External otitis is a group of inflammatory diseases of the external ear (concha of the auricle, acoustical duct and the external layer of the tympanic membrane) of various etiologies. A sufficiently wide prevalence and considerable growth of incidence of the disease, persistent course and high possibility of recurrence on the background of predisposing factors precondition focused attention of otorhinolaryngologists to various aspects of this pathology. Preference at therapy of patients with external otitis is given to drugs with topical action. One of the most effective drugs for therapy of patients with diffuse external otitis are ear drops Sofradex that showed themselves of good account in clinical practice. 

Abstract. Acute sinusitis is one of the most common pathological conditions encountered in outpatient practice by an otolaryn-gologist. Objective of the trial. Study of clinical efficacy and safety of the drug Spectracef in patients with acute bacterial sinusitis. Conclusions. On the basis of the conducted trials it is necessary to note fast dynamics of the main clinical symptoms of acute purulent sinusitis. The average time of disappearance of the main clinical symptoms of the disease was 3.7 days. 

The article provides data on diagnostics and tactics of patient management with external otitis especially of mycetogenic etiology (otomycosis). Possibiities of combined topical four-component drug Candibiotiс and its universal effect combining antibac-t erial, antifungal, anti-inflammatory and analgesic actions. An experience of application of Candibiotic has been shown in Russia in the recent 10 years, by results of studies its effectiveness in therapy of acute and chronic inflammatory diseases of the middle and external ear is provided, including otomycosis. 

The article deals with problems of diagnostics and therapy of purulent and inflammatory pathology of ENT-organs. The authors consider major reasons of acute focal infection of ENT-organs as well as factors contributing to inflammation chronization. The article provides data on the most popular causative agents of purulent and inflammatory ENT-organs diseases, peculiarities of microbe biocenoses of ENT-organs in normal conditions and in case of concomitant diseases, issues of rational antibacterial therapy are considered with use of short high-dosage courses of antimicrobial drugs.

Abstract. SARS in the overwhelming majority of cases are the initial link in the chain of pathological changes developing in acute rhinosinusitis, contribute to the severe course of the inflammatory process, development of local, remote and generalized complications. One of the important reasons for the growth of pathology of respiratory organs is increase of the prevalence of secondary immunodeficiencies (SIDS).

The purpose of the study is to assess the effectiveness of the drug ISMIGEN® (sublingual tablets) on the course and severity of acute exacerbations of chronic tonsillopharyngitis during the epidemiological season of acute respiratory infections. Study design. This study is a comparative randomized, prospective, cohort trial. All patients matching the inclusion criteria and included in the study were randomized into 2 groups by 30 persons in accordance with the plan of randomization. The duration of the observation period was 6 months.

Conclusions. Use of the drug Ismigen® allows significantly reduction of the likelihood of development in the patient of relapse/ exacerbation of HTF/SARS, the development of moderate and severe forms of the disease, as well as the need for additional antibiotic therapy. 

In the modern world infection of the upper respiratory acts and ENT-organs take the first place in the structure of the total incidence in the world, and the specific weight of this pathology makes in adults 27.6%, in teenagers – 39.9% and in children – 61% [4]. The disappointing statistical data precondition the undying interest to this issue in the practical medicine.

Acute rhinosinusitis is one of the most frequent diseases that doctors of various specialties – therapists, family doctors, otorhynolaryngolosts face. Despite the huge armoury of drugs and therapeutic methods the search for the drug providing complex therapy of rhinosinusitis reducing the duration of this disease therapy remains of vital importance till now. Phytotherapy is successfully used for the complex therapy of acute rhinosinusites. This therapeutic method is based on use of herbs and complex drugs from them. Due to the fact that currently the problem of antibiotic resistance is widely spread, it has become possible to search for the complex drug with a high safety profile for effective therapy and avoidance of polypharmacy in case of SARS, rhinosinusites and other diseases of the upper respiratory tracts. 

The article deals with application of local antibacterial therapy for the most frequent acute and chronic inflammatory diseases of the nasal cavity and paranasal sinuses. Advantages of the topic method of etiotropic therapy for this pathology are analyzed, indications for use of antibacterial drugs and the most frequently made errors in this case are discussed. A necessity to indicate topic antebacterial drugs in the post-surgical period to patients who underwent surgical intervention on nasal cavity and paranasal sinuses structures is specified. 

Acute and chronic pathology of oropharynx structures is one of the most frequent reasons to seek medical aid in pediatric practice. Taking into account the variety of the possible localization of inflammatory process in the oropharynx the inflammatory pathology of palatine tonsils – tonsillitis – is of greatest practical interest for practicing doctors. Despite the seeming simplicity of this disease currently there are a number of unresolved issues. One among them that causes hot discussion in Russia is division of recurrent and chronic forms of tonsillitis. 

