[Experience of laser myringoplasty in children with juvenile ideopathic arthritis]. / Opyt lazernoi miringoplastiki u detei s yuvenil'nym idiopaticheskim artritom.

Surgeons' dissatisfaction with the surgical treatment for tympanic membrane perforations results leads to the constant improvement of the surgical technique and the emergence of new techniques. Difficulties arise in the surgical treatment of rheumatological patients treated with immunosuppressive drugs due to the high potential risk of postoperative complications. The most promising direction in this cohort of patients can be considered the use of laser exposure techniques under endoscopic control. The experience of performing endoscopic laser myringoplasty in 9 children aged from 6 to 16 years (mean age 10±3 years) with tympanic membrane perforation up to 6 mm in diameter and juvenile idiopathic arthritis treated with methotrexate and tocilizumab is presented. The effectiveness of the studied technique in relation to the closure of perforation of the tympanic membrane was 66.7%. Considering that in children, reconstructive ear surgery is considered less effective than in adults, and the presence of chronic systemic rheumatoid disease and immunosuppressive therapy are risk factors for recurrence of perforation after tympanoplasty, these results can be considered successful. The presented method is promising in this cohort of patients for the restoration of small tympanic membrane defects. However, further research is needed.

[Current views on the treatment and prevention of recurrent acute otitis media in children (review of clinical recommendations)]. / Sovremennye predstavleniya o lechenii i profilaktike retsidiviruyushchego ostrogo srednego otita u detei (obzor klinicheskikh rekomendatsii).

Recurrent acute otitis media (RAOM) represents at least 3 or more separate episodes of acute otitis media within 6 months or four or more episodes over a 12-month period. The incidence of recurrent otitis media varies from 5 to 30% and does not tend to decrease. Until now, the questions of conservative and surgical treatment of patients remain unsolved. One of the main methods of treatment is antimicrobial therapy. Recently, the treatment of recurrent otitis media is complicated by the increasing acquired resistance of bacteria to antimicrobial drugs. There is also no consensus on the need for and scope of surgical interventions for children with RAOM. The authors in their article cite existing modern approaches to the prevention and treatment of RAOM in children.

[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.

[Basis of endoscopic dissection of the ear with analysis of endoscopic anatomy. Part 1]. / Osnovy endoskopicheskoi dissektsii ukha s razborom endoskopicheskoi anatomii. Chast' 1.

Today, endoscopic transcanal ear surgery with confident steps is becoming a practice. It will be used by the patient in repeated practice by the surgeon before being used in the patient. It is so important and popular in connection with this dissection work. Working on biomaterial sets itself several tasks: training manual skills to work with an endoscope and an instrument in the middle ear, stage-by-stage training for performing specific interventions, detailed analysis and understanding of structures anatomy and topography. This article presents a step-by-step dissection algorithm with an analysis of the each area anatomical landmarks, like a prototype. Moreover, the course of dissection allows you to work out the performance of type I tympanoplasty.

[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.

[Basis of endoscopic dissection of the ear with analysis of endoscopic anatomy. Part 2.] / Osnovy endoskopicheskoi dissektsii ukha s razborom endoskopicheskoi anatomii. Chast' 2.

Nowadays, endoscopic transcanal otosurgery with confident steps is becoming a practice. Obviously, any new method of intervention needs to be repeatedly tested by the surgeon before it is used on the patient. This is why dissection work is so important and popular. Working on biomaterial sets itself several tasks: training manual skills of working with an endoscope and an instrument in the middle ear cavities, stage-by-stage training for performing specific interventions, detailed analysis and repetition of anatomy and topography of structures. This article presents a step-by-step dissection algorithm with an analysis of the anatomical landmarks of each area, such as the prototype. The proposed training protocol allows practicing such interventions as endaural atticotomy, types of ossiculoplasty, stapedoplasty, decompression of the facial nerve to the geniculate ganglion area, infracochlear and transpromontorial approaches to the internal auditory canal. Keywords: endoscopic otosurgery, transcanal otosurgery, chronic otitis media, otitis media, otitis media in children, otodissection, endoscopic otodissection.

