The human nose, crucial for respiratory function and facial aesthetics, exhibits diversity influenced by evolution, genetics, and environment. Tibetan populations, indigenous to the high-altitude Qinghai-Tibet Plateau, possess well-documented physiological adaptations to hypoxia. However, a comprehensive anthropometric analysis of their external nasal morphology, particularly regarding sexual dimorphism and regional variation, remains lacking. We conducted a cross-sectional study of 508 healthy Tibetan adults (233 men, 275 women) aged 18 to 25 years from 4 prefectures. Standard anthropometric instruments were used to measure nasal dimensions. Derived indices included the nasal index (NI), nasal tip projection width index (NTPWI), and nasal tip projection length index (NTPLI). Data were analyzed using non-parametric tests, general linear models (GLM) adjusting for age, correlation analyses, and χ2 tests. Men had significantly greater nasal width (median: 3.80 vs. 3.39cm), nasal depth, and NI (median: 76.92 vs. 61.51), whereas women had greater nasal height (median: 5.41 vs. 4.90cm) (all P <0.01). Regional heterogeneity was more pronounced in men. Those from Shigatse had significantly greater nasal height and depth. In women, limited regional variation was observed, and nasal morphology was influenced by age. Nasal type distribution differed significantly by sex (χ²=306.803, P <0.001): mesorrhine was most common in men (65.7%), whereas leptorrhine predominated in women (58.2%). Nasal morphology in young Tibetan adults exhibits significant sexual dimorphism and regional variation, particularly among men. These patterns likely reflect a complex interplay of high-altitude adaptation, developmental plasticity, and population history.

Staphylococcus aureus colonises the nose in humans, with individuals defined as persistent, intermittent or non-carriers. Unlike the gut microbiome, the nasal microbiome has not been studied in large numbers of people. Here, we define the nasal microbiome in ~1100 individuals from the CARRIAGE study (ISRCTN: ISRCTN10474633) and combine with S. aureus culture data. We identify seven community state types (CST), including two CSTs more common in females. Approximately 70% of those who are persistently colonised with S. aureus have a CST dominated by S. aureus, while non-carriers are distributed across the other six CSTs. Intermittent carriers are not a unique state but have microbiomes that resemble non- or persistent carriers. Persistent carriage is positively associated with S. aureus abundance, and negatively associated with three Corynebacterium species, Dolosigranulum pigrum, Staphylococcus epidermidis, and Moraxella catarrhalis; the microbiome can be exploited with machine learning to accurately predict the persistence of S. aureus colonisation. Finally, we find that certain S. aureus lineages are better adapted to colonisation than others. Our data provides a comprehensive view of the nasal microbiome with respect to S. aureus colonisation, describing two key states: a S. aureus dominated CST in which S. aureus shapes the microbiome, and CSTs in which S. aureus is rare or absent.

