К 85-летию профессора Алексея Сергеевича Киселева. О моем отце

Abstract

The article is devoted to the Russian otorhinolaryngologist, professor of the Kirov Military Medical Academy Alexey Sergeevich Kiselev, a well-known rhinologist and author of probably the best monographs on the history of otorhinolaryngology in Russia. Having come to the Department of Otolaryngology in 1964, he initially engaged in vestibular research, proposed options for training astronauts to the effects of Coriolis accelerations to overcome motion sickness, and was in charge of the acoustic-vestibular laboratory. It was the time of space exploration, and at the department, under the guidance of his teacher, Professor Konstantin Lvovich Khilov, vestibulologists carried out intensive work in the field of aerospace medicine. Since the 1970s A.S. Kiselev studied the etiopathogenesis of otosclerosis and in 1984, in his doctoral dissertation, presented a hypothesis about its role in the genesis of a combination of “causal factors” (cause factors) – the presence of remnants of the embryonic cartilage of the labyrinth capsule, and “conditional factors” (conditional factors) – dysfunction of the endocrine system, hypervitaminosis D, etc. He suggested that the normally inert state of the labyrinth capsule (slowness of bone formation processes) is a “successfully chosen by nature developmental variant” of a very small bone for optimal functioning of the membranous labyrinth located in it. Since the 1990s A.S. Kiselev raised the problem of the “forgotten sinus” – the sphenoidal sinus and, more broadly, latent sinusitis in general in the development of visual and intracranial complications. He was a supporter of active surgical treatment of latent sphenoiditis in rhinogenic visual disorders. Performing surgical treatment on patients with rhinogenic optochiasmal arachnoiditis at the Medical Academy, he showed that in this way it is possible to stop the progression of vision loss in them. He drew attention to hyperpneumatization of the sphenoid bone as a possible symptom of rhinogenic optochiasmal arachnoiditis. Later, he described the "pneumatosinus" of the sphenoid sinus – a pathological variant of hyperpneumatization of the sphenoid bone, without inflammation, going beyond its anatomical boundaries, causing visual disturbances, and proposed a surgical method of its inhibition. Deeply studying rhinological problems, he became a well-known figure among Russian rhinologists and brought up a galaxy of students. For 25 years A.S. Kiselev studied the history of Russian otorhinolaryngology, leaving dozens of excellent articles and monographs. His historical texts are dedicated to outstanding figures in medicine – otiatrist Robert Vreden, Grand Duchess Elena Pavlovna – the founder of the Yeleninsky community of sisters of mercy and the Yeleninsky Clinical Institute, surgeon Pirogov, heads of the first department of otolaryngology in Russia – N. P. Simanovsky, V. I. Voyachek, K. L. Khilov, and many important events in the history of medicine. The cultural and scientific meanings that he drew by studying the lives of these remarkable personalities, he tirelessly sought to convey to his students and colleagues.