[Potential of azoximere bromide for treatment of patients with acute inflammatory and infectious upper respiratory diseases].

AIM: To evaluate the efficacy and safety of Polyoxidonium® in patients with inflammatory and infectious upper respiratory diseases in real clinical practice. MATERIALS AND METHODS: This retrospective multicenter study included data from adults and children over 6 months old with inflammatory and infectious upper respiratory diseases (n=16 365). The exploratory endpoints included: the proportion of patients with complete relief of symptoms, demographic characteristics of patients, the frequency of prescriptions of Polyoxidonium® by disease groups, determination of the groups of concomitant drugs, most commonly prescribed treatment regimen, frequency of prescribing different Polyoxidonium® dosage forms, duration of the most common specific symptoms of acute respiratory infections during therapy, the incidence of treatment-related adverse events. RESULTS: After treatment completion, the proportion of patients with complete relief of symptoms was 40%, with positive dynamics - 99.77%. Polyoxidonium® in combination therapy was also effective in the treatment of COVID-19 and Post-COVID-19 syndrome. The median patient age was 28 years. Polyoxidonium® was most frequently prescribed for the treatment of inflammatory and infectious upper respiratory diseases in combination with antibiotics or symptomatic drugs in dosage form solution. The primary routes of administration were intranasal and sublingual. The resolution of infection symptoms occurred predominantly within the first 5 days after the initiation of therapy. The therapy appeared to be equally effective across all age groups. No Polyoxidonium®-related adverse events occurred. CONCLUSION: Treatment with Polyoxidonium® contributes to achieving favorable outcomes in patients with inflammatory and infectious upper respiratory diseases. The study drug has a high safety profile.

[Possibilities of using recombinant human deoxyribonuclease I in otorhinolaryngology]. / Vozmozhnosti primeneniya rekombinantnoi dezoksiribonukleazy I cheloveka v otorinolaringologii.

ANNOTATION: Dornase alfa (Pulmozyme, Tigerase) is a purified solution of recombinant human DNase, clinically developed for the treatment of pulmonary diseases in patients with cystic fibrosis (CF). The action of the drug is aimed at destroying the viscous secretion, rich in DNA strands of neutrophils, through their fragmentation, the density of the secretion decreases, and the aeration of the lower respiratory tract improves. The similarity of pathological processes with the formation of viscous exudate on the surface of the mucous membrane in diseases of the upper respiratory tract and ear initiated studies on the use of Dornase alpha in otorhinolaryngology. MATERIAL AND METHODS: The analysis of materials of domestic and foreign authors on the effectiveness of the use of the drug Dornase alfa in otorhinolaryngology was carried out. RESULTS: The review included 132 patients (10 studies) in whom Dornase alfa was used to treat CF-associated nasal and paranasal sinus diseases. Analysis of the literature revealed only 3 studies, one of which consisted of two parts, examining the effect of Dornase alpha on middle ear exudate: two studies were demonstrated in an animal model; one - in vitro on samples of middle ear effusion which were aspirated through a myringotomy incision from patients with recurrent acute otitis media; and one in clinical 40 patients (40 ears) for hydrolysis of exudate in the tympanostomy tubes. CONCLUSION: Analysis of studies on the use of Dornase alfa demonstrates an improvement in clinical symptoms in all patients with CF and chronic rhinosinusitis. In experimental studies on an animal model, as well as in vitro research on exudate from the middle ear, Dornase alfa has demonstrated high efficacy and safety. Dornase alfa is a drug with high potential, further research is needed for wider use in ENT practice, especially in otiatrics.

[Anatomical factors of temporal bone residual cholesteatoma: our experience]. / Osobennosti stroeniya visochnoi kosti kak faktor retsidiva kholesteatomy: nash opyt.

The article describes clinical cases of invasive cholesteatoma of the temporal bone pyramid, leading to a massive destruction of the surrounding structures. Paying attention to the importance of knowing the microsurgical anatomy of critical structures of temporal bone (the anterior bony plate (cog), the tensor tympani fold and the tendon, the tympanic orifice of the eustachian tube, the pretympanic recess, tympanic sinuses) bearing a significance and helping to improve the removal of the invasive cholesteatoma.

[Microbiome of the external auditory canal and preoperative preparation of patients in otosurgery (literature review)]. / Mikrobiom naruzhnogo slukhovogo prokhoda i predoperatsionnaya podgotovka patsientov v otokhirurgii (obzor literatury).

OBJECTIVE: To analyze the effectiveness of methods of antiseptic and hygienic preoperative preparation of the operating field in otosurgery. MATERIAL AND METHODS: A review and an expert assessment of the corresponding research objectives of scientific publications contained in the PubMed and Google Scholar databases have been carried out. RESULTS: Various studies indicate a lower ototoxicity of 5-10% of the drug povidone-iodine compared to others. Drugs, such as Miramistin, Okomistin, Dioxidine, are actively used in otiatrics in Russia, but no data on their ototoxicity have been noted. The collected data point to the relevance and prospects of studying the microbiome of the external auditory canal, assessing its effect on the course of the postoperative period, depending on various methods of preparation (antiseptic, removal of earwax and hair depilation) of the surgical field for otosurgery.