Background. Chronic tonsillitis is a chronic disease with local manifestations in the form of a persistent inflammatory reaction of the palatine tonsils, a fairly common pathology in the human population. In some cases, such patients are shown and undergoing surgical intervention – bilateral tonsillectomy (BT), the most serious complication of which is bleeding from the amygdala niches. Unfortunately, modern measures aimed at preventing and stopping bleeding do not always adequately solve this problem. The topic of postoperative control and acceleration of regenerative processes after removal of palatine tonsils remains relevant. Aim. To evaluate the effect on the course of the wound process after BT of the use of a topical complex hemostatic drug based, among other things, on the results of digital optical methods for assessing blood supply. Materials and methods. The study was conducted at the Clinic of Ear, Throat and Nose Diseases at Sechenov First Moscow State Medical University (Sechenov University). The study included 140 (100%) patients aged 18 to 66 years, including 60 (42%) men and 80 (57%) women who underwent BT for medical reasons. A 1% aqueous solution of an incomplete silver salt of polyacrylic acid containing silver nanoparticles was used as a complex hemostatic preparation. All observed patients were divided into 3 groups: a control group 1 without the use of the drug, a group 2 with topical intraoperative use of the drug, a group 3 with topical intraoperative and postoperative use of the drug. All patients underwent pain assessment using the Wong–Baker visual analogue facial pain scale, cytological examination from the surface of the amygdala niche, and digital visual assessment of the condition of the postoperative field. Contactless photoplethysmography was used as a digital optical method for assessing blood supply. Results. The study showed a decrease in pain in the pharynx, an increase in bacterial phagocytosis, an acceleration of fibrin release, the appearance of fibroblasts and the transition of the leukocyte reaction to polymorphocellular in both groups with topical application of the studied drug. The severity of these effects was higher in patients who received intraoperatively and in the postoperative period. The possibility of carrying out a noninvasive quantitative assessment of blood filling of the oral mucosa tissues, which are difficult to access for traditional imaging methods, without causing discomfort to the patient is demonstrated. The proposed approach can complement the existing methods of managing patients after BT in clinical practice. Conclusion. In clinical conditions, the effectiveness and safety of a new integrated approach to the management of patients after BT, based on the use of the hemostatic drug Hemoblock to prevent bleeding and accelerate regeneration, as well as the photoplethysmography method for noninvasive quantitative assessment of blood filling of amygdala niches in the postoperative period, has been demonstrated.

Single cell sequencing analysis of respiratory syncytial virus-infected pediatric and adult human nose organoids reveals age differences, proliferative diversity and identifies novel cellular tropism.

Objective. Statistical analysis of morphometric indicators and morphological type of the crista galli depending on the sex and age of the child with dermoid cyst of the external nose and deviation of the nasal septum. Patients and methods. The results of multislice computed tomography (MSCT) of the paranasal sinuses (PNSs) were analyzed in 81 patients aged 1—17 years. The study included two groups: the 1st group — 31 patients with dermoid cyst of the external nose; the 2nd group — 50 patients with deviation of the nasal septum. Results and conclusion. There was no dependence of morphometric indicators and morphological type of the crista galli on the sex in the analysis of the MSCT of the paranasal sinuses data in children with dermoid cyst of the external nose and deviation of the nasal septum.

Objective. To determine the prevalence of nasal bone fractures (NBFs) using cone beam computed tomography (CBCT). Material and methods. The continuous study is devoted to prevalence, localization and sex-specific differences in NBFs based on a retrospective analysis of 1000 cone beam CT scans of patients who complained of the nose and paranasal sinuses disorder. Results. Radiographic signs of NBFs have been found in more than 43% of the examined patients, and significantly more frequently in men than in women. The differences between the isolated NBFs on the left were 32% higher than on the right, and variation amounted to 15% for the frontal processes of the maxilla. Significant differences in the frequency of external nose fractures depending on the sex have been found. This indicator amounted to 62% for nasal bones among men, and among women — 38%. Men also led among the fractures of the frontal processes of the maxilla: 78.5% of cases versus 21.5% in women. Conclusion. The wide prevalence of NBFs (43% of cases at admission with complaints of the nose and paranasal sinuses disorder according to CBCT) should be considered in the examination of patients with pathology of the nose and paranasal sinuses.

