[The results of the surgical treatment of otosclerosis in the elderly subjects].

The objective of the present study was to evaluate the effectiveness of the surgical treatment of otosclerosis in the subjects of advanced age. The medical histories of 19 patients aged above 65 years (20 ears) presenting with otosclerosis were available for the retrospective analysis. All of them had undergone surgical interventions (a total of 22 ones or 4.49% of the 489 operations performed between 2001 and 2012). The audiometric assessment was made at four wavelengths (0.5, 1, 2, and 4 kHz). Primary surgery (n=18) was preceded by the determination of the high air and bone conductivity thresholds (76.18 dB and 42.15 dB respectively), with the mean bone to air interval (BAI) being 33.99 dB. The surgical treatment resulted in the improvement of hearing; in 83.33% of the cases, BAI was reduced to 10 dB or below this value. It is concluded that the surgical intervention on the stirrup bone for the treatment of otosclerosis in the patients above 65 years of age is a safe and efficacious method despite marked hearing impairment in this group of patients.

[Stapedoplasty in a HIV-infected patient].

This paper reports an observation illustrating the possibility of the successful surgical treatment of otosclerosis in a HIV-infected patient presenting with acquired immunodeficiency syndrome (AIDS) and positive response in the test for hepatitis C. The authors used the results of multispiral computed tomography (MSCT) of the temporal bones as a basis for the prediction of the outcome of the surgical intervention taking into consideration specific primary manifestations of HIV infection as well as immunological and virlogical responses to anti-retroviral therapy.

[The potential of multislice computed tomography for the detection of specific anatomic and topographic features of the facial nerve canal prior to stapedoplasty].

The objective of the present study was to estimate the potential of multislice computed tomography (MSCT) for the detection of specific anatomic and topographic features in the structure of the middle ear and the oval window region prior to stapedoplasty. We analysed the results of MSCT of the temporal bones in 20 patients presenting with otosclerosis (40 observations). All these patients underwent stapedoplasty, and the intraoperative findings were compared with the MSCT data. Specificity and sensitivity of MSCT for the detection of structural abnormalities in the middle ear were estimated at 91.3% and 84.6% respectively. It is concluded that the preoperative MSCT examination of the temporal bones yields the data that allow for the more accurate planning of the succeeding surgical intervention as well as for choosing its optimal strategy and extent, proper instruments, the type and length of the implant (prosthesis), and thereby for avoiding the possible complications and improving the prognosis of the treatment.

[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.

[A case of congenital (juvenile) otosclerosis].

The present paper reports a case of congenital (juvenile) otosclerosis. This pathology is known to occur in 10% of the patients and cause severe hearing impairment. Precise diagnostics of the activity and extent of the otosclerotic process based on the results of functional multispiral computed tomography (MSCT) enables the practicing surgeons to identify indications for the surgical intervention, choose the adequate method and time for its performance, and make prognosis of its outcome. This inference is confirmed by the clinical observation described in this communication.

[A case of successful surgical treatment of labyrinth fistula in the sole hearing ear].

The objective of this communication is to demonstrate success of the surgical intervention on the sole hearing ear in the presence of absolute indications for such treatment, viz. the presence of cholesteatoma and labyrinth fistula (LF). The sensorineural loss of hearing is a rather common serious complication of LF surgery in the patients with cholesteatoma. The present observation concerns a 41 year-old woman with the history of an episode of suppurative otitis media experienced in the childhood. After a period of prolonged remission, she suffered systemic dizziness despite the intact tympanic membranes. The patient was examined with the use of multispiral computed tomography (MSCT) that revealed serious lesions in the middle ear (labyrinth fistula). It made possible careful planning and performing sanation surgery on the middle ear including tympano- and mastoidoplasty. This treatment produced good morphological and functional result.

[Conductive hearing loss caused by eustachian tube dysfunction according to the data of functional computed tomography].

The paper deals with computed tomography (CT) diagnosis of Eustachian tube dysfunction. A functional multislice spiral (MS) CT protocol has been first elaborated for the Eustachian tube. Twenty-three patients with unilateral conductive hearing loss and Eustachian tube dysfunction were examined. The normal functional anatomy of the Eustachian tube was evaluated on the side without evidence of pathology in 23 patients. Functional MSCT showed that the cartilaginous portion of the Eustachian tube opened partially and closed completely in 9 patients. Ten patients were found to have steady changes in the cartilaginous portion of the Eustachian tube. The developed method could confirm the cause of conductive hearing loss and optimally define a treatment policy.

[Functional multispiral computed tomography of sound-transmitting structures in the middle ear].

