[Investigation of vestibular function in patients with vestibular neuritis]. / Issledovanie vestibulyarnoi funktsii u patsientov s vestibulyarnym neironitom.

Vestibular neuritis occupies the third place in terms of prevalence in the structure of peripheral vestibulopathies, therefore, the choice of optimal diagnostic and differential diagnostic tactics at different stages of the disease is an urgent task. OBJECTIVE: To optimize the diagnostic algorithm for vestibular neuritis based on an assessment of the sensitivity of clinical methods for studying vestibular function in the recovery period of the disease. MATERIAL AND METHODS: A comprehensive assessment of the sensitivity of clinical methods for the study of vestibular function in the acute (up to 14 days: at the time of initial treatment, on the 7th and 14th day) and subacute (up to 3 months: on the 28th and 90th day) periods of the disease in 52 patients with upper vestibular neuritis was carried out. RESULTS: The timing of the processes of restoration of vestibular function after a transferred vestibular neuritis is individual: after 14 days, restoration of vestibular function was recorded in 52% (n=27) patients, after 1 month - in 62% (n=32), after 3 months - in 71% (n=37) patients with upper vestibular neuritis. Statocoordination, statokinetic, oculomotor tests under visual control have the highest sensitivity in the acute period of vestibular neuritis, within up to 7 days from the onset of symptoms. In the subacute period of vestibular neuritis, the study of spontaneous nystagmus and nystagmus in the head shaking test retains high sensitivity only when using special tools (Frenzel goggles or videonystagmography). A decrease in the sensitivity of the head rotation test and the dynamic visual acuity test in the subacute period of vestibular neuritis is associated with the processes of central compensation and the formation of a latent saccade. CONCLUSION: The sensitivity of clinical tests in patients with vestibular neuritis depends on the timing of the examination.

[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.

[Dissociation of the results of caloric and video head impulse tests as a marker of Meniere's disease]. / Dissotsiatsiya kaloricheskogo i videoimpul'snogo testov u patsientov s bolezn'yu Men'era.

The study of vestibular function in patients with Meniere's disease (MD) is an urgent task, since it influences the choice of treatment tactic. We evaluated the results of caloric and video head impulse (vHIT) tests in 76 patients who met the clinical criteria for significant Meniere's disease (AAO-HNS modified by the Barany Society, 2015). Dissociation of the results of caloric and vHIT tests is observed in the majority (74%) of patients with MD: at normal gain, according to vHIT data, hypofunction of peripheral vestibular structures is recorded according to the caloric test (KASL 47 ± 7.8%). In patients with MD, vestibular dysfunction is observed mainly at low frequencies (0.003 Hz), therefore vHIT, which allows assessing horizontal semicircular canal function at high frequencies (3-5 Hz), is not an optimal study for assessing the degree of vestibular dysfunction in patients with MD.

[Glucocorticosteroids in the treatment of acute neurosensory hearing loss. The current state of the problem. Part 2]. / Glyukokortikosteroidy v lechenii ostroi neirosensornoi tugoukhosti. Sovremennoe sostoyanie problemy. Chast' 2.

Modern literature data are presented on the choice of a drug for hormonal therapy in acute neurosensory hearing loss of various origins, the doses used for systemic therapy, the features and methods of intratympanic administration of glucocorticosteroids, and the evaluation of the effectiveness of treatment with this group of drugs.

[The effectiveness of transtympanic use of dexamethasone 4 mg in Meniere's disease, severe and moderate course of the disease]. / Effektivnost' transtimpanal'nogo primeneniya deksametazona 4 mg pri bolezni Men'era, tyazhelom i srednetyazhelom techenii zabolevaniya.

The results of transtympanic administration of 4 mg dexamethasone in 37 patients with moderate and severe Meniere's disease are presented. The endolymphatic hydrops was detected in all inner ear structures with predominant accumulation in vestibule and semicircular canals by MRI-visualization before therapy. After 1 month of 4 mg dexamethasone transtympanic therapy the hydrops degree decreased. Daily transtympanic administration of 4 mg dexamethasone for a month leads to reduction of vertigo attacks duration and expression in 92% of cases (follow-up period 24 months) and can be considered when conservative therapy is ineffective before destructive surgical interventions.

