[Changes in the type and amount of bone collagens in chronic suppurative otitis media]. / Izmenenie tipovogo i kolichestvennogo sootnosheniya kollagenov kostnoi tkani pri khronicheskom gnoinom srednem otite.

OBJECTIVE: Comparative assessment of the collagen-tissue interaction in the bone tissue of the middle ear structures in patients with chronic suppurative otitis media (CSOM). MATERIAL AND METHODS: A prospective study of 42 patients aged 16-60 years with CSOM admitted for reconstructive sanitizing surgery was performed. To study the collagen-tissue interaction, intraoperative samples of the bone tissue of the middle ear were used. A software calculation of vascular-stromal areas and ratios of various types of bone tissue collagen was carried out during histomorphological examination. RESULTS AND DISCUSSION: The quantitative and qualitative parameters of bone tissue collagen obtained intraoperatively in patients with CSOM were studied. The cavities of the middle ear are in the phase of a chronic purulent process, when the bone structures are morphologically disorganized according to the pathological type, and sclerosis with overgrowth of the cellular structure of the mastoid process is considered a favorable outcome for delimiting the focus of inflammation in the pyramid of the temporal bone. CONCLUSIONS: Changes in the processes of collagen remodeling of bone structures contribute to the maintenance of inflammation of the middle ear in all clinical forms of CSOM. Pathological osteogenesis can serve as an indicator of the progressive course of a purulent-destructive process in the cavities of the middle ear, which makes it possible to reliably determine the rate of bone tissue transformation to predict relapse after reconstructive and sanitizing surgery.

[Changes in the elemental composition of the temporal bone in patients with chronic suppurative otitis media]. / Izmenenie elementnogo sostava visochnoi kosti u patsientov s khronicheskim gnoinym srednim otitom.

TO STUDY: The effect of the elemental composition of bone tissue on the destruction of the structures of the temporal bone in chronic suppurative otitis media. PATIENTS AND METHODS: The study included 331 patients aged 16-75 years with a verified diagnosis of chronic purulent otitis media, subject to surgical treatment. Depending on the diagnosis and method of surgical treatment, patients are divided into groups: patients with tubotympanic otitis media and epitympanic-antral otitis media after reconstructive sanitation otosurgery in comparison with the control group. The elemental composition of the bone tissue of the cavities of the middle ear obtained intraoperatively was evaluated by x-ray fluorescence spectroscopy. Elements in the bone tissue of the cavities of the middle ear obtained intraoperatively were evaluated by spectrophotometric method. The data are processed by descriptive statistics methods and are presented in the form of a median and a range between quartiles with an estimate of the reliability of the intergroup differences by the Mann-Whitney U-criterion. RESULTS: A comparison of the indicators characterizing the elemental composition of the temporal bone tissue in patients with forms of chronic otitis media demonstrates the progression of the severity of pathological bone remodeling according to various options. In the dynamics of observation in patients with morphological signs of purulent destruction of the structures of the temporal bone, not only the most profound imbalance in the levels of calcium and phosphorus was revealed, but also the limitation of the levels of silicon and sulfur in a progressive and recurrent course at different periods of the disease. CONCLUSION: X-ray fluorescence spectroscopy allows an elemental chemical analysis of bone remodeling according to the pathological type and reliably differentiate purulent diseases of the temporal bone. The results are promising from the point of view of developing new prognostic approaches in otosurgery in the management of patients with chronic purulent otitis media, involving the combined use of morphological research methods with microelement analysis of the temporal bone bone tissue.

[Variants of bone tissue modification in chronic otitis media according to light and electron microscopy]. / Varianty modifikatsii kostnoi tkani pri khronicheskom srednem otite po dannym svetovoi i élektronnoi mikroskopii.

PURPOSE: Analysis of the results of surgical treatment of patients with chronic hepatitis C, depending on the characteristics of structural changes in the bone tissue of the middle ear. PATIENTS AND METHODS: Bone tissue of the retrotympanal cavities was obtained when performing various types of reconstructive sanitizing interventions: 123 samples for light microscopy and 35 samples in parallel for electron microscopy. RESULTS: The article presents the results of a retrospective analysis of the clinical features and surgical treatment of 177 patients with chronic suppurative otitis media. For histomorphological assessment, pathological processes of structural changes in the bone tissue of the middle ear were studied using acid-free microwave decalcification. CONCLUSION: The obtained data allowed to establish options for ultrastructural changes in the bone tissue of varying severity in chronic inflammation depending on the types of structure of the mastoid during the duration of the disease for more than 10 years.

[Evaluation of structural changes of bone in chronic purulent otitis media]. / Klassifikatsiia strukturnykh izmenenii kostnoi tkani pri khronicheskom gnoinom srednem otite.

Fragments of bone tissue of the temporal bone, obtained during reconstructive-sanitizing operations in patients with chronic purulent otitis media, were studied by light and electron microscopy. An analysis was made of the degree of structural changes in bone tissue in chronic inflammation at the cellular and tissue levels after a histomorphological study in microwave decalcification. The method of diagnosis reliably allowed to differentiate the diseases characterized by the rarefaction of bone tissue, due to chronic inflammation, and also to determine the processes of transformation of bone tissue. The method of diagnosis reliably allows to differentiate diseases characterized by the rarefaction of bone tissue due to chronic inflammation, as well as to determine the processes of bone tissue transformation, however, the study is time-consuming, long-lasting and expensive.

[Optimization of the pedagogical process at the department of otorhinolaryngology].

The objective of the present work was to optimize the educational process with respect to teaching otorhinolaryngology based on the experience accumulated in this sphere with the use of fundamental management components. Special emphasis is laid on the innovative teaching methods employed in the higher education institutions for training clinical otorhinolaryngologists. The analysis of the functional responsibilities of the academic staff in medical institutions and the main components of the educational activity is presented. The basic principles of the quality management system are described. The conclusions made by the authors concern the possibility of standardization and prognostication in the higher education system that can be used for the development of practical guidelines for the academic staff.

[Effects of morphological changes in the middle ear mucosa on reparative processes in the neotympanic membrane in reconstructive sanative operation in patients with chronic otitis media].

A complex clinicomorphological examination was performed in 39 patients with chronic otitis media (OM) who had undergone reconstructive sanative surgery. The analysis of the results of the above examination provided information on efficacy of the original method of semiquantitative assessment of local cell reactivity and qualitative composition of tissue elements (content of lymphocytes, plasmocytes, fibroblasts; the degree of development of the capillaries, fibrosis, stasis, edema, inflammation activity by neutrophil count). A retrospective analysis of tympanic membrane graft retention depending on morphological intraoperative condition of the middle ear mucosa and retrotympanic compartments enables prognosis of tympanoplasty outcome in chronic OM.