Acute otitis media remains one of the most common inflammatory diseases of ENT organs in children and adults, which is accompanied by severe pain syndrome, hearing impairment and reduced quality of life. Modern approaches focus on rational pharmacotherapy using topical drugs to quickly relieve clinical symptoms. Clinical observations of patients with acute otitis media at the pre-perforation stage are presented. The diagnosis was based on complaints, medical history and otorhinolaryngological examination. Patients were treated topically with combination of phenazone and lidocaine. The effectiveness of therapy was assessed by the dynamics of pain syndrome and the regression of inflammatory changes in the eardrum. Particular attention was paid to the tolerability of treatment and the identification of possible adverse events. The use of lidocaine and phenazone provided a rapid reduction in the intensity of pain syndrome: patients noted relief within a few minutes after instillation. Within 4–7 days of therapy, a pronounced regression of inflammatory symptoms was observed. No adverse reactions were detected during treatment. lidocaine and phenazone is an effective and safe tool for endaural therapy of patients with acute otitis media, providing quick relief of pain and reducing the severity of the inflammatory process.

The most common upper respiratory tract infections include the following nosologies: rhinitis, rhinosinusitis (sinusitis), nasopharyngitis (rhinopharyngitis), pharyngitis, acute tonsillitis (angina). In recent years, topical antimicrobial drugs are widely used for diseases of the nose and paranasal sinuses, acting in the focus of inflammation with minimal systemic absorption. In most patients, acute bacterial rhinosinusitis is a complication of viral infection with impaired sinus drainage, which can lead to complications and chronic disease. Streptococcus pneumoniae and Haemophilus influenzae are detected in 70–75% of cases, Streptococcus pyogenes in 15–20%, Moraxella catarrhalis, Staphylococcus aureus, anaerobes, etc. According to the literature, the main bacterium is beta-hemolytic group A streptococcus, but the prevalence of asymptomatic colonization with Staphylococcus aureus worldwide ranges from 3.7% to 48.6% (2024). Due to the problem of antimicrobial resistance in pathogens, it is important to use local antibacterial agents in bacterial rhinosinusitis, either in combination with systemic antibiotic therapy or in a different format. In this context, a clinical case illustrating the efficacy of combination therapy in acute purulent rhinosinusitis is presented. An 18-old-patient M. complained of a fever of 37.8°C (99.8°F), nasal obstruction, and purulent nasal discharge. She had been ill for 10 days after ARVI, irrigating her nasal cavities with saline solution without any positive effect. As a result of the treatment, the patient achieved a rapid clinical effect due to the local comprehensive action of framycetin, fixed-dose combination of N-acetylcysteine, tuaminoheptane, and sodium hyaluronate applied with systemic antibiotic therapy.

Upper respiratory tract infections remain one of the most common reasons for seeking medical care in outpatient practice. Acute rhinosinusitis, pharyngotonsillitis, and acute otitis media occupy a significant place in the structure of otorhinolaryngological diseases and are associated with a high rate of antibiotic prescriptions. At the same time, the majority of acute inflammatory diseases of the upper respiratory tract are of viral origin, which makes the problem of inappropriate antibiotic use particularly relevant. Excessive and irrational administration of antibacterial agents contributes to the development and spread of antimicrobial resistance among key respiratory pathogens, including Streptococcus pneumoniae, Haemophilus influenzae, and Streptococcus pyogenes. The aim of this study was to systematize current evidence on clinically significant manifestations of antibiotic resistance in the most common upper respiratory tract infections encountered in otorhinolaryngological practice. A literature analysis of recent publications indexed in international and Russian scientific databases, including PubMed, the Cochrane Library, and Cyberleninka, was conducted. The review summarizes current approaches to antibiotic prescribing in acute bacterial rhinosinusitis, streptococcal pharyngotonsillitis, and acute otitis media, and discusses patterns of antimicrobial resistance among the main bacterial pathogens responsible for these conditions. In addition, a clinical case of acute otitis media in an adult patient is presented. The case was characterized by the lack of clinical response to initial β-lactam therapy and required microbiological verification of the pathogen followed by adjustment of antimicrobial treatment according to the antibiotic susceptibility profile. The presented data emphasize the importance of rational antibiotic use, microbiological diagnostics, and an individualized therapeutic approach in the management of ENT infections in the context of increasing antimicrobial resistance.