The objective of this work was to estimate the potential of functional multispiral computed tomography (fMSCT) for the choice and planning of the treatment strategy and the extent of surgical intervention in the patients presenting with fibroosseous diseases of the middle ear associated with the pathologically altered mobility of the auditory ossicles. Studies with the use of MSCT and fMSCT for the examination of temporal bones in 21 patients (25 observations) provided information about normal CT anatomy of the middle ear and a basis for the development of the fMSCT protocol; moreover they allowed the range of mobility of the auditory ossicles to be determined in healthy subjects and patients with middle ear disorders. It is concluded that fMSCT of temporal bones may be recommended to patients suffering otosclerosis, tympanosclerosis, and adhesive otitis media. The use of this technique improves the accuracy of diagnosis and facilitates the choice and planning of the treatment strategy and the extent of surgical intervention in the patients presenting with middle ear diseases.

[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.

[Clinical features, diagnosis, and treatment of facial nerve lesions in the practical work of otorhinolaryngologyst].

Surgical treatment of persistent facial nerve lesions is currently the sole efficacious method for restoration of the voluntary locomotary function of mimetic muscles. Treatment of facial nerve neuropathy of otogenic nature requires a combined approach with surgical revision of the middle ear as its indispensable component including examination of the intrapetrous segment of the facial nerve canal. Facial nerve conductivity and controllable locomotary function of mimetic muscles are possible to restore by anastomosing this nerve with another (donor) one at the earliest possible stages of paresis development. Special importance of remedial gymnastics and its combination with medicamentous treatment in the pre- and postoperative periods is emphasized.

[Vestibular disorders in patients with otosclerosis: prevalence, diagnostic and therapeutic options].

A total of 177 patients with otosclerosis were selected for this study. Vestibular disorders were diagnosed in 40 (22.6%) of them. The patients were allocated to 2 groups comprising 11 and 18 subjects respectively. Patients of group 1 were given surgical treatment during the current hospitalization. Patients of group 2 were treated by conservative therapy following stapedoplasty performed 1 year or more earlier. The study included analysis of vestibular symptoms and evaluation of clinical effectiveness of the combined treatment in the form of therapy with betahistine dihydrochloride (betaserk) during 2 months and a course of 10-12 sessions of game exercises at a stabilographic complex. The patients of both groups enjoyed reduced severity of subjective and objective vestibular symptoms and statistically significant improvement of the equilibrium function assessed from statokinesigrams. It is concluded that combined vestibuloadaptive therapy is an effective method of preparation for stapedoplasty and correction of postoperative complications.

Acoustooptic interaction in science and applications.

Main results of acousto-optic investigations in physical acoustics of solids obtained in Ioffe Physico-Technical Institute during recent yeas are presented. Both monocrystals, and glass alloys of different compositions were used as objects of researches. The studies were fulfilled in wide ranges of optical wavelengths (0.63-10.6 mkm), temperatures (77-400 K) and frequencies (10-1800 MHz) of bulk and surface acoustic waves.

Acousto-electron interaction in InGaAsP/InP laser heterostructures.

The frequency modulation of the heterolaser radiation under the ultrasonic strain has been found out. The dynamic and static analysis of the spectral parameters change caused by the alternating strain has been fulfilled. A model is proposed for describing the experimental data, and their theoretical analysis is performed. It is demonstrated that the acousto-electron interaction is dominant under the action of surface waves in InGaAsP/InP laser heterostructures.

[The use of xenon irradiator in otology]. / Primenenie ksenonovogo obluchatelia v otiatricheskoi praktike.

Xenon irradiator " " (Yakhont-F) has been used in combined treatment of chronic purulent diseases of the external and middle ear in 50 patients. The unit is supplied with flexible multifiber light guides which can operate in the sites not easily accessible for other instruments. Such radiation leads to good bactericidal, antiinflammatory and antiedema effects. In reconstructive and cleansing surgery on the middle ear the transplant retension and epidermization of the postoperative cavity took less time. The technique is proposed for wide otiatric practice.

[Distribution of phage-resistant Pseudomonas aeruginosa strains]. / Raspredelenie fagoustoichivykh shtammov Pseudomonas aeruginosa.

The sensitivity of a number of P. aeruginosa clinical strains to virulent bacteriophages has been studied. Phage-resistant strains have been found to constitute a considerable proportion among the tested P. aeruginosa strains. The strains under study fall into 19 groups differing in their sensitivity to the bacteriophages used in this investigation. The strains belonging to some groups are phenotypically identical to experimentally obtained P. aeruginosa phage-resistant mutants PAO. The use of bacteriophage mutants has made it possible to demonstrate that in most cases the resistance of P. aeruginosa natural strains to type phi k phages is due to disturbances in their adsorption, whereas their resistance to type phi m and phi mn phages is, seemingly, not linked with disturbances in their capacity for adsorption on the cell membranes of the bacteria.