Multiple genes and their variants that lend susceptibility to many diseases will play a major role in clinical routine. Genetics-based cost reduction strategies in diagnostic processes are important in the setting of multiple susceptibility genes for a single disease. Head and neck paraganglioma (HNP) is caused by germline mutations of at least three succinate dehydrogenase subunit genes (SDHx). Mutation analysis for all 3 costs fUS$2,700 per patient. Genetic classification is essential for downstream management of the patient and preemptive management of family members. Utilizing HNP as a model, we wanted to determine predictors to prioritize the most heritable clinical presentations and which gene to begin testing in HNP presentations, to reduce costs of genetic screening. Patients were tested for SDHB, SDHC, and SDHD intragenic mutations and large deletions. Clinical parameters were analyzed as potential predictors for

Relevance: Any kind of the hearing loss, especially in the childhood, affects the mental and intellectual development negatively as well as behavior and social position of a deaf patient in the hearing world. Cochlear implantation is the most effective and reliable method of medical and educational auditory-speech rehabilitation for both adults and children with severe hearing loss and deafness. One of the key performance indicators of the cochlear implantation is a result of speech audiometry, especially on the noise background. The aim is to study the state of auditory function according to the subjective audiometry in the noise background and the influence of various factors on the effectiveness of rehabilitation of the children after cochlear implantation. Materials and methods: The study involved 150 children with severe sensorineural hearing loss and deafness after cochlear implantation. In age, they ranged from 3 to 18 years old. Evaluation of the efficiency of cochlear implantation was carried out in several stages. All studies were done in the free-field with the cochlear implant on. At first, we performed the pure tone audiometry. Then we defined the 50% intelligibility threshold of numeral test. After that, we defined a word recognition percentage. And finally we defined the impact of masker on speech intelligibility at SPL of useful signal 50, 60 and 80 dB. Results: Based on the analysis of the received data, all children with severe sensorineural hearing loss and deafness after cochlear implantation were divided into 3 groups depending on the speech intelligibility. The first group (high efficiency of cochlear implantation) included 68 children (45,3%). This group was divided into two subgroups depending on the difference between the values of the speech intelligibility in the free sound field and in the noise background. The second group (average efficiency) consisted of 45 children (30%). The third group (low efficiency) were 37 children (24,7%). The influence of various factors on the efficiency of cochlear implantation was analyzed. Conclusion: Speech intelligibility in the noise background must be examinated in all children after cochlear implantation. The main factors affecting the effectiveness of cochlear implantation according to test of speech intelligibility in the noise background are the ethiology of hearing loss and duration of post-operation period. Results of speech intelligibility in the noise background test will help specialists who practice the rehabilitation of children after cochlear implantation (teachers for deaf, speech therapists) to pay attention to the decrease of speech intelligibility in children in the real conditions of communication and to focus their efforts on its improving with the appropriate methods.

Introduction: It is considered proven that the state of the immune system determines the development and course of many pathological processes, which are based on inflammation. At the same time, taking into account current trends in assessing the immunological status, conditional variants of deviation from the norm, a decrease in the number of cells from the average statistical norm of the region and control parameters in the performing laboratory by 1.5 or 2 times were adopted, since deviations are within 30-60 % are borderline and quite easily compensated by the body. The aim of the work was to conduct an integrated analysis of data to determine the state of systemic immunity in inflammatory diseases of the upper respiratory tract (URT) to select the optimal informa-tional indicators. Materials and methods: Immunological methods were used to examine 260 people with inflammatory pa-thology of the upper respiratory tract, of which 82 had chronic tonsillitis, 76 with chronic rhinitis, 70 with chronic pharyngitis and 32 people made up a control group of healthy donors. The age of the subjects ranged from 16 to 60 years, the duration of the disease from 1 year to 5 years, female patients predominated (≈60%). Examinations were conducted in the clinical remission stage. When assessing systemic immunity, the number of T-lymphocytes (CD 3, 4, 8), B-lymphocytes (CD22), NK (CD56), monocytes (CD14), concentration of immunoglobulins of classes M, G, A, E, cytokines with regulatory properties, interferon-γ-IL4 were determined. Functional tests in assessing systemic immunity are presented by determining the cytolytic activity of blood mononuclear cells in relation to avian xenogenic red blood cells and the activity of phagocytic blood cells in relation to latex particles at the absorption stage. Statistical processing was performed using the angular transfor-mation method "φ" according to Fisher and the "one-sided" criterion "U" Wilcoxon. Results: Based on a wide range of immunological studies in patients with chronic diseases of the upper respiratory tract, it seems most appropriate to use the following laboratory tests to assess systemic immunity to determine the characteristic deviations in the immune status of patients: High diagnostic value: - decreased serum IgA concentration (<0.5 g/l); - low level of activity of ECC of blood (<20% for xenoerythrocytes); - increased level of interleukin-1β (> 25 pg/ml); Relative diagnostic value: - determination of the degree of dysimmunoglobulinemia in serum; - increased titers of antibodies to streptolysin-O, other microbial antigens; - increased serum IgM. Conclusion: The developed criteria and approaches in assessing systemic immunity in patients with in-flammatory diseases of the upper respiratory tract can be used to examine patients and assess the effectiveness of the treatment.

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Introduction: Squamous cell carcinomas of the head and neck, including laryngeal cancer, rank sixth in prevalence according to world statistics from developed countries. The role of laryngopharyngeal reflux as one of the risk factors for the development of laryngeal cancer remains controversial and needs further study. Objective: To analyze and compare clinical manifestations and morphological data in patients with laryngeal cancer T1-2N0M0 with LPR. Materials and methods: 87 patients with laryngeal cancer of the I-II stage T1-2N0M0. For the purpose of screening diagnostics of LPR, modified visualanalogue scales RSI and RFS were used,24-hour pH-monitoring was performed. To conduct a histopathological study, samples of surgical material were selected from 8 patients with laryngeal cancer of the I-II stage T1-2N0M0 with LPR; 8 patients with laryngeal cancer – without LPR and 8 patients with benign neoplasms of the larynx with LPR. Results: When analyzing the results of the examination, the RSI index exceeded “9” in 39 (44.8%) patients. According to 24-hour pH monitoring, the presence of LPR was diagnosed in 32 (36.8%) examined patients with morphologically verified squamous cell carcinoma of the larynx, which made up the study group. In 6 (75.0%) patients from the comparison group, areas covered by stratified squamous epithelium were determined within the mucous membrane, in 5 (62.5%) patients, transition zones containing both stratified squamous and single-layered multilayer ciliated were determined epithelium. The nature and intensity of lymphohistiocytic infiltration was more expressed in patients with associated LPR.