Otorhinolaryngology

Поражение органа слуха и верхних дыхательных путей при васкулитах, ассоциированных с антинейтрофильными цитоплазматическими антителами / А. А. Клименко [и др.] // Клиницист. – 2024. – Т. 18, № 2. – С. 12–20.

(Damage to the organ of hearing and upper respiratory tract in vasculitis associated with antineutrophil cytoplasmic antibodies)

 Antineutrophil cytoplasmic antibodies associated vasculitis (ANCA-AV) is a systemic necrotizing granulomatous vasculitis affecting mainly small-caliber vessels. ANCA-AV occupy a special place among systemic vasculitis, which is characterized by a highly active life-threatening course of the disease, requiring rapid differential diagnosis and aggressive
immunosuppressive therapy. The ANCA-AV group consists of 3 nosologies: granulomatosis with polyangiitis, eosinophilic granulomatosis with polyangiitis and microscopic polyangiitis. The “calling card” of ANCA-AV is the lesion of the upper
respiratory tract, especially the ENT organs (70–100 % of patients). The nasal cavity and paranasal sinuses are the most common areas of lesion in the head and neck (85–100 %), whereas ear damage occurs in about 35% (range, 19–61 %) of cases. Lesion of the ENT organs is typical for the debut of ANCA-AV, which makes early diagnosis difficult, since diseases of the upper respiratory tract are extremely common in all age groups. Diagnosis verification occurs mainly at the stage of generalized involvement of many organs and systems, causing severe course with the development of pulmonary-cardiac and renal insufficiency, which lead to the death of the patient. The main ENT manifestations
of ANCA-AV can be grouped into several groups: sinonasal, otological, tracheobronchial, oral cavity lesions and others. Pseudotumors are often found in ANCA-AV. They are characterized by the appearance of parapharyngeal, parotid, submandibular, paratracheal volumetric formations. As a rule, the appearance of tumor-like formations is observed
at an early stage of the disease and is associated with the presence of antibodies to proteinase 3, systemic manifestations of vasculitis. Pseudotumor in the ENT region may be accompanied by secondary neuropathies of cranial nerves, destruction of bone tissue, which requires histological verification of the disease
Актуальный взгляд на взаимосвязь гипертрофии аденоидов и патологии среднего уха: обзор литературы / А. А. Григорьева [и др.] // Оториноларингология. Восточная Европа. – 2024. – Т. 14, № 3. – С. 400–410.

(An Up-To-Date View on the Relationship Between Adenoid Hypertrophy and Middle Ear Pathology: A Literature Review)

 Adenoid hypertrophy is a fairly common pathology in childhood, and its prevalence is steadily increasing. The clinical picture of adenoid hypertrophy is very polymorphic. Otitis media with eff usion associated with adenoid hypertrophy occurs due to obstructive dysfunction of the auditory tube and possible tubogenic infection of the middle ear. Adenoid vegetations mechanically close the pharyngeal opening of the auditory tube, impairing its ventilation and drainage functions. The location of the adenoids is no less important an aspect than their size, since the obstruction of the auditory tube depends on the localization of adenoid vegetations in the nasopharynx. Thus, the lateral location of adenoid vegetations is associated with a higher incidence of otitis media with eff usion. Otitis media with eff usion is called “silent” otitis media for its often asymptomatic course. It is characterized by slowly increasing hearing loss, absence of pain and defect of the eardrum. Children usually experience fl uctuating hearing loss, which may be unnoticed, since children 2 to 5 years old usually do not complain of hearing loss. Complications of otitis media with eff usion can lead to persistent hearing loss and, as a consequence, to a decrease in the child’s social activity and quality of life. Thus, it is extremely important to promptly diagnose otitis media and provide appropriate treatment in patients with adenoid hypertrophy. Nowadays diagnosis of this pathology is represented by a comprehensive assessment of data obtained by various methods – otoscopy, nasopharyngeal endoscopy,
Дементьева, М. А. Механизмы патогенеза и биологической терапии хронического полипозного риносинусита (обзор литературы) / М. А. Дементьева, О. П. Гумилевская, Б. Ю. Гумилевский // Вестник новых медицинских технологий. – 2024. – Т. 31, № 3. – С. 23–28.

