Eurasian Journal of Otorhinolaryngology - Head and Neck Surgery

Etiology and microbiological range of chronic suppurative otitis media causatives: microflora evolution and the problem of antibiotic resistance

2026-07-06T11:22:02+00:00

This review analyzes the etiological structure of chronic suppurative otitis media (CSOM) and the changes its pathogen spectrum has undergone over decades of clinical observation. It is shown that the dominant microflora has consistently shifted: streptococci, which were prevalent before the widespread introduction of antibiotics, were replaced by antibiotic-resistant staphylococci, and subsequently, gram-negative bacteria, particularly Pseudomonas aeruginosa, assumed the leading role. The pathogenicity mechanisms of key microbial groups are characterized, the importance of methicillin-resistant Staphylococcus aureus (MRSA) strains, the increasing contribution of non-clostridial anaerobes and fungal flora, and the role of mixed microbial communities are discussed. Summarized data on the susceptibility of isolated cultures to antimicrobial agents are provided. Knowledge of pathogen dynamics and their resistance profiles is considered a prerequisite for an informed choice of etiotropic therapy and surgical tactics.

Pathogenesis, clinical-morphological forms, and functional hearing and vestibular disorders in chronic suppurative otitis media (literature review)

2026-07-06T11:32:40+00:00

This paper summarizes current views on the mechanisms of development of chronic suppurative otitis media (CSOM) and associated functional disorders. The role of Eustachian tube dysfunction, the degree of temporal bone pneumatization, neurovegetative systems, and local immunity in the chronicity of inflammation is analyzed. Morphological changes in the mucous membrane, bone tissue, and ossicular chain are characterized, and the significance of aditus block and cholesteatoma, including the molecular mechanisms of osteolysis, are discussed. The article presents a classification of clinical forms (mesotympanitis, epitympanitis, epimesotympanitis) in accordance with ICD-10. The mechanisms of conductive and sensorineural hearing loss, the relationship between the degree of hearing loss and the size and location of the perforation and the presence of cholesteatoma, as well as vestibular disorders are discussed. Understanding these patterns determines a differentiated approach to diagnosis and treatment.

Modern approaches to the diagnosis of trigeminal neuralgia: clinical, neuroimaging, and neurophysiological integration

2026-07-06T11:50:20+00:00

Trigeminal neuralgia is one of the most intense forms of craniofacial pain and poses a significant diagnostic challenge due to the similarity of its clinical manifestations to other types of facial pain. This review summarizes current concepts in the diagnosis of trigeminal neuralgia from the perspectives of clinical neurology and neuroimaging. It demonstrates that the clinical assessment of the pain syndrome, in accordance with the criteria of the International Classification of Headache Disorders (ICHD-3), remains crucial for diagnosis. This assessment includes analyzing the character, duration, and trigger factors of the pain. The role of neurovascular conflict as the primary pathogenetic mechanism of the disease and its diagnostic significance are examined. The leading role of magnetic resonance imaging with high-resolution protocols (e.g., 3D-CISS, FIESTA) in identifying trigeminal nerve root compression and ruling out secondary causes of the disease is emphasized. It is noted that the mere presence of neurovascular contact without morphological changes in the nerve lacks sufficient diagnostic significance. The potential of neurophysiological methods, including the study of trigeminal reflexes, as an auxiliary diagnostic tool is analyzed. Particular attention is given to the problem of overdiagnosis and the need for differential diagnosis with odontogenic, postherpetic, and other forms of facial pain. The review concludes that a comprehensive approach based on the integration of clinical and instrumental data is necessary, and highlights the promise of implementing quantitative methods for assessing neurovascular conflict.

Sensitization spectrum and a clinical-immunological diagnostic algorithm of allergic rhinitis in patients with chronic viral hepatitis.

2026-07-06T12:00:50+00:00

The sensitization spectrum and diagnostic features of allergic rhinitis (AR) on a chronic viral hepatitis (CVH) background remain understudied. The aim was to determine the sensitization spectrum of AR against a CVH background and to develop a clinical-immunological diagnostic algorithm. Ninety patients with AR on a CVH background (main group) and 60 with AR without CVH (comparison) were examined by skin prick tests and specific IgE; the diagnostic informativeness of immunological indicators was assessed by ROC analysis. In both groups the dominant allergen was house dust mite (80.0% in the main group); in the main group sensitization to fungal (45.6% vs 26.7%) and food (28.9% vs 15.0%) allergens was significantly higher (p<0.05), whereas pollen sensitization was more frequent in the comparison group (45.0%). Polysensitization predominated in the main group — 64.4% vs 48.3% (p<0.05). Total IgE, IL-13, eosinophil fraction and the CD4/CD8 ratio were identified as the most informative diagnostic markers. A three-step diagnostic algorithm combining these with clinical-anamnestic data was developed. AR on a CVH background is characterized by polysensitization and increased sensitivity to fungal/food allergens; the proposed algorithm enables early detection of the combined pathology.

