To determine a practical benefit from using this technology at the rehabilitation stage of cochlear implantation. Cases of 100 patients from 10 months to 74 years old, Δ=17±8.6 years, who underwent a rehabilitation course or the speech processor exchange at the St. Petersburg Research Institute of ENT in 2025 were prospectively studied. All patients had a MedEl cochlear implant with a straight type of electrode array: standard (n=69), flex-soft (n=31). Objectives of the study: to assess the correspondence between the standard implant telemetry and the impedance field telemetry heat maps; to identify additional information when analyzing heat maps; to determine indications for using the technology at the rehabilitation stage of cochlear implantation. : In all (100%) cases, impedance field telemetry heat maps served as a convenient graphical representation of the data, an additional opportunity appeared to evaluate each of the system contacts for all possible stimulation options. In 18 patients (18%), additional information had clinical significance and influenced the specialist's decision-making, which is illustrated by clinical examples of three patients. : Impedance field telemetry is an informative and convenient diagnostic method, both intraoperatively and at the rehabilitation stage. Heat maps do not completely replace classical telemetry, but they help to obtain additional information, which is of clinical significance in some cases. The method should be used in conjunction with implant telemetry in complex or ambiguous situations.

The analysis of cases of unilateral laryngeal paralysis identified in the Sverzhevsky Research Clinical Institute of Otorhinolaryngology in 2018-2024 was carried out. Laryngeal paralysis was detected in 11% of all outpatient patients with a phoniatric profile. The etiology is dominated by iatrogenic genesis, intraoperative trauma (71%), more often due to interventions on the thyroid gland, parathyroid glands and blood vessels. According to the results of a comprehensive examination of patients, laryngeal paralysis of unknown etiology was diagnosed in 16.5% of cases. The assessment of the clinical and functional state of the larynx in most cases showed a predominant paramedian position of the paralyzed vocal fold with the phenomena of rotation of the arytenoid cartilage and compensatory hypertrophy of the vestibular larynx. Complex therapy in combination with phonopedia has resulted in the best results of restoring mobility and compensating for vocal function and is preferred in patients with unilateral laryngeal paralysis.

Surgical intervention remains one of the main methods of treating chronic tonsillitis, it allows patients to completely eliminate the symptoms of the disease and improve their quality of life. However, bilateral tonsillectomy is associated with the risk of postoperative complications, which are often life-threatening for the patient. The presented systematic review contains information about bleeding that occurs after bilateral tonsillectomy, as well as measures to prevent it. The analysis includes original articles, case reports, and literature reviews.

Allergic rhinitis (AR) leads not only to significant nasal obstruction and ocular symptoms but also, by affecting the entire respiratory epithelium, causes combined damage to the Eustachian tube and middle ear, resulting in exudative otitis media (EOM). To evaluate the clinical features of EOM of allergic origin and to compare treatment regimens targeting allergic inflammation - with the goal of restoring Eustachian tube function and middle ear drainage - 329 patients with confirmed allergic rhinitis were examined. Following otorhinolaryngological and audiological evaluations, pathology of the middle ear and Eustachian tube was identified in 51% of cases (168 individuals). Interestingly, 16% of these patients subjectively reported no hearing loss or sensation of ear fullness, despite objective confirmation of pathology. To assess the comparative effectiveness of different AR therapy regimens and their impact on middle ear and Eustachian tube pathology, the 168 affected patients were divided into four parallel groups: Main group (41 patients): treated with a fixed-dose combination of mometasone furoate and olopatadine hydrochloride (Rialtris); Control group 1 (45 patients): received intranasal monotherapy with mometasone furoate; Control group 2 (41 patients): treated with the oral antihistamine levocetirizine; Control group 3 (41 patients): received combination therapy of intranasal mometasone furoate and oral levocetirizine. To monitor the restoration of auditory tube function and middle ear pneumatization, tympanometry and micro-otoscopy were performed on days 1, 7, 14, and 30. All treatment regimens positively influenced Eustachian tube dysfunction. The combination of intranasal mometasone furoate and oral levocetirizine demonstrated superior efficacy, with a statistically significant difference (p=0.01, CO = -33.60; 95% CI -61.05 to -6.15). Due to the accelerated recovery of Eustachian tube function and restoration of its drainage capabilities, the need for invasive middle ear drainage procedures (e.g., shunting, tympanostomy) was eliminated in the group receiving the fixed intranasal combination of mometasone furoate and olopatadine hydrochloride. This fixed-dose combination appears to be the optimal treatment for allergic Eustachian tube dysfunction, owing to its direct endonasal action on the respiratory epithelium at the Eustachian tube, allowing for rapid restoration of middle ear ventilation.

