiseptic drugs with the active substance ambazone are demonstrated by clinical examples.

Introduction. Surgical treatment of patients with ronchopathy and obstructive sleep apnea syndrome (OSAS) is a topical issue of modern medicine. The velopharyngeal muscle injury of various intensity due to surgical interventions on the soft palate leads to inflammation, tissue necrosis or partial rejection and wound healing with a fibrous scar, muscle hypotrophy and hypotonia, palatal ptosis and, as a consequence of this, disease recurrence.

Aim. To evaluate the effectiveness of laser surgery on the soft palate in patients with ronchopathy and obstructive sleep apnea syndrome.

Materials and methods. The results of examination and treatment of 523 patients with ronchopathy and obstructive sleep apnea syndrome of varying severity aged from 23 to 78 years (men 299, women 224) are presented. Surgical intervention on the soft palate was performed in 352 (67.3%) patients: 309 underwent laser sculptural uvulopalatoplasty, 43 underwent surgery using the Remacl method M. et al. (comparison group).

Results and discussion. A comparative analysis of subjective and objective indicators obtained in the same patients according to monitoring computer pulse oximetry, polysomnography and computer somnography before and at different times after laser sculptural uvulopalatoplasty demonstrates persistent and significant (p ≥ 0.005) positive changes. The data from the study of patients in the comparison group demonstrate a positive trend in the results obtained at different times after Remacl surgery M. et al. only if they have uncomplicated snoring and mild OSA.

Conclusion. Laser sculptural uvulopalatoplasty is a highly effective method of treating patients with ronchopathy, regardless of the presence and degree of obstructive sleep apnea syndrome. With high-quality and adequate selection for surgery, accurate determination of the levels of obstruction, shape and degree of collapse of the soft tissues of the upper respiratory tract, careful consideration of the individual characteristics of the structure of the soft palate and pharynx and minimization of surgical trauma to the palatine curtain, it is possible to achieve a positive effect of surgery in the vast majority of patients.

Introduction. To date, there is no uniform treatment and management strategy for patients with traumatic ear injuries.

Aim. To improve the myringoplasty technique in the early post-traumatic period by shielding the perforation with a silicone disc in combination with endaural helium-neon laser therapy, and to study the immediate and long-term results of the effectiveness of the proposed method.

Materials and methods. More than 40 years of experience using laser therapy in combination with traditional treatments for dis­eases of the outer and middle ear demonstrates the effectiveness of this combination of methods in treating patients. A treat­ment method has been developed for patients with traumatic eardrum perforations using silicone disc shielding in combination with endaural helium-neon laser therapy. A total of 134 patients were divided into three groups. The first group (47 patients) received silicone disc shielding in combination with endaural helium-neon laser therapy. The second group (46 patients) received silicone disc shielding alone. The third group (41 patients) underwent restoration without any medical interventions.

Results. Changes in defect area and the time to restoration of eardrum integrity were assessed over a three-month follow-up period. The average duration of restoration of the eardrum defect and the effectiveness of treatment in patients in the first group was 13 ± 5 days, and in 94% (44 patients), in the second group 16 ± 6 days, and in 87% (40 patients), in the third group 27 ± 12 days, and in 73% (30 patients).

Conclusions. Thus, it is advisable to screen the defect with a silicone disk in the early post-traumatic period, which acts as a skeleton and accelerates the repair process compared to natural healing. Combining screening with endo-auricular helium-neon laser therapy stimulates the regeneration of damaged tissues and shortens the treatment time. The study yielded statistically significant results using the developed method.

Introduction. In modern medicine, physicians are increasingly required to be versatile specialists, combining in-depth medical knowledge with technical expertise. While the accessibility of genomic research has dramatically increased over the past few decades, its full integration into medical practice still faces significant challenges. Given the rapid proliferation of new knowl­edge regarding the associations between genomic data and human diseases, there is a growing clinical need for physicians to be able to analyze this data themselves. This is especially true for subsequent medico-genetic studies, particularly when patients already have existing Next-Generation Sequencing (NGS) data (e.g., from exome sequencing).

Aim. The objective of this study is to develop and provide a detailed guide for medical specialists to independently perform bioinformatics analysis of a patient’s NGS data.

Materials and methods. The source data for this study are examples of NGS data files provided to patients following a medicogenetic examination. We used both established and custom-developed software algorithms for read alignment against a refer­ence genome, variant discovery, variant filtering based on quality criteria and specific genes (and their transcripts), and assess­ing their potential health impact.

Results. We developed a comprehensive algorithm and a bioinformatics processing pipeline for sequencing data analysis. This pipeline utilizes a Linux command-line interface, along with Docker containers for established bioinformatics tools such as bwa, gatk, samtools, and bcftools, as well as R scripts based on the Bioconductor project and our own proprietary developments. This algorithm allows medical professionals to independently obtain and interpret genetic variants from a patient’s NGS data.