[Prospects of endoscopic otosurgery in children]. / Perspektivy éndoskopicheskoi otokhirurgii u detei.

Active progress in otosurgery opens up new opportunities for minimally invasive surgeries and significantly improves the results of treatment, but a number of problems remain unsolved, including in children. Despite the general positive trend of using the endoscope in otosurgery, in pediatric practice the data are insufficient and extremely contradictory. Literary sources show that, with certain advantages, the existing techniques of endoscopic tympanoplasty are far from perfect and inferior in effectiveness to classical microscopic techniques, which also necessitates further research in this field.

Mechanisms of Erythropoietin-Stimulating Action of Anti-Erythropoietin Release-Active Antibodies in Complex Treatment of Experimental Anemia during Gestation.

We studied the mechanisms of erythropoiesis stimulation and effectiveness of Poetam, a preparation containing release-active anti-erythropoietin antibodies as a supplement treatment for experimental iron deficiency anemia during gestation. The results confirmed potency of combined therapy to stimulate erythropoiesis, which was more efficacious in comparison with monotherapy as assessed by the count of erythrokaryocytes and erythroid progenitors in the hematopoietic tissue as well as by the content of erythrocytes and hemoglobin in the peripheral blood. Activation of erythropoiesis is related to the modulatory effect of Poetam on proliferative activity and differentiation of erythroid precursors, which in most aspects results from stimulatory action of Poetam on secretion of the hematopoietically active factors by adherent elements of the hematopoietic microenvironment.

Pathogenetic Evaluation of Dysfunction in the Erythron System of Experimental Animals during Modeling of Iron Deficiency Anemia in the Gestation Period.

We studied the dynamics of erythropoiesis in CBA mice during gestation against the background of treatment with iron-binding drug. The mechanisms of suppression of the bone marrow erythroid stem were evaluated. Administration of deferoxamine in a dose of 1 g/kg induced hypoplasia of the erythroid hemopoietic lineage. Suppression of bone marrow erythropoiesis manifested in a decrease of hemoglobin concentration and counts of reticulocytes, erythrocytes, and erythrokaryocytes. These changes were accompanied by a decrease in functional activity of erythropoietic precursors and secretion of erythropoietically active humoral factors by bone marrow myelokaryocytes. These data indicate that deferoxamine can be used for modeling of iron defi ciency anemia in pregnancy.

Psychoimmune interactions in women of reproductive age with endometriosis.

Psychoimmune interactions were studied in women of reproductive age with endometriosis. Pronounced immunological shifts manifested in a shift of the T-cellular immunity, resulting in imbalanced production of pro- (IL-1ß, IL-2, IFN-γ) and anti-inflammatory (IL-4) cytokines. Significant correlations between the severity of mental shifts and immunopathogenetic factors in the studied patient population demonstrated the psychoneuroimmune nature of endometriosis.

Complex application of preparation containing ultralow doses of antibodies for the treatment of anemia caused by pubertal uterine bleedings.

Poetam and anaferon (pediatric formulation) administered in combination with iron preparation to patients with anemia induce pronounced positive shifts in metabolic and morphological status of mature erythrocytes: the number of sulfhydryl groups and lipoprotein complexes in cell membranes and dry weight of erythrocytes increased, while the number of forms at different stages of degeneration decreased.

Influence of poetam preparation on the state of autonomic nervous system in patients with severe anemia caused by dysfunctional uterine bleedings.

The use of poetam in the treatment of anemia in patients with dysfunctional uterine bleedings promotes recovery of the major parameters of the tone and reactivity of the autonomic nervous system.

Clinical study of the efficiency of Poetam in the treatment of the anemic syndrome in pubertal uterine hemorrhages.

Clinical study of the efficiency of Poetam (affinity-purified antibodies to recombinant human erythropoietin) in the treatment of anemia in patients with pubertal uterine hemorrhages proved that combined therapy with Poetam and iron preparation normalized erythron parameters, structural and metabolic status of erythrocytes, and ferrokinetic parameters of the peripheral blood sooner than monotherapy with Poetam or sorbifer.