The review is devoted to the problem of balance disorders combined with hearing loss in pediatric population. The balance function is implemented by three systems: visual, somatosensory and vestibular and plays an important role in the child's development. The critical period for vestibular system development occurs prior to a child taking their first independent steps and the balance system continues to mature until approximately 4-6 years of age. According to various sources, vestibular disorders may occur in children with sensorineural hearing loss with a frequency ranging from 8% to 85% without any correlation to the degree of hearing impairment. These balance disorders, in combination with hearing loss, have been shown to limit various aspects of a child's development such as motor and cognitive skill acquisition, learning, sports participation, physical activity, written expression, reading ability, communication, and social interaction. In modern clinical practice, a framework for an algorithm has been developed to diagnose balance disorders in children of different ages. These methods should be tailored to each child's developmental level and be highly informative, while also complementing each other in terms of results. Approaches are currently being explored to screen for vestibular issues in children with confirmed hearing loss. Data on changes in balance in children underwent cochlear implantation is conflicting. In the immediate postoperative period, some patients may experience transient vestibular dysfunction, but over time, there is a general trend towards improved balance. Discussions are underway regarding the potential of vestibular rehabilitation as part of a comprehensive approach for children with hearing impairment. This includes enhancing neuroplasticity through adaptation, habituation, and substitution. It is essential to investigate the efficacy of various methods of rehabilitation for children with hearing loss who experience balance issues.

The usage of stents is one of the effective prevention methods of postoperative complications during endonasal surgeries. Nowadays there is a large number of stenting methods, both using off-the-shelf technical solutions and using products made directly during surgery of available materials. This review is devoted to stents application in functional endoscopic surgery of paranasal sinuses. Different variants of stents are described, the author's classification of stents is proposed, the issue of stent placement time is studied, the effectiveness of different methods of endonasal stenting was compared. Stenting of the paranasal sinuses is an effective method of postoperative complications' prevention, but further studies are required to determine the most optimal forms of stents and the timing of their placement.

To study the data and results of surgical treatment of PBCs in the world literature, to study the factors and possible causes of recurrence of PBCs. Generalization of the obtained data, their systematization. A systematic literature search of databases (PubMed, Google Scholar, eLibrary) was conducted to identify articles from 2010 to 2025. Medical Subject Headings (MeSHTerms) and keywords were used as the search strategy petrous bone OR petrous[AllFields] AND bone[AllFields]) OR petrous bone[AllFields]) AND (cholesteatoma[MeSHTerms] OR cholesteatoma[AllFields] OR cholesteatomas[AllFields])). In eLibrary, the search was performed using the query petrous bone cholesteatoma. The search was limited to articles in English and Russian. Of the 530 articles devoted to the topic of petrous bone cholesteatoma and its recurrence, repeated publications and works performed by the same group of authors were excluded from the study at the data search stage; publications were also excluded for other reasons (in total, n=456). The inclusion criteria for the study were defined in the database of patients with petrous bone cholesteatoma of the presented series: the number of patients should be more than 10, the use of the PBCs classification according to Sanna from 2016, performed surgical approach, recurrence rate, time of observation. Taking into account the listed criteria, 16 publications were included in the study. The total number of patients was 970. The distribution of PBCs extension: supralabyrinthine (SL) 50.7%, then massive (M) 25.8%, infralabyrinthine (IL) 8.4%, infralabyrinthine apical (ILA) 8.2%, apical (A) 6.8%. The most common surgical options were transotic approach (TO) - 201, translabyrinthine approach (TL) - 165, modified transcholear approach (MTC) - 96. The types of complications and their frequency of occurrence, options for surgery ending and the impact of these factors on the recurrence of PBCs were analyzed. The recurrence rate in the 16 publications studied ranged from 1.6% to 29%. The causes of recurrence of PBCs are multifactorial. It is important to take into account the type of lesion, surgical approach using additional equipment, and the surgery ending. In the 16 described series of clinical cases the average incidence of recurrence of PBCs is 13.8%, with 50% of the recurrent lesions in the supralabyrinthine type. It is impossible to establish a causal relationship between the recurrence of PBCs due to the fact that the studied literature does not have enough data to conduct a meta-analysis. The problem of recurrent PBCs requires further studies, accumulation of experience, presentation of the obtained results, and a search for a relationship between recurrence and the factors that determine it.

