Diseases Of ENT Organs Research Articles

The main provisions of programs of medical and social rehabilitation of patients with occupational diseases of ent organs

The article discusses the main, modern provisions of the programs of medical and social rehabilitation of patients with occupational diseases of the ENT organs. The criteria of the degree of loss of professional ability to work in hearing loss and malignant neoplasms of the upper respiratory tract are presented. Rehabilitation programs and forms are developed taking into account the needs of the victim in medical, social and vocational rehabilitation, taking into account the potential capabilities and abilities of the victim to carry out professional, domestic and social activities.

Voice rehabilitation after laryngectomy: problems, complications and ways of their elimination

Voice rehabilitation after laryngectomy: problems, complications and ways of their elimination

The structure of lesions of the musculoskeletal system in adolescent children, considering the somatic pathology and living environment

BACKGROUND: Pathology of the musculoskeletal system ranks first among health disorders of the younger generation. The frequency of posture disorders, scoliosis, and flat feet increases as the child grows older and requires careful monitoring, preventive measures, and long-term rehabilitation measures.
 AIM: This investigation studies the formation frequency of lesions of the musculoskeletal system lesions, considering the somatic pathology in adolescent children brought up under various conditions, and addresses the issue of preventive and corrective measures.
 MATERIALS AND METHODS: The main group consisted of schoolchildren aged 1115 from social institutions (n = 60). The comparison group included children from complete families (n = 60). The health assessment was conducted in accordance with the methodological recommendations developed at the Research Institute of Hygiene of Children and Adolescents. The material was copied from forms 112/y, 003/y, 026/y, and the clinical examination results and the conclusions of other specialists were collected. Statistics were evaluated by the Pearsons 2-criterion with the Yates correction, with values of p 0.05.
 RESULTS: The health of children from social institutions was significantly worse than that of complete families (p = 0.04). They were 4.8 times more likely to form chronic diseases (p = 0.04), especially those of the central nervous and musculoskeletal systems, digestive organs, blood circulation, and the ear, nose, and throat (ENT) organs were leading (p = 0.001). Lesions of the musculoskeletal system were more often combined (p = 0.02). In the comparison group, functional disorders occurred more often (p = 0.04), and digestive and circulatory organ diseases prevailed. Pathology of the musculoskeletal system occupied the third position and was significantly less common (p = 0.0001).
 CONCLUSIONS: The health of children from social institutions is worse than that of schoolchildren from complete families. In them, lesions of the musculoskeletal system occupy second place, the frequency of combined lesions is higher, the increase in orthopedic pathology occurs mainly because of scoliosis, flat feet, and posture disorders. Neurodysplastic and idiopathic forms prevail in the structure of scoliosis. In children with scoliosis, diseases of the central nervous system, digestive organs, and blood circulation are more often registered. In children with flat feet, lesions of the digestive and circulatory organs are more often diagnosed. In children with impaired posture, diseases of ENT organs, circulatory organs, and vision are more often detected. Therefore, the musculoskeletal system pathology must be considered as an interdisciplinary problem, requiring a comprehensive rehabilitation program that involves other specialists.

The experience in studying the health status of liquidators to eliminate environmental pollution associated with the production of chemical products

Introduction. Maintaining health and achieving professional longevity is a priority task of medical support for specialists in the power and civil structures of Russia. It is especially important to take into account the impact of several factors of the labour process, as, for example, in the work to eliminate environmental pollution from enterprises producing chemical products, in particular, in the shop of mercury electrolysis. The study aims to explore the health status of employees of law enforcement agencies and civilian personnel involved in the elimination of environmental pollution in the city of Usolye-Sibirskoye, Irkutsk region as a result of economic activities associated with the production of chemical products. Material and methods. The study examined 370 people, whose average age was 28.4±5.5 years, with an average work experience of 6.0±1.05 years. The method of clinical observations was used, the analysis of the results of an in-depth medical examination was carried out in the conditions of the professional center of the clinic of the Federal State Budgetary Scientific Institution VSIMEI. The level and structure of morbidity by the main classes of chronic diseases have been studied. Results. As a result of the analysis of the data of the periodic medical examination, the structural composition of nosological forms of diseases was presented as follows: diseases of the cardiovascular system - 10%, ophthalmological diseases - 5%, endocrinological diseases - 5%, diseases of ENT organs - 10%, practically healthy persons - 70%. The mercury levels were determined at zero values, with the exception of 4 samples, in which the mercury content in the studied urine samples did not exceed the permissible level established by WHO (10 μg / L), the mercury levels in hair samples did not exceed the biologically permissible level (0.0-2,0 μg/g). Conclusion. This study showed the importance of medical examinations using extended examination methods and the need to monitor the health status of liquidators, since the safety of the work carried out also depends on the quality of workers' health.

