1
Vestn Otorinolaringol
. 2020;85(1):79-82. doi: 10.17116/otorino20208501179.
[Paracentez]
[Article in Russian]
V S Minasyan 1, E Yu Radtsig 1, K K Baranov 1, O V Bugaychuk 1, A A Pikhurovskaya 1, M R Bogomilsky 1
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PMID: 32241995 DOI: 10.17116/otorino20208501179
Abstract in English , Russian
In this article, we present the analysis of the data of the specialized literature and the results of our own observations on the use of paracentesis in the treatment of acute suppurative otitis media. We highlight a method for diagnosing acute otitis media, which makes it possible to determine the rational algorithm of treating this disease - digital videootoscopy. Common methods of procedures aimed at draining the tympanum in acute purulent otitis media, such as tympanic membrane puncture, myringotomy, tympanostomy, tympanocentesis, and the differential approach to these methods of surgical treatment of the disease are discussed. The very concept of paracentesis is specified, the history of this surgical intervention is presented. Authors described the technique and features of paracentesis, a number of indications for its implementation, possible complications of surgical intervention and their causes. The risk of developing a chronic pathological process after the use of paracentesis or, conversely, due to the rejection of this manipulation during acute inflammation in the middle ear is assessed.

Keywords: acute otitis media; chronic otitis media; paracentesis; tympanostomy.

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2
Vestn Otorinolaringol
. 2020;85(2):67-72. doi: 10.17116/otorino20208502167.
[Viral Co-Infection With Head and Neck Tumors]
[Article in Russian]
A M Pevzner 1, M M Tsyganov 1, M K Ibragimova 1, N V Litvyakov 1
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PMID: 32476395 DOI: 10.17116/otorino20208502167
Abstract in English , Russian
The review is devoted to assessing the prevalence of human papillomavirus (HPV) in combination with other viral agents for head and neck tumors (HNT). HPV is recognized as an etiological factor in the development of cervical cancer, but there is evidence that it may be involved in carcinogenesis in other locations, in particular the upper respiratory tract. However, HPV is not the most important factor in tumor growth and progression. Recently, many researchers have reported the presence of concomitant co-infection, affecting tumor progression. Of all the studies analyzed, only 3 studies showed the absence or low rates of co-infection in HNT: from the Czech Republic (0%), China (0.6%) and Japan (3%). Most often, HPV infection was detected together with the Epstein-Barr virus (EBV) - from 12.5 to 34.1% of cases. In Russia, the prevailing combination of viral co-infection was a combination of EBV and cytomegalovirus (9.5%) and a combination of EBV and herpes simplex virus (6.7%). Thus, the degree of incidence of HPV in HNT varies greatly, and the mechanisms of coinfection are poorly understood, which raises the question of whether HPV and concomitant infection can be involved in tumor progression. This makes further research in this direction relevant and promising.

Keywords: co-infection; human papillomavirus; overview; tumors of the head and neck.

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3
Vestn Otorinolaringol
. 2020;85(1):74-78. doi: 10.17116/otorino20208501174.
[Allergic Rhinitis in Children: From Diagnosis to Therapy]
[Article in Russian]
A I Asmanov 1, N D Pivneva 1, N V Zlobina 2, A N Pampura 2
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PMID: 32241994 DOI: 10.17116/otorino20208501174
Abstract in English , Russian
Allergic rhinitis, according to modern data, affects up to a quarter of the population of developed countries. The disease affects not only the nasal mucosa, but also affects the receptors and mediators of inflammation in the bone marrow. A significant decrease in the quality of life of patients against the background of exacerbation of allergic rhinitis makes us look for new approaches to both the treatment of attacks and their prevention. Correction, including surgical, of concomitant pathology of the nasal cavity and paranasal sinuses significantly improves the quality of life of patients with allergic rhinitis. For a long time, surgical treatment of concomitant pathology of the nasal cavity in children was extremely limited due to the risk of damage to the growth zones and, as a consequence, a high probability of recurrence of deformation of the structures of the nose and paranasal sinuses. With the development of endoscopic methods of surgical treatment of the nasal cavity and paranasal sinuses, operations with minimal invasiveness and, as a consequence, safe at any age were introduced into practice. Surgical intervention on the structures of the lymphoid pharyngeal ring in children with allergic rhinitis is causing heated debate in the pediatric community to date. The article considers modern approaches to the diagnosis and treatment of allergic rhinitis in children. Topical problems of conservative and surgical treatment are discussed. Special attention is paid to the safety of various treatment regimens. The discussed practical issues of tactics of treatment of allergic rhinitis are relevant for both pediatric allergists and ENT pediatricians.

Keywords: allergic rhinitis; children; treatment.