Open auditory tube: epidemiology, etiopathogenesis, and its place in non-supulsurous diseases of the middle ear

2026-07-06T12:06:59+00:00

Open auditory tube is a disease characterized by the pathological permanent or intermittent patency of the auditory tube, accompanied by such disturbing symptoms as autophony, respiratory autophony, and ear congestion. This literature review summarizes the epidemiological indicators, risk factors, etiopathogenetic mechanisms, and the role of open auditory tube in the structure of non-purulent middle ear pathology based on sources published over the past 10 years. The analysis of the literature showed that open auditory tube occurs in the range of 0.3–7.0% of the population, predominates in women, and is most often observed in adolescents and adults. The leading risk factor is rapid and significant weight loss, which leads to a decrease in the Ostrmann fat pad around the auditory tube, as well as pregnancy, hormonal changes, neuromuscular diseases, and scarring processes in the nasopharynx. A significant proportion of cases are idiopathic. Open auditory canal is recognized as an underdiagnosed problem among non-purulent diseases of the middle ear, but it seriously reduces the quality of life.

Modern conservative and surgical methods of treatment of open auditory tube

2026-07-06T12:12:50+00:00

Treatment of patent auditory tube remains a challenging clinical task, as there is no single standard method proven to be effective with a high level of evidence. This literature review summarizes conservative and surgical methods of treating patent auditory tube based on sources from the past 10 years. The conservative approach includes patient education and reassurance, lifestyle recommendations (adequate fluid intake, avoidance of weight loss), nasal saline and various intratubal medications (salicylic-boric acid powder, estrogen drops, etc.), and placement of a paper patch on the tympanic membrane. In most cases, conservative treatment is sufficient. In refractory and severe cases, surgical methods include tympanic membrane manipulation (ventilation tube, mass loading), tube injection/augmentation, plugging (Kobayashi silicone plug), tuboplasty, and tube closure. Systematic reviews suggest that plugging and trocar surgery are relatively effective and safe, but the available evidence is mainly limited to small clinical trials.

Modern opportunities and prospects of digital medicine technologies in otorhinolaryngology

2026-07-06T12:21:01+00:00

Digital medicine is being increasingly implemented in otorhinolaryngology, as in all other fields of healthcare. Initially, this process was mainly represented by telemedicine, that is, remote medical services. However, today the complete digitalization of medical records and the use of artificial intelligence technologies are also becoming increasingly widespread. This article discusses the role of digital medicine in the modern healthcare system and its significance in otorhinolaryngology practice. The possibilities of telemedicine, electronic medical records, mobile applications, and artificial intelligence technologies in diagnostics, treatment, and patient monitoring are analyzed. The paper also highlights the ongoing healthcare digitalization reforms in Uzbekistan and their effectiveness. The advantages of digital technologies, including convenience, cost-effectiveness, and improvement of healthcare quality,

Epidemiological dental examination of the condition of the temporomandibular joint of the rural population

2026-07-06T12:27:45+00:00

Lesions of the temporomandibular joint in residents of rural settlements require independent epidemiological analysis. In the Russian literature on dentistry, such observations for the south of the Tyumen region are presented in fragments: there are no works where information about the frequency of this pathology, its structure and changes in prevalence would be summarized in a comparable array. The lack of actual material accumulated specifically for the rural population does not allow us to confidently identify repeating clinical and population patterns, as well as to trace the stable features of the course of diseases of the temporomandibular joint in the conditions of the south of the Tyumen region.

Clinical and audiometric characteristics of hearing function in patients with chronic renal failure

2026-07-06T12:35:12+00:00

Chronic kidney disease (CKD) is recognized as a global health problem, and only a limited number of studies have demonstrated a possible association between hearing dysfunction and renal failure. The aim of this study was to evaluate the association between hearing loss and CKD in patients without major comorbidities.The study included 83 patients diagnosed with CKD. The results showed that CKD is often associated with sensorineural hearing loss. The overall prevalence of hearing loss was 27.7%. Pure-tone audiometry (PTA) is a non-invasive, reliable, and sensitive diagnostic tool for detecting hearing loss in patients with CKD.

Approaches to dental implantation in patients with malignant neoplasms of the maxillofacial region (literature review)

2026-07-06T12:41:49+00:00

The article is devoted to a comprehensive study of the etiological factors of dental and dentition defects, as well as to the analysis of dental implantation in patients with malignant neoplasms of the maxillofacial region (MFR). It also addresses issues of diagnosis, treatment, prevention, and rehabilitation at subsequent stages. Based on the analysis of a number of scientific publications, it is noted that only a limited number of studies have been conducted in this field, emphasizing the relevance of further research. In addition, attention is given to data on the use of radiation therapy and physiotherapeutic methods for therapeutic and preventive purposes.

Efficacy of aerosol therapy with natural essential oils in the complex treatment of chronic pharyngitis in children

2026-07-06T12:46:14+00:00

The efficacy of treating chronic pharyngitis (CP) in children is often temporary, and the uncontrolled use of antibiotics leads to resistant microflora and drug intolerance. The aim was to evaluate the clinical, microbiological and immunological efficacy of aerosol therapy with natural essential oils (NEO) in the complex treatment of CP in children. 112 children aged 3–15 with CP received individualized NEO aerosol therapy based on an aromogram (sensitivity of the microbial landscape to essential oils) together with pathogenetic therapy; 18 controls received pathogenetic therapy only. After treatment, disease signs resolved in 53 patients (47.1%), improvement occurred in 48 (42.8%) and the pharyngoscopic picture was unchanged in 11 (9.8%). At 6 months, no pathogenic microflora growth was observed in 49.5%. Immunological indices improved: IgA (catarrhal form 1.25→2.02 mg/dL), sIgA, IgG (12.1→18.3 g/L) rose, the relative T-lymphocyte count (51.8→56.3%) and CD4+ (→35.4%) increased, and B-lymphocytes decreased. In the control group efficacy was much lower and declined over time (cure 22.2% at 1 year). NEO aerosol therapy increases the clinical and laboratory efficacy of complex treatment of CP in children, has antimicrobial, antiviral and immunomodulatory effects, and does not produce a habituation effect.

