Sunday, July 18, 2021

Features of impedance audiometry in children of the first months of life after acute otitis media

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Vestn Otorinolaringol. 2021;86(3):41-45. doi: 10.17116/otorino20218603141.

ABSTRACT

The features of impedance audiometry with a 226 Hz probe frequency in newborns and children in the first months of life after acute otitis media were analyzed. The age dynamics of tympanograms in children in the first year of life is determined.

PMID:34269022 | DOI:10.17116/otorino20218603141

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Auditory tube dysfunction in children (literature review, part 2)

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Vestn Otorinolaringol. 2021;86(3):84-89. doi: 10.17116/otorino20218603184.

ABSTRACT

The presented literature review examines in detail the methods for diagnosing the auditory tube, the history of development of studies of the Eustachian tube and the treatment of its dysfunction in children. The issue of dysfunction of the auditory tube as one of the causes of the formation of chronic hearing loss in childhood is increasingly being identified because of the rapid development of technologies and methods for examining patients. Aim is to study the multiple etiologic factors of the disease and the need for an integrated approach to the study of this condition.

PMID:34269030 | DOI:10.17116/otorino20218603184

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Long-term results of the use of lyophilized xenodermoimplants in the surgical treatment of patients with cicatricial stenosis of the larynx

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Vestn Otorinolaringol. 2021;86(3):52-55. doi: 10.17116/otorino20218603152.

ABSTRACT

Purpose is to study the long-term results of patients with cicatricial stenosis of the larynx treated with use lyophilized xenodermoimplants for postoperative wound plasty.

MATERIAL AND METHODS: The results of treatment of 34 patients (age from 32 to 56 years) with cicatricial stenosis of the larynx were analyzed. A fundamentally new method of surgical treatment of such patients has been developed and introduced into practice, in which lyophilized xenodermoimplants were used for plasty of the wound surface.

RESULTS: The proposed technique made it possible in the immediate postoperative period to obtain a good result in 28 (82.4%) patients, satisfactory - in 6 (17.6%). The length of hospital stay was reduced by 8-10 days. In the long-term period (after 6-11 years), 27 patients were examined. Of these, 21 (77.8%) obtained a good result, and 6 (22.2%) - satisfactory.

CONCLUSION: The proposed method of surgical rehabilitation of the respiratory function of the larynx with its cicatricial stenosis using lyophilized xenodermoimplants is quite effective and can be proposed for use in clinical practice.

PMID:34269024 | DOI:10.17116/otorino20218603152

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First case of huge classic papillary thyroid cancer rupturing spontaneously leading to ischemic necrosis, perforation and inflammation of overlying skin: Case report and review of the literature

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Int J Surg Case Rep. 2021 Jun 29;85:106136. doi: 10.1016/j.ijscr.2021.106136. Online ahead of print.

ABSTRACT

INTRODUCTION: Papillary thyroid cancer (PTC) is the commonest form of well-differentiated endocrine carcinoma. It is categorized into indolent and aggressive, where the indolent subtypes (classic, follicular) rarely demonstrate aggressive behavior. We present a classic PTC presenting with a rapidly growing huge anterior neck mass that subsequently spontaneously ruptured sub cutaneously resulting in ischemia, necrosis, and perforation of overlying skin leading to inflammation.

PRESENTATION OF CASE: A 37-year-old female with no comorbidities presented to our emergency department with a neck swelling of 2 years duration that rapidly enlarged one week prior to presentation. Though the mass initially appeared of inflammatory nature, the tumor was a PTC, and she underwent total thyroidectomy with selective right side neck dissection and debridement of necrotic skin. The gross specimen revealed a fragmented non-intact right thyroid lobe mass causing pressure ischemia, necrosis and perforation of the skin. Histopathology showed a 9 × 9 × 5 cm classic PTC staged as pT3b N1b. Postoperative course was uneventful, she was discharged by the eighth postoperative day, and then she received a high dose of radioactive iodine ablation (RAI).

DISCUSSION: Classic PTC is usually of a smaller size and a relatively benign course compared to other PTC subtypes a nd thyroid cancers. It is indolent with favorable prognosis. Although it is associated with increased risk of lymph node metastases at the time of diagnosis, it is slow growing with high survival rates approaching 95%.

CONCLUSION: Despite that classic PTC progresses slowly, it should still be suspected in neck swellings presenting with rapid and aggressive behavior. Prompt and systematic assessment is required with surgical intervention and radioactive iodine ablation therapy.

