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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 ß1, 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.

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Results of the study on adaptive immunity in patients with polypous rhinosinusitis (PRS) proved to depend on the degree of eosinophilia in the peripheral blood. The patients were allocated to two groups, one comprised of those having up to 150 eosinophils per 1 microliter the other of the patients with a higher eosinophil concentration. Patients of the former group had a significantly reduced number of CD3+, CD4+, CD8+, and CD20+cells in the peripheral blood that may indicate the necessity of administering immunotropic agents. The opposite picture is characteristic of the latter group in which a rise in the number of the above cells is associated with the increased amount of IgG- and IgA-positive cells. In this situation, the use of systemic immunotropic agents should be restricted. It is concluded that evaluation of systemic and local adaptive immunity is of importance for the choice of an adequate strategy for the treatment of patients with polypous rhinosinusitis.

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Principles of a novel methodology for the combined assessment of the immune function in sickly children with pathological changes in the organs of the otorhinolaringological system are expounded. The new approach includes investigations into local cellular and humoral immunity, evaluation of functional relationships and correlations between its parameters, interpretation of these findings, and the use of the characteristics thus obtained in the development of concrete recommendations for immunotropic and/or anti-inflammatory therapy. This approach is illustrated by examples of variations in the number of CD4(+) and CD20(+) cells and interplay between them. These findings taken together with the data on the levels of serum IgG, IgA, IgM, and percentage of immunohistochemical preparations positive for these immunoglobulins indicate that the proposed method may prove useful for the development of new therapeutic modalities for the treatment of sickly children with ENT organ pathology following adenotomy and tonsilotomy.

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Experimental and clinical trials have shown that anesthesia and intensive therapy of shock incorporating tranexamic acid enhance analgesia, hyporeflexia, thus ensuring stable, adequate anesthesia which is safe under reduced doses of standard anesthesiological modalities. Application of tranexamic acid provided more favourable course of postanesthesiological and postoperative periods, decreased the number of complications and lethal outcomes compared to standard anesthesia.

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Optimal methods of endotracheal anesthesia using non-opiate drugs of four classes (clofelin, transamine, contrykal, ketanes) have been fundamentally grounded developed and tried in extensive and traumatic operations for ENT malignant and vascular tumors as well as inflammation in patients of high anesthesiological operative risk. The drugs were used in 174 patients including 13 children. 87.9% of the patients had concomitant diseases: blood hypertension, coronary heart disease, chronic nonspecific pulmonary diseases, bronchial asthma, asthmatic bronchitis, diabetes mellitus, anemia. Adequate stable anesthesia was achieved in reduced dosage of conventional anesthesiological agents.

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Patients of young age predominated in the group of 113 patients (69 males, 44 females) with orbital rhinogenic inflammation observed by the authors. 57.5% of the cases arose due to acute sinusitis, 42.5%-due to exacerbation of chronic sinusitis. The inflammation focus developed more frequently in the frontal sinuses and ethmoid labyrinth. Periostitis was diagnosed in 17 patients, subperiosteal orbital abscess in 9 patients. Inflammation of the orbital soft tissues presented as eyelid and orbital fat edema in 66 patients, as retrobulbar abscess in 11 and phlegmon in 10 patients. The treatment policy combined intensive antiinflammatory therapy and surgery if indicated. The treatment aimed at both elimination of the inflammatory focus in the sinus and drainage of the inflammatory focus in the sinus and drainage of the secondary suppuration focus in the orbit. A 100% cure was achieved, though residual phenomena such as limited movements of the eyeball, partial ptosis, reduced visual acuity, loss of vision (3, 3, 2 and 1 patients, respectively) remained.

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The search for methods providing selective action on some subpopulations of immune system cells is an important task of oncologic immunology. Adaptive immunotherapy [AI] may create new options in this field. AI was used as adjuvant in combined therapy of 180 patients with ENT cancer. The response was confirmed by correction of some immunological, cytological, biochemical, immunochemical, radioimmunological, biophysical and rheological parameters. Practical guides are presented on AI use at different stages of combined treatment.

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Present-day developments in oncological applications of laser therapy are adaptive laser immunotherapy (ALIT) and photodynamic therapy (PDT). ALIT (helium-neon laser) was used in 35 ENT-cancer patients to irradiate immunocompetent leukocytes isolated from blood in an Amino cell separator. The use of ALIT in the combined treatment of our patients improved their health condition. Cytological, immunochemical and immunological examinations of blood revealed an increased count of activated lymphocytes, normalization of acute-phase proteins, stimulation of cell-mediated immunity and nonspecific resistance. The pharmacokinetics and photodynamic activity of porphyrin compounds in mice with inoculated tumors were investigated. Experimental observations demonstrated that the application of photodynamic therapy of hematoporphyrins in ENT-oncology seems very promising.

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