Immunological features of allergic rhinitis in patients with chronic viral hepatitis: humoral, cellular immunity and cytokine profile

2026-07-06T12:53:29+00:00

Chronic viral hepatitis (CVH) causes systemic immune dysregulation that may alter the course of allergic rhinitis (AR). The aim was to determine the features of humoral and cellular immunity and the cytokine profile in AR against a CVH background. Ninety patients with AR on a CVH background (main group), 60 with AR without CVH (comparison), and 30 healthy subjects (control) were examined. Serum total IgE, IgA, IgM, IgG, circulating immune complexes (CIC), lymphocyte subpopulations (CD3, CD4, CD8, CD16, CD20), the CD4/CD8 ratio, cytokines (IL-4, IL-5, IL-13, IL-10, IFN-γ) and eosinophil cationic protein (ECP) were measured. In the main group, total IgE (412.6±18.4 IU/mL) and CIC (118.4±4.2) were the highest (p<0.05); the CD4/CD8 ratio was the lowest (1.35±0.04) owing to an increased CD8+ fraction. The cytokine profile showed a pronounced Th2 shift: IL-4, IL-5, IL-13 and ECP were elevated and IFN-γ was reduced (p<0.05). Total IgE correlated positively with liver fibrosis stage (r=0.52; p<0.01). AR on a CVH background is characterized by activation of the humoral arm, CD8-directed remodeling of cellular immunity and Th2-cytokine predominance, reflecting the immunopathogenetic interaction of the two diseases.

Complex treatment and prevention of recurrent otitis media in children, including microbiome-correction approaches: an evidence-based review of the last decade

2026-07-06T12:59:03+00:00

The optimal strategy for treating and preventing recurrent otitis media (ROM) in children remains a subject of ongoing debate. The aim of this review was to critically analyse, based on the evidence of the last decade (2015–2025), contemporary methods of complex treatment and prevention of ROM in children, including microbiome-correction approaches. Systematic reviews, meta-analyses and randomized controlled trials (RCTs) indexed in PubMed, Scopus, Web of Science and the Cochrane Library were analysed. The review shows that, although antibiotic therapy is effective for acute episodes, its repeated use increases resistance and deepens microbiome dysbiosis. Pneumococcal conjugate vaccines (PCVs) and influenza vaccine show a modest but limited effect in reducing otitis media frequency, with the problem of serotype replacement being observed. Tympanostomy tubes reduce the frequency of recurrent episodes in children with middle ear effusion and associated hearing loss. Meta-analyses of probiotics, prebiotics and synbiotics (notably nasal Streptococcus salivarius) have yielded conflicting results regarding the reduction of incidence, yet microbiome correction is regarded as a promising adjunctive strategy. Effective management of ROM requires an individualized, multicomponent approach that takes into account predictors, immunological status and microbiome state.

Microbiological, virological and immunological features of chronic pharyngitis in children

2026-07-06T13:04:44+00:00

Microbial and viral factors and the state of the immune system play a key role in the pathogenesis of chronic pharyngitis (CP) in children. The aim was to determine the microbiological, virological and immunological features of the different forms of CP in children. 112 children aged 3–15 with CP and 18 controls were examined; bacteriological and virological swabs from the posterior pharyngeal wall, serum IgA, IgM, IgG, sIgA, and peripheral-blood T- and B-lymphocytes, CD4+ and CD8+ cells were assessed. In the catarrhal form the leading pathogen was group A Streptococcus (Str. pyogenes — 44.7%), in the hypertrophic form Staphylococcus aureus (47.5%), and in the subatrophic form no microbial growth occurred in 42.1%. Viral antigen was found in 29.4%, mainly adenovirus (42.4%) and respiratory syncytial virus (36.3%), predominantly in the catarrhal and hypertrophic forms. Immunologically, IgA and IgG were reduced to the lower limit of normal, the relative T-lymphocyte count was decreased, B-lymphocytes were increased and CD4+ cells were below normal. The forms of CP in children differ in microbial landscape and viral carriage and are accompanied by inhibition of the T-arm and weakening of local humoral defence (IgA/sIgA), warranting correction of local immunodeficiency.