Approximation analysis in the study of the epidemiology of the epistaxis

2003 to 2019 the total number of patients treated in ENT hospitals was 563 189 people, 20 623 (3.7%) patients were treated with NB, of which 52 (0.25%) died. The average age of the deceased was 64.7 years, men are 73.7% more prevalent than women. In 96.2% of patients, epistaxis was a complication of the underlying disease, and in 3.8%, it was regarded as a concomitant condition. In 30.8% of the deceased, NB recurred with the background of malignant lesions of the nose and nasopharynx, in 69.2% - posthemorrhagic anemia aggravated diseases of other organs and systems. Over the past 17 years, there has been a tendency for the growth of treated patients with diseases of ENT organs and patients with nosebleeds by 58.5% and 51.1%, respectively. The studied approximation of the relative prevalence and mortality rates in patients with NB showed that for the period from 2003 to 2019. trend values are practically at the same level with the minimum multidirectional linear dynamics - -0.24% and +0.04%, respectively.

Headaches in children: a clinical lecture

Headaches are perhaps the most common complaint in children. Unfortunately, often not enough attention is paid to this complaint. Often, primary headache (tension headache, migraine) is interpreted as a symptom of a neurological or other disease, less often the opposite. Not enough attention is paid to the collection of an anamnesis, which determines the correct diagnosis for 90%. Despite its high prevalence, most of our knowledge about pathophysiology, diagnostic criteria and treatment methods is based on extrapolation of the results of studies conducted on adult patients. These extrapolations should be carried out carefully in the pediatric age group, since there are significant differences between children and adults in relation to the development and maturation of neuronal networks, psychosocial development and status, and therefore the pathophysiology and prevalence of various types of headaches. These differences, with respect to the type and manifestations of headaches in children and adolescents, can shed light on the progression of childhood headaches in adulthood.
 We present a description of the clinical picture, diagnostic criteria, and treatment features for the most typical forms of headaches in children: tension headaches, migraines, infectious diseases (including meningococcal meningitis), diseases of ENT organs, urgent conditions, such as traumatic brain injury and subarachnoid hemorrhage. Also, attention is paid to some genetic syndromes CADASIL and MELAS. Special attention is paid to the so-called red flags dangerous symptoms that require immediate diagnostic or treatment procedures. The lecture presents the practical features of the clinical and neurological examination of children with headache complaints, modern classifications of tension and migraine headaches, age-specific prescribing algorithms, illustrations including the results of MRI, external examination of patients, and the course of various forms of headache.

Персистирующий аллергический ринит как фактор, вызывающий и осложняющий течение острых и хронических бактериальных заболеваний ЛОР-органов

Персистирующий аллергический ринит как фактор, вызывающий и осложняющий течение острых и хронических бактериальных заболеваний ЛОР-органов