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4
Vestn Otorinolaringol
. 2020;85(2):78-83. doi: 10.17116/otorino20208502178.
[Etiopathogenetic Factors of Wound Healing in Chronic Post-Intubation Cicatricial Stenosis of the Larynx and Trachea]
[Article in Russian]
V V Vavin 1, D A Kuznetsova 2, I I Nazhmudinov 1, Kh Sh Davudov 1
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PMID: 32476397 DOI: 10.17116/otorino20208502178
Abstract in English , Russian
Despite the existing modern high-tech methods of examination and a variety of surgical treatment methods, the problem of diagnosis, treatment and rehabilitation of patients with chronic post-intubation cicatricial stenosis of the larynx and trachea still requires further study. Improving the understanding and correction of cellular, molecular genetic and biochemical disorders in a chronic wound is a key condition for increasing the efficiency of diagnosis, individual prognosis of the clinical course and the conduct of adequate therapeutic and preventive measures for post-intubation cicatricial laryngotracheal stenoses. In this regard, it seemed appropriate to analyze the existing etiopathogenetic factors of pathological wound healing in chronic post-intubation cicatricial stenosis of the larynx and trachea. Our attempt to summarize the available literature data demonstrated that laryngotracheal scars are a fibro-proliferative disease caused by aberrant wound healing after a damaging effect on the tissues of the larynx and trachea. The article describes the most pathogenetically significant healing, repair, and scarring factors in post-intubation laryngotracheal stenoses, including transforming growth factor β1, vascular growth factor A, type I and III collagen, and matrix metalloproteinases. An assessment of the features of the diagnostic and prognostic significance of these markers will increase the effectiveness of the treatment of patients with chronic cicatricial stenosis of the larynx and trachea, and will also serve as a prerequisite for the development of strategies for diagnostic, treatment, prophylactic and rehabilitation measures that will improve the quality of medical care and the quality of life of patients with chronic cicatricial stenosis of the larynx and trachea.

Keywords: MMR-2; MMR-9; TGF-β1; VEGF-A; chronic post-intubational scar stenosis of the larynx and trachea; collagen types I and III.

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5
Vestn Otorinolaringol
. 2020;85(1):88-93. doi: 10.17116/otorino20208501188.
[Our First Experience With Endoscopic Ear Surgery]
[Article in Russian]
N S Grachev 1, G A Polev 2, I I Morozov 3, A E Samarin 2, I N Vorozhtsov 2, D A Shcherbakov 4
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PMID: 32241997 DOI: 10.17116/otorino20208501188
Abstract in English , Russian
Introduction: For the last decades endoscopic ear surgery has become a common practice. Advantages of the endoscopic technique in middle ear surgery are high definition and magnification of the endoscope with a modern camera and the ability to 'look around the corner' with the angled scope.

Material and methods: From March 2017 to November 2019 in NSRC PHOI named after Dmitry Rogachev in the Department of Oncology and Pediatric Surgery 53 patients (81 surgeries) have undergone endoscopic-assisted ear surgery: 3 biopsies for middle ear neoplasm with the transcanal endoscopic approach, 1 endoscopic tympanoplasty for attic retraction pocket with cholesteatoma, 2 endoscopic removal of middle ear tumors (including 1 combined approach) and 32 endoscopic myringoplasties, 22 canal wall down mastoidectomies for extensive middle ear and mastoid cholesteatoma, 21 second-look surgery with ossiculoplasty with overall good outcome. Age of the patients varied from 2 months to 16 years. Follow up period varied from 1 month to 3 years.

Results: Two cases of middle ear tumor removal via endoscopic transcanal approach are described. In one case endoscopic transmeatal approach was used as an addition to the middle fossa approach for removal of facial nerve neurinoma located on the upper surface of petrous bone with expansion to the middle ear cavity. In the second case endoscopic transmeatal approach was used alone for removal of benign tumor (salivary gland choristoma) of middle ear cavity with extension to pneumatic system of petrous bone. In both cases endoscopic approach allowed to biopsy the tumor first and then to remove the tumor in a less invasive way, which lead to faster patient recovery.

Conclusion: In the majority of cases endoscopic technique is a method of assistance in otologic surgery, but sometimes could be a used a single method in middle ear surgery, allowing less traumatic approach and the implementation of high-definition camera for more precise disease control. In our preliminary experience endoscopic technique could be used in pediatric practice independently of the patient's age.

Keywords: endoscopic ear surgery; endoscopic tympanoplasty; middle ear tumors; myringoplasty; otologic surgery.