Objective:To observe the effects of different repair methods in the defects after Mohs surgical excision of malignant nasal tumors. Methods:Twenty-two cases of external nasal malignant tumor surgery from January 2021 to May 2024 were selected as the research. The tumors were resected using Mohs surgical technique, and the defects were repaired using forehead axial flap, bipedicle flap, nasolabial flap, free full-thickness skin graft from the groin, forehead axial flap, facial kite flap, and composite flap of earlobe cartilage and perichond. The postoperative flap survival, external nasal morphology, and tumor recurrence were observed. Results:Among the 22 cases, there were 1 case of Kaposis sarcoma（KS）, 2 cases of squ cell carcinoma, and 19 cases of basal cell carcinoma. Tumors were located at the nasal root in 3 cases, the nasal dorsum in5 cases, the nasal tip in 2 cases, the ala in 8 cases, both the ala and the nasal dorsum in 2 cases, nasal columella, the nasal tip, and the ala in 1 case, the nasal tip, the nasal dorsum, the ala, and paranasal area in 1 case. The size of the defects ranged from 1.2 cm×1.4 cm to 3.7 cm×4.8 cm. Three cases were repaired with forehead axial flaps, four cases with bilobed flaps, thirteen cases with nasolabial groove flaps, one case with free full-thickness skin grafts from the inguinal region, and one case with a combination of forehead axial flaps and facial kite flaps plus a composite of earlobe cartilage and perichondrium. All flaps survived well after surgery. Patients were followed up for 6 months to 3 years after surgery, during which no tumor recurrence was observed, and most patients were satisfied with appearance of their nose. Conclusion:Mohs surgery is used to excise the malignant tumor of the external nose, and satisfactory surgical results can be obtained by using different repair methods based the location and size of the postoperative defect.

Adult male proboscis monkeys, Nasalis larvatus, develop an enlarged external nose. Males often produce loud, long-distance calls filtered through the nasal passage. The enlarged nose probably functions as a visual badge of social status and a visual key representing the owner's physical and sexual quality, and thus is useful for females in selecting mates. In addition to such visual signalling, a larger external nose enhances the lower frequencies in calls, possibly exaggerating acoustic signals related to body size. Here, we used computational simulations with three-dimensional models of the nasal passage to show how the external nose modifies the acoustic property, indicating that the external nose develops to enhance lower frequencies in adults but varies in a specific formant position among adult males. This finding suggests that the external nose generates acoustic signals about physical-sexual maturity in adult males and individual identity among them. The unusual features of the social organization in this species, a patrilineality of a multilevel community consisting of one-male-multi-female units, may reinforce the functional importance of individual male recognition for males and females to monitor the location of both their own units and those of other males.

Introduction: Anthropometry serves as a scientific framework for collecting and analysing morphometric data, enabling the study of human diversity across geographical and ethnic boundaries. The nasal index is a multifaceted anatomical entity. Nasal anthropometry is a study concerned with the precise measurement and analysis of nasal size, shape, and proportions. The human nose exhibits considerable variation in size and shape, which is attributed to the combined effects of age, sex, environmental influences, ethnic background, and regional characteristics. Knowledge of nasal measurements is indispensable for rhinoplasty, facial surgery, and forensic analysis, enabling professionals to make informed decisions and achieve optimal outcomes. Aim: To provide the variations in nasal index among Punjabi males and females in the age group of 18-25 years. Materials and Methods: The present cross-sectional study was conducted on 1,420 participants (710 males and 710 females) from Punjab, aged between 18 and 25 years. Nasal length and nasal width were measured with the help of a digital sliding vernier caliper in the natural head position, and the nasal index was calculated using the validated formula: Nasal Index = (Nasal Width/Nasal Length) × 100. Results: The mean value of the nasal index was 67.32±6.21 for males and 65.40±6.07 for females. A significant difference was found in nasal length, nasal width, and nasal index between males and females, with a p-value&lt;0.05. Conclusion: A significantly higher nasal index was observed in males than in females of the Punjabi population. From this study, it was concluded that the dominant nose type in both males and females was leptorrhine.