СТРУКТУРА СОМАТИЧЕСКОЙ ПАТОЛОГИИ У ДЕТЕЙ С АФТОЗНЫМ СТОМАТИТОМ

Aphthous stomatitis is an urgent problem of modern medicine dentistry and is an inflammatory disease of the mucous membrane mouth with a long, manifest flow. The aim of the study is to study the structure of somatic pathology in children with aphthous stomatitis. In the course of the study, a single-center clinical examination and treatment was performed at the clinical dental clinic of the Federal state budgetary educational institution of higher education "Bashkir state medical University" of the Ministry of health of the Russian Federation in 37 patients (20 boys and 17 girls) aged 4 to 14 years. The diagnosis of concomitant systemic pathology was recorded based on the results of the conclusions of district pediatricians, ENT doctors, gastroenterologists, immunologists, allergists, and rheumatologists. As a result of the study, it turned out that all the examined patients had comorbidities, namely, chronic diseases of the gastrointestinal tract, diseases of ENT organs, allergic reactions, as well as a violation of the immune status, Behcet's disease. Based on the results of the study, it turned out that patients with aphthous stomatitis, as a rule, have a wide range of health-related problems, which should be taken into account when drawing up a comprehensive treatment plan for patients with this disease. The somatic status of all patients with aphthous stomatitis is burdened with comorbid pathology. The structure of somatic pathology in patients with aphthous stomatitis is dominated by diseases of the gastrointestinal tract (chronic gastritis in 17 people, gastric and duodenal ulcer in 1 person, biliary dyskinesia in 5 people, chronic cholecystitis in 3 patients, Crohn's disease in 1 patient).

Modern approaches to diagnosis and treatment of Eagle’s syndrome

Stylohyoid syndrome (Eagle Sterling syndrome) – a complex of symptoms caused by the change in the position, shape and size of the styloideus process and (or) calcification of the stylohyoideus and submucosal ligaments, resulting in irritation of the dorsal and posterior process and muscle structures. As a rule, this disease is not diagnosed because of the low awareness of practitioners. Patients with different diagnoses are treated by different specialists: dentists, ENTs, neurologists, and prolonged symptomatic treatment is ineffective. In patients with the presence of Eagle Sterling syndrome impaired performance is present and dramatically reduced quality of life, which determines the social significance and relevance of problem of diagnosis and treatment of this disease. Materials and methods: During the period from 2009 to 2020 in the department of inflammatory diseases of ENT-organs of the State Institution «O.S. Kolomiychenko Institute of Otolaryngology of National Academy of Medical Sciences of Ukraine» 13 persons with this pathology (10 men and 3 women) aged from 25 to 60 years, who turned to our institution after unsuccessful treatment by a neurologist, dentist and specialists of other related specialties, were examined and operated. 3 people were diagnosed with a stylo-carotid and in 10 – stylopharyngeal type of SHS. Surgical removal of styloideus process of the temporal bone, depending on the anatomical features of the styloideus process, was performed by external access at the anterior edge of the nodding muscle (10 patients) or transoral access (3 patients). Results: No patients were observed in the postoperative period, the wounds healed with primary intention. The disappearance of the pain syndrome a few days after surgery was noted in 7 patients, in others complaints it persisted up to 1 month, while there was a positive trend, and only 1 patient remained the intensity and nature of the pain syndrome. Thus, patients with the Eagle’s syndrome have a high effect of surgical treatment and relatively short postoperative rehabilitation, which significantly improves their quality of life.

Integration of diagnostic and treatment methods of pediatric ENT diseases into the practice of a pediatrician

In his or her daily practice, a pediatrician often has to encounter various ENT diseases, since more than half of visits to children's clinics are associated with various conditions of ENT organs. This article highlights the issues of introducing diagnostic and treatment methods for acute and chronic diseases of ENT organs into the daily practice of pediatricians.

Inflammatory diseases of ENT organs and purulentseptic intracranial complications associated with them in the Kabardino-Balkarian Republic

Actuality. The growth of inflammatory diseases of ENT organs and associated purulent-septic intracranial complications is an urgent problem of modern otorhinolaryngology. Severe complications associated with sepsis and inflammatory lesions of the membranes and brain matter are life-threatening conditions for otorhinolaryngological patients.Objective. To study the epidemiological situation of inflammatory diseases of the ENT organs and associated purulent-septic intracranial complications in the Kabardino-Balkarian Republic.Materials and methods. Data of official statistics, electronic databases, statistical reports of the Ministry of Health of the KabardinoBalkan Republic, data of outpatient’s medical records and hospital medical records of multidisciplinary medical and preventive institutions, data on the prevalence of diseases of ENT organs in the Kabardino-Balkarian Republic from 2011 to 2018 among adults and children.Results and conclusions. The results obtained reflect a significant increase in inflammatory diseases of the ENT organs in the Kabardino-Balkarian Republic from 2011 to 2018. both in the number of reported cases and in the primary incidence. Despite the decrease in the number of inpatient ENT beds in the Republic in 2013, the number of patients treated increased. The reduction of ENT beds entailed an increase in hospital mortality, which is represented exclusively by ENT-associated intracranial complications. Today, the Republic has a rather high level of ENT-associated intracranial complications associated with low prevention and diagnosis of inflammatory ENT diseases, which dictates the importance of using a multidisciplinary approach (ENT doctor, neurologist, ophthalmologist, resuscitator, therapist, neurosurgeon), the need for review management tactics, development of algorithms for the diagnosis and optimal treatment of patients with ENT-associated HFD.

