[Closing of nasal septum perforation using adipose stromal vascular fraction: an experimental study]. / Zakrytie perforatsii peregorodki nosa s primeneniem stromal'no-vaskulyarnoi zhirovoi fraktsii: eksperimental'noe issledovanie.

Nasal septal perforation (NSP) is a complex problem in otorhinolaryngology, which leads to impaired nasal breathing and dryness in the nose. This reduces the patient's quality of life and leads to psychological discomfort. The treatment of nasal septum perforation is selected taking into account the clinical manifestations, perforation parameters and general condition of the patient. Currently, a large number of different surgical methods have been described in order to closing the defect of nasal septum. To date, there is no universally accepted method for closing NSP, which stimulates the search and development of new treatment options. OBJECTIVE: Under experimental conditions, to study a new method for closing nasal septum perforation using a collagen scaffold together with adipose stromal vascular fraction containing multipotent mesenchymal stromal cells. MATERIAL AND METHODS: The experiment was carried out on a model of nasal septum perforation in 24 male rabbits divided into four groups, depending on the construct, implanted into the defect zone: the 1st group was the control group - without the introduction of implantation material; the 2nd group - collagen scaffold without adipose stromal vascular fraction; the 3rd group - collagen scaffold with xenogenic adipose stromal vascular fraction; the 4th group - collagen scaffold with allogeneic adipose stromal vascular fraction with further dynamic evaluation of endoscopic control on day 14, after 1 month, 3 months, and 6 months. At month 6, the animals were removed from the experiment, followed by morphological examination in color with hematoxylin and eosin, as well as safranin and methyl green. RESULTS: As a result of the experiment using adipose stromal vascular fraction of allogeneic and xenogenic origin, closing of perforation of the nasal septum of a rabbit for 3 months of dynamic endoscopic control, as well as according to morphological research, was demonstrated. CONCLUSION: Our study showed that the use of adipose stromal vascular fraction containing not only endothelial cells and pericytes, but also multipotent mesenchymal stromal cells in combination with a collagen scaffold closes the perforation of the nasal septum in a rabbit, without increasing the risk of violations of habitual vital activity.

[A comparative study of the effectiveness of azoximer bromide and surgery on the quality of the life of patients with chronic rhinosinusitis without nasal polyps]. / Sravnitel'naya otsenka vliyaniya azoksimera bromida i khirurgicheskogo lecheniya na kachestvo zhizni patsientov s khronicheskim rinosinusitom bez polipov.

OBJECTIVE: The aim of this study was to compare the effects of azoximer bromide and surgery on the quality of life of patients with chronic rhinosinusitis (CRS) without polyps. We also wanted to examine changes in the patient's emotional state and the nature of their complaints. MATERIAL AND METHODS: The results of using the Visual Analogue Scale (VAS) and the Sino-Nasal Outcome Test-22 (SNOT-22) questionnaire in patients with CRS without severe or moderate-severe polyps, before treatment and 3 months after treatment, are presented. Patients, depending on their choice, were treated with functional endoscopic intervention or a course of 6 mg/ml azoximer bromide (1 ml per day, a course of at least 10 days). RESULTS: The median [interquartile range] score for VAS in patients before azoximer bromide treatment was 6.7 [6.3; 7.05] points, after treatment 4.2 [3.50; 4.70] points. The median [interquartile range] of VAS scores in patients before surgical treatment was 6.4 [6.1; 6.9] points, and after 4.8 [4.50; 5.30] points. The median [interquartile range] of the SNOT-22 score before azoximer bromide treatment was 33 [32; 36] points, after treatment - 24 [22; 25] points. The median [interquartile range] of the SNOT-22 score before surgery was 34 [32; 36] points, after treatment - 19 [18; 21.25] points. CONCLUSION: Azoximer bromide treatment and surgery improve the quality of life of patients with CRS (according to the visual analog scale and all SNOT-22 domains) during a control survey after 3 months (p<0.001). Surgical treatment has a stronger impact on the quality of life, which is more noticeable in the influence on the domains "Rhinological symptoms", "Extranasal symptoms", "Ear/facial symptoms" (p<0.05). According to the domains "Psychological dysfunction", "Sleep dysfunction", surgical intervention had no advantages in affecting the quality of life, compared with taking azoximer bromide (p<0.05).

[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 usage of modern herbal medicinal product in the treatment of patients with acute viral rhinosinusitis]. / Vozmozhnosti primeneniya sovremennogo rastitel'nogo lekarstvennogo preparata v lechenii patsientov s ostrym virusnym rinosinusitom.

