[Long-term stenting as an option to ensure the stability of the respiratory tract in a patient with rhonchopathy and overlap syndrome]. / Dlitel'noe stentirovanie kak variant obespecheniya stabil'nosti dykhatel'nykh putei u patsienta s ronkhopatiei i sindromom perekresta.

Rhonchopathy is a major problem of both a medical and social nature, it is detected in about 33% of the adult population. It should be noted that snoring is often accompanied by a more formidable disease - obstructive sleep apnea (OSA) syndrome, which, in turn, is considered a life-threatening condition. It is known that in severe forms of OSA syndrome, up to 400-500 respiratory stops per night with a total duration of up to 3-4 hours can occur, which leads to acute and chronic lack of oxygen during sleep. In turn, chronic obstructive pulmonary disease (COPD) is one of the most common diseases and one of the leading causes of death worldwide. The association of OSA syndrome and COPD, which is designated by the term overlap syndrome, is characterized by the summation of the negative effect of these pathological conditions on the parameters of blood oxygen saturation during night sleep. Diagnosis, treatment and prognosis in patients with overlap syndrome should be based on an interdisciplinary approach, including the use of modern and highly informative methods of functional diagnosis. To date, many methods of treatment (conservative, surgical, combined) of rhonchopathy and OSA syndrome are known. In most cases, preference is given to minimally invasive methods, creating constant positive pressure in the respiratory tract. Tracheostomy is an absolutely effective method of treating OSA syndrome, however, it is very traumatic, but in exceptional cases it is necessary. This paper describes a clinical case of installing a T-shaped stent not only for the treatment of chronic cicatricial stenosis, but also to compensate for OSA syndrome and restore vocal function.

[Vocal fold polyps: modern possibilities of laser surgery in comparison with the use of cold microinstruments]. / Polipy golosovykh skladok: sovremennye vozmozhnosti lazernoi khirurgii v sravnenii s ispol'zovaniem kholodnykh mikroinstrumentov.

OBJECTIVE: To perform a comparative analysis of phonosurgical interventions, which were made using a 445 nm semiconductor laser or cold microinstrumentation in patients with «vocal fold polyp¼ diagnosis. MATERIAL AND METHODS: The number of surgical interventions equal 30 regarding vocal fold polyp was done in otorhinolaryngology clinic of Pavlov First State Medical University of St. Petersburg in the period from September 2021 yr. to September 2022 yr. The phonosurgical intervention was performed under the conditions of direct suspension microlaryngoscopy by Kleinsasser under general anesthesia using high frequency ventilation through an endotracheal catheter. Surgical interventions were carried out using a 445-nm semiconductor laser in pulsed mode for patients of the 1st group (n=15) and using microsurgical instruments for patients of the 2nd group (n=15). The comparative analysis was conducted based on the results of an objective vocal function assessment by acoustic analysis, as well as on the data of a subjective assessment of the voice using the questionnaire VHI-10rus. The severity of reactive inflammatory phenomena in the postoperative period has been compared and the oscillating movements of vocal folds have been evaluated according to the videolaryngoscopy data. The severity of pain syndrome in the postoperative period was assessed by visual analogue scale. RESULTS: There were no statistically significant differences in the results between two groups. Similarly, there were no statistically significant differences in parameter recovery degree, evaluated by videolaryngoscopy data. Moreover, a full recovery of mucosal wave was found in 93% of patients operated with laser on 7th day, while 47% of patients had the same result after use of cold microinstrumentation. CONCLUSION: The use of 445-nm semiconductor laser for phonosurgical interventions in vocal folds' polyps can be recommended for predicted successful recovery of vocal function, minimization of reactive inflammatory phenomena in postoperative period and early patients' rehabilitation.