Level of Stress in Students with the Disturbance of Nasal Breathing and Comorbid Disorders

Background. The progressive increase of the number of schoolchildren with adaptation disorders and low level of health in recent years determines the need to assess the characteristics of the psychosomatic status in children and adolescents with various types of somatic pathology, including diseases of ENT organs, accompanied by nasal breathing disorders and hypoxia. It is also necessary to determine the severity of stress in children, for timely prevention and correction of these disorders.Aim: to assess the level of stress in schoolchildren with nasal breathing disorders against the background of nasal diseases and concomitant psychosomatic disorders.Materials and methods. 481 schoolchildren aged 12–17 (boys and girls) were examined. Nasal breathing disorders were assessed by a comprehensive ENT examination, including rhinoscopy, radiography of the sinuses, and olfactometry. The presence and severity of stress were determined by the questionnaire “Social factors and stress”.Results. We found that the high level of stress in children with nasal breathing disorders on the background of ENT pathology is more often associated with the high frequency and severity of psychosomatic symptoms: the presence of dorsalgia, asthenic syndrome, chronic headache and frequent episodes of abdominal pain. Moderately and significantly increased levels of stress associated with the presence of children with hypertension, asthenic syndrome, frequent abdominal pain, frequent pain in the cervical spine, panic disorders.Conclusions. Thus, the presence of certain psychosomatic complaints in children with nasal breathing disorders is directly related to the level of stress, which is important to take into account when planning preventive and corrective measures aimed at increasing the adaptive capacity and stress resistance of children. The studies illustrate the need to assess the psychosomatic status and the level of stress in schoolchildren with nasal breathing disorders taking into account their existing comorbid disorders of the psychosomatic spectrum.

ETIOLOGICAL STRUCTURE OF PURULENT- INFLAMMATORY DISEASES OF ENTORGANS IN AMBULATORY PATIENTS OF CHERNIVTSI TOWN

Objective - to study the etiology of purulent-inflammatory diseases of ENT organs andestablish its features, depending on the localization of the infectious process.Material and methods. The bacteriological research of a material selected from 632 ambulatory patients of different age with suppurative and inflammatory diseases of ENTorgans of Chernivtsi was carried out. The inoculum from the mucous membrane of thepalatine tonsils, the nose and from the outer ear in the number of 561, 56 and 15 respectively was isolated and studied. Identification of the selected cultures was carried outaccording to the morphological, tinctorial and physiological-biochemical characteristics.Results. Dependence of the spectrum of isolated etiologically significant microorganismson the localization of the pathological process was revealed. S.aureus strains (55.8% and72.0% respectively) were most often isolated from the tonsils and nasal mucosa, whereasmicroscopic fungi (44.4%) from the outer ear. In the vast majority of cases, monoculture ofan etiologically significant microorganism was isolated from one sample. The associations of two pathogens were identified from the mucous membranes of the tonsils in twocases and three strains of microorganisms in two cases more, which together amounted to14.5% of cases. The etiological role of the associations of two pathogens was alsoidentified in 12.5% of the cases from the outer auditory passage and in 8.7% of the casesof nasal mucosa.Conclusions. 1. The main etiologically significant pathogens of purulent-inflammatorydiseases of ENT organs in ambulatory patients were conditionally pathogenic microorganisms (including fungi). 2. The leading role in the etiology of purulent-inflammatorydiseases of the tonsils and the nasal cavity has S.aureus.3. Microscopic fungi of the genus Candida and Aspergilus are the most common cause ofinflammatory diseases of the external ear