The mechanism by which the human nose perceives an odor is complex and involves various chemical reactions. The instrumental detection of the smell can be carried out through the “electronic nose”, an interactive device that lends itself to various applications. In the agri-food sector, the development of portable devices makes it possible to smell foods and measure their level of deterioration and maturation. Applications regard the olfactory nuisance in environmental compatibility of materials and techniques for packing and laying conglomerates (for example, bituminous), as well as the environmental monitoring of pollutants. The electronic nose also represents an important resource in the screening of respiratory pathologies. The gas sensor market leverages physics, chemistry and materials engineering to develop highly sensitive, reliable and stable sensor platforms. In this direction, new materials are being considered, including polymers, nanostructured metal oxides and nanostructured carbon-based materials (CNTs). In addition to the experimental aspects, theoretical-mathematical modeling plays an extremely important role in this sector, with particular attention to the case of micro- and nanometric dimensions. The paper also offers an overview of the mathematical models relating to mechanical processes and dynamics at the micro-nanometric scale, focusing on the Drude-Lorentz-type models, with related more recent generalizations.

Annotation. This study aims to explore the age-related features of nasal trauma. The nose, protruding from the facial contour, often becomes the focal point of traumatic injuries. Treatment of these injuries is complex and requires extensive experience in otolaryngology, maxillofacial surgery, and, particularly, plastic surgery. For six years, 72 patients with nasal injuries were treated. The causes of injury were: dog bite – 6 (8.3%), cat bite – 2 (2.8%), human bite – 1 (1,4%), injury by a sharp object (knife, glass) – 38 (52.8%), injury by a blunt object (board, stick, rebar) – 25 (34.7%). Reconstructive surgeries aimed at closing nasal defects were performed on the first day of hospitalisation in 61 (84.7%) of the patients. Surgical interventions for the remaining 11 (15.3%) patients were postponed for 4-5 days due to signs of inflammation, which were addressed before the surgeries. In cases of large nasal defects, a rotation flap from the forehead (Indian technique), flaps from the wing and tip of the nose (French technique), and the upper third of the nose dorsum (Barrow technique, with excision of two supraorbital triangles) were used. Defects in the cartilage of the nasal wings and tip indicated the use of composite (skin-cartilage) flaps (from the ear bowl). Postoperative complications occurred in 7 (9.7%) patients: wound dehiscence – 4 (5.6%), seroma – 2 (2.7%), and wound infection – 1 (1.4%). The duration of hospital stay ranged from 1 to 8 days (average length of stay – 3.2 days). After discharge, patients continued treatment in outpatient settings near their place of residence. Nasal trauma is a complex issue in otolaryngology, maxillofacial, and particularly plastic surgery. A characteristic feature of paediatric patients is prolonged psycho-emotional stress; however, the treatment proceeds without complications and achieves good aesthetic results. The most compliant patients for treatment are adults, with good results and possible minor complications. Postoperative complications are most common in elderly and geriatric patients, associated with involutional processes in the skin, especially its blood supply.

Abstract Rhinofacial entomophthoromycosis is a rare subcutaneous fungal infection caused by Conidiobolus coronatus. It predominantly affects the nasal and facial tissues and is endemic in tropical and subtropical regions. These case reports describe two male patients, one aged 52 years and one aged 45 years, with 1-year histories of rhinofacial swelling, initially posing a diagnostic challenge. These cases of rhinofacial entomophthoromycosis were treated successfully with oral itraconazole and a supersaturated potassium iodide two-drug regimen in challenging cases, underscoring the regimen’s therapeutic potential. Both of these patients presented with a history of progressive swelling of the nose, cheeks and forehead for about 1 year with difficulty in opening the mouth and mild dysphagia. Clinical examination revealed diffuse, firm, mildly tender, indurated subcutaneous swelling involving the external nose and bilateral malar prominences, and the left side and central aspect of the forehead. The facial deformity resembled the classical ‘hippopotamus facies’. Imaging showed soft-tissue thickening without bone erosion, suggestive of an infectious pathology. Histopathology demonstrated eosinophilic infiltration and fungal hyphae consistent with C. coronatus. The patients were treated with a combination of itraconazole (200 mg twice daily) and supersaturated potassium iodide (1 g mL−1, oral drops titrated to tolerance). Therapy was continued for 6 months with regular clinical follow-ups. Clinical assessment was done by measuring head circumference and extent of induration before medication, then after 1 week, and 2 months of treatment (Table). The assessments demonstrated a notable reduction in swelling and resolution of symptoms within a few days of medication, indicating a favourable response. The patients achieved complete clinical remission at 6 months, with no evidence of relapse. The regimen was well tolerated, with no side-effects. In conclusion, these cases highlight the effectiveness of a combined itraconazole and potassium iodide regimen for rhinofacial entomophthoromycosis. The disease, although rare, is increasingly recognized due to improved diagnostic capabilities and awareness. The two-drug regimen offers a promising therapeutic approach, providing rapid clinical improvement and sustained remission with minimal side-effects. Further research is needed to establish standardized protocols and explore the role of adjunctive therapies in managing this emerging fungal disease.TableClinical assessment. Measurements are in cmSiteBaselineAfter 1 weekAfter 2 monthsCase1212121. Forehead50.855.950.055.447.054.62. Bridge of the nose49.356.448.356.445.753.33. Tip of nose53.358.448.353.345.752.84. Philtrum61.056.455.953.154.649.5