PMID:34274758 | DOI:10.1016/j.ijscr.2021.106136

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Comparative morphological assessment of the damaging effects of cold plasma and radio wave energy on the mucous membrane of the lip in the experiment

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Vestn Otorinolaringol. 2021;86(3):61-65. doi: 10.17116/otorino20218603161.

ABSTRACT

The aim of this study was a comparative morphological assessment of changes in the mucous membrane of the lip in the field of radio wave and cold plasma exposure in the experiment.

MATERIAL AND METHODS: Experimental animals removed a portion of the mucous membrane of the inner surface of the lip with a Surgitron radio knife (group 1) and an electrode of the Coblator II cold plasma apparatus (observation group 2). Tissue was taken from the edge of the surgical wound as a trapezoidal flap containing mucous and submucous membranes immediately after the incision and 3 weeks after the surgery. Histological sections were prepared, which were stained with hematoxylin and eosin, as well as according to van Gieson.

RESULTS: It was found that, both in cases of using a radio knife and a coblator along the edges and in the depth of the wound, coagulatio n tissue necrosis was observed, which was more evident in group 1 of observations. In addition, after the radio wave exposure, in the areas close to the defect, the epithelial lining was disrupted to one degree or another, which was not observed when using the coblator. After 3 weeks of the experiment, the stratified squamous non-keratinizing epithelium in both groups had a normal histological structure. At the same time, when using the coblator, the lamina propria of the mucous membrane was completely restored, and in cases with the use of a radio knife, sclerotic processes with the formation of scar tissue took place in the lamina propria of the mucous membrane in some areas.

CONCLUSIONS: The use of a coblator should be recognized as a more gentle method, since a comparative analysis of histological changes immediately after the incision showed a more intense damaging effect of the radio knife on the surrounding tissues, which in later stages was accompanied by incomplete re generation (substitution) of the lip mucosa.

PMID:34269026 | DOI:10.17116/otorino20218603161

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Modern methods in diagnostics of lacrimal system vertical part obliteration

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Vestn Otorinolaringol. 2021;86(3):97-103. doi: 10.17116/otorino20218603197.

ABSTRACT

A review of the literature is devoted to the description of modern diagnostic methods that are directed at detecting lacrimal pathway obstruction. The presented analysis is based on the study of data from Russian and foreign literary sources on both routine and high-tech lacrimal system examination methods, as well as on authors' experience in studying the diagnostic efficiency of imaging methods such as lacrimal scintigraphy, computed tomography with lacrimal pathway contrasting, and also single photon emission computed tomography. The article gives information about the advantages and disadvantages of the presented methods, highlights the questions of the prospects of their usage in practical dacryology.

PMID:34269032 | DOI:10.17116/otorino20218603197

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Acute sinusitis: topical issues of terminology and diagnosis

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Vestn Otorinolaringol. 2021;86(3):72-77. doi: 10.17116/otorino20218603172.

ABSTRACT

OBJECTIVE: To analyze and summarize data on terminology, etiology, diagnostic criteria for acute sinusitis.

DATA SOURCES: Publications (articles and related abstracts) submitted to the PubMed database. The choice of material was carried out, according to the keywords: cold, acute viral sinusitis, acute bacterial sinusitis, post-viral sinusitis, acute respiratory viral infection, diagnosis of acute sinusitis.

RESULTS: The published research results indicate the existence of certain disagreements regarding the terminology, diagnostic criteria, indications for diagnostic studies in acute sinusitis. The data on the etiology, pathogenesis, and diagnostic features of acute sinusitis are presented in the current guidelines, reviews and publications of the results of clinical trials.

PMID:34269028 | DOI:10.17116/otorino20218603172

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Prospects of antimicrobial peptides application in otorhinolaryngology in conditions of increasing antibiotic resistance

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Vestn Otorinolaringol. 2021;86(3):104-109. doi: 10.17116/otorino202186031104.

ABSTRACT

The use of antibacterial drugs has become widespread over the past 10-15 years. In this regard, there is a significant increase in antibiotic resistance in the world. Combating this problem has been one of the priorities of WHO since 2015. In light of this situation, the use of antimicrobials with no antibiotic resistance is of paramount importance. Topical antimicrobial peptides are used to treat infectious skin and mucosal diseases. The review highlights the role of the antimicrobial polypeptide thyrotricin and the complex drug doritricin in the treatment of pharyngeal pathology in adults and children according to foreign and domestic literature. The obtained data indicate the effectiveness and safety of a topical complex preparation containing thyrotricin, benzalkonium chloride and benzocaine (doritricin) as a monopreparation in the treatment of viral and bacterial tonsillopharyngitis, as well as in the complex therapy of streptococcal tonsillopharyngitis.

