[Possibilities of differential diagnosis of chronic diseases of the nasal cavity after surgical treatment and topical antibiotic therapy]. / Vozmozhnosti differentsial'noi diagnostiki khronicheskikh zabolevanii polosti nosa posle khirurgicheskogo lecheniya i topicheskoi antibakterial'noi terapii.

OBJECTIVE: The study was performed to assess the endoscopic state of the nasal mucosa after the use of local anti-inflammatory and antibacterial therapy, in particular, Polydexa nasal spray with phenylephrine containing Dexamethasone sodium metasulfobenzoate + Neomycin + Polymyxin B + Phenylephrine, and for the treatment of granulomatosis with polyangiitis. MATERIAL AND METHODS: The study included 940 patients who underwent examination and treatment for chronic rhinosinusitis in the clinic of otorhinolaryngology of I.P. Pavlov SPbSMU surgical treatment of the paranasal sinuses underwent 907 patients. In the postoperative period, the first group (211 patients) underwent toileting of the nasal cavity. The second group (307 patients) received irrigation therapy. The third group (389 patients) received a topical treatment combined of Polydexa with phenylephrine. The dynamics of the condition was assessed on the 1st, 3rd and 7th days of treatment, the evaluation of the effectiveness of the treatment was carried out on the 3rd and 7th days. Differential diagnosis with granulomatosis with polyangiitis was carried out in 33 patients. All patients with granulomatosis with polyangiitis showed signs of chronic rhinosinusitis. Patients were prescribed local anti-inflammatory and antibacterial therapy with Polydexa with phenylephrine for 7 days with endoscopic control of the nasal cavity. CONCLUSION: The use of the combined topical drug Polydexa with phenylephrine in patients with chronic rhinosinusitis and in patients with granulomatosis with polyangiitis has a positive effect, which reduces the clinical manifestations of chronic rhinosinusitis.

[Methods of maxillary sinus foreign bodies removal]. / Sposoby udaleniya inorodnykh tel verkhnechelyustnykh pazukh.

THE AIM: To characterize methods of extraction of foreign bodies of maxillary sinuses, features of postoperative treatment of patients. MATERIAL AND METHODS: The experience of treatment of patients with maxillary sinuses foreign bodies in the clinic of ENT of PFSMU of St.Petersburg is presented. In 2019 124 patients undergo treatment of maxillary sinus foreign bodies in our clinic. All surgeries are done by endoscopic endonasal method, mostly via inferior nasal passage. Clinical case of maxillary sinus foreign body removal is presented. RESULTS: Almost any kind of foreign body can be removed from the maxillary sinus endoscopically through the nasal cavity. The most reliable method to diagnose foreign body is computed tomography. In most cases local antibacterial therapy is enough in postoperative period.

[Prevention of frontal pocket stenosis after endoscopic transnazal surgery on the frontal sinus and endoscopic septoplasty in acute and chronic pathology of frontal sinuses]. / Profilaktika stenozirovaniia lobnogo karmana posle éndoskopicheskoi transnazal'noi operatsii na lobnoi pazukhe i éndoskopicheskoi septoplastiki pri ostroi i khronicheskoi patologii lobnykh pazukh.

The main idea of our manuscript is prevention of frontal recess stenosis after endoscopic endonasal frontal sinus surgery and septoplasty during to acute and chronic frontal sinuses pathology. PURPOSE: To offer an effective method to prevent postoperative frontal recess stenosis after endoscopic endonasal frontal sinus surgery and surgical correction of intra-nasal structures. MATERIAL AND METHODS: In our manuscript we analyzed 274 cases of endoscopic endonasal frontal sinus surgery: postoperative treatment (local and systemic). All of them were operated by endoscopic endonasal approach both initially and repeatedly for acute and chronic frontal sinusities in the ENT department Pavlov First state medical university of Saint Petersburg from 2013 to 2019. RESULTS: In 10 cases, patients with previous endoscopic endonasal frontal sinus surgery underwent revision endoscopic procedure due to frontal recess obstruction, in 4 cases - due to a recurrence of the polypous process involving the frontal sinus, in 6 cases - without visible provoking factors contributing to restenosis of the frontal recess. First step in all cases was a correction of the nasal septum. It is necessary to assess the factors that contribute to restenosis of the frontal recess. Careful endoscopic care of the nasal cavity and the frontal recess in the postoperative period can reduce the risk of restenosis of the latter. Local antibacterial nasal therapy is recommended for the prevention of purulent processes in the nasal cavity in the early postoperative period.

[Inferior turbinate neoplasms]. / Osteoma nizhnei nosovoi rakoviny.