Background. Dermoid cysts (DCs), or dermoids, are benign tumors that result from the immersion of ectodermal germ layer into the underlying tissue during embryogenesis or from a malformation of three germ layers. DCs are often located in areas where sulci and clefts were located during the embryonic period, or in the areas of closing ectodermal depressions or budding cutaneous rudiments. Dermoids are most often found in the face, neck, occiput, mediastinum, sacrum, ovaries, manubrium, and floor of the mouth. DCs may not manifest in any way, characterized by a benign course and slow growth. The main treatment modality is exclusively surgical. The clinical case. Male patient B., 1 year old, was admitted with complaints (according to his mother) of a mass around the nasal dorsum. He was examined at the place of residence, where ultrasound scan of the soft tissues of the nose and paranasal sinus CT scan were performed. According to the examination data, a mass was detected in the nasal dorsum area, with nasal bones uninvolved. Under endotracheal anesthesia, the patient underwent removal of the nasal dorsum tumor. A year and a half after the surgical treatment, the patient’s parents complained of a nasal dorsum mass present below the postoperative scar. The mass was considered a recurrence of the epidermal cyst of the nasal dorsum. Under ETA, the nasal dorsum and nasal cavity mass was removed. Outcomes. Patient B. has successfully undergone two radical surgical operations for removal of nasal dorsum masses with an interval of one and a half years. There were no complications in the postoperative periods. This clinical case is special in view of the histologically confirmed two types of external nasal heterotopia in the child, the second case not being a recurrence. No recurrence was detected in the child during the follow-up period lasting 2 years Актуальность. Дермоидная киста (ДК), «дермоид» – доброкачественное новообразование, которое воз- никает в результате погружения эктодермального зародышевого листка в подлежащие ткани в эмбрио- нальном периоде или пороке развития трех зародышевых листков. ДК часто располагаются в тех местах, где эмбриональном периоде находились борозды, щели или в местах закрытия углубления эктодермы или отшнуровки кожных зачатков. Чаще всего дермоиды обнаруживают в области лица, шеи, затылка,средостения, крестца, яичников, рукоятки грудины и дна полости рта. ДК может никак себя не проявлять, характеризуется доброкачественным течением и медленным ростом. Основным методом лечения является только хирургическое. Клинический случай. Пациент Б., 1 года поступил с жалобами (со слов матери) на образование в области спинки носа. Обследован по месту жительства, выполнено УЗИ мягких тканей носа и КТ ОНП. По данным методов исследования выявлено образование в области спинки носа без деструкции костей носа. Под ЭТН пациенту выполнено удаление новообразования спинки носа. Через полтора года после проведенного хи- рургического лечения родители пациента вновь обратились с жалобами на образование спинки носа ниже послеоперационного рубца. Образование расценено как “рецидив” эпидермальной кисты спинки носа. Под ЭТН выполнено удаление образования спинки носа и полости носа. Заключение. Пациенту Б. успешно проведено хирургическое лечение образования спинки носа методом радикального удаления с интервалом в полтора года. Осложнений в послеоперационном периоде не было. Особенностью данного клинического случая является гистологически подтвержденные два вида назальной гетеротопии наружного носа у ребенка, поэтому второй случай не являлся рецидивом. В катамнестическом наблюдении в течение 2 лет рецидива у ребенка не выявлено.