Clinical-anamnestic predictors of recurrent otitis media in children and risk-based stratification: a review of the last decade

2026-07-06T13:18:11+00:00

Recurrent otitis media (ROM) is one of the most common problems in paediatric otorhinolaryngology, associated with repeated antibiotic therapy, hearing impairment and reduced quality of life. The aim of this review was to systematically analyse, based on the literature of the last decade (2015–2025), the clinical, anamnestic and comorbidity-related predictors of the development and recurrence of ROM in children and to summarize risk-stratification approaches. Systematic reviews, meta-analyses and large observational studies indexed in PubMed, Scopus, Web of Science and the Cochrane Library were analysed. The review shows that an early age at the first otitis episode (especially before 6 months), a family history of otitis media in siblings, male sex, short duration of breastfeeding, day-care attendance, passive smoking, adenoid and tonsillar hypertrophy, an allergic background and recurrent upper respiratory tract infections are the most reliable predictors of ROM. Immunological and microbiological changes (deficient mucosal antibody responses in otitis-prone children, nasopharyngeal dysbiosis) further increase the risk of recurrence. Stratifying patients into low-, moderate- and high-risk groups based on identified predictors enables a differentiated diagnostic and preventive approach. A multifactorial analysis of ROM predictors and risk stratification allows early detection, prevention of recurrent episodes and reduction of unjustified antibiotic use.

Clinical-functional and endoscopic features of vasomotor rhinitis in thyrotoxicosis

2026-07-06T13:22:08+00:00

Vasomotor rhinitis on the background of thyrotoxicosis has its own clinical and functional characteristics and requires a comprehensive approach to diagnosis. The aim of the study was to determine the clinical, functional and endoscopic characteristics of vasomotor rhinitis in patients with thyrotoxicosis. The study material included 75 patients aged 18–65 years with vasomotor rhinitis on the background of thyrotoxicosis (33 with mild, 42 with moderate thyrotoxicosis) and 20 healthy individuals (controls) examined at the clinic of the Andijan State Medical Institute. Anamnesis, endoscopy, autonomic tests, functional state of the nasal cavity (breathing, transport, pH, sense of smell) and rhinocytogram were assessed. As a result of the study, the leading complaints of patients were nervousness and muscle weakness (88%), rhinorrhea and palpitations (82.6%), and nasal congestion (81.3%). Endoscopy revealed a change in the color of the mucous membrane (93.3%), swelling of the nasal turbinates (81.3%), and serous discharge (80%). Autonomic tests showed vegetative dystonia with a predominance of sympathicotonia (paradoxical Aschner reaction 60%). Functional examination revealed a sharp decrease in nasal respiratory function (Glatzel 4.5/4.3 cm²; norm 9.0), slowed mucociliary transport (31.0–31.4 min; norm 23.7), alkaline pH (7.7; norm 7.2), and decreased sense of smell (hyposmia) (p<0.001). In conclusion, vasomotor rhinitis on the background of thyrotoxicosis is accompanied by sympathicotonia, changes in the functions of the nasal mucosa, and a specific endoscopic picture, which requires a comprehensive diagnosis by an otolaryngologist and an endocrinologist.

Modern approaches to diagnosis and treatment of mandibular condylar fractures

2026-07-07T04:09:09+00:00

Mandibular condylar fractures remain one of the most debatable topics in maxillofacial surgery. The relevance of this search and analytical study is determined by the growth of traumatism, improvement of diagnostic and treatment methods, as well as the lack of a unified approach to choosing patient management tactics. Despite numerous publications, issues of optimal choice of treatment method, access, and fixation continue to cause disputes among specialists. This review systematizes current data on diagnosis and treatment of mandibular condylar fractures, analyzes comparative effectiveness of various approaches, and determines promising directions for development in this surgical area. The main results of the search and analytical work show that computed tomography has become the gold standard of diagnosis, open reduction with internal fixation is preferable for displaced fractures, and endoscopic approaches and 3D plates demonstrate good functional results. The novelty of the work lies in a comprehensive analysis of modern technologies, including virtual planning and navigation, which allows the reader to get a complete picture of the current state of the problem and promising solutions.

Optimization of surgical treatment of open-type tympanosclerosis: one-stage tympanoplasty, prevention of stapes refixation and use of a subannular shunt

2026-07-07T04:14:56+00:00

Functional results of surgery in patients with tympanosclerosis are not always satisfactory, one of the main causes being stapes refixation. The aim was to optimize the surgical treatment of open-type tympanosclerosis and reduce the risk of recurrence. Between 2016 and 2023, 166 patients aged 18–60 were treated according to a one-stage surgical principle: depending on the extent of the process, tympanoplasty, ossiculoplasty with a partial (PORP) or total (TORP) prosthesis, and, when required, stapedoplasty were performed. To prevent stapes refixation, the stapes was separated by two ultrathin allocartilage plates or sodium carboxymethylcellulose (Na-CMC) was applied locally. In patients with eustachian tube dysfunction, a subannular shunt was placed for long-term ventilation of the tympanic cavity, through which hyaluronic acid was administered. The anatomical and functional efficacy of the first surgical stage was achieved in 87.9% (tympanic membrane defect closure — 92.2%), and the efficacy of the second stage was 93.1%; stapedoplasty was performed in 4.6% of patients. A differentiated surgical tactic based on process extent, measures to prevent stapes refixation, and the use of a subannular shunt increase the efficacy of tympanosclerosis treatment and reduce the risk of recurrence.