Conclusion. The information obtained through this pipeline can serve as a foundation for further work in diagnosing hereditary diseases, personalized medicine, and pharmacogenetics. The proposed algorithm effectively achieves the study’s objective, enabling the retrieval of patient genomic sequence variants (exomes) suitable for subsequent analysis and interpretation on a personal computer. We anticipate that a physician’s computer can handle this task in a reasonable amount of time, ensuring reliable and reproducible data processing.

Introduction. For the multi-million-strong army of voice and speech professionals, the voice is not only a means of communication but also a tool in their professional activities. Phonation disorders have a severe impact on the emotional state of a professional, as they often lead to disability and professional ineptitude, which significantly reduces the quality of life. The urgency of the study is determined not only by the significant prevalence of acute laryngitis within dysphonias, but also by lack of effect of the current treatments.

Aim. To evaluate the efficacy of combination therapy with Homeovox in the rehabilitation of voice professionals who underwent acute laryngitis. For this purpose, the following specific objectives have been set: to develop a treatment algorithm for patients with acute laryngitis using a homeopathic preparation as part of combination therapy and to evaluate its clinical efficacy in voice professionals.

Materials and methods. A total of 20 patients (17 women and 3 men) were included in the study. The examination included videolaryngostroboscopy, acoustic voice analysis, and a subjective functional assessment of phonation quality using the author's Voice Visual Analogue Scale (VVAS) over three diagnostic visits. The patients were divided into two groups, medical rehabilitation in which was carried out in accordance with clinical recommendations and the use of a homeopathic drug group 1, and group 2 according to standard rehabilitation measures.

Results and discussion. The comprehensive treatment using the homeopathic preparation has shown significant efficacy and safety of the developed algorithm for rehabilitating dysphonia in voice professionals from the first days of therapy, as confirmed by objective and subjective examination methods over time.

Conclusions. The developed algorithm for the comprehensive treatment of voice professionals and introduction of Homeovox in conventional rehabilitation therapy proved to be effective and can be recommended for widespread implementation in daily practice, as they significantly improve clinical and functional outcomes and allow reaching the functional results in normalizing the voice quality much quicker.

CHARGE syndrome is a rare genetic disorder characterized by a combination of birth defects. In CHARGE syndrome, auditory nerve (CH) abnormalities are most common. The state of HF is important for candidates for cochlear implantation (CI). The decision to have a CT scan is difficult due to the presence of inner ear abnormalities, developmental delay, and severe concomitant pathology, which may affect further rehabilitation. The aim of this work is to analyze the literature on the results of hearing and speech rehabilitation after CI for HF abnormalities in patients with CHARGE syndrome and to present two of our own clinical observations of children with CHARGE syndrome who underwent CI. Based on literature data and our own clinical observations, it has been shown that the detection of HF hypo-/aplasia cannot be an absolute contraindication to CI, since CI has brought certain benefits to children who participated in the studies. The results of rehabilitation ranged significantly from a simple improvement in communication with the outside world, the appearance of the ability to distinguish environmental sounds to mastering oral speech. According to their own observations, both children have a reaction to sounds, one responds to a name, understands simple phrases, the second uses sounds and syllables in communication, but mostly uses gestures in everyday life. Children with CHARGE syndrome require the supervision of a multidisciplinary team of specialists. Raising awareness among doctors about the importance of early detection of hearing disorders in children with CHARGE syndrome and the possibilities of early auditory rehabilitation of children is an urgent task.

Introduction. Tinnitus is the perception of sound without an external acoustic stimulus, which leads to maladaptation, anxietydepressive disorders and a decrease in the quality of life. The prevalence among the adult population is about 14%, including 2% of cases with severe symptoms. Psychoacoustic noise measurement is a method of quantifying subjective ear noise by determining its frequency and intensity characteristics using an audiometer that selects an acoustically equivalent tone and is used to identify auditory parameters correlating with noise perception, as well as to assess the influence of external sounds on its manifestations. In Russia, the development of psychoacoustic noise measurement began in the middle of the 20th century with the work of the Leningrad Research Institute of Ear, Throat, Nose and Speech. There are a large number of subjective methods for assessing ear noise.

Aim. Study was to determine the relationship of tinnitus parameters during various types of well-known diagnostical tests.

Materials and methods. 49 patients participated in the study, all of them underwent noise measurement, a questionnaire using the visual analog noise scale (VAS) and the THI questionnaire (Tinnitus Handicap Inventory). Statistical processing of the results was carried out and a comparative analysis of the data obtained was carried out.