(Mechanisms of Pathogenesis and Biological Therapy of Chronic Polypous Rhinosinusitis (literature review))

 The problem of choosing treatment tactics for patients with chronic polypous rhinosinusitis is still relevant and unresolved, despite the noticeable successes in the use of targeted biological therapy in patients with this disease. Purpose of the research is
to study the current state of the problem of chronic polypous rhinosinusitis based on the results of the scientific papers of recent years. Material and research methods. The material for the analysis of the current state of the chronic polypous rhinosinusitis problem was the articles of domestic and foreign magazines written in recent years. Results and discussion. The complexity of treatment is associated with the comorbidity of the disease and therefore the heterogeneity of the contribution of different immune and non-immune factors to the chronic polypous rhinosinusitis pathogenesis. For this reason, quite a lot of patients have a very low quality of life, they are often forced to get hospitalized due to the need for surgical treatment or the use of parenteral forms of glucocorticosteroids. Conclusion. The use of biological therapy preparations in patients with a severe course of chronic polypous rhinosinusitis made it possible to
take control of the symptoms of this complex disease. However, the absence of a 100 % response from the smell loss symptom, as well as the presence of a weak or moderate response to treatment in some patients, requires the continuation of the studies of well-known monoclonal antibodies and the development of new and/or combinations of existing targeted therapy, which acts at different points of the disease pathogenesis. It is obviously vital to conduct comparative studies of the effectiveness of various monoclonal antibodies which have successfully established themselves in the treatment of ŚPRS, depending on the characteristics of the disease pathogenesis to personalize targeted therapy.
Модифицирование пирамиды носа при ринопластике: современное состояние вопроса / С. А. Горбунов [и др.] // Российская ринология. – 2024. – Т. 32, № 2. – С. 126–135.

(Modification of nasal pyramid in rhinoplasty: current state of issue)

 Rhinoplasty is one of the most sought-after operations in aesthetic facial surgery, one of the most important parts of which is the nasal pyramid correction. To analyze and generalize data on the evolution and current state of issues of surgical correction of the nasal pyramid. Analysis of publications on surgical correction of the nasal pyramid (articles and related abstracts) presented in the PubMed database has been conducted. The choice of material was carried out by the following keywords: reduction rhinoplasty, structural rhinoplasty, preservation rhinoplasty, ultrasonic rhinosculpture, sculpture rhinoplasty, piezoelectric instruments, osteotomy, nasal pyramid. Early concepts suggested resection, the excessive performance of which led to functional and aesthetic complications associated with the impaired stability of the nasal framework. The subsequent widespread implementation of grafts, structural elements, and preserving techniques solved the problem of cartilage framework stability, but the problem of maintaining the stability of bony vault remained unsolved. In the classical variant, changing the shape of bony vault requires a complete osteotomy, quite traumatic and not always well-controlled manipulation, which can give an unpredictable functional and aesthetic result. The adaptation of new technologies and their implementation into practice allowed to develop new, less traumatic and at the same time more accurate and stable approaches to rhinoplasty, which do not interfere with the function of the nose and are aesthetically effective.
Григорьева, А. А. Особенности лечения пациентов с переломом стенок лобной пазухи / А. А. Григорьева, В. В. Старцева, Е. А. Нелюбова // Российская ринология. – 2024. – Т. 32, № 2. – С. 136–139.

(Treatment features of patients with frontal sinus fractures)

 Analysis and generalization of literature data on the treatment of patients with the frontal sinus fractures. The publications presented in Medline, Embas, PubMed information databases are used for the analysis. The choice of material was carried out by following keywords: frontal sinus fracture, injuries of the nose and paranasal sinuses, traumatic sinusitis. The article summarizes data on the tactics of managing patients with the frontal sinus fractures. It has been concluded that at present, preference should be given to endoscopic interventions in reconstructive surgery of the frontal sinuses with traumatic injuries. The individuality of traumatic injuries to the facial skeleton requires a personalized approach in each case.
Применение метода биологической обратной связи при лечении дисфонии (обзор литературы) / А. И. Крюков [и др.] // Вестник оториноларингологии. – 2023. – Т. 88, № 6. – С. 67–72.

(Application of the biofeedback method in the treatment of dysphonia (literature review))

 The literature review describes the experience of using the biofeedback method in the treatment of dysphonia of various etiologies. Indications for the use of this method and its effectiveness in a certain contingent of patients are discussed.
Шиленкова, В. В. Топическая антибактериальная терапия риносинуситов / В. В. Шиленкова // Российская ринология. – 2024. – Т. 32, № 1. – С. 39–47.

