[Features of olfactory impairment connected with trigeminal nerve system]. / Osobennosti narusheniya obonyaniya v aspekte sistemy troinichnogo nerva.

Data on the state of sense of smell in patients who had a new coronavirus infection caused by the SARS-CoV-2 virus are currently reduced because of the impairment of the olfactory nerve system. There are practically no results in studies of disorders in the trigeminal nerve system. OBJECTIVE: Qualitative assessment of olfactory disorders after COVID-19 according to the system of olfactory and trigeminal nerves with a targeted assessment of the functional component of olfactory disorders. MATERIAL AND METHODS: We examined 40 patients aged 19 to 66 who had a coronavirus infection. All patients underwent neurological, otorhinolaryngological examinations, olfactometry, filled out the hospital anxiety and depression scale. RESULTS: Anosmia was diagnosed in 5 (12.5%) patients, hyposmia in 21 (52.5%) patients, and normosmia in 14 (35%) patients. Formed: the 1st group - 14 patients (35%) with normogram according to olfactometry; the 2nd group - 26 patients (65%) with anosmia/hyposmia. In the 1st group, disorders of the anxiety-depressive spectrum were significantly more common. In the 2nd group, a low identification of odors was found, lying in the spectrum of fresh, sharp, unpleasant, irritating, compared with sweet and pleasant or neutral, which indicates a predominant lesion of the trigeminal system. CONCLUSION: In patients with complaints of impaired sense of smell after undergoing COVID-19, the possible functional nature of anosmia/hyposmia should be taken into account, which requires the referral of such patients to psychotherapeutic specialists, and the possible entry of olfactory disorders into the 'trigeminal' spectrum.

[Involvement of the trigeminal nerve system in the sense of smell]. / Uchastie sistemy troinichnogo nerva v obonyanii.

A systematic review of literature on the issue of involvement in the sense of smell, as well as the interaction between the trigeminal and olfactory nerves, was carried out. The article discusses the features of the chemical perception systems, as well as the treatment of olfactory disorders using transcranial electrical stimulation of the trigeminal nerve.

[Dedicated to the memory of Yuri Nikolaevich Volkov]. / Pamyati Yuriya Nikolaevicha Volkova posvyashchaetsya.

One of the brilliant representatives of medicine of the XX century is Yuri Nikolaevich Volkov. His results of scientific and practical activities are impressive in their scale. They are represented in numerous printed works devoted to the most important theoretical and practical aspects of otorhinolaryngology. Yuri Nikolaevich Volkov also created some inventions. His works are included in a four-volume guide to otorhinolaryngology and textbooks for medical students.

[Features of thermal effect at high-frequency laser impact on biological tissue (experiment). Technique of laser ablation of a pharyngeal tonsil]. / Osobennosti termicheskogo éffekta pri vysokochastotnom lazernom vozdeistvii na biologicheskuiu tkan' (éksperiment). Metodika lazernoi abliatsii glotochnoi mindaliny.

In the conditions of the experiment the peculiarities of thermal influence of Ho:YAG on biological tissue in the ablation mode were studied. In the experiment we used: surgical laser system LUMENIS VersaPulse PowerSuite 20, universal thermal imaging camera FLIR SC7000. The biological object (turkey meat) was remotely, at a distance of 5 mm, affected by a Holmium laser (E = 0.9 J and R = 12 Hz) for 6 seconds. The maximum temperature (Tmax, °C) in the ablation zone was measured in real time. As a result, it was found that laser ablation of a biological object is characterized by thermal effects, which largely depend on the state of irradiated tissue: the temperature of the irradiated object rises to critical values equal to 100.07-111.24 ° C, after which the surface layer of biological tissue is charred, and the process of laser "removal" stops; intact biological tissue reaches critical heating after 3.48 s, while under the influence of a high-frequency laser on the previously irradiated biological tissue development period It was also established that in order to continue laser ablation with controlled thermal effect it is necessary to remove charred areas of biological object. On the basis of the obtained data the method of laser ablation of pharyngeal tonsils was developed.

[The strategy of the of surgical treatment of the cysts in the maxillary sinus]. / Taktika khirurgicheskogo lecheniia kist verkhnecheliustnoi pazukhi.