Optimization of complex treatment of vasomotor rhinitis on a thyrotoxicosis background: comparative efficacy of desensitizing and thyrostatic therapy

2026-07-07T04:20:23+00:00

Treatment of vasomotor rhinitis on a thyrotoxicosis background with conventional methods is not always effective because the hormonal factor is not taken into account. The aim was to evaluate the comparative efficacy of desensitizing and thyrostatic therapy in the complex treatment of thyrotoxicosis-associated vasomotor rhinitis and to substantiate a pathogenetic treatment algorithm. 75 patients with vasomotor rhinitis on a thyrotoxicosis background were randomly divided into four subgroups: main 1 (n=40) — new-generation antihistamine + membrane stabilizer + topical corticosteroid + immunomodulator + thyrostatic; main 2 (n=15) — specific immunotherapy (SIT) + thyrostatic; control 1 (n=10) — nonspecific hyposensitizing therapy only (without thyrostatic); control 2 (n=10) — thyrostatic only. Efficacy was assessed by clinical symptoms, endoscopic picture and nasal functional indices. Full restoration of nasal breathing occurred in 67.5% (main 1) and 73.3% (main 2), versus 60% and 20% in the control groups. In the main groups, clinical symptoms, endoscopic picture and functional indices (respiration, transport, pH, olfaction) improved significantly (p<0.01–0.001). Combining desensitizing therapy with thyrostatics in the treatment of vasomotor rhinitis on a thyrotoxicosis background is superior to conventional methods and requires cooperation between an otorhinolaryngologist and an endocrinologist.

Comparative analysis of the functional state of the hearing analyzer in tympanosclerosis before and after surgical treatment

2026-07-07T04:31:11+00:00

In tympanosclerosis the degree of hearing loss depends on the extent of the process and the restriction of ossicular mobility, so accurate pre- and postoperative assessment of hearing is essential for optimizing treatment. Aim. To perform a comparative analysis of hearing function before and after surgical treatment of tympanosclerosis and to improve treatment efficacy. Materials and methods. Of 78 patients with chronic otitis media (2022–2023), 34 underwent surgery (15 men, 19 women; aged 15–50). Patients were assigned to three groups by otoendoscopy and audiometry, with repeat audiometry at 1 and 2 months. Results. The preoperative air–bone gap was 5–10 dB in group I, 15–20 dB in group II and 25–30 dB in group III; a direct relationship between the extent of the process and hearing loss was established. Tympanoplasty and ossiculoplasty were performed in various combinations; hearing improved in all groups, with recovery to normal levels in group I. Conclusion. The degree of conductive hearing loss allows patients to be stratified into groups and the appropriate surgical tactics and type of operation to be planned optimally.

The importance of botulinum toxin type a in the treatment of laryngeal granuloma: a modern review of the literature

2026-07-07T04:38:37+00:00

Laryngeal granulomas are benign tumors that often arise from trauma, chronic inflammation, or reflux. Traditional treatment involves endoscopic microsurgery; however, a high recurrence rate (up to 50%) prompts the search for alternative methods. Botulinum toxin type A (BTA) is a promising therapeutic agent due to its ability to inhibit muscle contractions and reduce acid reflux. This review analyzes the current literature on the use of BTA in the treatment of laryngeal granulomas. The toxin's mechanisms of action, administration techniques, clinical efficacy, and safety profile are discussed. Study results demonstrate that BTA promotes granuloma regression, reduces recurrence, and improves voice function with minimal side effects. BTA injections can be used either alone or in combination with surgical removal. Despite promising results, additional randomized controlled trials are needed to optimize dosages and administration techniques. Conclusion: Botulinum toxin type A represents a promising and safe treatment option for laryngeal granuloma, potentially improving clinical outcomes and quality of life for patients.

Molecular genetic markers GJB2 and MT-RNR1 in children with congenital and acquired sensorineural hearing loss

2026-07-14T13:40:26+00:00

Introduction. Nonsyndromic sensorineural hearing loss (SNHL) in children is chiefly caused by pathogenic GJB2 variants and the mitochondrial MT-RNR1 m.1555A>G mutation, associated with aminoglycoside ototoxicity. Audiological severity does not always match clinical severity, warranting molecular clarification. Aim. To study the frequency and clinical-audiological significance of GJB2 variants (c.35delG, c.167delT, c.235delC, c.313_326del14) and MT-RNR1 m.1555A>G in children with congenital and acquired SNHL versus controls and assess their predictive value. Material and methods. 255 children: group 1 (n=113) congenital nonsyndromic SNHL; group 2 (n=112) acquired SNHL with neonatal risk factors; controls (n=30). Real-time allele-specific PCR; χ², Fisher's exact test, Haldane–Anscombe correction, AUC. Results. GJB2 c.35delG was the most frequent variant (28.4% combined), predominantly homozygous C/C in group 1 (15.9%) and heterozygous T/C in group 2 (21.4%); best predictive performance (AUC=0.72). Genetic load strongly correlated with ABR wave V threshold (rs=0.81; p<0.001). MT-RNR1 m.1555A>G occurred only in group 2 (2.7%) and was linked to a severe phenotype. Conclusion. GJB2 and MT-RNR1 testing clarifies etiology and predicts SNHL severity in children and warrants inclusion in the diagnostic algorithm.