Birth injury to the cervical spine as a cause of acute ethmoiditis in children

Aim. Improvement of the efficacy of diagnosis of spondylogenic ethmoiditis in children. 
 Methods. The study sample included 82 children aged 3 to 10 years: 39 (47.6) boys and 43 (52.4) girls. Patients were divided into three groups. Group 1 included 20 patients with acute ethmoiditis; group 2 included 31 patients with other diseases of ENT-organs; group 3 included 31 relatively healthy children. Apart from physical examination performed by an otorhinolaryngologist, pediatrician, neurologist and other specialists, and X-ray of paranasal sinuses including contrast radiography, the investigation plan included facial electromyography in ethmoid sinus projection area. 
 Results. Electromyographic parameters in relatively healthy children corresponded to the reference while in patients with acute ethmoiditis muscle tone in ethmoid sinus projection area was increased and amplitude of contractions was decreased, which was caused by muscle spasm. Increased latency of M response was revealed compared to the norm on both sides. In the group of patients with other diseases of ENT organs the following results were obtained: muscle tone in ethmoid sinus projection area was increased as well as in group 2, contraction amplitude was decreased that is a result of spasm and muscle tension. M response latency exceeded normal value only on one side where the most severe inflammatory process was observed. 
 Conclusion. To confirm the relationship between congenital pathology of the cervical spine and inflammatory process in nasal cavity and cells of ethmoid labyrinth, electromyography is warranted.

Features of defeat of ent organs at adult patients with CF

Among diseases of ENT organs at patients with the CF prevails chronic rhinosinusitis. Stagnation of the infected dense slime in the paranasal sinus and violation of nasal breath aggravates weight of a course of lung pathology. Timely inspection and treatment of pathology of the top airways at patients with CF is necessary. In surgical treatment method of a choice is expanded FESS. This technique allows to keep anatomy of a facial skeleton and to provide a drainage the paranasal sinus. Supervision by the ENT specialist and conservative treatment of a chronic rhinosinusitis has to is carried out during all life of the patient with CF. Continuous use of local mukolitichesky and antibacterial therapy is necessary. As method of delivery of medicines the compressor inhaler with the mode for the chronic rhinosinusitis can serve.

Application of semiconductor LED laser generators in otorhinolaryngology

The review article provides brief data on the classification of lasers in medicine, the history of the use of therapeutic lasers. The problems of the use of semiconductor lasers in inflammatory diseases of various etiologies, as well as in various diseases of ENT organs, in particular, in diseases of the middle ear are considered.

Паратонзиллиты. Современное состояние проблемы по материалам Ростовской клиники болезней уха, горла, носа

Paratonsillitis is one of the most common urgent diseases of ENT organs. The objectives of the study included a retrospective analysis of patients’ complaints about acute exacerbation of chronic tonsillitis and its complications, as well as the study of the specific features of microbial spectrum of paratonsillitis pathogens and its changes at various stages of the disease. The authors analyzed the out-patient encounters logs for a 10-year period. In parallel, bacteriological studies of the contents of the cavities of paratonsillar abscesses in 76 outpatient patients treated for this pathology were conducted. It has been found that anginas and paratonsillitis occupy a significant position in the structure of urgent pathology of ENT organs, with a steady increase of the number of visits. At the same time, the statistics of planned surgical interventions for chronic tonsillitis and its complications indicate an insufficient use of surgical treatment methods The predominant paratonsillitis pathogens were: Streptococcus-β-haemolythicus, Streptococcus pneumoniae and Staphylococcus aureus, which had high levels of colonization. Cephalosporins and penicillins used as monotherapy, in most cases, did not completely suppress the growth of pathogenic microflora in the focus of inflammation. The authors revealed high level of non-clostridial anaerobic flora (in more than 20% of cases). Anaerobic flora was found in primary and repeated smears in the equally high percentage of cases, which indicates its resistance to the standard antibiotics used for the treatment of this pathology.