Rhinosinusitis is a common group of inflammatory diseases of the nose and paranasal sinuses that have a significant impact on the health and quality of life of patients. Despite the frequent appointment of systemic antibiotic therapy for rhinosinusitis, this etiotropic treatment is not indicated in most patients, and pathogenetic treatment is rational in almost all clinical cases. To evaluate the efficacy and safety of phytotherapy, including the standardized drug myrtol, in the treatment of patients with rhinosinusitis according to literature data. A literature review was performed using the databases PubMed, Scopus, eLIBRARY. RU and Cochrane Library for the keywords: “rhinosinusitis”, “phytotherapy”, “Myrtol standardized extract”, “pathogenetic treatment”. Both experimental studies and clinical observations are considered. It has been demonstrated that systemic antibiotic therapy is indicated only in a small proportion of patients with rhinosinusitis who have a moderate to severe bacterial process. The main focus is on pathogenetic treatment, including mucoactive, anti-inflammatory and secretolytic drugs. Phytotherapy, in particular standardized myrtol extract, demonstrates evidence of improved mucociliary clearance, decreased inflammatory response, and symptom relief in the experiment. Clinical studies confirm the safety and efficacy of standardized myrtol extract in acute and chronic rhinosinusitis, with minimal risk of adverse events. Pathogenetic treatment using standardized phytotherapy is a promising method of managing patients with rhinosinusitis. Standardized myrtol extract can be recommended as a safe and effective drug, especially in patients without indications for systemic antibiotics.

Sore throat in children and adults is one of the most common complaints presented to physicians of various specialties. The causes of sore throat can be infectious or non-infectious. In real-life clinical practice, physicians most often encounter manifestations of acute and chronic tonsillopharyngitis, laryngitis, stomatitis, gingivitis, and other conditions. This article describes and discusses two clinical cases of patients from different age groups with sore throat. The article outlines the stages of diagnostic workup at the outpatient and inpatient levels, including verification of the clinical diagnosis and subsequent prescription of pharmacotherapy. Based on the presented data, it is demonstrated that in outpatient practice, the problem of irrational use of antibacterial therapy in patients with sore throat from the first days of observation without confirmation of bacterial etiology persists. The presented clinical case in a young child demonstrates the prevalence of general symptoms, primarily those of intoxication and refusal to eat, which may indirectly indicate the presence of pain and a viral etiology of the disease – factors that must be considered in real-life clinical practice. These clinical cases demonstrate the potential of multi-targeted topical therapy in children of different ages with severe sore throat, as well as the role and advantage of benzydamine hydrochloride in rapidly resolving inflammation and relieving pain.

Introduction. The problem of effective therapy of infectious and inflammatory diseases of the pharynx remains relevantdespite numerous studies.

Aim. To study the effectiveness of using a combination of 2,4-dichlorobenzyl alcohol (1.2 mg) and amylmetacresol (0.6 mg) in combination with levomenthol (8 mg) or in combination with lidocaine (10 mg) in patients with acute pharyngitis, exacerbation of chronic pharyngitis or exacerbation of chronic tonsillitis.

Materials and methods. The sample included 159 patients (from 12 to 74 years old, average age 41.3 ± 18.3 years) with clinically confirmed diagnoses of acute pharyngitis, exacerbation of chronic pharyngitis and exacerbation of chronic tonsillitis. Three groups were identified, taking different combinationsbased on dichlorobenzyl alcohol in combination with amylmetacresol. Results and discussion. The treatment regimen included irrigation of the throat with a saline solution (based on sea water) 3 times a day and the use of one of the combination based on dichlorobenzyl alcohol in combination with amylmetacresol in the dosages recommended by the instructions – 1 tablet for slow absorption every 2–3 hours (no more than 8 tablets per day), the observation period was 3 days. New data on the dynamics of the main symptoms of infectious and inflammatory diseases of the pharynx depending on the nosology were obtained. The use of various forms of the combination based on dichlorobenzyl alcohol in combination with amylmetacresolcontributed to a reliable (p < 0.001) decrease in the intensity of pain in the throat, a decrease in the severity of complaints of discomfort when swallowing, sore throat and / or dry throat and cough.

Conclusions. When choosing a drug, the nosology should be taken into account; the greatest dynamics of symptoms and clinical picture were observed when using dichlorobenzyl alcohol in combination with amylmetacresoland levomenthol and dichlorobenzyl alcohol in combination with amylmetacresoland lidocaine hydrochloride monohydrate.

Introduction. Pharyngitis is one of the most common reasons for patients to seek medical care from a general practitioner and an otorhinolaryngologist. In this case, drugs with a proven mechanism of action and a high safety profile are considered an etiopathogenetically justified component of topical therapy for uncomplicated cases of the disease.

Aim. To evaluate the effectiveness of using an antiseptic with the active ingredient ambazone as part of local therapy for acute uncomplicated pharyngitis of infectious etiology.