Conclusions. Аs a result, a variety of reactions was revealed, indicating complex noise generation mechanisms. No statistically significant relationship was found between the noise parameters. Thus, a promising direction is the development of integrated approaches, including multi-frequency stimuli and 3D modeling of perception. Improving the methods will allow you to create personalized therapeutic strategies.

Introduction. Lost voice function compensation determines the personal and social life of laryngectomees. Automatic speech recognition and synthesis methods are widely used as apps for additional and alternative communication. One of the urgent tasks in clinical practice is voice restoration effectiveness evaluation.

Aim. To evaluate the effectiveness of voice rehabilitation results in laryngectomized patients using the automatic assessment of speech intelligibility.

Materials and methods. 3 groups of 30 laryngectomized patients depending on the method of voice rehabilitation (esophageal voice, tracheoesophageal voice, electrolarynx), and 14 patients after various surgical interventions on the larynx were included. All patients underwent pseudo-voice recording for further assessment of phrasal intelligibility using the automatic assessment software module, as well as by a trained and untrained listener.

Results and discussion. Comparative analysis shows a minimum intelligibility level in automatic recognition, apparently due to semantic and contextual recognition even in untrained listener. Alaryngeal speech demonstrates worse recognition, compared to organ-preserving operations on the larynx, in untrained listeners and in automatic recognition. Experienced listeners demonstrate a consistently high level of recognition of all types of substitute speech.

Conclusion. Objectification of the intelligibility assessment of substitute speech using automatic recognition systems allows leveling semantic and contextual recognition during assessment by both trained and untrained listeners. Automatic speech recognition and synthesys systems have application prospects in rehabilitation medicine, in particular, in patients with head and neck cancer.

Introduction. In foreign studies, dysosmia is more often considered as a marker for for diagnostics various pathologies. The question of whether olfactory disorder can act as an etiological factor and influence the occurrence of pathological psychoemotional states (anxiety, depression) remains ambiguous.

Aim. Тo assess the correlation between the severity of olfactory dysfunction and changes in the psychoemotional state (depression, anxiety disorder).

Materials and methods. 60 patients participated in this study. According to the nosology, the patients were divided into 3 groups: polypous rhinosinusitis (n = 23); post-traumatic (n = 10) and post-infectious olfactory dysfunction (n = 27). Before the study, all patients underwent an assessment of their olfactory identification ability using a Russian olfactory test. The study included patients who, according to the test results: olfactory identification ability < 16 points. The PHQ-9 (Patient Health Questionnaire 9) and the GAD-7 (Generalized Anxiety Disorder 7) were used as a method for diagnosing depression and anxiety.

Results. When analyzing the obtained data for the entire sample of patients using Spearman correlation, a correlation was found between the severity of olfactory dysfunction and changes in the psychoemotional state (depression rs = -0.388, p < 0.01; anxiety rs = -0.275, p = 0.034). Statistically significant results were also obtained in groups of patients for each nosology: polypous rhinosinusitis rs = -0.485, p = 0.019; post-infectious olfactory dysfunction rs = -0.501, p < 0.01; post-traumatic olfactory dysfunction rs = -0.945, p < 0.001. Similar results were found in patients with anxiety symptoms: polypous rhinosinusitis rs = -0.46, p = 0.027; post-infectious dysfunction rs = -0.52, p < 0.01 and post-traumatic dysfunction rs = -0.73, p = 0.017.

Conclusions. The obtained data substantiate the clinical significance of a comprehensive examination of patients with olfactory disorders using validated scales for assessing symptoms of depression and anxiety.

Introduction. Acute rhinosinusitis (ARS) is one of the most common diseases in outpatient practice, with olfactory impairment reaching up to 35%.

Aim. To study the effectiveness of olfactory training in patients with ARS and olfactory impairment.

Materials and methods. A prospective observational study included 30 patients (mean age 29.5 ± 9.3 years) with ARS combined with dysosmia and a history of SARS-CoV-2 infection. Patients were divided into groups: Group 1 consisted of 46.7% with anosmia, Group 2 included 53.3% with hyposmia. Patients were treated according to the standard scheme in accordance with the Clinical Guidelines of the Russian Federation. Additionally, olfactory training was performed on the ReviSmell hardware and software complex using virtual reality technology. To monitor the effectiveness of olfactory training, the SST-12 test and SNOT-22 survey were used on the 14th day, on the 1st and 3rd month.

Results and discussion. In Group 1, by the 3rd month of the study, 42.9% of patients restored the olfactory function to hyposmia levels, 50.0% of patients completely restored the olfactory function. In Group 2, normosmia levels were achieved in 81.3% of cases. According to SST-12, the most pronounced dynamics were in Group 1 patients by the 14th day after olfactory training (p = 0.020), in Group 2 patients, a pronounced increase in the average total SST-12 score was recorded by the 3rd month of observation (p < 0.001). The positive result of olfactory training naturally affected the improvement in the quality of life of patients (p < 0.001) according to the SNOT-22 questionnaire in both study groups.