INTRODUCTION: The issues of epidemiology, etiopathogenesis, diagnostics and clinic of acute catarrhal rhinosinusitis are considered, the possibility of using the herbal medicinal product Sinupret extract in the treatment of patients with acute viral rhinosinusitis is substantiated. OBJECTIVE: To evaluate the efficacy and safety of using the drug Sinupret extract in patients with acute viral rhinosinusitis. MATERIAL AND METHODS: A comparative study of the efficacy and safety of clinical use in patients of the drug Sinupret extract in patients with acute viral rhinosinusitis was carried out in comparison with symptomatic treatment. RESULTS AND DISCUSSION: After analyzing and processing the results obtained using statistical methods for the main group, a faster rate of decrease in the severity of complaints (data with the use of the MSS visual analogue scale), the severity of inflammation in the nasal cavity and nasopharynx, the amount of discharge from the nose and its viscosity were confirmed. Restoration of respiratory function according to rhinomanometry and mucociliary transport according to the results of the saccharin test also occurred more quickly in patients of the main group compared to the control group. The effectiveness of using Sinupret extract is also confirmed by the results of photoplethysmography. CONCLUSIONS: The use of the drug Sinupret extract not only contributes to a more rapid improvement in the general well-being of patients and a decrease in the severity of complaints, but also leads to an improvement in the objective picture of the disease (rhinoscopy, the results of anterior active rhinomanometry, saccharin test) compared with the control group, favorably affects the quality life of patients, causes a decrease in economic and social costs against the background of the development of acute viral rhinosinusitis.

[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.

[Application of new technologies in postgraduate education of otorhinolaryngologists]. / Primenenie novykh tekhnologii v poslediplomnom obrazovanii vrachei-otorinolaringologov.

The article is devoted to one of the urgent problems of modern medical education - postgraduate education, further development of skills and deepening of knowledge among otorhinolaryngologists after training in clinical residency. The long-term experience of training in advanced training cycles for both otorhinolaryngologists beginning their professional path and doctors with a long, decades-long work experience in the specialty is analyzed. The trajectory of professional development is presented, which allows structuring the acquired knowledge, distributing the stages of training over time, taking into account the priorities of students and combining training with the exchange of experience and personal communication with colleagues. The problems and the most promising directions of the development of postgraduate education of otorhinolaryngologists are considered.

[Transnasal endoscopic orbital decompression in the algorithm of surgical treatment of endocrine ophthalmopathy]. / Transnazal'naya endoskopicheskaya dekompressiya orbity v algoritme khirurgicheskogo lecheniya endokrinnoi oftal'mopatii.

OBJECTIVE: To develop an algorithm for the use of transnasal endoscopic orbital decompression (TEOD) in endocrine ophthalmopathy (EOP). MATERIAL AND METHODS: The results of 225 TEODs are analyzed. 139 patients with EOP were under observation, who were divided into two groups. Group 1 included 64 patients with an inactive form of EOP, group 2 included 75 patients with EOP complicated by optical neuropathy. Group 2 patients are divided into three subgroups. In the first subgroup there were 36 patients who underwent only TEDO, in the second subgroup there were 17 patients who underwent simultaneous TEOD and lateral bone orbital decompression (LBOD), in the third subgroup there were 22 patients who underwent TEOD and with an interval of 7-14 days - LBOD. After surgery, visual acuity, visual fields and color perception, regression of exophthalmos, as well as the presence of strabismus and diplopia were evaluated. RESULTS: In patients of group 1 (64 patients, 104 TEODs), the average regression rate of exophthalmos was 5.49±1.22. Diplopia was observed in 23 (36%) patients, strabismus - in 18 (28%) patients. The transient nature of diplopia and strabismus was noted in 11% of cases. Patients of the first subgroup showed an increase in visual acuity from 0.4±0.28 to 0.7±0.2 (p<0.05). Strabismus and diplopia were observed in 54% of cases. In the subgroup with step-by-step performed TEOD and LBOD, the increase in visual acuity was more pronounced and amounted to 74% (from 0.78±0.71 to 0.2±0.3 according to LogMAR, p<0.05), postoperative strabismus and diplopia remained at a high level - 40% of the number of surgical operations performed. The best results of improving visual functions were obtained in patients of the second subgroup with simultaneous TEOD and LBOD (balanced orbital decompression): the increase in visual acuity was 79% (from 0.57±0.47 to 0.12±0.2 according to LogMAR, p<0.05). In patients of this subgroup, strabismus develops less frequently (22% of the number of operated orbits). CONCLUSION: Transnasal endoscopic decompression of the orbit in the inactive form of the disease is indicated for exophthalmos of more than 4-8 mm. In optical neuropathy, transnasal endoscopic orbital decompression is indicated regardless of the initial visual acuity of the patient and should be supplemented with lateral bone orbital decompression with visual acuity below 0.1. The obtained results allowed us to form an algorithm for surgical treatment of patients with endocrine ophthalmopathy and optical neuropathy using transnasal endoscopic orbital decompression as a surgical intervention.