Early Predictors of the Response to Adalimumab Therapy in Patients With Juvenile Idiopathic Arthritis Without Systemic Manifestations: A Prospective Cohort Study

Background . Tumour necrosis factor alpha inhibitors are widely used in the treatment of juvenile idiopathic arthritis (JIA). To achieve maximum efficiency of genetically engineered biologic drugs, it is necessary to study predictors of the response to therapy. Objective . Our aim was to identify early predictors of the response to adalimumab therapy in patients with JIA without systemic manifestations. Methods . A prospective cohort study analysed treatment results of patients with JIA without systemic manifestations, who were prescribed adalimumab for the period from August 2008 to August 2014. We studied the relationship between baseline demographic indicators as well as baseline and registered after one month of treatment clinical and laboratory parameters and the best (remission according to the Wallace criteria) response to therapy after one year. Results . In the first year of therapy, 94 (43.9%) of 214 patients achieved remission according to the Wallace criteria. In a multivariate analysis, predictors of achieving remission after one year of adalimumab therapy were the improvement according to the ACR70 criterion after one month of therapy [odds ratio (OR) 3.3; 95% confidence interval (CI) 1.7–6.7], a history of uveitis (OR 1.86; 95% CI 1.03–3.33), a decrease in the number of joints with active arthritis after one month of therapy (OR 1.09; 95% CI 1.02–1.16). During therapy, injection reactions in the form of pain were observed in 36 (16.8%) of 214 patients, infectious diseases of ENT organs — in 85 (39.7%), of the respiratory tract — in 17 (7.9%), and tubinfection — in 13 (6.1%) children. Conclusion . The presence of uveitis, rapid reduction in the number of joints with active arthritis and a high level of response to treatment after one month of adalimumab therapy are predictors for achieving remission during the first year of treatment.

Diagnostics and treatment of myofascial syndrome in the ENT-clinic: analysis of five-year experience of L. I. Sverzhevskiy Otorhinolaryngology Research Clinical Institute

Goal of research - to evaluate the role of myofascial syndrome developing on the background of cervical pathology, dysfunction of the temporomandibular joint or occlusive disorders. The myofascial syndrome manifests itself in the development of pain phenomena, cochlear and vestibular symptoms similar to the symptoms of the diseases of the ENT organs.Materials and methods. We have analyzed the results of several studies conducted in 2012-2017 at L. I. Sver-zhevsky Otorhinolaryngology Research Clinical Institute, which involved more than 3 000 people with neck and head pain and/or cochleovestibular symptoms in combination with myofascial pain syndrome (MFPS), developing on the background of cervical pathology, dysfunction of the temporomandibular joint or occlusive disorders.Results. Patterns of development of the MFPS in head and neck regions, as well as peculiarities of diagnostics of trigger points with pain and non-pain manifestations (buzzing in ears, ear fullness, loss of hearing, dizziness) were defi ned. The principles of MFPS treatment with pain and non-pain manifestations and therapy options used in L. I. Sverzhevsky Otorhinolaryngology Research Clinical Institute were described. The effect of pathogenetic therapy is shown in the collaborative work of doctors of different specialties: ENT specialist, neurologist, physiotherapist and dentist.Conclusion. Myofascial syndrome of the pericranial muscles can be one of the causes of face and neck pain imitating diseases of ENT organs and dental pathologies. Treatment of such clinical forms should be the subject of an interdisciplinary approach. It should include pharmaceutical and non-pharmaceutical methods: analgesia, relaxation and stretching of the corresponding muscles.

RATIONAL SOLUTION OF THE PROBLEM OF LOCAL SYMPTOMATIC TREATMENT IN ACUTE OTITIS MEDIA

Inflammatory diseases of the middle ear are found in all age groups. Acute otitis media is diagnosed in 20–30% of cases among the total number of patients with various diseases of ENT organs. The disease usually lasts no more than three weeks, but the development of a prolonged or recurrent acute otitis media, which can lead to persistent changes in the middle ear and hearing loss, may occur. The recurrent course of acute otitis media leads to the development of chronic inflammatory pathology of the middle ear, to a progressive decrease in hearing, causing a disruption in the formation of speech and general development in young children. Timely diagnosis and adequate treatment of acute otitis media prevent the development of possible menacing complications.