[Neuroimaging of the endolymphatic hydrops of the labyrinth in severe and moderately severe Meniere's disease]. / Neirovizualizatsiya endolimfaticheskogo gidropsa labirinta pri tyazhelom i srednetyazhelom techenii bolezni Men'era.

The results of magnetic resonance imaging (MRI) of the inner ear 24 hours after intratympanic administration of 1 ml of diluted (1:7) contrast substance for gadolinium-based MRI in 43 patients with moderate and severe Meniere's disease course are presented. It has been revealed that in case of severe and moderate course of Meniere's disease endolymphatic hydrops is presented in all departments of labyrinth: cochlea, vestibule, semicircular canals, but is most pronounced in vestibular department of labyrinth: horizontal semicircular canal and vestibule. The neuroimaging method according to the presented protocol is safe and can be applied in a wide practice both to assess the presence and localization, and the degree of expression of the endolymphatic hydrops.

[Clinical and diagnostic criteria and differential diagnosis in the first and second stages of the development of Ménière's disease - A modern view of the problem]. / Kliniko-diagnosticheskie kriterii i differentsial'naya diagnostika pri pervoi i vtoroi stadiyakh razvitiya bolezni Men'era: sovremennyi vzglyad na problemu.

The results of a comprehensive examination of 82 patients with clinical signs of definite Ménière's disease, unilateral lesion and confirmed by extratympanic electrocochleography endolymphatic hydrops are presented. The results of the study showed that only 38% of patients had cochleovestibular syndrome due to Ménière's disease. In 45% of patients, Ménière's disease was combined with other diseases: benign paroxysmal positional vertigo, vestibular migraine, persistent postural-perceptual dizziness, superior semicircular canal dehiscence. In 17% of patients cochleovestibular syndrome was due to other reasons: vestibular migraine, tumor of the posterior cranial fossa, superior canal dehiscence syndrome, Cogan's syndrome, enlarged vestibular aqueduct, otosclerosis. Complaints, medical history of the disease and life, brain MRI, temporal bone CT and pure tone audiometry in dynamics are important in suspected Ménière's disease. For 1 and 2 Ménière's disease stages the most important characteristic are: progressive unilateral sensorineural hearing loss and reduced slow faze velocity values of caloric nystagmus in dynamics, mainly in warm response if attacks of vertigo is maintain; normal head impulse test between vertigo attacks and pathological result of this test in attack of vertigo with the normalization of gain during the first day.

[Vertical downbeat nystagmus in benign paroxysmal positional vertigo]. / Vertikal'nyi nistagm vniz pri dobrokachestvennom paroksizmal'nom pozitsionnom golovokruzhenii.

Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vestibulopathy. Ppatients with BPPV contact with otorhinolaryngologists in 25% of cases. Due to the polymorphism of this pathology, an urgent task is to asess differential diagnosis of BPPV with various variants of the central positional syndrome: vestibular migraine, myofascial cervical syndrome, organic changes in the structures of the cerebellum. OBJECTIVE: To distinguish atypical forms of BPPV with downbeating vertical nystagmus and the central positional syndrome.

[Labyrinth hydrops and its diagnosis]. / Gidrops labirinta i ego diagnostika.

The article deals with the basic theories of maze and labyrinth hydrops, which are often used in clinical practice for its diagnosis according to the world literature. Tonal threshold, suprathreshold audiometry, broadband thympanometry, ultrasound tests, test for determination of lateralization of loud sounds, dehydration test, extra-timbanical electrocochleography, method of registration of evoked vestibular myogenic potentials, study of vestibular function (video pulse test, caloric sample), CT of temporal bones with gadolinium, MRI, and other methods are considered. None of these study methods gives an accurate confirmation of the presence of maze hydrops. Only taking into account the history, complaints of the patient, clinical manifestations of the disease and a comprehensive evaluation of the results of all the above methods of study can we speak with confidence about hydropse.