Анализ полиморфизмов генов IL4 rs2243250 и FCER1A rs2251746 в диагностике аллергического ринита

2026-07-14T13:49:39+00:00

Аллергический ринит представляет собой хроническое IgE-опосредованное воспалительное заболевание слизистой оболочки полости носа, в развитии которого важное значение имеет взаимодействие наследственной предрасположенности и факторов окружающей среды. Варианты генов, регулирующих дифференцировку T-хелперов 2-го типа, синтез иммуноглобулина E и передачу сигнала через высокоаффинные IgE-рецепторы, могут влиять на предрасположенность к заболеванию и вероятность его коморбидного течения с бронхиальной астмой. Цель исследования. Определить взаимосвязь полиморфизмов генов IL4 rs2243250 и FCER1A rs2251746 с аллергическим ринитом, а также оценить их потенциальную значимость в качестве дополнительных молекулярных маркеров тяжести заболевания и сопутствующей патологии дыхательных путей. Материалы и методы исследования. В исследование были включены 124 пациента и 30 практически здоровых лиц контрольной группы, всего 154 участника. Первую группу составили 62 пациента с хроническим катаральным ринитом. Во вторую группу были включены 62 пациента с аллергическим ринитом. Данная группа была разделена на подгруппу IIA, включавшую 34 пациента с аллергическим ринитом без бронхиальной астмы, и подгруппу IIB, состоявшую из 28 пациентов с аллергическим ринитом в сочетании с бронхиальной астмой. Генотипирование полиморфизмов IL4 rs2243250 и FCER1A rs2251746 проводили в образцах геномной ДНК, выделенной из периферической венозной крови, методом полимеразной цепной реакции в режиме реального времени. Распределение генотипов и аллелей сравнивали с показателями контрольной группы, рассчитывали отношение шансов и 95-процентный доверительный интервал. Результаты. При анализе полиморфизма IL4 rs2243250 частота аллеля T увеличивалась с 21,7% в контрольной группе до 36,8% в подгруппе IIA и 46,4% в подгруппе IIB. Соответствующее отношение шансов составило 2,11 в подгруппе IIA (95% доверительный интервал: 1,03–4,29; p<0,05) и 3,14 в подгруппе IIB (95% доверительный интервал: 1,46–6,75; p<0,01). При анализе полиморфизма FCER1A rs2251746 частота аллеля T составила 23,3% в контрольной группе, 38,2% в подгруппе IIA и 48,2% в подгруппе IIB. Отношение шансов составило соответственно 2,04 (95% доверительный интервал: 1,01–4,12; p<0,05) и 3,07 (95% доверительный интервал: 1,43–6,58; p<0,01). Статистически значимых различий между пациентами с хроническим катаральным ринитом и лицами контрольной группы не выявлено. Заключение. Носительство аллеля T и генотипов CT/TT полиморфизмов IL4 rs2243250 и FCER1A rs2251746 ассоциировано с развитием аллергического ринита, особенно при его сочетании с бронхиальной астмой. Данные полиморфизмы могут использоваться для молекулярной стратификации риска, однако без проведения внешней валидации их не следует применять в качестве самостоятельных диагностических тестов.

Clinical and audiological characteristics of children with sensorineural hearing loss of congenital and acquired genesis

2026-07-14T13:57:03+00:00

Introduction. Sensorineural hearing loss (SNHL) in children may be congenital/genetic or acquired (neonatal) in origin; timely differentiation determines the timing of diagnosis, hearing aid fitting, and rehabilitation. A battery of audiological tests (pure-tone audiometry, otoacoustic emissions, ABR, tympanometry) clarifies the level and nature of auditory impairment. Aim. To study the clinical and audiological features of children with congenital and acquired SNHL, including severity and configuration of hearing loss, timing of diagnosis and hearing aid fitting, and the pattern of impairment associated with specific neonatal risk factors (hyperbilirubinemia, ototoxic drugs). Material and methods. 225 children: group 1 (n=113) congenital SNHL; group 2 (n=112) acquired SNHL. Severity was graded per WHO (2021) classification. Pure-tone audiometry, TEOAE/DPOAE, tympanometry, ABR and, when indicated, temporal bone CT were performed. Statistics: chi-square, Fisher's exact test, Mann-Whitney U test, Spearman's rank correlation. Results. Group 1 showed a predominance of severe/profound loss (62.8% vs 32.1%; p<0.001) and earlier diagnosis (before 3 months in 59.3% vs 5.4%; p<0.001); hearing aid fitting began at 8.4±3.2 months vs 2.7±1.4 years (p<0.001). A dissociation between preserved OAE and abnormal ABR was found in hyperbilirubinemia (retrocochlear level), whereas ototoxic drugs showed selective wave V amplitude reduction with normal interpeak intervals (cochlear level). Conclusion. The clinical-audiological profile of children with SNHL differs significantly by etiology; combined OAE and ABR assessment differentiates cochlear from retrocochlear levels of impairment and supports individualized diagnostic and rehabilitation strategies.