(Topical antibacterial therapy of rhinosinusitis)

 The global problem of antibiotic resistance requires the necessity of redefinition of approaches to treatment of inflammatory respiratory tract diseases with a shift in priorities towards local drug use. Topical antibacterial therapy is the one of the treatment methods of acute and chronic rhinosinusitis. To analyze clinical researches demonstrating the effect of topical antibacterial drugs in pathogens’ eradication, improvement of clinical, endoscopic pattern and life quality. The review uses the data of publications included in the MEDLINE, EMBAS, PubMed databases. The data was selected according to the keywords: acute rhinosinusitis, chronic rhinosinusitis, nasal polyps, adenoiditis, topical antibiotics, framycetin, neomycin with polymyxin B, isofra, polydexa with phenylephrine, followed by data systematization. Priority was given to aminoglycosides, which are relevant even for chronic rhinosinusitis caused by Pseudomonas aeruginosa and Staphylococcus aureus, including methicillin-resistant Staphylococcus, when selecting an antibiotic for topical rhinosinusitis therapy. Topical antibiotics are need for patients with difficult to treat rhinosinusitis, who were performed functional endoscopic surgery of the nasal sinus and for whom treatment with nasal cavity irrigation, intranasal corticosteroids and/or systemic antibiotics was ineffective. Nasal antibiotic sprays demonstrate a synergistic effect greater than that of topical corticosteroids, systemic antibiotics and local antibiotic monodrug by more than 3 times.

 
Особенности клиники и патогенеза атрофического ринита в условиях резко континентального климата: обзор литературы / Р. К. Тулебаев [и др.] // Оториноларингология. Восточная Европа. – 2024. – Т. 14, № 1. – С. 101–108.

(Clinical Features and Pathogenesis of Atrophic Rhinitis in a Sharp Continental Climate: A Literature Review)

 Introduction. Among chronic rhinitis, vasomotor and atrophic rhinitis occupy a significant share. Currently, vasomotor rhinitis, from the point of view of the nature of its origin and some mechanisms of its occurrence, is considered the most studied. As for atrophic rhinitis, a number of etiological factors and the pathogenesis of this disease from the point of view of the underlying causes, its relationship with the pathology of disorders of the mucous membranes of the upper respiratory tract and the whole organism as a whole, have not yet been suffi ciently studied. Many researchers believe that atrophic rhinitis is a chronic disease of the nasal mucosa, characterized by atrophic changes in the nasal septum and turbinates and aff ects its structural components, including homeostasis, as well as the glands that produce mucous secretion, which determines the basic physiological functions of this epithelium. Purpose. To study the clinical features and pathogenesis of atrophic rhinitis. Materials and methods. The analysis of sources of Kazakh and foreign literature was carried out using scientifi c literature databases for the period from 1979 to 2023. Results. After analyzing the available literature, we came to the conclusion that despite numerous assumptions about the causes of the development of atrophic rhinitis, the etiology and pathogenesis of this disease are not fully understood.
Conclusion. Unfortunately, to this day the place of atrophic rhinitis in the general classifi cation of diseases has not been determined; there is no clear diagnostic algorithm, effective treatment methods and preventive measures for the disease in Kazakhstan as a whole. This pathology deserves special attention due to the fact that it aff ects the nasal mucosa to its deep layers, is characterized by a progressive course and still has no effective treatment
Носкова, В. В. Эндотелиальная дисфункция как патогенетический фактор сенсоневральной тугоухости / В. В. Носкова, А. Н. Храбриков // Вестник оториноларингологии. – 2024. – Т. 89, № 1. – С. 21–27.

(Endothelial dysfunction as a pathogenetic factor of sensorineural hearing loss)

 Chronic sensorineural hearing loss (SNHL) is a common disease that leads to disability of the population. Despite the many reports devoted to SNHL, the question of the pathogenesis of the disease is still open. Many researchers consider the development of SNHL as a manifestation of microangiopathy. The mechanism of development of microangiopathy in SNHL is multifactorial, but most researchers agree that endothelial dysfunction (ED) triggers a complex of pathological changes in the vessels of the inner ear. Review of the results of scientific research in recent years on the problem of etiopathogenesis of sensorineural hearing loss from the perspective of endothelial dysfunction in the formation of auditory disorders.