Materials and methods. During 2025, 67 patients aged 20 to 45 (32 ± 1.2) with a diagnosis of acute pharyngitis (J02) were examined. The effectiveness of treatment was assessed based on complaints, pharyngoscopy results, and quality of life indicators using the SF-36 questionnaire. All patients were divided into two groups. The patients in the main group, in contrast to the control group, received ambazone in addition to standard conservative therapy (antiviral and non-steroidal anti-inflammatory drugs, anti-inflammatory herbal drugs, and elimination therapy). The treatment duration was 4 days.

Results and discussion. On the 2nd day after the end of the course of treatment, patients in the group receiving ambazone in addition to standard therapy had pharyngoscopy without hyperemia of the pharyngeal mucosa, hyperemia of the palatine tonsils, mucous plaque on the pharyngeal mucosa, “granularity” of the posterior pharyngeal wall, swelling of the uvula, while the group receiving standard therapy had hyperemia of the pharyngeal mucosa was expressed by 1.6 points, hyperemia of the palatine tonsils – by 1.8 points, mucous plaque on the pharyngeal mucosa – by 1.2 points, “granularity” of the posterior pharyngeal wall – by 1.3 points, swelling of the uvula – by 1.0 points.

Conclusions. The conducted clinical study and the presented clinical example demonstrate the high efficacy profile of an ambazone in the treatment of uncomplicated acute pharyngitis.

Introduction. One of the key issues in the treatment of various forms of pharyngitis is the priority use of topical antiseptics. Aim. To evaluate the effectiveness of the inclusion of a topical antiseptic drug from the group of quaternary ammonium cationic compounds in the complex therapy of acute pharyngitis.

Мaterials and methods. A prospective randomized controlled outpatient trial included 63 patients aged 22–45 years (M = 33.5 ± 11.5) with unspecified acute pharyngitis (J02.9). All participants received standard therapy: in the main group (n = 31), in contrast to the control group (n = 32), a 0.01% solution of benzyldimethyl-myristoylamino-propylammonium was additionally prescribed in the form of irrigation or rinsing 3–4 times a day for 7 days. The effectiveness of treatment was assessed by the dynamics of the pharyngoscopic picture, the severity of complaints on a visual analog scale and quality of life indicators according to the SF-36 questionnaire at the initial visit, on the 3rd and 7th days of treatment.

Results and discussion. It was noted that the addition of a local antiseptic from the group of quaternary ammonium cationic compounds in the complex therapy of acute pharyngitis was accompanied by a faster decrease in the total severity of symptoms according to VAS: from 61 to 23 points by day 3 and up to 4 points by day 7 against 52 and 30 points, respectively, in the control group. The most pronounced improvement was noted in the parameters of sore throat, tickling, feeling of a lump in the throat, cough, sleep disorders and general weakness. After the course of therapy, the increase in the total SF-36 quality of life index was 179.8 points in the main group and 69.2 points in the control group.

Conclusions. The addition of benzyldimethyl-myristoylamino-propylammonium solution to standard treatment of acute pharyngitis in adults increases the clinical effectiveness of treatment, promotes faster relief of symptoms, improves the pharyngoscopic picture and quality of life of patients compared with standard therapy without topical antiseptic.

Allergic rhinitis (AR) is one of the most common chronic diseases of the upper respiratory tract, in which a focus of inflammation forms in the mucous membrane of the nasal cavity. Pathogenetically, inflammation in the nasal cavity is caused by the development of immediate-type hypersensitivity involving IgE, the so-called T2 inflammation. The diagnosis of AR is a multidisciplinary task. The treatment of AR is a complex of measures, including elimination therapy, drug treatment and allergen-specific immunotherapy. An important aspect of the management of such patients is their training in order to manage the disease. Currently, one of the most modern areas of therapy for AR patients is the use of biological therapy, namely monoclonal antibodies. Monoclonal antibodies have proven their safety and effectiveness in the treatment of various diseases based on the results of numerous studies. The clinical recommendations of the Ministry of Health of the Russian Federation recommend the use of omalizumab for the treatment of patients with severe persistent rhinitis or severe exacerbation. The results of clinical studies have demonstrated that the addition of omalizumab to standard therapy for patients with AR is well tolerated and more effective than traditional treatment. There was a marked reduction in nasal and ophthalmological symptoms, a clinically significant improvement in quality of life and a decrease in the impact of the disease on daily activities and labor productivity. An observation of a patient presenting with AR, allergic conjunctivitis, and bronchial asthma revealed a positive clinical and functional response to genetically engineered biological therapy. This improvement was documented through validated questionnaires, detailed patient history, and comprehensive otorhinolaryngological examination.