[Optimization of an integrated approach to voice correction for endocrinopathies (analytical review)].

Dysphonia is a symptom of many endocrine pathologies. Hoarseness, voice fatigue, decrease of the voice pitch, reduce of the range are typical complaints for hypothyroidism, caused by an increased amount of polysaccharides and accumulation of fluid in the lamina propria of the vocal folds. An excess of growth hormone causes an overproduction of insulin-like growth factor-1, which leads to abnormalities in the craniofacial region and proliferation of the upper respiratory tract tissues, including thickening of the laryngeal cartilages, vocal folds and decreasing of the voice pitch. Hyperglycemia, changes in the balance of fluid and electrolytes in diabetes mellitus can indirectly affect the voice: xerostomia complicates phonation due to impaired hydration of the laryngeal mucosa, diabetic neuropathy often disrupts the work of the laryngeal muscles involved in voice formation. Voice changes are observed not only in endocrine disorders, but also during puberty, the phases of the menstrual cycle and during menopause. Laryngeal structures are modified under the influence of hormones and external factors, which generally changes pitch and intensity of the voice, timbre and resonance, articulation and prosodic characteristics. The purpose of this review is to summarize and systematize data on physiological and pathological voice changes in patients of different age groups and sex. The possibilities of a multidisciplinary approach to rational voice correction are demonstrated.

[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.

[Improving of the nasal cavity mucous membrane restoration efficiency of the after rhinosurgical interventions]. / Primenenie irrigatsionnoi terapii posle khirurgicheskikh vmeshatel'stv v polosti nosa.

The article discusses aspects of the use of irrigation therapy after surgical interventions on intranasal structures, in particular, the features of using the Aqua Maris Leyka device in comparison with traditional methods of nasal cavity care in this group of patients. The use of the Adriatic Sea salt solution for nasal lavage Aqua Maris using a special device in the postoperative period leads to an earlier subsidence of reactive postoperative changes in the nasal cavity, a decrease in edema, an increase of reparative processes. This is evidenced by the dynamics of clinical signs and the results of cytological examination of smears-prints from the nasal cavity. During the irrigation of the nasal cavity using the Aqua Maris Leyka device, the liquid is supplied by gravity, without additional pressure, ensuring safety and uniform irrigation of all parts of the nasal cavity with saline solution, which is especially important in the presence of reactive changes in the postoperative period.

[Clinical significance of radiological methods for diagnosing endolymphatic hydrops in Ménière's disease]. / Klinicheskaya znachimost' luchevykh metodov diagnostiki endolimfaticheskogo gidropsa pri bolezni Men'era.

Ménière's disease is a chronic disorder of the inner ear, a permanent sing of which is endolymphatic hydrops. For the diagnosis of Ménière's disease in clinical practice, criteria that are primarily based on the clinical picture. However, instrumental methods for diagnosing Ménière's disease, aimed at identifying endolymphatic hydrops, continue to be developed and improved. Radiation diagnostics contribute significant contribution and aimed at identifying the characteristic signs of Ménière's disease. Recently, it has become possible to visualize endolymphatic hydrops using MRI of the temporal bones. This publication presents an analysis of the current state of this topical aspect of the problem of diagnosing Ménière's disease. The purpose of this review is to conduct a comparative analysis of radiation methods for diagnosing Ménière's disease. MATERIAL AND METHODS: The study included publications in English and Russian found in the PubMed, eLibrary database related to the diagnosis of Meniere's disease. RESULTS: A comparative analysis of computed tomography of the temporal bones, magnetic resonance imaging of the temporal bones and diagnostic possibilities for detecting signs characteristic of Ménière's disease are presented. The most diagnostically significant method of studying Ménière's disease is identified. CONCLUSION: MRI of the temporal bones with contrast enhancement is a promising method that can be used to develop an effective treatment algorithm.

[Role of topical antibacterial therapy in patients with cystic fibrosis]. / Rol' mestnoi antibakterial'noi terapii u patsientov s mukovistsidozom.

