[Obliteration of the middle ear cavity in children: the current state of the problem and our first experience]. / Obliteratsiya polostei srednego ukha u detei: sovremennoe sostoyanie problemy i nash pervyi opyt.

Chronic otitis media is one of the most common ear pathologies among children. This article provides a short overview of publications on surgical techniques. Currently, the most effective treatment is the surgical sanitation of the middle ear cavities. There are two fundamentally different approaches of operations in relation to the posterior wall of the external auditory canal - «open¼ and «closed¼ types. Both methods have their advantages and disadvantages, which are especially noticeable in pediatric revision otosurgery. Surgical obliteration of the sanitized middle ear cavities is an effective compromise option. However, the techniques of bone obliteration, which are actively applied among adults, are difficult if we discuss children ear. A way out of this situation may be the use of modern osteoplastic materials for filling large trepanation cavities. The article describes in detail the technique of revision sanitizing surgery on the middle ear using osteoplastic granules. Purpose of the study. The analysis of the first results of separate obliteration of paratympanic cavities in children using osteoplastic materials. MATERIAL AND METHODS: In the period from May 2018 to November 2020, on the basis of the Federal State Autonomous Institution «National Medical Research Center of Children's Health¼ of the Ministry of Health of Russia, 28 children aged from 6 to 17-year-old with chronic otitis media and cholesteatoma were operated using osteoplastic obliteration, who had previously sanitizing operation on the middle ear. All children on admission to the hospital and 6-12 months after the operation underwent a complex examination. The condition of each patient was assessed using the OMO-22 quality of life questionnaire, to which the parents answered the questions twice - before and 1 year after surgery. RESULTS: During the postoperative period none of the patients had clinical signs of recurrence of cholesteatoma, which was confirmed by CT scan. When assessing the quality of life of children using a questionnaire, the average score before the operation was 130.2±27.7, after the operation - 61.5±21.1. The indicator of the bone-air interval before surgery in patients averaged 29.8±9.7 dB, 1 year after surgery - 13.0±10.9 dB (p>0.05). FINDINGS: The first experience of using osteoplastic materials for obliterating the paratympanic spaces in children has shown high efficiency, ease of use and safety.

[Analysis of current diagnostic and treatment approaches for acute rhinosinusitis according polyclinics data of the outpatient service of Administrative Directorate of the President of the Russian Federation]. / Analiz sovremennykh skhem diagnostiki i lecheniya ostrogo rinosinusita po dannym ambulatornoi sluzhby poliklinik Upravleniya delami Prezidenta RF.

Acute rhinosinusitis is one of the most common outpatient diseases. The duration of antibiotic therapy in practice can be a cause of disagreement. The latest European guideline for rhinosinusitis EPOS 2020 does not specify clear terms for antibacterial therapy for acute bacterial rhinosinusitis, which suggests that they are determined by the attending physician based on the rate of regression of clinical manifestations in each specific clinical case. OBJECTIVE: To analyze the treatment regimens of adult patients with acute rhinosinusitis in the system of the outpatient service of Administrative Directorate of the President of the Russian Federation in Moscow and compare these schemes with guidelines. MATERIAL AND METHODS: A retrospective analysis of 2267 outpatient disease histories of patients who were on outpatient treatment with a diagnosis of acute rhinosinusitis treated by otorhinolaryngologists from 7 ambulance clinics for the period from January 2016 to May 2018 was performed. Diagnostic methods and treatment regimens of these patients were evaluated. RESULTS: At the diagnostic stage, X-ray methods were recommended in 87% of cases, and ultrasound examination of the paranasal sinuses was performed in 4% of cases. Elimination and irrigation therapy was prescribed in 88.05% of cases (1996 people), maxillary sinus punctures were performed in 9.82% of cases, the average number of procedures was 2±1.3, treatment by displacement was performed in 31.8% of patients, the average number of procedures was 3±1.2. Antibiotic therapy was recommended in 77.4% of cases (1755 people), penicillin group drugs were prescribed in 41.5% of cases, macrolides in 30.5% of cases, cephalosporins in 20.7% of cases, and fluoroquinolones in 7.3% of cases. Intranasal glucocorticosteroids were submitted by 67.7% of patients (1535 people), mucolytics and mucoregulatory drugs - 41% of patients, decongestants for acute rhinosinusitis were recommended in 60.9% of cases, antihistamines - in 36.8% of cases. An average course of antibacterial therapy was 5.9±1.34 days, the recovery of the patients was observed on the background of complex treatment. CONCLUSIONS: In general, in the system of the outpatient service of Administrative Directorate of the President of the Russian Federation, diagnostic and therapeutic measures are carried out in accordance with current clinical recommendations. There is a fairly high percentage of prescribing macrolides (30.5%) and fluoroquinolones (7.3%) in starting therapy, which is a violation of the principles of starting antibacterial therapy.

[Surgical treatment of chronic otitis media in children using three-dimensional imaging]. / Khirurgicheskoe lechenie khronicheskogo srednego otita u detei s ispol'zovaniem trekhmernoi vizualizatsii.

The introduction of three-dimensional exoscopy has opened a new stage in microsurgery in recent years. Researchers from various specialties give mostly positive reviews. There are very few works on the use of three-dimensional imaging in otorhinolaryngology, and there are practically no such works on otosurgery. This article presents a short review of publications and our own clinical examples, which are the first detailed description of VITOM 3D KARL STORZ exoscope use for cholesteatoma surgery in children, published in the available world literature. The first experience allowed us to draw preliminary conclusions about the comparability of this method of intraoperative imaging with a microscope. In addition, we have identified additional benefits of the exoscope. Further research will make it possible to better adapt the technique to the peculiarities of otosurgery, and it should take its place in the arsenal of ENT surgeons, along with microscopy.