Introduction. One of the important components of the diagnosis of “adenoid hypertrophy” and the determination of treatment tactic is to determine the significance of the negative impact of adenoids on the life quality of a child. However, to collect medical history from preschool children is a difficult task even for teachers, because preschool children are hardly to describe their complaints and sensations. Children under 5 years old cannot clearly express their feelings. To date, the assessment of quality of life in pathological conditions has not been widely used in otorhinolaryngology.

Aim. To investigate the quality of life of preschool children with adenoid hypertrophy and its changes after surgical treatment.

Materials and methods. The object of the study is 66 patients aged 3–7 years with a diagnosis of “Adenoid hypertrophy”, who underwent a questionnaire survey using the PedsQLtм4.0 (Pediatric Quality of Life Inventory) before surgical treatment. In the postoperative period, the same patients were surveyed as part of 3 equal groups of observation: Group 1: patients after adenotomy performed by mechanical dissection with a Backman adenotome. Group 2: patients after cold plasma adenoid coblation. Group 3: patients after molecular resonance adenotomy. The questionnaire was repeated 10 days and one month after surgical treatment.

Results and discussion. The initial level of physical functioning in the examined patients is lower than in healthy children of the same age. In the postoperative period, emotional functioning is restored quickly, and the restoration of physical functioning is closely correlated with the experienced pain syndrome.

Conclusions. The physical and emotional functioning of children who undergo adenotomy due to adenoid hypertrophy is below the age norm. Adenotomy is accompanied by a significant improvement or normalization of emotional functioning in the first 10 postoperative days. One month after surgical treatment, physical functioning was normalized in 90.9% of patients after curettage adenotomy, and in 50% of patients after adenotomy with high-frequency currents in the cold-plasma and molecular-resonance ranges.

Introduction. Head and neck paragangliomas are classified according to their location: carotid body tumor, jugular, vagal, tympanic, etc. Surgical treatment of temporal bone paraganglioma is considered the primary and radical method, however in some cases, total resection due to involvement of neurovascular structures can lead to complications such as blood loss, cranial nerve paralysis, and stroke.

Aim. To study the effectiveness of preoperative embolization to reduce blood loss during surgical treatment of temporal bone paragangliomas.

Materials and methods. A retrospective analysis of the medical records of patients who underwent surgical treatment for temporal bone paragangliomas according to the U. Fisch and D. Mattox classification, as modified by M. Sanna, was conducted in the Ear and Skull Base Pathology Department of the National Medical Research Center for Otorhinolaryngology of the Federal Medico-Biological Agency of Russia from February 2015 to December 2025 in the amount of 337 patients, of whom 156 had types B3, C1, C2, C3, C4.

Results and discussion. During the construction of a generalized linear model, it was found that in both main and control groups the volume of intraoperative blood loss was significantly higher in patients with C3 and C4 paragangliomas compared to patients with B3, C1, and C2 tumors. Additionally, a direct correlation was found between the volume of intraoperative blood loss and the extent of the tumor process, the duration of the surgical intervention, and the patients’ sex.

Conclusion. Statistically significant differences in blood loss volume between the group of patients who underwent embolization and the group without embolization were found exclusively for patients with C3 and C4 paragangliomas according to the U. Fisch and D. Mattox classification modified by M. Sanna. In patients with types C3 and C4, a correlation was found between the volume of intraoperative blood loss and the duration of surgical treatment, the volume of the formation, and the patient’s sex.

Introduction. Uncontrolled cicatrical adhesion processes in the middle ear is one of the causes of hearing loss in patients with chronic suppurative otitis media who underwent tympanoplasty. This problem has long been known to otolaryngologists. In the 20th century, otolaryngologists developed methods to prevent such surgical outcomes. The use of materials implanted in the middle ear during the final stage of surgery has become one of the ways to solve this problem. One of such material is thin medical-grade silicone.

Aim. To evaluate the effect of using thin medical-grade silicone in tympanoplasty on functional outcomes in the late postoperative period.

Patients and methods. This study included 59 patients with chronic suppurative otitis media who underwent primary and repeat surgery. Patients were divided into the treatment group and control group. The treatment group included 31 patients who underwent surgical treatment involving the use of thin medical-grade silicone. The control group included 28 patients who underwent surgical treatment not involving the use of thin medical-grade silicone.

Results and discussion. A prognostic scale assessing the potential severity of middle ear scarring in the late postoperative period was developed. The authors identified three scar risk classes that were assigned to patients based on their scores. Patients in the treatment group and control groups were also divided into scaring risk classes. The functional outcomes of patients in each risk class in the treatment and control groups were also assessed on an individual basis.

Conclusions. The results confirm the effectiveness of thin medical-grade silicone in improving functional outcomes of tympanoplasty in the late postoperative period in patients undergoing surgery. The greatest efficacy of thin medical-grade silicone was observed in patients with low risk of scarring.