Ossicular chain prostheses in ossiculoplasty: types, materials and comparative efficacy

2026-07-14T14:02:43+00:00

Ossiculoplasty and ossicular chain prostheses play a key role in correcting conductive hearing loss caused by middle-ear pathology. Aim. To assess, based on current literature, the types, materials and comparative efficacy of the prostheses used. Material and methods. Modern retrospective, prospective and multicenter studies, as well as national register data, were analyzed; the main outcome measure was air-bone gap (ABG) closure and the rate of achieving ABG < 20 dB. Results. Both partial (PORP) and total (TORP) prostheses significantly reduce the ABG; PORP usually yields slightly better hearing outcomes (a register-based advantage of ~3.3 dB), whereas TORP provides more stable long-term results in severe ossicular damage. No statistically significant difference between titanium and hydroxyapatite was found in hearing outcomes or extrusion rate. Preservation of the stapes superstructure and the malleus handle decisively affects the outcome. Conclusion. PORP and TORP are effective, complementary tools for treating conductive hearing loss; success depends more on the biomechanical context and prognostic factors than on the prosthesis type itself.

Эффективность эндоназальной оценки постоперационных рубцовых изменений в полости носа

2026-07-27T15:20:21+00:00

Эндоскопическая эндоназальная хирургия стала широко применяемым методом лечения патологий основания черепа, однако она неизбежно сопровождается травматизацией тканей полости носа и последующими воспалительными процессами. Послеоперационные рубцовые изменения в полости носа, включая синехии и стенозы, могут негативно влиять на результаты хирургического вмешательства, а также ухудшать обонятельную и дыхательную функции. В данном обзоре проанализирована эффективность эндоназального эндоскопического исследования в оценке процессов послеоперационного рубцевания. Анализ доступной литературы показывает, что эндоскопический мониторинг является важнейшим инструментом для раннего выявления рубцовых поражений, определения тактики лечения и оценки эффективности реконструктивных методик. При септопластике, выполненной эндоскопическим методом, частота встречаемости синехий составляет 10%, что значительно ниже по сравнению с традиционными методиками (36,7%).

Clinical-epidemiological characteristics and diagnostics of peripheral olfactory disorder following viral diseases

2026-07-27T15:13:46+00:00

According to the World Health Organization, olfactory and gustatory disorders affect 1-2% of the general population, with viral infections - particularly coronavirus, adenovirus and rhinovirus infections - being among the most common etiological factors of peripheral olfactory dysfunction. To study the clinical and epidemiological characteristics of patients with post-viral peripheral olfactory dysfunction and to evaluate structural changes of the olfactory analyzer using modern diagnostic methods (endoscopy, cone-beam computed tomography). The study included 80 patients with post-viral peripheral olfactory dysfunction treated at the Republican Specialized Scientific-Practical Medical Center of Otorhinolaryngology and Head and Neck Diseases in 2024-2025, and 20 healthy controls. Patients were divided into four groups according to disease duration. All patients underwent standard otorhinolaryngological examination, nasal endoscopy and cone-beam computed tomography (CBCT). Among patients presenting with nasal disease during 2024-2025, olfactory dysfunction was detected in 256-345 cases, of which 35-45 were confirmed to be of post-viral peripheral origin. Disease duration was up to 6 months in 39% of patients, 6 months to 1 year in 21%, 1-3 years in 25%, and more than 3 years in 15%. Coronavirus infection was the leading etiological factor (34 cases across all groups), followed by adenovirus (23 cases) and rhinovirus (16 cases) infections. Endoscopy revealed mucosal hyperemia in 88.2-95.5% of cases and inferior turbinate hypertrophy in 88.2-95.0%. CBCT demonstrated predominance of Keros type II and III olfactory fossa configurations (68.05% and 20.7% respectively), with statistically significant differences compared to controls (p≤0.05). No correlation was found between olfactory cleft width and the degree of olfactory dysfunction. Post-viral peripheral olfactory dysfunction frequently follows a prolonged course and is most commonly associated with coronavirus infection. Cone-beam computed tomography is a highly informative method for evaluating olfactory analyzer structures and is of considerable value for diagnosis and treatment planning.

The role of the microbiotics of the nasal cavity in the development of recurrent rhinosinusitis

2026-07-27T15:24:46+00:00

Despite the great achievements in medicine, recurrent rhinosinusitis is a pressing problem today, as it causes constant discomfort and a decrease in the quality of life of patients. The purpose of the review is to analyze data on the role of the microbiocenosis of the nasal cavity in the development of recurrent rhinosinusitis. Articles published in the international databases PubMed, Scopus, and Google Scholar on recurrent rhinosinusitis over the past 10 years were analyzed as review materials. Thus, the review showed that the study of the prevalence and specific course of recurrent rhinosinusitis and the microbiocenosis of the nasal cavity is relevant and requires the development of diagnostic and treatment tactics.

Вопросы патогенеза хронического гнойного отита среднего отита

2026-07-27T15:29:05+00:00

Заболеваемость хронического гнойного среднего отита, несмотря на значительный прогресс в профилактике, диагностике и лечении, имеет тревожную тенденцию к увеличению в структуре патологий уха, горла и носа. Цель данного обзора является изучение вопросов патогенеза хронического гнойного среднего отита. Материал обзора составил научные публикации за последние 10 лет, опубликованных в международных базах E-library, Scopus и Web of Science. Таким образом, изучение особенностей развития хронического гнойного среднего отита является актуальной и требует дальнейшего исследования.