The problem of therapy of acute ENT-organs infections is far from final resolution, despite the fact that peculiarities of their course are sufficiently well studied. What is the reason of it? There is no decisive answer so far. The choice of antibacterial drug and ways to administer it is still a complicated task for the practical ENT-specialist. When prescribing the antibiotic it’s necessary to rely on certain algorithms developed with the aim to provide the maximum therapeutic effectiveness and prevention of antibiotic resistant strains selection. The latter provision provides for a possibility to manipulate antibiotics of choice and rescue drugs. 

The problem of treatment of purulent-inflammatory diseases of the neck continues to be relevant. The number of patients with inflammatory diseases of the neck has no tendency to reduction. The number of patients with phlegmons of the neck, common in several cellular spaces, most often accompanied by the development of severe complications such as sepsis, mediastinitis, thrombosis of the cavernous sinus of the dura mater and others is increasing. Standards for the treatment of patients with purulent-inflammatory diseases of the neck, which include conducting an adequate surgical sanitation and drainage of the purulent focus, antibacterial, detoxification, anti-inflammatory therapy, correction of system homeostasis, were currently developed and put into practice. Each year new methods of purulent wounds management appear but none of them meets requirements of the modern surgeons fully. More and more authors are inclined to believe that routine methods of treatment of purulent processes become ineffective. This is due to increased antibiotic resistance, virulence and variability of microorganisms. Reduction of the morbidity of surgical treatment of a purulent focus is of great importance in the treatment of purulent wounds. In the treatment of patients with purulent-inflammatory diseases of the neck improvement of cosmetic results of treatment, lack of rough and deforming scarring, which directly affects the quality of life of patients, is very important. 

The issue of allergic rhinosinusitis therapy is extremely urgent as of today. This is related, on the one hand, to the intense growth of the disease incidence, on the other hand, with aggravation of the allergic process course, addition of infectious complications, development of polysensitization. The approach to diagnostics of this disease must be consistent and complex. The accurate analysis of clinical manifestations and rational use of diagnostics tests are extremely important for the correct diagnosing. Allergic rhinitis is IgE-mediated primary chronic inflammatory disease of the mucous tunic of the nasal cavity. The basis of prescription of the rational therapy of this disease is clear understanding of pathogenic mechanisms of its development. Surgical therapy is indicated for these patients in the majority of cases, but it doesn’t have any pathogenic role. 

This article covers the issue of diagnostics and method of surgical therapy of such reason of the middle exudative otitis and syndrome of the obstructive sleep apnoea as hypertrophy of the tubal rollers and hyperplasia of tubal tonsils. Experience of application of endoscopic Shaver-laser tuboplasty in pathology of the middle ear in children as well as of obstructive sleep apnoea is described. Results of the work showed high effectiveness of a new surgical method for these pathologies. 

The disturbance of the voice function is a socially significant problem. Small anatomical anomalies (SAA) along with organic causes of impaired voice function can cause dysphonia. Disturbances of the voice in the presence of SAA belong to little studied and persistent dysphonias. Information about the prevalence of this group of anomalies in domestic and foreign literature is few and controversial. Objective: to determine the incidence of SAA of the larynx in patients with dysphonia. Materials and methods: Retrospectively were analyzed the 58 case histories of patients who were diagnosed with functional dysphonia in the clinic of diseases of ear, nose and throat of Sechenov First MSMU from 01.09.2011 to 01.10.2015. Patients underwtent videostroboscopic and fibrolaryngoscopy studies. Results: Average age 37 ± 6 years, women-37 (64%), men – 21 (36%). In 27 (47%) patients spastic dysphonia was diagnosed, 23 (39%) – dysphonia hipotenusa, 7 (12%) – mutational dysphonia, only 1 (2%) patient in the course of stroboscopic studies was diagnosed with SAA - grooves of both vocal folds. Conclusions: the SAA of the larynx are small and the prevalence with early detection and treatment can produce favorable prognosis. However, being a disease with unknown etiology and prevalence until the end and if untreated can lead to adverse consequences and should not remain undiagnosed. It should be kept in mind during differential search to find out the cause of dysphonia. 

Acute and chronic pain has a signal function in pathologic process or traumatic damage. According to pathophysiologic mechanisms of the pain syndrome, the major factor leading to its formation is development of hyperalgesia. In the outpatient practice of the ENT-specialist pain syndrome management is an important part of a complex of therapeutic measures, which justifies rationality of use of non-steriod anti-inflammatory drugs. One of the representatives of this group of drugs is OKI (ketoprofen) that have anti-inflammatory, analogizing and anti-febrile action. 