To evaluate the features and the effectiveness of surgical removal of an inverted papilloma with preliminary endovascular embolization as a preparatory stage. We conducted a retrospective analysis of the medical cards of 8 patients with a diagnosis of inverted papilloma of the nasal cavity and paranasal sinuses, who underwent elective surgical treatment with preliminary embolization of the vessels feeding the tumor in the ENT department of Botkin Moscow Multidisciplinary Scientific and Clinical Center from the beginning of 2020 to December 2024. The demographic and clinical data of patients, as well as the main aspects of endovascular interventions and characteristics of the surgical stage of sinonasal papilloma removal were analyzed. A clinical case of simultaneous embolization and removal of an inverted papilloma in a hybrid operating room using the Artis pheno (Siemens Healthineers) angiographic system is described. Males predominated among the studied patients, accounting for 75%. The age of the patients ranged from 37 to 82 years, with an average age of 70.5 [49; 74.5]. In the analyzed cases, inverted papilloma was at stage T3 (6 patients) and at stage T4 (2 patients) according to Krouse classification. 7 patients had concomitant chronic non-communicable diseases. In all cases, the first stage was performed by distal embolization of the branches of the maxillary artery. No post-embolization complications were registered in any of the cases. In the second stage, all the patients were operated on using an endoscopic or combined (endoscopic and external) approach, depending on the extention of the tumor, by the same surgeon. Four patients with stage T3 were undergone of the tumor removal through a prelacrimal approach. The volume of blood loss was 200 [137.5; 262.5] ml. The tumors were radically removed due to excellent visualization of the surgical field. The surgery time was 67.5 [62.5; 77.5] minutes. After analyzing the presented series of clinical cases, we can conclude that endovascular embolization is safe and effective stage before surgical removal of an inverted papilloma of the nasal cavity and paranasal sinuses. As a minimally invasive stage of preoperative preparation, it can be used in somatically compromised burdened patients. The combination of high-quality visualization of blood flow features, including the use of flat-detector computed tomography, and a rational method of endovascular occlusion allows interventional radiologists to perform intravascular intervention with minimal risk of complications. As a result, improved intraoperative overview due to devascularization and the choice of optimal surgical access ensure radical removal of the tumor. The undoubted advantages make it possible to integrate this approach into clinical practice.

To improve the results of treatment of acute rhinosinusitis through the use of Inflasinusans, taking into account the assessment of the clinical picture and olfactory function. 70 patients with acute sinusitis aged 18 to 65 years (39 women, 56%; 31 men, 44%) were examined. To assess the treatment results, a visual analog scale, an endoscopic examination of the nasal cavity, an assessment of the olfactory thresholds using the RVSS test and an olfactory dysfunction questionnaire were used. According to the study, it was reliably confirmed that the use of the natural herbal vitamin complex Inflasinusans, consisting of extracts of herbs (elderberry, primrose, hops and thyme), enriched with vitamin C, zinc and dihydroquercetin, contributed to a more intensive improvement in the clinical picture and restoration of the sense of smell. The olfactory index in patients using Inflasinusans was 0.2 higher than in the control group. In addition, 8.5% of the control group did not recover their sense of smell even after 3 weeks of treatment, which was not detected in the main group. The use of Inflasinusans in the treatment of acute rhinosinusitis reduces the symptoms and inflammatory response, as well as accelerates the restoration of the sense of smell, which makes it possible to recommend the plant-vitamin complex Inflasinusans as part of combination therapy for acute rhinosinusitis both at the start and on any day of the disease.

An algorithm has been developed to accompany adolescents at the stages of determining indications and postoperative rehabilitation for sequential bilateral cochlear implantation with a long interval between operations, minimizing the risk of failure to use a cochlear implant (CI) in the second ear (CI2) and ensuring its effective use. The algorithm includes: 1) 2 groups of factors influencing the results of CI2 - unchangeable (medical and biological) and influenceable (psychological and pedagogical - teenager's motivation for CI2, adequate expectations of the results, regular auditory training with CI2); 2) 4 stages of adaptation to stimulation with CI2 and use of CI1 with CI2; 3) audiological, physiological, psychological, auditory training components of the adaptation process to CI2. The study involved 26 prelingually deaf adolescents aged 10-16 years (mean 13.5±3.1 years) implanted in one up to 3 years, who did not use a hearing aid in the second ear after the surgery. The interval after the first surgery was 8-15 years (9.3±4.4 years). 2 candidates were denied implantation in the 2nd ear because of the low effectiveness of CI1 due to additional severe impairments. In two patients, the decision to perform CI2 was postponed due to the lack of motivation. After 6 months with regular auditory training with CI2 and CI1+CI2 with the participation of parents, all 22 adolescents constantly used both CIs and noted the advantage of use of CI1+CI2. The level of auditory perception with CI2 approached the level of perception with CI1 according to the CAP scale in 64% of adolescents. In 8 patients the auditory perception indices with CI2 were lower than with CI1, primarily due to underdevelopment of phonemic hearing.