Introduction. Endoscopic endonasal rhinosinus surgery is the leading method of treating chronic rhinosinusitis, which restores the patency of the ostiomeatal complex and improves ventilation of the paranasal sinuses, as well as eliminates signs of chronic inflammation in the paranasal sinuses. However, the postoperative period in this group of patients is difficult due to the risk of possible inflammatory reactions in the nasal cavity and paranasal sinuses, as well as the development of other complications.

Аim. To evaluate the clinical effectiveness of using various nebulizer therapy regimens in the postoperative period in patients after endoscopic endonasal rhinosinusosurgery.

Materials and methods. A prospective single-center comparative study was conducted involving 90 patients aged 18–65 years with a diagnosis of Chronic polysinusitis (ICD J 32.8) who underwent endoscopic endonasal surgery on the anterior group of the paranasal sinuses. The patients were randomized into 3 groups, depending on the postoperative management regimens used. The effectiveness of therapy was evaluated using the SNOT-22, VAS, and Lund-Kennedy scales.

Results. In the course of the study, it was statistically proven that in patients after endoscopic endonasal surgery on the anterior group of the paranasal sinuses, who received, in addition to the standard postoperative management regimen, inhalation therapy with a combined drug containing An antibiotic and mucolytic through a compressor nebulizer with pulsating technology (43 Hz), a faster rate of recovery of the nasal cavity and paranasal sinuses is noted compared to patients without nebulizer therapy or using inhaled therapy with isotonic sodium chloride solution.

Conclusions. The inclusion of nebulizer therapy with pulsating technology in the postoperative management of patients after endoscopic rhinosinusosurgery improves the course of the postoperative period, and the maximum effect of its use is achieved when using a combined drug containing a mucolytic and an antibiotic.

Introduction. Chronic rhinosinusitis with nasal polyps (CRSwNP) is a pressing problem in modern otolaryngology.

Aim. To evaluate the efficacy of mometasone furoate in symptom control in patients with newly diagnosed CRSwNP.

Materials and methods. The sample included 66 patients aged 18 to 60 years (mean age 45.6 ± 12.6 years) with newly diagnosed CRSwNP. All patients received mometasone furoate monotherapy, two sprays (100 mcg) in each nasal passage twice daily for 30 days. The efficacy of the treatment was assessed dynamically over 6 months using the SNOT-22 and QOD-NS questionnaires. The SST-12 test was used to assess olfactory function, and respiratory function was assessed using anterior active rhinomanometry (AAR).

Results. During the dynamic observation, a decrease in the average total score on the SNOT-22 questionnaire was revealed from the beginning of therapy with mometasone furoate (45.0 ± 14.1 points) to the end of the treatment course (10.0 ± 5.1 points, p < 0.001). Already by the 14th day, regression of severe complaints of nasal congestion and nasal discharge was noted; the overwhelming majority of patients noted this complaint as mild – 30.3% and 37.9% of patients, respectively. By the end of the course (day 30), nasal congestion was absent in 45.5% of patients, and nasal discharge stopped in 44.9% of patients. Self-assessment of the severity of sinonasal symptoms was confirmed by AAR data (p < 0.001). The complaint of «decreased sense of smell/taste» showed the most significant improvement by the first month of observation: 57.6% of patients reported no decrease in sense of smell/taste, while 25.8% rated it as mild.

Conclusion. In patients with newly diagnosed CRSwNP, administration of intranasal topical mometasone furoate as monotherapy for one month significantly improved quality of life and controlled the main symptoms of the disease.

Introduction. Anxiety-depressive spectrum disorders (ADSD) represent a significant medico-social burden, substantially complicating the course of somatic diseases. Despite the recognized impact of affective disorders on the course and treatment outcomes of chronic ENT pathology, the prevalence and structure of ADSD, particularly in patients with chronic nonspecific pharyngitis (CNP), remain largely unexplored.

Aim. Тo assess the prevalence, structure and severity of ADSD in patients with CNP.

Materials and methods. We screened 90 patients in the treatment group with a verified diagnosis of chronic pharyngitis who underwent outpatient and inpatient treatment at N.A. Semashko Nizhny Novgorod Region Clinical Hospital and Department of Ear, Throat, and Nose Diseases named after V.Yu. Shakhov of Privolzhsky Research Medical University of the Ministry of Health of the Russian Federation and 40 volunteers in the comparison group without chronic inflammatory pharyngeal pathology. Screening for affective disorders was performed using the Hospital Anxiety and Depression Scale (HADS). We evaluated the structure of the disorders (isolated anxiety, isolated depression, mixed disorder), the phenotype of depressive syndrome, and the specific severity of cancerophobia.