Based on the results of the retrospective analysis of 12 094 medical histories available from five large otorhinolaryngological clinics of the city of Moscow the authors arrived at the conclusion that the surgical treatment of maxillary sinus patholologies including the resection of retentional cysts accounts for 4.1% of the total number of surgical interventions on the ENT organs. The endonasal and extranasal approaches were used in 28.5% and 68.9% of the cases respectively. The combined approach to the maxillary sinus was applied in 2.6% of all the cases. The vector studies of the anatomical features of the ostiomeatal complex in 102 patients presenting with cystic lesions of the maxillary sinus with the use of computed tomography have demonstrated that the lumen of the complicated system communicating the maxillary sinus and the nasal cavity remains patent along its entire length; its part in the ethmoidal infundibulum region is as long as 1.31±0.03 mm and amounts to 2.09±0.02 mm in the region of natural anastomosis of the maxillary sinus (p<0,01). The results of the histological study of 81 histological preparations give evidence that the lesions of the mucous membrane in the regions of ethmoidal infundibulum and natural anastomosis of the maxillary sinus have a chronic character and manifest themselves as sclerosis of lamina propria and hyperplasia of mucous glands. The authors nave come to the conclusion that the surgical approach to the maxillary sinus through the middle meatus is not sufficiently well substantiated and therefore can not be recommended for the resection of the cysts from this air cavity in the body of the maxilla.

[The application of contrast-enhanced X-ray salpingography for the evaluation of the effectiveness of catheterization of the acoustic tube with the use of the Eustachian catheters]. / Rentgenokontrastnaia sal'pingografiia v otsenke éffektivnosti kateterizatsii slukhovoi truby ushnymi kateterami.

The objective of the present study was to evaluate the effectiveness of the administration of a medication into the middle ear structures during catheterization of the acoustic tube (AT) in the course of the contrast-enhanced X-ray salpingographic investigation. The study included 18 patients (18 ears) presenting with chronic otitis media and the perforated tympanic membrane without the disturbances of the ventilation function of the auditory tube. All the patients were allocated to two groups depending on the type of the Eustachian catheters being used. Group 1 was comprised of 9 patients treated with the use of traditional Giyot's catheter, group 2 was composed of another nine patients who were treated with the use of the Eustachian catheters having an original shape with a specific configuration of its distal part. The X-ray studies were carried out before and after catheterization of the acoustic tube with the administration of 1 ml of the hypaque contrast medium. The study has demonstrated that the X-ray contrast agent did not penetrate into the inner structures of the middle ear of the patients comprising group 1 whereas in the patients of the second group the contrast medium reached as far as the bony portion of the acoustic tube.

[Identification of the specific topographic features of the neck vessels for the prevention of bleedings during tonsillectomy]. / Identifikatsiia osobennostei topografii sosudov shei v profilaktike krovotechenii pri tonzilléktomii.

The objective of the present work was to study syntopy of the large neck vessels in relation to the capsule of palatine tonsils with the use of the MRI technology. A total of 109 patients (218 palatine tonsils) presenting with chronic tonsillitis were available for the examination including 64 women and 45 men at the age varying from 15 to 54 years. All of them underwent MRI-guided vascular visualization in the paratonsillar region together with the measurements of the vessels extending to the capsule of the palatine tonsils at the level of the upper and lower poles, and also close to the mid-third of each palatine tonsil. The distance from the external carotid artery to the upper and lower poles of the palatine tonsils was found to be 17.1±1.01 mm and 10.3±0.18 mm respectively and in the mid-third the palatine tonsil 10.7±0.12 mm; the distance from the internal carotid artery to the upper and low poles of the palatine tonsil amounted to 14.5±0.84 mm and 16.8±0.77 mm respectively while that to the mid-third of the palatine tonsil was 15.3±0.07 mm. The branches of the external carotid artery feeding the palatine tonsils are the most frequent sources of bleedings; the following measurements were obtained: the maxillary artery 16.4±0.43 mm (17.4%) - the upper pole 9.6±0.02 mm (46.2%), the mid-third of the palatine tonsil 18.5±0.74 mm (29.5%) - the lower pole; the lingual artery 4.7±0.02 mm (6.8%) - the mid-third of the palatine tonsil, 6.2±0.82 mm (56.8%) - the lower pole; facial artery: 4.2±0.01 mm (0.76%) - the mid-third of the palatine tonsil; the occipital artery 25.6±0.12 mm (19%) - the upper pole; 14.8±0.11 mm (18.9%) - the mid-third of the palatine tonsil 9.56±0.12 mm (3.8%) - the lower pole; the tonsillar artery 1.88±0.01 mm (9.8%) - the upper pole; 2.51±0.01 mm (23%) - the mid-third of the palatine tonsil; 2.12±0.01 mm (11%) - the lower pole. The distance from the internal jugular vein to the capsule of the palatine tonsils in the region of the upper pole of the palatine tonsil was 28.3±1.01 mm, in the lower pole region 26.6±1.54 mm, and in the region of the mid-third of the palatine tonsil 22.7±1.24 mm. It is concluded that the results of the present study may be useful for the planning of the surgical strategy for the treatment of the patients presenting with chronic tonsillitis and for the prevention of hemorrhagic complications of tonsillectomy.