Nasal septal perforation is an uncommon condition caused by several aetiologies. The recent trend in the increased use of Tapentadol intra-nasal analgesic spray has led to various systemic and local complications. This is one of the first few case reports on Tapentadol-induced nasal septal perforation. A 34-year-old female presented to the Otorhinolaryngology clinic with a two-week history of a painful non-healing ulcer in the palate associated with pus discharge.She also had bilateral nasal obstruction and foul-smelling discharge. The patient had used Tapentadol nasal spray (22.5mg/spray) 4-5 times daily for two years to manage her lumbar disc prolapse pain.Oral cavity examination showed a 0.5 × 0.5cm fistula at the junction of the hard and soft palate. Diagnostic nasal endoscopy exhibited extensive dried crusting and pus discharge, along with a perforation in the cartilaginous part of the septum, and eroded bilateral inferior turbinates. Patient was worked up for granulomatous disease of nose / malignancy. Biopsy showed acute on chronic inflammation with necrotic tissue.Bood investigations included cANCA, pANCA, and Rheumatoid factor, which was negative. Treatment involved the cessation of the Tapendalol nasal spray, local debridement, and a regiment of antibiotics and steroids. Upon follow-up, endoscopy demonstrated improved symptoms and the regeneration of normal mucosa. Drug-induced septal perforation is recognized as a rare condition, but it should be taken into account in all cases of septal perforation. Meticulous history and clinical examination is essential for accurate diagnosis.

Respiratory syncytial virus (RSV) is the leading cause of respiratory infections in children. Extracellular vesicles (EVs), released by airway epithelial cells, contain proteins and different families of non-coding RNAs (EV cargo) that can modulate the responses of target cells to viral infection. Nasal mucosa is a primary site of viral entry and the source of EVs present in the upper airway secretions. In this study we characterized proteins, including inflammatory mediators and cytokines, and the piwi-interacting RNA (piRNAs) cargo of EVs isolated from pediatric human nose organoids (HNO) and nasopharyngeal secretions (NPS) positive for RSV. Using Proximity Extension Assay (PEA) and Luminex multi-target arrays, we found significant enrichment in several chemokines and other mediators/biomarkers, including CCL2, CCL20, CXCL5, CX3CL1, CXCL6, MMP-1, MMP-10, uPA, Flt3L, ARNT and CD40 in EVs secreted by RSV-infected HNO compared to control mock HNO. Analysis of NPS samples from RSV infected children revealed that CCL3, CCL20, CXCL8, uPA, VEGFA, were concentrated in the NPS-EV fraction. LC-MS/MS and Gene Ontology indicated that RSV positive NPS-EVs originate from different cellular sources, with the most abundant proteins from neutrophils and epithelial cells. A total of 490 piRNAs were detected by NGS sequencing of small RNA libraries obtained from NPS-EVs, which has not been reported prior to this study. Identification of inflammatory mediators and small non-coding RNAs which are compartmentalized in EVs contributes to understanding mechanisms of virus-mediated pathogenesis in RSV infections.