Results. The overall prevalence of ADSD in patients with CNP was 38.9%. The structure of affective pathology was significantly dominated by isolated anxiety (57.1%) and mixed anxiety-depressive disorder (34.3%). A trend towards a predominance of the anxious depression phenotype (80.0%) over the melancholic phenotype was observed in the CNP group. Cancerophobic experiences were reported by 34.4% of respondents with anxiety disorders.

Conclusions. Chronic nonspecific pharyngitis is associated with a high frequency of anxiety-depressive disorders, primarily of the anxious and mixed spectrum. These findings substantiate the need for interdisciplinary collaboration between otorhinolaryngologists and psychotherapists to optimize treatment and rehabilitation strategies for this patient population.

Introduction. A common problem in sinonasal surgery is intraoperative tearing of the nasal cavity mucosa, resulting in impaired microcirculation in the mucoperichondrium and subsequent complications, including nasal septal perforation. Current clinical correction methods do not always ensure complete tissue restoration, underscoring the need for new approaches to repair damaged nasal mucosa.

Aim. To assess the potential of the combined use of two bioresorbable implants – a collagen-containing microheterogeneous hydrogel (an extracellular matrix biomimetic) and a biopolymer membrane based on a bacterial copolymer – for repair of full-thickness nasal septal defects and prevention of postoperative perforations in an experimental animal model.

Materials and methods. The study was conducted in 12 rabbits in which a full-thickness nasal septal defect model was created. The animals were assigned to two groups: an experimental group (n = 6) and an untreated control group (n = 6). Intact specimens (n = 6) were obtained from a biobank. In the experimental group, the defect was closed using resorbable bioimplants. The animals were followed up with endoscopic monitoring. On day 30, the animals were withdrawn from the experiment, and the tissues were subjected to morphological examination.

Results. In the control group, no defect closure was observed by day 30; the defects increased in size, and synechiae developed in 33% of cases in the area of injury. In the experimental group, complete restoration was achieved in 50% of animals; in the remaining cases, a marked reduction in defect size was observed. Morphological examination in the experimental group demonstrated complete epithelialization, formation of mature cartilage, less pronounced inflammation and fibrosis, and more physiological vascularization compared with controls (p < 0.05).

Conclusions. Combined application of a hydrogel extracellular matrix biomimetic and a biopolymer membrane in nasal mucosal defects promotes more complete anatomical and morphological tissue restoration, reduces the risk of postoperative complications, and supports formation of tissue morphologically close to the intact nasal septum.

Introduction. Tissue engineering technologies to activate cells and promote regenerations have been successfully used to treat tympanic membrane perforations over the last few years. Laser irradiation, in our view, may be deployed as such a promoter, including those for the closure of persistent tympanic membrane defects.

Aim. To determine therapeutic potential of near IR-laser irradiation for the regeneration of persistent tympanic membrane defects in small laboratory animals.

Materials and methods. A total of 12 male chinchillas were included in a pilot experimental study, in which the creation of a permanent, bilateral tympanic membrane perforation served as the first phase. Afterwards, the animals were equally allocated to two groups. In Group 1 (6 animals), the right tympanic membrane tissue was exposed to 1450 nm laser irradiation; in Group 2 (6 animals), the right tympanic membrane tissue was irradiated by 1560 nm laser. All left persistent tympanic membrane perforations (n = 12) constituted the control group.

Results and discussion. In both groups, endoscopic examination showed complete closure of the tympanic membrane perforations in all animals. In animals in Group 1 (No. 6), the formation of a subtle scar at the perforation site was observed, while in chinchillas in Group 2 (n = 6), a more hypertrophic scar was developed. In the control group (left perforations n = 12), the endoscopic examination didnʼt reveal any closure of the left perforations in any animal at any time point. According to histological examination findings, 1450 nm laser irradiation produced the best results in regenerating persistent tympanic membrane perforations.

Conclusions. Laser irradiation of the tympanic tissue leads to the complete closure of its persistent perforation. The resulting scar tissue in the defect bed displays a three-layer structure. At the same time, more complete restoration of the fibrous layer occurs after 1450 nm laser irradiation of the tympanic tissue.

Introduction. Bilateral vocal fold immobility is one of the causes of upper airway stenosis and a serious disease. It is often difficult to establish the true cause of dyspnea and make a clinical decision in a patient with bilateral vocal fold immobility, especially when combined with lower respiratory tract pathology.

Aim. To study the possibility of using the expiratory disproportion index (EDI) as an additional indicator for the clinical assessment of patients with bilateral vocal fold immobility.

