[Age features of the lower nasal passage according to endoscopy in children]. / Vozrastnye osobennosti nizhnego nosovogo khoda po dannym endoskopii u detei.

OBJECTIVE: To study the anatomical features of the lower nasal passage in children in the age aspect by analyzing the results of endoscopic examination of the nasal cavity. MATERIAL AND METHODS: The study included 377 children who did not have otorhinolaryngological and ophthalmological pathologies, as well as congenital anomalies in the architectonics of the nose. The distribution into 4 groups, depending on age, was carried out according to the main provisions of the classification of childhood periods by N.P. Gundobin: the first group - children under 1 year old - 80 (21.2%), the second group - from 1 year to 3 years inclusive - 97 (25.7%), the third group - from 4 to 6 years inclusive - 96 (25.5%), the fourth group (control) - from 7 years and older - 104 (27.6%). All patients underwent endoscopic examination of the nasal cavity using rigid endoscopes with a viewing angle of 0 and 30 degrees, 2.7 mm in diameter, and a fibroscope with an inspection angle of 0 degrees, 2.5 mm in diameter. RESULTS: The data on the features of the development of the lower nasal passage in children were obtained. Changes in such anatomical parameters as the diameter of the lower nasal passage, the location of the distal opening of the nasolacrimal canal and the lower turbinate itself in the nasal cavity are presented. Highlighted the peak age periods of the development of the lower nasal passage in children: the first 6 months, 3-4 years and 7-8 years of a child's life. It was revealed that in children under 6 months of age, the middle turbinates are closely adjacent to the lower ones, which, as a rule, are large, tightly pressed to the bottom of the nasal cavity, and therefore the lower nasal passages are extremely weakly expressed. With growing up, their diameter grows from less than 2.0 mm to an average value of 2.90±0.03 mm, while after 7 years, fully formed volumetric lower nasal passages are already noted. In newborns and children of the first year of life, the mouth of the nasolacrimal duct is as close as possible to the bottom of the nasal cavity, and during growing up it gradually shifts upward (finally settling in the area of the fornix of the lower nasal passage or in the area of transition of the fornix to the lateral wall of the lower nasal passage) and posterior to the anterior the end of the inferior turbinate (up to 4 years old is at a distance of less than 1.0 cm, from 4 to 6 years old - 1.0 cm, from 7 years old - 1.14±0.01 cm). CONCLUSIONS: The data obtained as a result of the study are necessary for an otorhinolaryngologist and an ophthalmologist for a full understanding of the processes of development and course, as well as methods of treating various combined rhinological and dacryological pathologies in children.

[Features of the architectonics of the structures of the nasal cavity and choanal zone in children with congenital malformations of the eyes]. / Osobennosti arkhitektoniki struktur polosti nosa i khoanal'noi zony u detei s vrozhdennymi porokami razvitiya glaz.

The article provides data on the embryogenesis of the eyeball, nasolacrimal canal and nasal cavity. A frequent combination of congenital choanal atresia and anomalies in the development of the eyes was noted, most likely associated with the temporal and topographic parallelism of the intrauterine development of these anatomical areas. In order to assess the condition of the nasal cavity and choanal region in congenital eye pathology, 43 children with ophthalmological malformations were examined. In 32 (74.4%) children, according to endoscopic examination, changes in the anatomy of the choanal region with a change in its size in the form of incomplete atresia were revealed. The results obtained allow the authors to recommend that all children with congenital ophthalmological malformations be examined and monitored by an otolaryngologist with an endoscopic examination of the nasal cavity and nasopharynx.

[Paracentez]. / Paratsentez.

In this article, we present the analysis of the data of the specialized literature and the results of our own observations on the use of paracentesis in the treatment of acute suppurative otitis media. We highlight a method for diagnosing acute otitis media, which makes it possible to determine the rational algorithm of treating this disease - digital videootoscopy. Common methods of procedures aimed at draining the tympanum in acute purulent otitis media, such as tympanic membrane puncture, myringotomy, tympanostomy, tympanocentesis, and the differential approach to these methods of surgical treatment of the disease are discussed. The very concept of paracentesis is specified, the history of this surgical intervention is presented. Authors described the technique and features of paracentesis, a number of indications for its implementation, possible complications of surgical intervention and their causes. The risk of developing a chronic pathological process after the use of paracentesis or, conversely, due to the rejection of this manipulation during acute inflammation in the middle ear is assessed.

[The application of digital video-otoscopy for diagnostics of various forms of otitis in the children]. / Tsifrovaia videootoskopiia v diagnostike razlichnykh form otita u deteĭ.

Digital video-otoscopy (DVO) is one of the modern high-tech methods for otiatric diagnostics that allows to enlarge the image of the area being examined, i.e. the otoscopic picture. DVO has been shown to facilitate the objective dynamic observation of the clinical course of the disease by means of photo- and videodocumentation of he changes in the tympanic membrane and other otoscopicstructures. The DVO technique makes it possible to substantially improve the quality of diagnostics, detect the middle ear conditions at the early stagesof their alteration, and choose the optimal strategy for the continued conservative and/or surgical treatment.

[Exacerbation of chronic suppurative otitis media in the childhood].

Chronic suppurative otitis media has for many years remained one of the most serious forms otorhinolaryngological pathology in the children since its exacerbation may lead to the life-threatening extra- and intracranial complications. This disease is a most frequent cause of the loss of hearing in the childhood. The present paper is designed to present the analytical review of the relevant literature publications and compare its results with the original observations of the authors. Special attention is given to the etiopathogentic, therapeutic, and diagnostic aspects of exacerbation of chronic inflammatory pathology of the middle ear in the children. The most challenging problems of prophylaxis of this disease are discussed along with the available approached to their solution with the use of moderm methods for its diagnostics, conservative and surgical treatment.