The article provides modern clinical recommendations on diagnostics and therapy of acute middle otitis. A necessity of obligatory use of otomicrosopy for diagnostics of this state as well as the importance of the systemic and structured approach to therapy of this disease is stressed. Use of local anesthetics on the pre-perforative otitis stage is substantiated. Paracentesis execution for prevention of intracranial complications and immediate arrest of the pain syndrome. 

Area Moscow’s regional research clinical institute n.a. M.F. Vladimirskiy Abstract. The article analyzes the experience of application of the immunomodulator Polyoxidonium in patients with respiratory diseases. Polyoxidonium has expressed immunomodulatory activity, providing nonspecific protective effect against a broad spectrum of pathogens, is not based on direct inhibition of microorganisms, and stimulation of the immune system of the macroorganism. In addition, the drug has antitoxic and antioxidant properties. In the acute period of the disease, Polyoxidonium is recommended to assign in combination with etiotropic therapy, and in the period of rehabilitation or prevention of infectious diseases possible use of the drug as monotherapy. 

On the premises of the SBUE Sverzhevsky Moscow Scientific and Practical Center of Otorhinolaryngology we examined 30 patients at the age from 21 to 53 years with a deviated nasal septum (IIT), vasomotor rhinitis (n = 10), a cyst of the maxillary sinus (n = 10) and chronic tonsillitis (TAF. I, II, n = 10). All patients were admitted for planned surgical procedures - septoplasty with vasotomy of inferior turbinates, the endonasal maxillectomy and tonsillectomy under combined endotracheal narcosis. Clinical studies demonstrate safety, efficacy and ease of use of the drug Umckalor in this category of patients. Umckalor effectively eliminates subjective symptoms of nasal breathing obstruction, pain when swallowing, accelerates normalization of nasal breathing, mucosilia transport and indicators of intratympanic pressure and can be recommended for treatment in the postoperative period in patients undergoing surgical treatment for septoplasty and bilateral tonsillectomy. 

The article discusses the features of clinical pattern of acute and chronic inflammatory diseases of nasal cavity and paranasal sinuses of various etiologies. The article also describes the scheme of treatment of rhinitis and sinusitis of infectious and noninfectious nature. The article provides a detailed description of the place of the drugs with anti-inflammatory and antihistamine effect, such as cetirizine in the treatment of this group of diseases. 

Chronic tonsillitis takes an important place in the structure of the otorhinolaryngologic practice. The most important etiotropic factor of this diseases development is β-hemolytic streptococci of A group. In a number of cases clinical manifestations of chronic tonsillitis practically do not worry the patient, which doesn’t exclude formation of metatonsillar complications and on the whole negative effect on the human body. The method to treat chronic tonsillitis patients is determined by a form of the disease. In the event of the process decompensation tonsillectomy is indicated, in the compensated form conservative therapy is performed. One of the major methods of therapy is washing of tonsil lacunes. With this purpose it’s possible to use the antimicrobial drug Dioxidine produced in Russia. The drug has a selective activity with respect to various pathogens: bacteria, viruses, fungi, the protozoa, including Streptococcus pyogenes, Staphylococcus aureus, Streptococcus pneumonia, Staphylococcus epidermidis. The experience of use of Dioxidine for the therapy of ENT-organs pathology testifies about high effectiveness and safety of the drug for topical use. 

Summary: Infectious-inflammatory diseases of the pharynx, in spite of the powerful mechanisms of natural protection, are among the most common causes of seeking doctor’s aid. Timely and adequate pharmacotherapy of inflammatory diseases ensures favorable regression of the pathological process, maintains functional safety of the protective factors of the pharyngeal mucosa and activity of the Pirogov-Waldeyer’s pharyngeal lymphadenoid ring as relevant factors of local and systemic immunity. 

Xerostomia (drymouth) is a state that develops in reduction or stoppage of the saline secretion and is characterized by dryness in the oral cavity. Due to the numerous diseases and states that xerostomia might accompany the issue of therapy of this category of patients is extremely important for medical practitioners of a wide range of specialties: ENT-specialists, dentists, oncologists. 

Sore throat is one of the most frequent complaints that doctors of various specialties face. About 80% of diseases a symptom of which might be sore throat and throat irritation is acute pharyngitis or acute tonsillitis developing on the background of SARS [6]. 

The publication presents the methodology of the combined approach to decompression of the orbit in the endocrine ophthalmopathy. The analysis of our own results of surgical interventions on the orbit was performed by resection of its bone walls. Patients underwent transethmoidal decompression of the orbit by endonasal access and resection of the lateral orbital wall by the external access. The technique of operations, postoperative patient management and treatment outcomes were analyzed. The study showed high efficacy of a combined surgical approach to decompression operations on the orbit in relation to the exophthalmos regression.