PMID:34269033 | DOI:10.17116/otorino202186031104

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External otitis: clinical diagnostics and treatment tactics

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Vestn Otorinolaringol. 2021;86(3):36-40. doi: 10.17116/otorino20218603136.

ABSTRACT

OBJECTIVE: To summarize modern data about the epidemiology, etiology, clinical course and diagnosis of otitis externa.

MATERIAL AND METHODS: Materials of scientific publications included in the Cochrane Library, information bases of the RSCI, MEDLINE, PubMed were used as a data source. The choice of material was carried out according to the keywords: otitis externa, etiology, diagnosis, treatment, local treatment.

RESULTS: The role of combined drugs in the main etiopathogenetic mechanisms of the external ear inflammatory process is shown.

CONCLUSION: Analysis of published data from clinical trials indicates the importance of a fixed antibacterial agents and anesthetic combination in increasing the effectiveness of topical therapy for otitis externa.

PMID:34269021 | DOI:10.17116/otorino20218603136

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The evolution of methods of active irrigation of paranasal sinuses in rhinosinusitis. Part 1

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Vestn Otorinolaringol. 2021;86(3):110-117. doi: 10.17116/otorino202186031110.

ABSTRACT

Inflammation of the paranasal sinuses significantly reduces the quality of life of people and causes marked economic damage to society. The striking clinical picture of sinusitis has always forced doctors to study the disease, as evidenced by the first records of the anatomy and diseases of the paranasal sinuses by doctors in ancient Egypt more than 3.000 years BC. Sinusitis has been treated in different ways in different historical periods. Effective medication treatment appeared relatively recently and began to steadily replace the older instrumental methods, to which many people had a preconceived notion of invasiveness. However, many studies are showing the positive effect of active drainage methods and, moreover, there is data showing that the discomfort during such procedures is slightly higher than during dental treatment under local anesthesi a. This article presents a review of the available scientific literature on the use of different treatments for bacterial rhinosinusitis at different historical stages, ranging from the first publications on puncture techniques to balloon dilatation and the modern approach to conservative treatment.

PMID:34269034 | DOI:10.17116/otorino202186031110

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Uvulopalatoplasty with a severe form of obstructive sleep apnea: long-term results

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Vestn Otorinolaringol. 2021;86(3):56-60. doi: 10.17116/otorino20218603156.

ABSTRACT

OBJECTIVE: To assess the severity of daytime sleepiness and the level of sleep apnea/hypopnea index (AHI), as well as the possibility of their correction, in the long-term period after uvulopalatoplasty (UPP) in patients suffering from obesity and obstructive sleep apnea syndrome (OSAS).

MATERIAL AND METHODS: We retrospectively analyzed the data of the patients, who requested a consultation due to nighttime snoring, witnessed sleep apneas and daytime drowsiness. We included men and women of ages 40 to 65 (24 male, 17 female) without cardiac or lung insufficiency. Group 1 consisted of 19 patients, who underwent UPP 3-5 years prior to current consultation. Group 2 consisted of 22 patients, who underwent UPP 6-12 earlier, despite prior diagnosis of severe OSAS. We performed cardiorespiratory sleep monitoring, additionally patients completed the Epwor th scale and sleep quality scale. Patients were re-interviewed 2 months after initiation of CPAP therapy and or intraoral device treatment.

RESULTS: Group 1 (n=19) displayed obesity (Body Mass Index 34.2±6.1 kg/m2), severe OSAS (AHI 55.2±18.5), high level of daytime drowsiness (Epworth score 18.7±6.3) and low sleep quality (13.0±6.8 sleep quality score). Group 2 (n=22) displayed reduction in AHI level - significant statistically, but not clinically without changes in daytime drowsiness and sleep quality, which were improved in 29 cases out of 41 with the help of CPAP-therapy (18 cases) or intraoral fixation devices (11 cases).

CONCLUSION: UPP does not exert a clinically significant affect the severity of sleep disturbance in patients with obesity and severe OSAS. Night sleep study is essential before making a decision about UPP. Clinical state correction of patients in the long-term period of UPP is possible with the help of CPAP therapy or i ntraoral fixation devices.

PMID:34269025 | DOI:10.17116/otorino20218603156

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