[Neutrophil extracellular traps in the pathogenesis of chronic rhinosinusitis]. / Neitrofil'nye vnekletochnye lovushki v patogeneze khronicheskogo rinosinusita.

The review presents the current understanding of the pathogenesis of chronic rhinosinusitis. The causes of damage to the mucous membrane of the paranasal sinuses are most often the result of a combination of immunological, infectious and anatomical factors. This indicates the need for a multidisciplinary approach to the study of the pathogenesis of this pathology. There is no single universally recognized classification of chronic rhinosinusitis, which takes into account histological and immunological changes in the mucous membrane of the paranasal sinuses. The discovery of the mechanism of completion of the life cycle of neutrophils - the formation of a neutrophil extracellular trap or NETosis, different from necrosis and apoptosis, opened up new prospects in the study of the pathogenesis of inflammatory processes, including rhinosinusitis. Neutrophil extracellular traps reduce the permeability of the epithelial barrier in the mucous membrane of the paranasal sinuses. This determines their possible role in the etiopathogenesis of rhinosinusitis. In recent years, more and more attention has been paid to the feasibility, effectiveness and safety of therapy that affects the immune component of the inflammatory process, including NETosis. The data obtained in the study of extracellular traps can be used in clinical practice. It is neutrophil extracellular traps that can become a potential target in the treatment of patients with chronic rhinosinusitis.

[The experience of surgical treatment of a patient with a cholesteatoma of the temporal bone pyramid]. / Opyt khirurgicheskogo lecheniya patsienta s kholesteatomoi piramidy visochnoi kosti.

The article describes the clinical case of the cholesteatoma of the temporal bone pyramid, leading to a massive destruction of the surrounding structures. Attention is drawn to the importance of timely diagnosis of this pathology with the use of objective visualization methods to select the optimal surgical approach, which allows to completely remove this formation.

[The experience with the education based at the clinical residency of the Department of Ear, Throat and Nose Diseases, I.M. Sechenov First Moscow State Medical University (on the occasion of the 260th anniversary of the Sechenovsky University)]. / Opyt obucheniia v klinicheskoi ordinature na kafedre boleznei ukha, gorla i nosa Pervogo MGMU im. I.M. Sechenova (k 260-letiiu osnovaniia Sechenovskogo universiteta).

This publication was designed to report the experience gained by the Department of ear, nose and throat diseases at I.M. Sechenov First Moscow State Medical University in the matters concerning professional medical education in the framework of the clinical residency. The main factors that contribute to the adequate shaping of the future ENT-doctor are considered. These include the continuity of generations and conservation of the traditions in the combination with the development of the leading areas of scientific, clinical and educational work.

[Cholesteatoma of the external auditory meatus]. / Kholesteatoma naruzhnogo slukhovogo prokhoda.

This article was designed to present a concise overview of the literature concerning cholesteatoma of the external auditory meatus and to report the original clinical observation of this condition with special reference to the necessity of its early diagnostics and surgical treatment with the use of the combination of simultaneous sanation and reconstruction.

[Our experience with the application of collagen-based preparations in reconstructive surgery of the middle ear].

This paper summarizes our experience with the application of collagen-based preparations for reconstructive surgery of the middle ear. The best morphological results (88.46%) were obtained by the closure of extensive defects with the Oblecolum membrane as a temporary supporting structure and the outer atraumatic dressing for the tympanic transplant (in 30 patients) or by the use of the compact-porous explants from the "Sanguicol" preparation as an overlay on the transplant (in 22 patients). Twenty seven patients presenting with the so-called "operated ear disease" underwent mastoidoplasty with the use of the compact-porous preparation "Stimul-oss" as a supporting structure to induce the ingrowth of the bone tissue and the subsequent substitution of the defect. This treatment ensured the reduction of the volume of the bony trepanation cavity. In addition, we have obtained preliminary encouraging results of the application of collagene preparations for the surgical intervention on the stirrup in the patients suffering otosclerosis.

[Peculiarities of sanitizing middle ear reoperations].

This paper is devoted to the problem of surgical rehabilitation of patients with the so-called <>. Twenty such patients underwent second operation following sanitization ear surgery for the treatment of recurrent (more than once a year) otorrhoea in the previous period. The operation was performed in two (sanitizing and reconstructive) steps. All the patients were allocated to 3 groups based on the results of preoperative examination and the cause of purulent discharge. Group 1 comprised patients with the <> Eustachian tube, group 2 included patients with the carious-granulation process in the mastoidal part of the cavity, group 3 was composed of patients with the both conditions. Reconstructive surgery in patients of groups 1 and 2 included tympanoplasty (n=7). Four patients of group 2 underwent mastoidoplasty with the use of osteotropic material Stimul-oss, and 9 patients were treated by simultaneous tympano- and mastoidoplasty using Stimul-oss blocks. The outcome of surgical treatment in all reoperated patients was regarded as positive taking into account the absence of purulent discharge from the treated ear and the formation of a small self-purifying cavity. Improved hearing was documented in 15 cases. These results give reason to recommend two-step (sanitizing and reconstructive) reoperation to patients with <> using a surgical procedure chosen individually depending on the cause of purulent discharge.