Foreign bodies within the external nose, though uncommon, pose potential risks including chronic inflammation and localized infection, despite the inert nature of most metallic materials. Prompt identification and appropriate removal are essential to mitigate complications. This report presents three clinical cases involving embedded nasal foreign bodies, each successfully diagnosed via endoscopic examination and managed through an open rhinoplasty approach. The open rhinoplasty technique offers a distinct advantage by ensuring optimal surgical exposure while preserving aesthetic outcomes, surpassing the cosmetic limitations associated with conventional incisions. Although literature on nasal foreign bodies remains limited-often focusing on durations ranging from three months to five years—these cases underscore the importance of early and precise diagnosis. Radiographic evaluation, particularly with computed tomography (CT), remains the gold standard for accurate localization of intranasal foreign bodies. Upon confirmation, surgical extraction is typically warranted, with endoscopic-assisted methods increasingly favored for their minimally invasive nature and lower procedural risk. In asymptomatic individuals, conservative management with regular radiographic monitoring may be considered as an alternative to immediate intervention.

Acute bacterial rhinosinusitis is about 0.5–2% of the total number of acute rhinosinusitis. Most often the etiological agents are Streptococcus pneumoniae, Moraxella Catarrhalis and Haemophilus Influenzae. Amoxicillin is most often used as antibacterial therapy of the first line. The growth of S. pneumoniae resistance to penicillins is increasing. Penicillin’s not working. It is necessary to find a viable alternative antibacterial treatment. It should be considered as an initial treatment of the third-generation cephalosporins, in particular Cefixime. A clinical case of patient treatment is presented sought medical care at the clinic of the ear, throat and nose diseases. The patient complained of а purulent nasal discharge, postnasal drip, hyposmia, unpleasant odor from the nose, temperature of 37.6 °C, discomfort in the projection of both maxillary sinuses, swelling in the area of the upper eyelid of the right eye. Аn additional examination was carried out and the diagnosis of “Acute bacterial rhinosinusitis” was established. The patient was on outpatient treatment. The initial antibacterial therapy was the Cefixime in the form of dispersed tablets 400 mg once a day for 7 days. Positive dynamics was already noted on the 3rd day of treatment, the complete relief of clinical symptoms was achieved by the tenth day. On the NOSE scale, the patient scored 80 points on the day of circulation, on 3 days – 40 points, on the 7th day – 20 points. The results of a microbiological examination were obtained seven days after the start of treatment. It detected the growth of S. Pneumoniae 10^6 sensitive to all antibacterial drugs. The presented clinical case demonstrates the high response of the outpatient medicine. The Cefixime can be recommended as the drug of choice in causal treatment of the acute bacterial rhinosinusitis, especially in the case of resistance or allergy to penicillin.

Acute upper respiratory infections are common among children and are often accompanied by inflammation of the mucous membrane of the nose and paranasal sinuses. Vasoconstrictive decongestants are one of the key methods of symptomatic therapy in inflammatory ear, throat, and nose (ENT) diseases. This research explores the pharmacology of decongestants, their classification, mechanism of action, features of administration in pediatric practice, and potential side effects. The safety of drugs in terms of their chemical structure, age groups and duration of use are given special attention. The article provides a review of current guidelines on the prescription of decongestants, including international standards for the treatment of rhinitis and rhinosinusitis in children, as well as the advantages of the fixed combination of phenylephrine and dimethindene over other vasoconstrictors. Nasal dosage forms of the fixed combination of phenylephrine and dimethindene have many advantages and are considered to be the safest in pediatric practice. A comparative analysis of drugs of different pharmacological groups shows that intranasal decongestants are the most effective and virtually non-competitive drugs used in a range of inflammatory ETN diseases that are accompanied by nasal obstruction: acute rhinitis (including acute respiratory viral infections), chronic rhinitis, allergic rhinitis, acute and chronic sinusitis, acute otitis media (as an adjuvant treatment). They are indispensable in the preparation for nasal surgical interventions, swelling of the mucous membrane of the nose and paranasal sinuses after surgical interventions and in other circumstances when it is pathogenetically and symptomatically necessary to reduce the swelling of the mucous membrane of the nasal cavity and paranasal sinuses in a faster way.