Cystic fibrosis (cystic fibrosis) is an important medical and social problem. The main clinical manifestations that determine the prognosis and outcome of this disease are changes in the respiratory and digestive systems. In recent years, there has been an understanding of the importance of assessing pathological changes in the nasal cavity and paranasal sinuses in patients with cystic fibrosis. RESEARCH OBJECTIVES: Assess the efficacy of topical antibacterial therapy in adult cystic fibrosis patients after surgery on nasal cavity structures and paranasal sinuses. MATERIAL AND METHODS: In the clinic for ear, nose and throat diseases at Sechenov University, 46 adult patients with cystic fibrosis and chronic rhinosinusitis were observed; all patients underwent extended endoscopic polysinusotomy. According to clinical studies, Isofra nasal spray is highly effective and safe in the treatment of patients with infectious diseases of the nasal cavity, nasopharynx and paranasal sinuses. FINDINGS: The use of Isofra nasal spray (the active ingredient is framycetin sulfate) in our clinic in patients with cystic fibrosis against the background of basic therapy (inhalation with bronchodilators and mucolytics, intranasal topical steroids), had a positive effect on the microbial landscape in the nasal cavity in patients with cystic fibrosis in the postoperative period and allowed to reduce the need for the appointment of systemic antibacterial drugs.

[Modern aspects of inflammatory external ear diseases treatment]. / Sovremennye aspekty lecheniya vospalitel'nykh zabolevanii naruzhnogo ukha.

The article deals with the problem of inflammatory diseases of the external ear. A review of pruritic dermatoses of the external auditory canal was carried out. It has been shown that in chronic dermatoses, the contamination of the skin with bacterial and fungal pathogens significantly increases, which leads to a high risk of developing secondary infectious pathological processes. Treatment of dermatological inflammatory ear diseases includes careful daily hygiene of the external auditory canal and pharmacotherapy, a key aspect of which is the use of topical etiotropic, anti-inflammatory, and symptomatic drugs. The advantage of the combined drug candiderm is described, which, thanks to the unique combination of beclomethasone, gentamicin and clotrimazole in the composition, effectively relieves the symptoms of external ear dermatoses.

[Method of endonasal endoscopic dacryocystorhinostomy with plastic stoma formation]. / Metod plasticheskogo formirovaniya stomy pri endonazal'noi endoskopicheskoi dakriotsistorinostomii.

The article presents modern methods of surgical treatment of chronic dacryocystitis, a brief historical review of various options for endonasal endoscopic dacryocystorhinostomy is carried out. The method of plastic seamless formation of dacryocystostomy, which does not require intubation of the lacrimal passages and/or using of silicone stoma dilators, is described. Between 2010 and 2019 at The State Budgetary Healthcare Institution of Moscow Area Moscow regional research clinical institute n.a. M.F. Vladimirskiy, according to the developed technique, 32 patients (32 eyes) with chronic dacryocystitis were operated on. According to the results of observation 1 year after surgical treatment, all 100% of patients recorded a positive result (absence or significant decrease in lacrimation, good anatomical visualization of dacryocystostomy with a good tear passage, both passive and during washing the lacrimal passages).

[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.

[Resolution of the Council of Experts «Bioregulatory drugs in the complex treatment of common ENT diseases¼]. / Rezolyutsiya Soveta ekspertov «Bioregulyatsionnye preparaty v kompleksnoi terapii rasprostranennykh LOR-zabolevanii¼.

Within the framework of the III All-Russian scientific and practical conference of otorhinolaryngologists, audiologists, somnologists and maxillofacial surgeons with international participation, a meeting of experts in the field of ENT diseases was held with the support of Heel RUS LLC, October 17-18, 2019, Kazan.

[Argumentation for use of laser fluorescence spectrometry in identification of inflammatory diseases of pharynx]. / Obosnovanie primeneniya lazerno-flyuorestsentnoi spektrometrii v identifikatsii vospalitel'nykh zabolevanii glotki.

OBJECTIVE: The article demonstrates the experience of using laser fluorescence spectrometry (LFS) in the diagnosis of inflammatory diseases of pharynx, describes a method for recording spectra of pharyngeal tissues using the EnSpectr L405 hardware-software complex operating on the basis of laser radiation with a wavelength of 405 nm, and identifies characteristic features of spectral curves. PATIENTS AND METHODS: The authors presented the characteristics of the spectra from the surface of the pharynx tissue of healthy volunteers, patients with chronic tonsillitis and granular pharyngitis. RESULTS: The most informative parameters of the spectral curves were calculated, analyzing which it is possible to identify the morphometric, metabolic, functional features of the tissue of the tonsils and posterior pharyngeal wall in normal and pathological conditions. CONCLUSION: The article illustrates the importance of developing highly sensitive and highly specific methods for the rapid diagnosis of inflammatory diseases of the pharynx. The presented technology can be used in clinical practice in future.

[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.