[Features of sleependoscopy in children]. / Osobennosti slipendoskopii v detskom vozraste.

OBJECTIVE: To describe the technique and determine the indications for sleep endoscopy in children. MATERIAL AND METHODS: This study included 35 children, the average age of 5 years 1 month ± 3 years 4 months (from 1 year 6 months to 14 years 5 months). All children underwent standard polysomnography and sleep endoscopy. RESULTS: According to polysomnography, severe obstructive sleep apnea (OSA) was diagnosed in 21 children, moderate - in 8 children and mild - in 6 children. Sleep endoscopy revealed that in most cases in unoperated children (about 70%), adenoids and palatine tonsils were the cause of obstruction. In the group of children, who previously underwent surgery for OSA, the causes of residual apnea more often were soft palate and palatine tonsils. In 5 of 8 children, tonsils pharyngoscopy size did not exceed the 1st degree. In 1 child after adenotonsillectomy, the hypertrophic tori tubarii were the cause of obstruction. Another rare cause of upper airway obstruction, lingual tonsil hypertrophy, was found in 2 primary patients. CONCLUSION: Sleep endoscopy is a safe and useful method that makes it possible to determine the level of obstruction in children and to plan the optimal amount of surgical treatment.

[The possibility of using tranexamic acid for the treatment of bleeding in otorhinolaryngology].

This article is focused on the analysis of the literature publications pertaining to the problem of bleeding in otorhinolaryngology. It reports the epidemiological data on the structure of bleeding and the main methods used to arrest it. Special attention is given to the possibilities of application of tranexamic acid as an effective hemostatic agent not only for systemic but also for topical administration.

[The silent sinus syndrome in the patients presenting with the uncinate process apposed to the orbital wall].

The objective of the present study was to analyze the frequency of the silent sinus syndrome (SSS) based on the results of computed tomography of the paranasal sinuses (PNS) in the patients presenting with the uncinate process (UP) apposed to the orbital wall. The study included 35 patients with the uncinate process apposed to the orbital wall who had been operated in the Clinic of ENT Diseases of I.M. Sechenov First Moscow State Medical University. The examination of the nasal cavity with the use of computed tomography and PNS endoscopy revealed the silent sinus syndrome in 14 patients. Ten of them had endoscopically confirmed type 2 hypoplasia of maxillary sinuses (MS). This finding suggests the necessity of computed tomography of paranasal sinuses in the patients with this condition in order to exclude the diagnosis of silent sinus syndrome even in the absence of exophthalmos. All the patients included in the present study underwent endoscopic surgery on maxillary sinuses that resulted in the adequate widening of the ostium and comprehensive sanation of the sinuses.