[Disorder of mobility of vocal folds on the background of hypoparathyroidism at patient after subtotal resection of thyroid gland]. / Narushenie podvizhnosti golosovykh skladok na fone gipoparatireoza u bol'noi posle subtotal'noi rezektsii shchitovidnoi zhelezy.

During surgery on the thyroid gland, injury to the recurrent nerve is possible with the development of a clinical picture due to impaired mobility of the vocal fold. A disturbance of the mobility of the opposite vocal fold in the form of a paradoxical spasm may join these manifestations if the parathyroid glands were affected during surgery, followed by a decrease in the level of ionized calcium in the blood. Management of such patients presents certain difficulties. A clinical case of examination and treatment of a patient with bilateral impairment of mobility of the vocal folds resulting from thyroid surgery is presented. The peculiarity of this observation is that because of our treatment, we managed to stop the spasm of one vocal fold, and then restore the mobility of the other vocal fold, due to which a complete restoration of the respiratory and vocal function was achieved.

[Reflectory cough. The causes, diagnostics and the possibilities for the combined treatment]. / Reflektornyi kashel'. Prichiny, diagnostika i vozmozhnosti kompleksnoi terapii.

The main cause of reflectory cough is neurogenic hyperventilation. The clinical signs of reflectory cough include its dry and back-breaking character, the gradual increase and abrupt beginning, impossibility to stop the coughing fit, and the feeling of shortness of breath. The triggers of a coughing attack can be a deep breath, a talk, physical and/or psycho-emotional stress, fatigue, and other sensations. The typical laryngological signs of the condition in question include the broad glottal aperture (up to 20 mm and more in contrast to its normal maximum width of 15 mm) and the spasm of the vocal cords in response to inspiration. The clinic of Diseases of Ear, Throat and Nose affiliated with I.M. Sechenov First Moscow State Medical University has gained the extensive experience with the treatment of more than 500 patients presenting with reflectory cough. All these patients received the combined treatment including 10 procedures for intracutaneous novocaine blockade of the Zakhar'in-Geda zones in the larynx in the combination with auricular reflexotherapy and respiratory gymnastics intended to eliminate hyperventilation and sedative medications and myorelaxants to remove the pathologically enhanced muscle tone as well as calcium-containing preparations if indicated.

[Extended trans-ethmoidal decompression of the orbit for the treatment of frontal sinus mucopyocele]. / Kombinirovannyi khirurgicheskii dostup pri posttravmaticheskom mukotsele lobnoi pazukhi. Klinicheskoe nabliudenie.

Mucocele of the paranasal sinuses is a rare disease not infrequently associated with massive bone destruction, orbital and intracranial complications. The authors report a patient presenting with the giant post-traumatic frontal mucopyocele associated with the erosion of the posterior and inferior sinus walls that was clinically manifested as hypo- and exophthalmos and has caused the inferolateral eye deviation and orbital decompression. The patient displayed the ophtalmological symptoms 8 years after the frontal sinus fracture. The mucopyocele was treated effectively with the combination of the endoscopic trans-ethmoidal and open trans-frontal approaches. The noticeable intraoperative finding in this patient was the absence of complaints as well as the combination of dura mater defects in the form of its erosion and the leakage of the cerebrospinal fluid together with the presence of purulent discharge in the sinus in the absence of intracranial complications.

[A glomus tumour of the bulb of the jugular vein: complications during the postoperative period]. / Glomusnaia opukhol' lukovitsy iaremnoi veny: oslozhneniia posleoperatsionnogo perioda.

The article presents a clinical case that reflects the difficulties of postoperative management of patients after the removal of the jugular glomus tumor.

[Cochlear implantation with cochlear otosclerosis with bilateral deafness. Case from practice]. / Kokhlearnaia implantatsiia u bol'noi s otosklerozom i dvustoronnei glukhotoi. Sluchai iz praktiki.

Rehabilitation of patients with sensorineural hearing loss is an urgent task of otorhinolaryngology. One of the diseases leading to a pronounced hearing loss is the cochlear form of otosclerosis. The article describes a clinical case of rehabilitation of a patient with this pathology by means of cochlear implantation. The classification of otosclerosis based on the interpretation of computer tomography of temporal bones is presented.

[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.

[Eosinophilic Necrotizing Myocarditis Complicated by Myocardial Rupture].

In this female patient eosinophilic myocarditis was complicated by myocardial rupture and hemopericardium with cardiac tamponade. Special features of this case were old age of the patient, fulminant course of the disease, myocardial infarction-like ECG changes, absence of peripheral blood eosinophilia. Presentation is accompanied by discussion of issues of epidemiology, clinical course, diagnostics, and possible causes of eosinophilic myocarditis.

[The modern approach to the conservative treatment of the patients presenting with postoperative bilateral vocal fold palsy]. / Sovremennyi podkhod k konservativnomu lecheniiu bol'nykh s posleperatsionnym dvustoronnim narusheniem podvizhnosti golosovykh skladok.

The objective of the preset study was to further improve the diagnostics and treatment of unilateral palsies of the laryngeal recurrent nerves associated with transitory reflective spasm of the functionally competent vocal fold. The study included 49 patients (46 women and 3 men) at the age varying from 21 to 75 years presenting with unilateral palsies of the laryngeal recurrent nerves associated with transitory reflective spasm of the functionally competent vocal fold that developed after the surgical intervention on the thyroid gland. The electromyographic test for latent tetany was performed for diagnostics and objective evaluation of the results of the treatmen. In addition, the blood ionized calcium levels were measured and videolaryngostroboscopy was used. The treatment included respiratory gymnastics, reflexotherapy (novocaine blockade of the Zakhar'in - Head's zone for the larynx, auricolotherapy, and pharmacotherapy with the prescription of vitamin-calcium preparations, myorelaxants, sedatives, and phonopedia. A loud enough resounding voice was restored in all the 49 participants of the study with the normalization of respiration and the complete cessation (or reduction to a minimum) of the reflexive coughing spells and laryngeal reflex spasms. None of the patients required tracheotomy during the follow-up period.

[Oxidative stress as an indicator of metabolic disorders in the pathogenesis of cerebral stroke]. / Okislitel'nyi stress ­ indikator metabolicheskikh narushenii v patogeneze mozgovogo insul'ta.

AIM: To verify the oxidative stress as an indicator of metabolic disorders in the complex pathogenesis of hemorrhagic and ischemic stroke. MATERIAL AND METHODS: The study included 50 hemorrhagic stroke patients and 50 ischemic stroke patients. A control group consisted of 20 age-matched healthy subjects. In total 12 biochemical parameters, including blood indicators, indicators of free-radical oxidation (ketodiens, diene conjugates, malonic aldehyde, bityrosin, Schiff bases) and endogenous system antioxidant defense (vitamin E, reduced glutathione, total antioxidative activity, superoxide dismutase, glutathione peroxidase, glutathione reductase, catalase) were determined. RESULTS: An increase in free-radical oxidation of lipids and proteins as well as functional imbalance in non-enzymatic and enzymatic links of endogenous antioxidant defense system were found in patients with hemorrhagic stroke and ischemic stroke compared to controls. CONCLUSION: The findings obtained in the study have made it possible to identify two factors in the oxidative stress formation in hemorrhagic and ischemic stroke that will extend the knowledge about the pathogenesis of this severe vascular process.