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6
Vestn Otorinolaringol
. 2020;85(1):14-21. doi: 10.17116/otorino20208501114.
[On the Issue of Treatment of Exudative Otitis Media in Children]
[Article in Russian]
A I Kryukov 1, N L Kunelskaya 1, A Yu Ivoylov 2, V Ya Kunelskaya 3, V R Pakina 3, V V Yanovsky 3, Z N Morozova 3
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PMID: 32241982 DOI: 10.17116/otorino20208501114
Abstract in English , Russian
Aim: To increase the effectiveness of treatment of children with catarrhal and secretory stages of exudative otitis media (EOM) through the development of a therapeutic and diagnostic algorithm for the management of children with this condition.

Material and method: From 2008 to 2017, 346 children (682 ears) aged from 3 to 13 years with exudative otitis media were examined and treated. Two groups of patients were formed: Group 1 (150 children, 298 ears) - with a catarrhal stage of EOM, group 2 (196 children, 384 ears) - with a secretory stage of EOM. Diagnosis and treatment algorithm was created for such patients based on the results of the examination.

Results: Depending on the treatment, 3 groups of patients were formed: Group I - 150 children with a catarrhal stage of EOM who received conservative and surgical treatment for upper respiratory tract conditions; Group II - 146 children with an a secretory stage of EOM, who underwent conservative and surgical treatment: myringotomy / installation of a shunt in the eardrum simultaneously with surgical removal of the block of the auditory tube ostium, a course of conservative treatment for children who did not require surgical treatment; Group III - 50 children with a secretory stage of EOM and grade III adenoids, whose parents, contrary to the doctor's advice, refused the proposed myringotomy / installation of a shunt in the eardrum simultaneously with surgical removal of the block of the auditory tube ostium. These children underwent only adenotomy.

Conclusion: The developed treatment algorithm for children with EOM, depending on the stage of the disease, demonstrated high clinical efficacy and made it possible to achieve stable positive results in 94.7% of cases in patients with the catarrhal stage of ESO and in 84.8% of cases in patients with the secretory stage of ESO, which makes it possible for us to recommend it as an integrated method that improves the quality of treatment for children with EOM.

Keywords: children; exudative otitis media; myringotomy; shunting; treatment algorithm.

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7
Vestn Otorinolaringol
. 2020;85(1):48-53. doi: 10.17116/otorino20208501148.
[Balloon Sinuplasty in Children - Russian First Experience]
[Article in Russian]
I V Zyabkin 1, N S Grachev 2, E P Karpova 3, I N Vorozhtsov 2, E Yu Yaremenko 2
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PMID: 32241989 DOI: 10.17116/otorino20208501148
Abstract in English , Russian
Aim: To evaluate and compare the clinical outcome and impact of balloon sinuplasty and functional endoscopic sinus surgery (FESS) on the quality of life of pediatric patients and adolescents suffering from chronic rhinosinusitis (CRS).

Material and methods: A retrospective study was performed of 47 children with failed medical therapy, who were scheduled for surgery. The first one pediatric balloon sinuplasty was performed by Ilya Zyabkin in Filatov Children's City Hospital on the 30-th of August 2012.They underwent treatment by balloon sinuplasty of selected sinuses in 553% (n=26) cases and hybrid FESS with BSP - in 44.7% (n=21). Data were collected, including perioperative CT Lund-Mackay score and SN-5 quality of life findings.

Results: Compared with preoperative values, Lund-Mackay scores were significantly lower at 1 year (p<0.05) in 92,3% (n=12) patients after surgery. Moreover, balloon sinuplasty improved sinusrelated quality of life score in 93.3% (n=42) patients for up to 1 year after operation (p<0.05).

Conclusion: Balloon sinuplasty showed a clinical curative effect in the treatment of children and adolescents with refractory CRS, and was relatively safe by itself. BSP allows to postpone, if necessary, FESS or avoid circular mucosal trauma and infundibulotomy in hybrid FESS with balloon sinuplasty technique.

Keywords: Balloon sinuplasty; children; chronic rhinosinusitis; nasal surgery; pediatric rhinology; sinus surgery.

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8
Vestn Otorinolaringol
. 2020;85(1):25-29. doi: 10.17116/otorino20208501125.
[Age Aspects of the Clinical Course of the Middle Ear Cholesteatoma in Children]
[Article in Russian]
G V Vlasova 1
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PMID: 32241984 DOI: 10.17116/otorino20208501125
Abstract in English , Russian
Material and methods: The study included 125 patients with middle ear cholesteatoma, from 1 year to 17 years (131 cases - 6 patients had bilateral cholesteatoma). All patients were operated in the ENT department of St. Petersburg State Medical University from 2000 to 2017. A comparative analysis of the clinical course and results of surgical treatment of the middle ear cholesteatoma in two age groups was performed: 1 group (1-6 years) - 34 patients (37 cases); 2 group (7-17 years) - 91 patients (94 cases).