Materials and methods. The study included 26 adult patients with bilateral vocal fold immobility and no lower respiratory tract pathology. The control group included patients without laryngeal pathology and lung pathology. All subjects underwent an assessment of the pulmonary ventilation function with determination of the expiratory disproportion index (EDI). In patients with bilateral vocal fold immobility, the MRC (Medical Research Council) dyspnea scale was used to assess the severity of dyspnea, and a videoendoscopic examination of the larynx with a subjective assessment of the maximum glottic opening was performed.

Results. The mean EDI value in patients with bilateral vocal fold immobility was 57 and was significantly different from the control group, in which the EDI was 38. The mean MEF50/MEF50 inspiratory ratio was 1.7 and was significantly different from the control group. Other parameters were within normal limits, with only a slight decrease in FEV1 to an average of 73%. According to the ROC analysis, the EDI threshold value was 45.4, with excellent model quality, a sensitivity of 94.4%, and a specificity of 80%. The diagnostic efficiency of the MEF50/MIF50 inspiratory ratio was lower, with a sensitivity of 83.3% and a specificity of 70%.

Conclusions. The results of the study demonstrated the possibility of using the expiratory disproportion index as an additional and accessible indicator for the clinical assessment of patients with bilateral vocal fold immobility.

The article presents a clinical observation demonstrating the importance of an improved protocol for computed tomography (CT) of the temporal bones in patients with developmental abnormalities of the inner ear before cochlear implantation (CI). The interest of the observation is due to the fact that the standard CT placement does not allow reliable visualization of the key structures of the cochlea, which, if inaccurately diagnosed, can affect the tactics of surgery and the results of rehabilitation. The clinical observation includes a 5-year-old patient with grade IV bilateral chronic sensorineural hearing loss, who was referred for a preoperative examination before undergoing CI. Taking into account the unclear quality of the CT scan of the temporal bones, as well as the suspicion of an anomaly in the development of the inner ear from these images, a CT scan of the temporal bones was used according to the proposed method. Repeated examination revealed the absence of an apical curl and an expansion of the cochlear aperture, which determined a high risk of intraoperative cerebrospinal fluid and the need to select an individual electrode. Based on the diagnostic data, a shortened electrode array with SEAL technology was selected. Intraoperatively, gusher-type liquorrhea occurred, which was successfully stopped after the introduction of the electrode. When the implant was subsequently connected, positive auditory reactions and improved sound perception were obtained. Thus, accurate preoperative visualization of cochlear anomalies thanks to the proposed method makes it possible to optimize surgical tactics, minimize intraoperative risks and ensure the effectiveness of auditory rehabilitation, which emphasizes the importance of an individualized approach in patients with congenital anomalies of the inner ear.

Chronic suppurative otitis media is a common ENT disorder leading to persistent hearing loss and secondary intracranial complications. Given the shortage of qualified medical personnel, especially in the periphery, the implementation of automated systems for diagnosing this condition is crucial. This study examines current methods for using artificial intelligence in the analysis of otoendoscopic images obtained during the diagnosis of chronic suppurative otitis media. Key studies demonstrating the effectiveness of machine learning are considered, including architectures of convolutional neural networks and ensemble models that achieve accuracy of up to 95–97% in differentiating middle ear pathologies. Special attention is paid to comparing the results of artificial intelligence with the diagnostics of doctors: the algorithms are superior to non-specialists and comparable to experienced otorhinolaryngologists. Attention is paid to discussing the problems of heterogeneity of data, limited samples of rare forms of chronic purulent otitis media and the dependence of the result on image quality. The potential of mobile applications based on artificial intelligence for telemedicine is assessed, and the need to create large-scale annotated databases for model training is highlighted. The integration of artificial intelligence into medicine promises to significantly improve the quality and accessibility of medical care. The use of AI solutions in clinical settings can significantly improve early disease detection procedures, which, in turn, will enable timely intervention. At the same time, the implementation of these systems can significantly reduce the workload of medical personnel, freeing them up to perform more complex and demanding tasks. Furthermore, the use of advanced AI algorithms can minimize the likelihood of unwanted complications, which is especially important for remote areas and regions where access to highly specialized medical care is often limited.

Introduction. Modern personalized medicine requires physicians to possess skills for the independent interpretation of genetic variants. Bioinformatics tools within the R environment provide a powerful framework for the verification of suspicious findings. The assessment of the evolutionary conservation of amino acid positions using alignment algorithms is a critical step in determining the clinical significance of missense variants (according to ACMG criteria).

Aim. To demonstrate a standalone bioinformatics analysis algorithm in the R environment for assessing the pathogenicity of the V37I mutation in the GJB2 gene, associated with hereditary hearing loss.

