[Olfactory impairment in patients of the older age group with COVID-19 in the acute period and in the period of convalescence.]

Complete or partial loss of sense of smell significantly reduces the quality of life and in some cases is life-threatening. A new coronavirus infection in some cases leads to hypo- or anosmia. The defeat of the olfactory epithelium, swelling of the mucous membrane, the presence of discharge in the nasal cavity complicate the effect of odorants on the neuroepithelium. With COVID-19, anosmia may be the first and leading symptom. The restoration of the sense of smell occurs more often during the first weeks, but in some cases it is persistent. A special group of patients are older patients, older than 60 years. The course of a new coronavirus infection due to concomitant pathology proceeds in a more severe form. We present the experience of olfactory training with a set of essential oils (juniper, turmeric, eucalyptus and rose). Aromatherapy was preceded by irrigation of the nasal cavity with isotonic saline solution. In the absence of a clear clinical effect for 3 weeks, the set of oils was changed to fir oil, rosemary oil, monarda and lavender. The course of treatment continued for an average of 2 months. The technique included physiotherapy (endonasal electrophoresis with 0,25% zinc sulfate solution № 10), zinc preparations, pumpkin seeds 20-30 g per day, B vitamins (B6 and B12).

[Halitosis. Multidisciplinary approach]. / Khalitoz ­ mezhdistsiplinarnaya problema.

Halitosis is a common complaint among patients. Up to 50% of people worldwide claim to have persistent or intermittent bad breath. Often, bad breath not only disrupts the social life of patients, but is also a symptom of systemic diseases. An important step in the treatment of halitosis is the localization of the source and possible cause of the unpleasant smell. Most often, the problem of halitosis is solved by dentists, because intraoral halitosis accounts for up to 90% of all cases, but doctors of many specialties should deal with the differential diagnosis of its causes. This article considers the main causes of halitosis in patients with diseases of various organ systems.

[Aging nose (presbinasalis) in the practice of an otorhinolaryngologist.]

Population aging, increasing in duration of active life dictate to keep the level of health and create conditions for prolongation and preservation of ability to work. An otorhinolaryngologist often has to deal with age-related changes occurring in the nasal cavity and paranasal sinuses. The study of age-related features occurring in the nasal cavity and paranasal sinuses at the level of not only function, but also structures providing maintenance of mucous membrane protective mechanisms, preserving nasal architectonics, becomes a topical issue. Detailed consideration can be the key to understanding what is a natural process over time, and what should be viewed as pathology. These processes are often interrelated. For example, cartilage aging and nasal tip ptosis may trigger pathophysiologic mechanisms that create an obstacle to normal nasal breathing in older patients. Nasal aging accompanied by increasing dryness, rhinorrhea in some cases, postnasal drip in others, decreased sense of smell, reduces the quality of life, which will also need the involvement of an otorhinolaryngologist. In otorhinolaryngology, some of the terms used to describe age-related changes in the ent organs have been known and used since ancient times - presbyacusis (decreased hearing), presbyosmia (decreased sense of smell), presbyathacsia (ability to maintain equilibrium). Others are relatively recent, such as presbynasalis - an aging nose.

[Medicinal products in the treatment and prevention of occupational diseases of the upper respiratory tract]. / Lekarstvennye sredstva v lechenii i profilaktike professional'nykh zabolevanii verkhnikh dykhatel'nykh putei.

Occupational diseases of the upper respiratory tract (URT) represent a significant section of occupational pathology of the respiratory system, since the mucous membrane of the nasal cavity and paranasal sinuses is the outpost that first comes into contact with inhaled agents (pollutants), including professional aerosols. The pathogenesis of occupational diseases of URT is based on long-term contact of pollutants with cells of the scintillating epithelium and violation of the function of the mucociliary system of URT. Occupational diseases of URT include: chronic catarrhal, subatrophic, atrophic, hypertrophic rhinitis, rhinopharyngolaryngitis; all forms of laryngitis, laryngotracheobronchitis, allergic diseases. Treatment and prevention of these diseases should be comprehensive with the use of personal respiratory protection equipment, mandatory preventive examinations and various local effects (inhalation, instillation, lavage, herbal medicine, etc.).

[The rationale for the conservative treatment of chronic tonsillitis in the patients of the older age groups by the «soft¼ therapy methods]. / Obosnovanie konservativnogo lecheniya khronicheskogo tonzillita u lits starshikh vozrastnykh grupp metodami «myagkoi¼ terapii.

The objective of the present study was to develop an efficient system for the treatment of chronic tonsillitis in the patients of advanced and middle age based on the application of polyvalent bacteriophages in the combination with the physical factors and herbal medicines. The study involved 65 patients (39 women and 276 men) at the age from 65 to 73 years presenting with chronic tonsillitis. The treatment included washing the tonsillar lacunae with herbal infusion consisting of a tetterwort (Choledoniummajus) extract. This procedure was followed by phonophoresiswith the use of the combined polyvalent bacteriophage preparation in the non-liquid formulation during 7-10 days. The effectiveness of such treatment was evaluated based on the results of clinical examination and the analysis of the subjective feelings reported by the patients. In addition, the rosette-forming function of lymphocytes was estimated and palatine tonsil microbiotas in different patients were compared. The effectiveness of therapy was estimated at 89.2%. The positive outcome of the proposed treatment was documented in 78.6% of the cases within 6 months after the onset of therapy. It is concluded that the treatment of chronic tonsillitis with bacteriophagal preparations and herbal infusions in combination with thetraditionallow-frequency ultrasound treatment is highly efficacious (favourable outcome in 78.6% of the patients of middle and advanced age) without the use of antibiotic medications.