Conclusions. Olfactory training in patients with ARS combined with dysosmia and a history of SARS-CoV-2 infection showed a significant improvement in olfactory function, taking into account the initial degree of its impairment.

The article describes the problem of perforation of the tympanic membrane, which remains one of the most pressing in modern otolaryngology. A classification of tympanic membrane defects is given, debatable issues of the need and timing of surgical treatment are discussed. For a better understanding of the healing processes, the structure of the tympanic membrane is described in detail. A review of the literature on the regeneration of the tympanic membrane is conducted, indicating the cellular processes occurring at different stages of its recovery. A separate section of the article is devoted to regeneration disorders leading to the formation of persistent perforation of the tympanic membrane. The causes of this pathology are analyzed. The authors paid special attention to the review of works devoted to latent epithelial stem cells that were found in the tympanic membrane. The presence of intrinsic regenerative potential in the form of epithelial progenitor cells, as well as knowledge of their localization, suggest that stimulation of their differentiation and proliferation leads to closure of both acute and chronic perforation of the tympanic membrane. Using tissue engineering methods, it is possible to initiate regeneration of these cells. The authors of this article draw attention to a new alternative to classical surgical treatment method for restoring tympanic membrane defects, namely, activation of its regenerative centers using laser radiation. It has an effect at the cellular and molecular levels, restoring metabolism and microcirculation of tissues. The effects of laser radiation on the stimulation of various cells are presented. The authors of the article describe the advantages of laser stimulation of the endogenous regenerative potential of the tympanic membrane and the prospects for its use in clinical practice.

Aim. To conduct a comparative analysis of the audiological profile of patients to develop criteria for the early diagnosis of ANSD.

Materials and methods. A total of 21 children with hearing impairment (mean age 6.25 ± 4.15 years) were examined. All patients underwent clinical, audiological, and molecular genetic testing. Based on the genetic testing results, the patients were divided into two groups: Group 1 (12 children) – with genetically determined forms of ANSD, and Group 2 (9 children) – with other etiological factors.

Results and discussion. According to the molecular genetic testing results, nucleotide sequence variants were identified in the genes OTOF (24%), CDH23, TMC1, COL11A1, PRPS1, and HOMER2 in 12 (57%) children with ANSD; eight of these variants were previously unreported. All patients with OTOF-associated ANSD exhibited present transient evoked otoacoustic emissions (TEOAEs), unlike the other groups. Statistically significant differences were found in otoacoustic emission parameters and the discrepancy between audiometry and ASSR test results among the ANSD groups. In our study, parents of children with genetically caused hearing loss reported a higher quality of life than parents of patients with ANSD of other etiologies.

Conclusions. Despite the genetic heterogeneity of ANSD, pathogenic variants in the OTOF gene played a leading etiological role. The presence of TEOAE is a specific marker for OTOF-mediated ANSD. The study results confirm that the implementation of an integrated molecular-genetic and audiological diagnostic workup is a necessary condition for the verification of ANSD subtypes and the development of personalized rehabilitation measures tailored to the disease etiology.

Tinnitus is a significant clinical problem that has a significant impact on the quality of life of patients. Despite the development of conservative and invasive treatment methods, chronic tinnitus often persists, especially in neurogenic and idiopathic etiologies. In recent years, the attention of researchers has been drawn to the involvement of the autonomic nervous system in the pathogenesis of tinnitus, in particular, the potential for modulating central auditory activity through the vagus nerve. The aim of our study was to evaluate the effectiveness of transcutaneous stimulation of the left cervical branch of the vagus nerve in the complex therapy of tinnitus as a method of neuromodulation in order to reduce the severity of tinnitus and correct autonomic imbalance. The method was evaluated using the example of treating a patient with chronic tinnitus, who, after an acoustic injury, underwent a course of combination therapy: daily 20-minute transcutaneous stimulation of the vagus nerve using the Neurostim device in combination with individually selected sound therapy. Efficacy was assessed using THI, VAS and analysis of autonomic regulation indices (LF/HF). After a 20-day course of therapy, the noise intensity on the THI scale decreased from 58 to 34 points (from severe to mild), the LF/HF index decreased from 4.45 to 3.42, indicating a decrease in sympathicotonia. The patient noted improved sleep and general well-being, a decrease in subjective noise intensity to 3 points on the VAS scale. Transcutaneous vagus nerve stimulation in combination with sound therapy can be considered a promising direction in neuroregulatory therapy for tinnitus. The method is well tolerated and has the potential for wide clinical application, but requires further research to standardize stimulation parameters and select patients.