INTRODUCTION: The main aim of the work was to describe a rare clinical case of osteoma of inferior turbinate. The interest of the case is that such tumors are extremely rare. RESULTS: A female patient of 63 years old attended an ENT clinic. She complained on absence of nasal breath at the right side and headache. After a full ENT-examination, anamnesis, and a thorough analysis of the radiation examination results (computed tomography data), a decision was made to surgical treatment. Under general anesthesia, controlled hypotension surgery was done. First step was septoplasty, then the dense bone tumor was reduced and removed. At the control examination in 3 months, the complete removal of the formation of the inferior turbinate on the right is determined. There were no signs of continued or recurrent tumor growth. CONCLUSION: Neoplasms of the nasal cavity, in particular the inferior turbinate, are extremely rare pathologies. They are mainly detected when performing anterior rhinoscopy, endoscopic examination of the nasal cavity. The result of histological examination is compact osteoma. The gigantic size of the inferior turbinate osteoma in our case is probably due to the patient's failure to consult a specialist (otorhinolaryngologist) for a long time. Surgical treatment of this pathology should consist in an endoscopic endonasal approach: this approach allows the most complete and minimally traumatic removal of the tumor.

[Potential of computer-assisted navigation systems in the surgical treatment of chronic sinusitis, nasal cavity and paranasal sinuses tumors]. / Vozmozhnosti komp'iuter-assistirovannykh navigatsionnykh sistem v operativnom lechenii khronicheskikh sinusitov, novoobrazovanii polosti nosa i okolonosovykh pazukh.

PURPOSE: To describe the principles of medical navigation systems in head and neck surgery, the possibility of their application and the existing limitations. MATERIAL AND METHODS: The article presents the generalized experience of image-guidance equipment using in the ENT Department of First Pavlov State Medical University. 298 operations, mostly FESS, were performed from 2013 to 2018 under the control of navigation system. The majority of cases consisted of surgical treatment of chronic sinusitis, tumors of the nasal cavity and paranasal sinuses; also, navigation control was useful in the case of altered intranasal anatomy after previous surgical treatment or due to chronic polyposis. A case report of frontal sinus inverted papilloma surgical treatment, controlled by an electromagnetic navigation system, is presented. RESULTS: The use of navigation systems in head and neck surgery can improve surgery accuracy and safety, as well as providing a unique opportunity to learn FESS in real time.

Endoscopic endonasal removal of median palatine cyst.

Endoscopic endonasal removal of median palatine cyst. PROBLEM: A 49-year-old man presented with a median palatine cyst, as an incidental finding in a work-up of vision disturbance, due to a cyst in the sphenoid sinus. METHODOLOGY: The median palatine cyst was removed with a diode laser in the contact mode under endoscopic vision; forceps were used to remove the sphenoid sinus cyst. RESULTS: Follow-up over 6 months showed authentic absence of left eye vision impairment, no signs of recurrence of the median palatine cyst, and no acute inflammation in the nasal cavity or paranasal sinus area. CONCLUSIONS: A median palatine cyst is mostly asymptomatic and painless at palpation. However, its structure, with chronic inflammation and detritus, can be regarded as a focus of chronic infection. Surgery is the only effective method of treatment, and relapse after surgery is rare.

[Endoscopic endonasal surgery of paranasal sinus osteomas]. / Endoskopicheskaya endonazal'naya khirurgiya osteom okolonosovykh pazukh.

This article was designed to summarize the experience gained withendoscopic endonasal removal of paranasal sinus osteomas during the period from January 2013 till February 2016. In addition a review of the relevant literature is presented encompassing the publicationsthat provide information about etiology, pathogenesis, clinical picture, diagnostics, and treatment of bone tumours. The objective of the study was to enhance the effectiveness and safety of the surgical treatment of the patients presenting with paranasal sinus osteomas. A total of 81 cases of paranasal sinus osteoma were documented in the patients admitted to I.P. Pavlov Saint-Peterburg First State Medical Universityduring the period from January 2013 till February 2016. Forty nine of them were given the surgical endoscopic endonasal treatment with the removal of the neoplasm. The remaining 32 patients were included in the group for the further dynamic follow up. The authors report the data of morphological studies and the results of computed tomography performed in the pre- and postoperative periods with special reference to the potential for the use of the electromagnetic navigation station (an image-guidance system) that makes it possible to significantly reduce the risk of development of possible complications. In addition, the findings suggestive of the progressive tumour growth in the group of the patients under dynamic observation are discussed.

Case report: Endoscopic endonasal removal of large osteoma in the ethmoid sinus.

PROBLEM: A 25-year-old man presented with a large osteoma in the right ethmoidal sinus. METHODOLOGY: The osteoma was removed by an endoscopic endonasal approach with a curved diamond drill and an electromagnetic navigation system. RESULT: Computed tomography 3 days after surgery showed complete removal of the osteoma and normal position of the right eyeball. No long-term follow-up results were available. CONCLUSIONS: This clinical case highlights the use of the endoscopic endonasal approach for the safe and reliable treatment of sinus osteomas, particularly large osteomas. We also describe various manifestations of osteoma, its diagnosis, and surgical management.