Materials and methods. This study utilized Bioconductor packages (Biostrings, pwalign, msa) within the R environment. The material comprised nine full-length orthologous sequences of the connexin 26 protein (CXB2), obtained from the UniProt database, covering the taxonomic groups of primates, rodents, and even-toed ungulates. A two-step analysis was implemented: pairwise alignment to identify the substitution in the patient and multiple sequence alignment (MSA) to calculate the conservation index of the locus.

Results. Using the analysis of the missense variant V37I (GJB2 gene) as an example, the functionality of the two-step alignment algorithm in the R environment was demonstrated. Pairwise alignment (pwalign package) successfully identified the nucleotide substitution leading to the amino acid change (PID = 93.75%). MSA of sequences from 9 mammalian species allowed for a clear visualization of the absolute invariance of the protein’s 37th position in the wild-type state. Calculation of the conservation index (0.9) confirmed the feasibility of automated data acquisition for variant evaluation according to the PP3 criterion (ACMG). The proposed computational approach enables a clinician-researcher to independently transition from “raw” UniProt data to expert-level visualization without the need for cumbersome computational systems.

Conclusion. The independent use of bioinformatics tools in the R environment by physicians facilitates a shift from the passive interpretation of laboratory reports to the active analysis of genomic data. The demonstrated approach provides a high level of evidence for clinical conclusions and represents an important element of the clinical decision support system within the framework of personalized medicine.

Introduction. Despite the abundance of existing surgical methods, the problem of nasal obstruction treatment still remains unresolved due to inefficiency and postoperative recurrence. The failure of operations on the nasal septum and inferior turbinates encourages the search for other objects of surgical treatment. One such solution is the expansion of the piriform aperture. Aim. To develop a relatively simple to perform surgical treatment method for nasal obstruction, aimed at partial resection of the pyriform aperture rim and lateralization of the anterior portion of the inferior turbinate.

Materials and methods. The goal is achieved through the proposed method (patent RU 2770270 C1) lateralization of the inferior turbinate with preliminary resection of the edge of the piriform aperture. Thus, 11 patients from 18 to 70 years old (7 men and 4 women) with chronic nasal obstruction were treated, 5 patients were operated on one side, 6 on both sides. The evaluation of the results of the surgical treatment was carried out by means of a questionnaire of patients on the NOSE (Nasal Obstruction Symptom Evaluation) scale before and 6 months after the operation.

Results. The median score on the NOSE scale before surgical treatment is 90 (82.5–95). The median score on the NOSE scale 6 months after surgical treatment is 5 (0–10) (p < 0.01, Wilcoxon test).

Conclusions. The proposed method of surgical treatment of nasal obstruction with limited resection of the edge of the pyriform aperture allows to obtain a good functional result and a 16-fold reduction in nasal obstruction scores according to the NOSE scale before and after surgery.

Introduction. The presented observation is of interest due to the high prevalence of sensorineural hearing loss, frequent late presentation of patients, and reduced treatment effectiveness when therapy is delayed.

Aim. To improve the effectiveness of treatment of acute, subacute, and progressive sensorineural hearing loss. To evaluate the causes of ineffective treatment of sensorineural hearing loss and to propose possible solutions.

Materials and methods. A retrospective analysis was conducted of 7 651 patients who consulted audiologists at the Budgetary Healthcare Institution of the Voronezh Region “Voronezh Regional Clinical Hospital No. 1” (BUZ VO “VOKB No. 1”) in 2024–2025, with diagnoses H90.3 “Bilateral sensorineural hearing loss” and H90.4 “Unilateral sensorineural hearing loss with normal hearing in the opposite ear”. Acute sensorineural hearing loss (SNHL) was identified in 1 369 patients, subacute in 604, progressive course in 513, and chronic form in 5 165 patients. In 32% of patients with acute SNHL, consultation with an audiologist occurred more than 25 days after disease onset.

Systemic therapy with dexamethasone (international non-proprietary name: dexamethasone; trade name, manufacturer, and country of production to be specified by the authors based on prescription records) was administered to 1 703 patients. Effectiveness was assessed by changes in the average hearing threshold.

Results and discussion. Hearing improvement of 10 dB or more was observed in 46% of patients with acute SNHL, 14% with subacute SNHL, and 15% with progressive SNHL. The main treatment for sensorineural hearing loss is steroids, particularly dexamethasone. The effectiveness of treatment depends on early intervention.

Conclusions. Treatment effectiveness depends on the timing of presentation. Late diagnosis, incorrect initial interpretation of symptoms, and lack of accessible hearing self-monitoring limit treatment outcomes. The introduction of digital screening tools is a promising direction, which in the long term will reduce the overall costs and challenges associated with hearing loss.