[The original method for the endonasal surgical access to the maxillary sinus through crista conchalis of the maxillary bone]. / Original'nyi metod éndonazal'nogo khirurgicheskogo dostupa k verkhnecheliustnomu sinusu cherez crista conchalis verkhnecheliustnoi kosti.

The objective of the present work was to develop a technique for the endonasal surgical access to the maxillary sinus through crista conchalis of the maxillary bone and to evaluate the effectiveness and safety of the surgical treatment by this method. A total of 210 patients underwent the CT-assisted examination of the paranasal sinuses. The data obtained made it possible to characterize the detailed anatomical structure of crista conchalis of a maxillary bone that forms the anterior part of the medial wall of the maxillary sinus. The syntopy in relation to the distal end of the nasolacrimal canal and the cavity of the maxillary sinus was investigated. The results of the study were used to develop the original technique for endonasal antrotomy that included the 0.5-1.0 cm long vertical section of the mucous membrane at the level of the anterior end of the inferior turbinated bone approximately 1 mm from the edge of the bone aperture of the nose which exposed crista conchalis up to the place of fixation of the inferior turbinated bone. Then, the diamond drill burr was use to carry out trepanation of the medial wall of the maxillary sinus in the region of crista conchalis of the maxillary bone; sanitation of the of the sinus was followed by the apposition of the edges of the incision and their fixation with two sutures. The safety of the proposed surgical technique was confirmed by results of the repeated CT examinations of the paranasal sinus and its effectiveness by the clinical follow-up observations.

[Preoperative MRI diagnostics of the topographic features of neck arteries in the patients presenting with chronic tonsillitis]. / Predoperatsionnaia MRT-diagnostika topografii sosudov shei u patsientov s khronicheskim tonzillitom.

The objective of the present study was to determine the frequency of abnormalities of the major neck vessels and elucidate the specific features of blood supply of palatine tonsil based on the results of MRI performed in the vasculature-targeting regimen. A total of 109 patients presenting with chronic tonsillitis (including 64 women and 45 men at the age varying from 15 to 54 years) were available for the examination. All the patients underwent the MRI diagnostic study of the neck vessels by way of the preliminary evaluation of their condition at the pre-hospital stage. Abnormalities in the internal carotid artery were documented in 11.9% of the cases (including C- and S-shaped tortuosity of internal carotid artery in 6.88%, kinking and coiling of internal carotid artery in 4.13% and 0.92% of the patients, respectively). The majority of the detected abnormalities were located above the upper pole of the palatine tonsil which allowed to avoid the risk of the injury to the main neck vessels and prevented possible hemorrhage. One patient (0.46%) presented with kinking of the right internal carotid artery located in the immediate proximity to the capsule of the palatine tonsil close to its mid-third portion. There was no evidence that the present study gave rise to any malformation of the internal carotid artery and internal jugular vein. The proposed diagnostic method makes it possible to detect a rare anatomical feature of the development of the internal carotid artery discovered in a single patient (0.04%) out of the 2398 operated ones. This finding is of clinical significance and needs to be borne in mind when preparing the planned surgical intervention for the treatment of chronic tonsillitis. The results of the present study should be taken into consideration when prescribing the surgical treatment to the patients suffering not only from chronic tonsillitis but also from other ENT diseases, in the first place pharyngotympanic tube pathology.

[The application of lasers in otorhinolaryngology]. / Lazery v otorinolaringologii.

The objective of this review is to summarize and systematize the data concerning the modern laser and laser-based systems, their characteristics, and possible applications in various spheres of medicine including otorhinolaryngology. The application of laser technologies in medical practice gains ever increasing popularity. Lasers have been successfully used during a long period for the diagnostic and therapeutic purposes. At present, they are just as actively applied in different fields of the surgical practice. Otorhinolaryngology makes the most extensive use of neodymium, CO2, and holmium lasers. The latter has the most universal characteristics and is operated in a relatively short wavelength range (λ=2.01 mcm); moreover, its radiation penetrates as deep as 0.4 mm into the biological tissues. In other words, the holmium laser not only combines the advantages of the CO2 and neodymium lasers but is also devoid of their shortcomings. The holmium laser is considered to be the most promising source of laser radiation for the application in otorhinolaryngological surgery with a potential encompassing the most wide spectrum of surgical manipulations needed to treat pathological changes in the ears, nose, and throat. The application of this instrument in medical practice opens up new prospects for the development of otorhinolaryngology.