Acute purulent inflammatory processes of the soft tissues of the external nose deserve special attention in clinical practice, considering their potential for diverse clinical manifestations such as furuncles, carbuncles, abscesses, cellulitis, and erysipelas. These pathologies are associated with an elevated risk of generalized infection, which can lead to life-threatening complications including intracranial and orbital complications, Lemierre’s syndrome, sepsis, and septic embolism. The article describes the mechanism of complication development related to septic emboli, the stepwise progression of symptoms, and the possible challenges in diagnosis and treatment that may be encountered based on a clinical case study. The article describes a clinical case of a 43-year-old patient who developed a nasal phlegmon complicated by septic embolic pneumonia with multiple lung abscesses and bilateral pleuritis after self-removal of a pustule on the wing of his nose. The development of such a complication in an otherwise healthy individual highlights the significance of topographic-anatomical features of this region and the high likelihood of systemic complications when medical assistance is delayed. Despite initial treatment, symptom progression and the emergence of secondary foci of purulent infection following changes in therapeutic strategy and successful surgical debridement of the primary infection site emphasize the need for a multidisciplinary approach, dynamic assessment of clinical and laboratory data, and additional diagnostic methods to ensure timely detection of complications. This case underscores the danger of self-intervention in facial skin infections and the necessity of early medical consultation. Timely diagnosis, adequate antibiotic therapy, and surgical intervention are key factors for successful treatment and prevention of life-threatening complications.

The rational use of healthcare resources is an important component of preparedness for crisis situations, the ability of the general population to be covered by healthcare services. However, the issue of using hospital beds in accordance with the clinical needs of the patient and specific diseases has not been resolved. Ear, throat, and nose diseases often become targets for infection by respiratory viruses, which are the causes of epidemics and pandemics, which makes the study relevant on the example of analyzing hospitalizations of patients with these diseases. The objective: to analyze hospitalizations of adult patients in Kyiv with ear, throat, and nose diseases in Kyiv during the 2019 and 2022. Materials and methods. Statistical data of the City Scientific Information and Analytical Center of Medical Statistics, Kyiv, for 2019 and 2022; Forms No. 20 for 2019 and 2022, Forms No. 003/o (174 cases for 2019 and 83 cases for 2022, total – 257 cases) of the Municipal Non-Profit Enterprise “Kyiv City Clinical Hospital No. 12”; expert assessment data (7 units). The following research methods were used: medical and statistical; analytical; graphic; expert assessments; generalization. Results. Despite the reduction in otolaryngological beds in Kyiv from 250 in 2019 to 155 in 2022, the average number of days of bed operation decreased from 286.7 to 234.4 days, the average duration of a patient’s stay in bed increased from 7.4 to 7.9 days. In 50.0% of cases in 2019 and 41.0% of cases in 2022, the patients visited the otolaryngology department by their own decision, after the referral by a family doctor – in 9.7% and 6.3% of cases, respectively, after the referral by a specialist in 37.3% and 31.0% of hospitalizations, respectively. In 65.1% of hospitalizations in 2022 and 72.4% in 2019, hospitalization was for emergency indications. The leading causes of hospitalizations in 2022 were nasal septum curvature (20.5%), acute sinusitis (15.8%), other diseases of the ear, throat, nose (13.3%), in 2019 – acute sinusitis (23.6%), acute otitis (19.0%), paratonsillar abscess (10.9%). According to the experts’ conclusions, in 2022 34.9%, and in 2019 35.6% of hospitalizations were unjustified. Conclusions. The low effectiveness of the reduction of otolaryngological beds was demonstrated, which is confirmed by the low rates of bed utilization in both 2019 and 2022, likely due to the COVID-19 epidemic and the war. A high level of self-referrals of patients for hospital care (41.0% in 2022, 50.0% in 2019), hospitalizations for emergency indications (65.1% in 2022, 72.4% of cases in 2019) and unjustified hospitalizations (34.9% in 2022, 35.6% of cases in 2019) was found.