[ENT care in the context of the new coronavirus infection COVID-19]. / Aktual'nye voprosy okazaniya spetsializirovannoi lor-pomoshchi v usloviyakh novoi koronavirusnoi infektsii COVID-19.

The spread of the pandemic of the new coronavirus infection COVID-19 inevitably makes adjustments to the medical care. Given that the main route of transmission is airborne, otorhinolaryngologists are at increased risk of infection. Based on the literature data of leading otorhinolaryngologists, as well as their own experience working with patients with the new coronavirus infection COVID-19, the authors present relevant recommendations on the organization of specialized otorhinolaryngological care in the context of the COVID-19 pandemic. The authors consider the etiology, pathogenesis, and clinical manifestations of COVID-19. The features of the examination of ENT, diagnostic and therapeutic procedures, including the use of silicone hydrotamps to stop the front and rear nose bleeds, developed in L.I. Sverzhevskiy OHRIM, and indications for hospitalization in the ENT hospital. Features of operations on the otorhinolaryngological profile during a COVID pandemic are also described. Summing up, the authors indicate that during the pandemic of the new coronavirus infection COVID-19, otorhinolaryngologists need to adhere to two fundamental principles aimed at preventing the spread of infection: the use of modern effective personal protective equipment and the use of examination methods (surgical treatment methods) that prevent the formation of biological aerosols.

[Possibility of application Mexidol for the treatment of patients suffering from sensorineural hearing loss and cerebrovascular insufficiency]. / Perspektivy primeneniia preparata Meksidol dlia lecheniia bol'nykh, stradaiushchikh neirosensornoi tugoukhost'iu i tserebrovaskuliarnoi nedostatochnost'iu.

Sensorineural hearing loss can develop as a consequence of vascular pathology. The etiology and pathogenesis of chronic sensorineural hearing loss allow us to consider promising the use of neuroprotective drugs in the treatment regimen that can activate the function of the neural structures of the auditory pathway. Ethylmethylhydroxypyridine succinate, having complex pharmacological capabilities and a wide range of effects realized at the neural and vascular levels can be used in the treatment of hearing impairment and speech intelligibility.

[The use of Gliathiline in patients with sensorineural hearing loss]. / Ispol'zovanie preparata Gliatilin u bol'nykh neirosensornoi tugoukhost'iu.

The results of treatment of 38 patients suffering from sensorineural hearing loss with the Gliatilin (solution 3 ml intravenously for 10 days, capsules 400 mg 3 times a day or solution for ingestion 600 mg 2 times a day for 3 months) are presented. All patients in dynamics were given a comprehensive audiological, neurological examination, as well as an assessment of psycho-emotional status and cognitive function. Subjective improvement of ear noise tolerance by patients by 40 days of observation and continuation of this trend during the whole period (100 days) outside of the form of the medicinal preparation is noted. A reliable improvement in the 50% speech intelligibility threshold by day 100 of observation was established in patients of both groups, with a tendency towards earlier (on day 70 of the study) onset of this effect when taking the drug inside as a solution. The Gliatilin has been proven to reduce anxiety and depression, as well as reliably improve cognitive function. Thus, Gliatilin (injection solution, ingestion solution, capsules) can be used to improve the subjective tolerance of ear noise, speech intelligibility and quality of life of patients in chronic sensorineural hearing loss.

[The influence of Memoplant monotherapy on the dizziness]. / Vliianie preparata Memoplant v rezhime monoterapii na golovokruzhenie.

The objective of the present work was to study the influence of the dry extract from the leaves of Ginkgo biloba EGb 761 (used as monotherapy at a dose of 120 mg twice daily during 4 months) on the vestibular function of the patients presenting with cochleovestibular pathology of peripheral and mixed genesis. We present the results obtained by the objective and subjective methods for the evaluation of the vestibular function as well as the neurological and psychoemotional state of the 40 patients that was carried out during the four months of memoplant monotherapy. It is concluded that monotherapy with the use of the dry extract from Ginkgo biloba leaves can be applied for the purpose of improvement of static and dynamic balancing state. Moreover, this memoplant preparation can be used as a means of prophylaxis of recurrent dizziness that in addition reduces the severity of anxiety and depression without producing adverse side effects.