The role of laser doppler flowmetry in assessing the effectiveness of hypertrophic rhinitis treatment

2026-07-27T15:33:29+00:00

The problems of diagnosing and treating hypertrophic rhinitis are one of the important tasks of modern otorhinolaryngology. The aim of the study was to compare the results of various surgical methods with laser Doppler. The Republican Specialized Scientific and Practical Medical Center for Otorhinolaryngology and Head and Neck Diseases conducted a study in 2024-2025 on 100 patients diagnosed with hypertrophic rhinitis and a control group of 20 practically healthy patients who agreed to participate in the study in writing. The study showed that it is necessary to assess the state of microcirculation in the inferior nasal sinuses using laser Doppler flowmetry, which allows us to assess changes after surgical intervention.

Characteristics of immunological changes in recurrent rhinosinusis

2026-07-27T15:40:49+00:00

The course of inflammatory diseases of the ENT organs, including ENT, is a marker of long-term or resistance to traditional therapy, including URS, and immune system imbalance. The purpose of the review is to analyze data on immunological changes in recurrent rhinosinusitis. Articles published in the international databases PubMed, Scopus, and Google Scholar on recurrent rhinosinusitis over the past 10 years were analyzed as review materials. In conclusion, the study of the specific features of immunological changes in recurrent rhinosinusitis is of great importance for a deeper understanding of the pathogenesis of the disease and the development of effective treatment strategies.

Clinical results of simultaneous endoscopic surgery in patients with chronic dacryocystitis

2026-07-27T15:45:04+00:00

In many cases chronic dacryocystitis does not occur in isolation but against a background of pathological processes within the nasal cavity or adjoining sinuses, making the choice of surgical strategy a genuine challenge for the clinician. This study compared two approaches - simultaneous endoscopic endonasal dacryocystorhinostomy and the traditional external procedure directed solely at the lacrimal duct. Eighty patients with chronic dacryocystitis were enrolled and evenly split: forty (Group I) underwent the external technique alone, while the remaining forty (Group II) had simultaneous correction of nasal changes, with a Propel device fitted in most cases. Treatment outcomes were reassessed at six months using the Munk score, endoscopic examination, and acoustic rhinometry and rhinomanometry reflecting respiratory indices. At baseline, no meaningful difference emerged between the two groups (p>0.05). By six months, however, the picture changed considerably: in Group II nearly nine of every ten patients (90.3%) achieved full recovery, with recurrence in only 2.8%, whereas the corresponding figures for Group I were 69.9% and 9.6% (p<0.05). Patients whose nasal changes were addressed at the same time also regained respiratory function more quickly and more reliably. Where the Propel device was used, a stable opening formed in almost every case (97.2%). It follows that, in chronic dacryocystitis accompanied by nasal pathology, simultaneous surgery addressing both problems at once yields considerably more reliable outcomes than the traditional isolated procedure and substantially lowers the risk of recurrence.

Features of endoscopy in the surgical treatment of chronic suppurative otitis media

2026-07-27T15:49:42+00:00

Despite significant progress in prevention, diagnosis, and treatment, the incidence of chronic suppurative otitis media has shown an alarming trend toward increasing prevalence among ear, throat, and nose pathologies. The purpose of this review is to examine the use of endoscopy in the surgical treatment of chronic suppurative otitis media. The review material includes scientific publications from the past 10 years, published in the international databases E-library, Scopus, and Web of Science. Thus, the use of endoscopic techniques in middle ear surgery is advisable and facilitates thorough removal of pathological tissue and prevents recurrence.

The role of rinogenic factors in the origin of chronic dacryocystitis

2026-07-27T15:54:03+00:00

Anatomically, the lacrimal sac lies almost inseparably close to the lateral wall of the nasal cavity, which is why establishing, through a combination of clinical observation and histological evidence, the part that prolonged inflammation in this region plays in the development of dacryocystitis is a matter of particular scientific interest. This work sought to clarify precisely that question - whether changes in the lateral nasal wall constitute an independent (rhinogenic) factor triggering chronic dacryocystitis. Eighty patients with chronic dacryocystitis were enrolled and underwent rigid-optic (Storz, Eleps; 0°, 30°, 70°) endonasal endoscopy together with 3D computed tomography; in forty-seven of them, tissue from the lateral nasal wall and the lacrimal sac obtained intraoperatively was stained with hematoxylin and eosin and examined microscopically. Endoscopic observation showed that these patients had middle turbinate concha bullosa in 21.9-25% of cases, septal deviation in 17.8-22.2%, anterior ethmoid cell hyperplasia in 16.4-18.1%, hypertrophic rhinitis in 8.2-9.7%, polypoid ethmoiditis in 6.8-8.3%, and vasomotor rhinitis in 5.5-6.9%. Tomographic measurements indicated that the mean distance from the base of the lacrimal sac to the attachment point of the middle turbinate was 3.4±0.7 mm, while the uncinate process and ethmoidal infundibulum lay considerably posterior and inferior to the sac's projection. Among the forty-seven patients examined histologically, twenty-nine (61.7%) showed secondary, or 'sympathetic', inflammation of the lacrimal sac occurring alongside inflammation of the lateral nasal wall; overall, 71.5% of lateral wall inflammation cases were accompanied by exactly this secondary process. It follows that lateral nasal wall pathology should be regarded as an independent, rhinogenic factor in chronic dacryocystitis, which scientifically justifies simultaneously addressing intranasal changes when treating the disease.