Results and discussion: The average duration of the period from diagnosis to surgery was 7.1±6,4 months in the 1 group and 27.3±23.1 months in the 2 group. This is due to a brighter and more aggressive manifestation of cholesteatoma in children under 7 years old. Due to extensive bone destruction and cholesteatoma, 30% of children of the 1st group underwent radical surgery on the middle ear, in the 2nd group - only 15%. The postoperative period in children under 7 years was more unfavorably: large radical cavities, their late epithelization, growth of granulation tissue. The percentage of cholesteatoma recurrence after hearing-saving operations in the 1st group was 50%, in the 2nd group - 25%.

Conclusion: The tendency to a more unfavorable course of the disease in young children has been identified. This must be taken into account in choosing the type of operation and predicting the course of the disease.

Keywords: chronic otitis media; congenital cholesteatoma in children; middle ear cholesteatoma in children; surgery of middle ear cholesteatoma.

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9
Vestn Otorinolaringol
. 2020;85(1):54-59. doi: 10.17116/otorino20208501154.
[Prevention of Frontal Pocket Stenosis After Endoscopic Transnazal Surgery on the Frontal Sinus and Endoscopic Septoplasty in Acute and Chronic Pathology of Frontal Sinuses]
[Article in Russian]
S A Karpishchenko 1, O E Vereshchagina 1, E V Bolozneva 1, P R Bibik 1
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PMID: 32241990 DOI: 10.17116/otorino20208501154
Abstract in English , Russian
The main idea of our manuscript is prevention of frontal recess stenosis after endoscopic endonasal frontal sinus surgery and septoplasty during to acute and chronic frontal sinuses pathology.

Purpose: To offer an effective method to prevent postoperative frontal recess stenosis after endoscopic endonasal frontal sinus surgery and surgical correction of intra-nasal structures.

Material and methods: In our manuscript we analyzed 274 cases of endoscopic endonasal frontal sinus surgery: postoperative treatment (local and systemic). All of them were operated by endoscopic endonasal approach both initially and repeatedly for acute and chronic frontal sinusities in the ENT department Pavlov First state medical university of Saint Petersburg from 2013 to 2019.

Results: In 10 cases, patients with previous endoscopic endonasal frontal sinus surgery underwent revision endoscopic procedure due to frontal recess obstruction, in 4 cases - due to a recurrence of the polypous process involving the frontal sinus, in 6 cases - without visible provoking factors contributing to restenosis of the frontal recess. First step in all cases was a correction of the nasal septum. It is necessary to assess the factors that contribute to restenosis of the frontal recess. Careful endoscopic care of the nasal cavity and the frontal recess in the postoperative period can reduce the risk of restenosis of the latter. Local antibacterial nasal therapy is recommended for the prevention of purulent processes in the nasal cavity in the early postoperative period.

Keywords: endoscopic endonasal frontal sinus surgery; endoscopic nasal septal surgery; frontal recess; stenosis.

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10
Vestn Otorinolaringol
. 2020;85(1):34-39. doi: 10.17116/otorino20208501134.
[Application of the Matrix Sentence Test Russian Version in Children]
[Article in Russian]
E S Garbaruk 1, M V Goykhburg 2, A Warzybok 3, G A Tavartkiladze 4, P V Pavlov 5, B Kollmeier 3
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PMID: 32241986 DOI: 10.17116/otorino20208501134
Abstract in English , Russian
The Russian version of the matrix sentence test (RUMatrix test) has been shown to be suitable for accurate assessment of speech intelligibility in adults.

Aim: To approve the RUMatrix for measurements in children and to evaluate its simplified version (Simplified RUMatrix).

Material and methods: 20 normal-hearing adults and 81 normal-hearing children aged from 5 to 10 years were involved into the study. Both versions of the test were developed by the University of Oldenburg, Germany. The tests contain syntactically homogeneous, semantically unpredictable sentences/phrases presented under the background noise. Each test list is composed of 20 sentences of 5 words for RUMatrix and of 14 speech phrases of 3 words for Simplified RUMatrix.

Results: A limitation in the use of the RUMatrix test in children under 10 years of age has been revealed. Evaluation of Simplified RUMatrix test in adults confirmed the perceptual homogeneity of the test list. The results of the RUMatrix test and the Simplified RUMatrix test in children were lower than in adults; they were improving with age and reach adult values by 10 years. One training track of Simplified RUMatrix test should be carried out before the assessment.

Conclusion: The RUMatrix can be used for children of 10 years and older. The normative data of Simplified RUMatrix both for adults and children of the different ages have been obtained.

Keywords: Russian version of sentence Matrix test; Simplified RUMatrix test; speech audiometry.

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