A large number of studies is devoted to the problem of acute odontogenic sinusitis at the intersection of two specialties - otorhinolaryngology and dentistry. However, the diagnosis and management of this form of nosological pathology by the specialists is not defined. As a rule, this means odontogenic maxillary sinusitis (OMS), which incidence tends to increase despite the significant progress in the dental care.
Introduction. Chronic rhinosinusitis is a disease that occurs everywhere, characterized by inflammation of the mucous membrane of the paranasal sinuses and nasal cavity. If it is impossible to eliminate the causes of the recurrent disease with medical therapy, the use of surgical treatment help to recover the normal functioning of the ostium, including the ostiomeatal complex to improve ventilation and drainage of the paranasal sinuses and recover nasal breathing to relieve chronic inflammation.Purpose of the study. Assessment of the degree of intraoperative bleeding in patients with chronic rhinosinusitis.Materials and methods. On the basis of the FGBU SPB Research Institute of ENT of the Ministry of Health of the Russian Federation in the period from 2020 to 2021. the study of the effect of local intranasal glucocorticosteroids (INGKS) in the intraoperative period in patients with chronic polypous rhinosinusitis was carried out. The total amount of blood loss during surgery for chronic polypous rhinosinusitis in patients who used mometasone furoate preoperatively and in patients not taking topical hormonal drugs was analyzed.Results. In the study group, the average blood loss per operation was 257 ml, in the control group – 401 ml. In patients who took intranasal glucocorticosteroids during surgery, the intensity of bleeding is less pronounced. Undoubtedly, there are many reasons that affect the intensity of bleeding in general, however, a decrease in the inflammatory response in the nasal cavity and a decrease in inflammatory metabolites have a beneficial effect on the state of the nasal mucosa.Conclusion. The use of intranasal glucocorticosteroids in the preoperative period has a positive effect on reducing the inflammatory process in the nasal cavity, which helps to reduce the intensity of intraoperative bleeding.
The cochlear form of otosclerosis is characterized by irreversible metabolic changes that lead to complete hearing loss. Cochlear implantation, which is a high-tech method of rehabilitation for patients with profound hearing loss and complete deafness, becomes an opportunity for hearing restoration. However, CI in patients with cochlear otosclerosis may be accompanied by a number of difficulties due to the remodeling of the cochlea of varying severity. Thus, changes in the bony labyrinth play a crucial role in the management of patients with the cochlear form of otosclerosis and sensorineural hearing loss IV.
Over the past few decades, in the world scientific literature devoted to the problems of auditory-speech rehabilitation, there has been an increased interest in studying the etiological features of congenital deafness. A deep understanding of the etiology and mechanisms of deafness development helped optimize the various stages of cochlear implantation and, thereby, increase its effectiveness. Objective. To develop an algorithm for obtaining the earliest possible information about the causative factor of congenital deafness for timely planning of rehabilitation measures, reducing the cost of excessive diagnostic search, and achieving the most effective results in the auditory and speech development of children. Patients and methods. From 2018 to 2021, a study of the etiological spectrum as well as the characteristics of cochlear implantation in patients with various etiologies of congenital deafness was conducted at the Saint Petersburg Research Institute for Ear, Throat, Nose, and Speech. We examined 100 patients under the age of 3 years (mean age 2,15 ± 0,2 years), of which 58 were female, and 42 were male. All patients had congenital bilateral deafness on newborn audiological screening and were candidates for cochlear implantation. Results and discussion. According to the data obtained, 37 patients (16 boys, 21 girls, mean age 2,3 ± 0,3 years) had congenital cytomegalovirus infection as an etiological factor in deafness. The presence of signs of congenital deafness of genetic etiology was detected in 58 patients (24 boys, 34 girls, mean age 1,9 ± 0,2 years): 43 of them with nonsyndromic deafness and 15 patients with syndromic deafness (4 boys, 11 girls, mean age 2,1 ± 0,4 years). In 5 patients, the etiological factor of congenital deafness could not be established even at the present stage of diagnostic search.
ВВЕДЕНИЕОтогенные и риносинусогенные гнойно-воспалитель-ные внутричерепные осложнения (ВЧО) до настоящего времени являются актуальной проблемой оториноларин-гологии. По данным главных специалистов-оторинола-рингологов 34 субъектов Российской Федерации, сред-ний показатель летальности при отогенных внутричереп-ных осложнениях составил 19,7%, при риносинусогенных осложнениях -13,2%, при сочетании ото-и риносинусо-генной этиологии -34,6%. Высокий уровень летальности при данной патологии обусловлен общей тяжестью состо-яния больных при госпитализации: синдромом системно-го воспалительного ответа (ССВО), интоксикационным и очаговым поражением головного мозга [3][4]7]. Важнейшей проблемой, влияющей на результаты лече-ния больных с тяжелыми гнойно-септическими и внутри-черепными осложнениями, является сложность диагно-стики этой патологии, обусловленная полиморфизмом клинической картины заболевания [8][9][10][11]. ЦЕЛЬ ИССЛЕДОВАНИЯАнализ эффективности дифференцированного под-хода к диагностике и лечению больных с отогенными и риносинусогенными гнойно-воспалительными внутри-черепными осложнениями с использованием современ-ных критериев оценки тяжести общего состояния и стра-тификации риска. To evaluate the condition of patients and changes in course of the disease, the integral and quantifying scores to assess the severity of the systemic inflammatory response syndrome were used: SOFA, which allows to evaluate the level of organ dysfunction, the APACHE II severity of disease score and the Glasgow coma scale. The outcome is directly dependent on early comprehensive diagnosis of injury to the vital organs and systems of the body, timely initiation of specialized treatment. МАТЕРИАЛЫ И МЕТОДЫ
This review aims to describe the materials most commonly used for middle ear packing during tympanoplasty. These materials promote local hemostasis, limit wound surfaces, and fill the volume of the tympanic cavity. The usage of these materials is aimed at reducing the probability of developing cicatricial adhesive changes in the middle ear, stabilizing ossicular prostheses in the desired position, and maintaining the tympanic membrane graft. Main attention is paid to the description of the characteristics of materials and the results of their application in experimental and clinical studies. The pros and cons, possibilities and prospects of these materials usage in clinical practice are reflected.
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