[Local cytokine therapy of inflammation of the rhinosinusotubal area]. / Mestnaya tsitokinovaya terapiya vospaleniya rinosinusotubarnoi zony.

The objective of the present work was to elaborate a scheme for the effective combined treatment ofinflammation of the rhinosinusotubal area including the local administration of roncoleukin and cyclopheron without antibiotics. The study included 82 patients (27 men and 55 women) at the age from 25 to 55 years presenting with acute inflammation ofroncoleukin and cycloferon. They were divided into two groups. Group 1 was comprised of 39 patients dominated by those with the clinical picture of sinusitis whereas group 2 contained 43 patients in whom symptoms of catarrhal otitis media prevailed. The patients of both groups were treated by the local application of roncoleukin in combination with cycloferon inhalation, intranasal administration of decongestants and mucomodifiers. All the patients underwent, before and after the treatment, the microbiological study of the contents of the sinuses, impedancobarometry, 3D computed tomography, and measurement of the IgA, IgM, IgG, IgE, SIgA, IL-8, TNF-alpha, and albumin levels in the blood sera and lavages. The study has demonstrated the difference between the local cytokine levels in the two groups of the patients. The clinical improvement was documented within 24 hours after the onset of therapy. 93.3% of the patients recovered by day 5. Three (3.7%) of them had to be prescribed antibiotic therapy for the lack of the desired effect of the cytokine treatment. It is concluded that the local application of ronkoleukin and cycloferon in combination with elimination therapy provides a tool for the efficient treatment of the patients suffering frominflammatory pathology of the rhinosinusotubalzone due to its stimulatory action on the immune system at the inflammation site mediated through the activation of the earlier formed targeted immune response, the promotion of the accelerated elimination of the causative factor, and the termination of the pathological process.

[Tonsillitis and tonsillogenic conditions]. / Tonzillit i tonzillogennye zabolevaniia.

The objective of the present study was to analyze and summarize the literature publications concerning tonsillitis and related (tonsillogenic) pathological conditions. The retrospective analysis of these materials made it possible to collect and summarize information about the influence of palatine tonsillar pathology (chronic tonsillitis) on the function of various organs and their systems. It has been shown that pathogenesis of a great variety of disease is underlain by pathology of palatine tonsils. Also, the possibility to stabilize the pathological processes in certain organs and systems by the conservative and/or surgical treatment of chronic tonsillitis has been demonstrated. It is concluded that the patients presenting with chronic tonsillitis make up a group of risk of development of many serious somatic diseases and require enhanced attention not only of otorhinolaryngologists but also specialists representing other medical disciplines. The multidisciplinary approach to the management of such patients is the sole way to reduce the frequency ofgeneral complications in the patients with chronic tonsillitis.

[Basic principles of immunocorrective therapy in otorhinolaryngology].

The structural and functional basis of ENT mucosa immunity, leading methods of local immunity assessment in ENT pathology are presented. The experience of the chair and clinic of I.P. Pavlov St-Petersburg State Medical University in the field of immunotropic therapy of ENT pathology is reviewed.

[Peculiarities of immune responses during general anesthesia in otosurgery]. / Osobennosti immunnykh reaktsii pri obshchei anestezii v otokhirurgii.

Immune responses were investigated in 118 patients suffering from chronic purulent inflammation of middle ear. All of them were operated under different methods of anesthesia. Immunotherapy preceding intravenous anesthesia with combination of phentanyl and clophelline along with supporting spontaneous breathing was found to be the most optimal from the immunologic point of view. This anesthetic approach has such advantages as IgG, IgA elevation by 50%-100% and sIgA secretory antibodies content increment by 30% in local mucosal immune system, activating the macrophageal-phagocyte system of antigen treatment.

[Otitis externa in industrial workers]. / O naruzhnom otite u rabochikh promyshlennykh predpriiatii.

The problem of the therapy of otitis externa in industrial workers is one of the most serious in otiatria. The fact that the disease is caused by various factors is responsible for the low effectiveness of traditional therapy. This paper describes a combined treatment which includes trichopol ointment, drugs that enhance regenerative processes, drugs that decrease sensitization, and elements of chronotherapy. The treatment proved to be effective and can therefore be recommended for clinical application.

[Microcirculation of the nasal mucosa in persons of the older age groups]. / Osobennosti mikrotsirkuliatornogo rusla slizistoi obolochki polosti nosa u lits starshikh vozrastnykh grupp.

Specific features of microcirculation of the mucous membrane of the nasal cavity of 32 patients over 57 years were investigated. Additionally, microcirculation of the mucous membrane of the nasal septum and wall of untreated rabbits and rabbits, that for 5 months were on a cholesterol enriched diet, was examined. It was shown that in both cases the transport function of capillaries and, consequently, the structure of the mucous membrane deteriorated which may contribute to the development of persistent rhinosinusitis.

[Effects of nasal respiration on the thermo-adaptive capacity of the airways]. / Vliianie nosovogo dykhaniia na termoadaptatsionnuiu sposobnost' dykhatelnykh putei.

Respiratory thermography characterizes the role of nasal respiration in the thermo-adaptive function of airways. During nasal inspiration the air temperature in alveoli is 1.5--2.0 degrees C higher than during oral inspiration not only in patients with chronic pulmonary diseases but also in healthy people. In this context, correction of nasal respiration in people with chronic pulmonary diseases should be considered as an efficient factor for preventing exacerbation of the diseases.