[The algorithm of the treatment and diagnostic strategy for the treatment the children presenting with acute mastoiditis]. / Algoritm lechebno-diagnosticheskoi taktiki lecheniia detei s ostrym mastoiditom.

This article was designed to report the results of the analysis of the cases of chronic otitis media complicated by mastoiditis in the children admitted to the Morozovskaya City Children's Clinical Hospital for the examination and treatment during the period from 2009 till 2017. The objective of the present study was to evaluate the clinical significance and the optimal time schedule of computed tomography (CT) of the temporal bones in the patients with suspicion of mastoiditis for the determination of the indications for their surgical treatment. All the patients were divided into three groups differing in the severity of clinical manifestations of the disease. A special algorithm of the treatment and diagnostic strategy was developed for the management of the patients included in each group that made possible the structured approach to the choice and performance of the treatment and diagnostic procedures.

[Acute otitis media in a 5 year-old child complicated by mastoiditis and abscess of the temporomandibular joint]. / Ostryi srednii gnoinyi otit u rebenka 5 let, oslozhnivshiisia mastoiditom i abstsessom visochno-nizhnecheliustnogo sustava.

This article was designed to report a case of otogenic abscess of the temporomandibular joint in a 5 year-old child. The specific feature of this observation is a rare complication of acute otitis media (otogenic abscess of the temporomandibular joint). Of crucial importance for the establishment of the correct diagnosis was the timely evaluation of the state of the temporomandibular bones by means of CT examination.

[The influence of an isotonic solution containing benzalkonium chloride and a hypertonic seawater solution on the function of ciliary epithelium from the nasal cavity in vitro].

The objective of the present study was to evaluate the influence of an isotonic saline solution containing benzalconium chloride and of a hypertonic seawater solution on the function of ciliary epithelium in the nasal cavity in vitro. To this effect, we investigated the cytological material obtained from 35 children presenting with adenoid tissue hypertrophy. The tissue samples were taken from the nasal cavity by the standard method. A cellular biopsy obtained from each patient was distributed between three tubes that contained isotonic saline solution supplemented by benzalconium chloride (0.1 mg/ml), a hypertonic seawater solution, and a standard physiological saline solution. It was shown that the number of the viable cells in both isotonic solutions was statistically comparable and significantly higher than in the hypertonic solution (p<0.05). The ciliary beat frequency of the cells embedded in the two isotonic solutions was not significantly different but considerably exceeded that in the hypertonic seawater solution (p<0.05). Thus, the present study has demonstrated the absence of the ciliotoxic influence of isotonic saline solution containing benzalconium chloride at a concentration of 0.1 mg/ml and the strong ciliotoxic effect of the hypertonic seawater solution. This finding gives reason to recommend isotonic solutions for the regular application whereas hypertonic solutions can be prescribed only during infectious and/or inflammatory ENT diseases.

[Balloon dilatation of the cartilaginous portion of the Eustachian tube in the children presenting with relapsing exudative otitis media].

The objective of the present study was to evaluate the effectiveness and the safety of balloon dilatation of the cartilaginous portion of the Eustachian tube in the children presenting with relapsing exudative otitis media. A total of 15 children (22 ears) at the age from 3 to 16 years suffering from relapsing exudative otitis media over 18 months in duration were available for the examination. Neither conservative nor surgical treatment produced any stable beneficial effect in these patients. Acoustic impedancometry yielded type B tympanograms. All the children were treated with the use of balloon dilatation of the cartilaginous portion of the Eustachian tube under endotracheal anesthesia. The follow-up examination carried out within 6--8 weeks after the treatment revealed the complete recovery of the function of the middle ear (type A tympanograms) in 11 (73.3%) children. Partial restoration of this function (as evidenced by type C tympanogram) was documented in 4 children. These patients underwent the second course of conservative therapy that resulted in the complete restoration of the function of the middle ear. It is concluded that balloon dilatation of the cartilaginous portion of the Eustachian tube in the children presenting with relapsing exudative otitis media provides the efficient and safe approach to the management of this condition. Being a minimally invasive method, it has good prospects for the practical application and is worth further investigation.

[Congenital parotid gland fistula in the children: diagnostics and surgical treatment].

The objective of the present study was to improve diagnostics and surgical treatment of congenital parotid gland fistulae. It involved 86 children presenting with this defect at the age varying from 4 months to 17 years who were admitted to the Department of Otorhinolaryngology of the Morozovskaya City Children's Clinical Hospital during the period from 2010 till 2014. It was shown that parotid fistula suppuration is an absolute indication for the surgical treatment of such children regardless of their age. The proposed diaphanoscopic technique was shown to produce good results and can be recommended for both diagnostics an intraoperative visualization of the fistulous passage.

[Apical petrositis, osteomyelitis of the base of the skull bones and of the first cervical vertebra in a 5 year-old children following chicken pox].

This publication was designed to describe a rare case of development of apicalpetrositis in a child presenting with acute otitis mediafollowing chicken pox experienced in the preceding period. We carried out the study with the use of computed tomography (CT) that demonstrated destruction of the temporal bone, bones of the base of the skull and of the first cervical vertebra. The treatment strategy chosen for the management of this condition that included antibiotic therapy and expectant observation proved justified and can be recommended as an algorithm of choice taking into consideration the difficulty of surgical approach to the apex of the petrous pyramid. However, this approach is associated with the high risk of disability arising from the potential injury to the craniocerebral nerves.

[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.

[The method for the direct evaluation of the state of mucociliary clearance in the children].

The objective of the present study was to develop a readily available, simple to use and acceptable for the application in the childhood method for the evaluation of the state of mucociliary clearance. We have proposed and presented the detailed description of the simple approach to the direct investigation of the ciliary apparatus of the ciliary epithelium cells that requires neither the expensive sophisticated equipment nor the software programs to be implemented. Investigations by this method made it possible to elucidate and identify certain details of the functioning of ciliary epithelium. Other methods for the study of the ciliary apparatus are considered with special reference to their main advantages and disadvantages. Some debatable problems pertaining to the choice of optimal techniques for the evaluation of the functional state of ciliary epithelium are discussed.

[Ciliary epithelium and topical decongestants: how to minimize the undesirable events?].

The objective of the present study was to evaluate the influence of the combination of 0.1% xylometazoline with seawater (Rinomaris, "Jadran", Croatia) on the state and functional activity of the ciliary epithelium of the nasal cavity. The results of the study confirm the safety of this treatment and the possibility of its application in routine clinical practice.