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BACKGROUND: Acute bacterial sinusitis is one of the most common causes of prescribing systemic antibacterial drugs in otorhinolaryngology. With bacterial etiology of the disease, beta-lactam antibiotics are prescribed, in particular cefixim. Cefixim in the form of dispersible tablets has high clinical and bacteriological efficiency, as well as good tolerability in patients with acute sinusitis. OBJECTIVE: To study the therapeutic equivalence of two drugs of cefixim (reproduced drug Cefixim Express and reference drug Suprax Solutab) in patients with acute bacterial sinusitis. MATERIAL AND METHODS: 60 adult patients with a diagnosis of acute bacterial sinusitis took part in a randomized open comparative clinical study. Patients of group 1 (n=30) received the drug Cefixim Express in the form of dispersible tablets 400 mg once a day. Group 2 (n=30) received Suprax Solutab in the form of dispersible tablets 400 mg once a day. The duration of treatment course was 7 days. All patients conducted general clinical and otorhinolaryngological examinations, assessment of symptoms of acute sinusitis, assessment of the general clinical impression of the therapy, tolerance of treatment, analysis of the frequency of unwanted phenomena before treatment, 3 days after the beginning of therapy and after the course completion (7 days). RESULTS: Recovery occurred in 63.3% of patients in group 1 according to the inspection on the 7th day of treatment and in 66.67% of patients in group 2. The rate of clinical symptoms regression by the end of therapy was comparable in the comparison groups. Hyperemia of the nasal mucosa, purulent nasal discharge and difficulty in nasal breathing (p<0.01) regressed by the 7th day in patients of both treatment groups. The incidence of adverse reactions on the 7th day of treatment in group 1 was 10%, in group 2 - 6.7% (p>0.05). CONCLUSION: The drug Cefixim Express has high therapeutic effectiveness in the treatment of acute bacterial sinusitis, comparable to Suprax Solutab. Cefixime EXPRESS has demonstrated a good tolerability and a favorable safety profile.

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In recent years, inflammatory diseases of the nose and paranasal sinuses have been on the rise. In addition to infectious diseases, in the modern world a large percentage of the population suffers from allergic diseases. The approach to therapy and the choice of a drug should take into account the pathogenesis of the inflammatory reaction in the nasal cavity and paranasal sinuses. By exerting its effect, the drug should reduce hyperemia and swelling of the nasal mucosa, reduce the level of mucus secretion, improve the drainage of the paranasal sinuses, i.e. possess vasoconstrictive and anti-allergic properties. As such a drug, you can use the combined intranasal spray Frinozol, which basically contains cetirizine and phenylephrine. The use of Frinozol in the complex treatment of inflammation of the mucous membrane of the nasal cavity and paranasal sinuses contributes to the rapid and pronounced weakening of the symptoms of the disease, and is also the key to successful therapy.

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The cerumen impaction is a pathological accumulation of earwax in the external auditory canal, which is accompanied by hearing loss, heaviness and discomfort in the ear, which leads to a significant decrease in the quality of life. The authors of the article consider the most common causes of excessive formation of cerumen, the mechanisms that prevent the normal separation of cerumen from the ear canal and the age-related features of the composition of earwax. The article discusses various ways to remove cerumen impaction, indications and contraindications to them. The authors conclude that the most effective and gentle way to evacuate sulfuric masses is the use of cerumenolytics, drugs that break down and thin the cerumen impaction, which facilitates its subsequent removal. Cerumenolytics based on plant components gently affect the skin of the outer ear, which allows them to be used for the purpose of hygiene of the ear canal and prevention of the formation of excess cerumen.

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Currently, the problem of acute rhinosinusitis continues to be relevant due to the frequent occurrence of this pathology. A certain difficulty is caused by the differential diagnosis of viral, post-viral and bacterial forms of rhinosinusitis, which carries the risks of irrational therapy. The authors of the article discuss the role of a viral infection in the etiology and pathogenesis of acute rhinosinusitis, the stages in the development of an inflammatory reaction on the mucous membrane of the nose and paranasal sinuses, and the disruption of mucociliary clearance. The authors consider options for the pathogenetic therapy of postviral sinusitis, concluding that the use of local combined preparations containing the mucolytic acetylcysteine and the vasoconstrictor component of tuaminoheptane sulfate is effective.

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Systematic analysis of various indicators of the educational process becomes important to assess the effectiveness of the training of residents. One of the most common tools for monitoring the effectiveness of the educational process is a questionnaire of students. OBJECTIVE: To analyze the results of the assessment of the quality of training in the residency of the Sverzhevky Research Clinical Institute of Otorhinolaryngology according to the survey of residents. MATERIAL AND METHODS: The study includes the results of an anonymous questionnaire survey of a sample group of residents of the residency of the Sverzhevky Research Clinical Institute of Otorhinolaryngology of the second year of study. RESULTS: The data obtained allow us to judge the satisfaction with the quality of training of the absolute majority of the interviewed residents, their active use of specialized electronic search engines, a high assessment of the level of lectures, the desire to improve their surgical training. The importance for the professional development of residents of participation in weekly scientific and clinical conferences of the Sverzhevky Research Clinical Institute of Otorhinolaryngology, meetings of the Moscow Scientific Society of Otorhinolaryngologists, traditional annual scientific and practical conferences of otorhinolaryngologists of Moscow, as well as in the activities of the Youth Council of the Institute is noted. CONCLUSION: The results of the survey create prerequisites for improving the educational process, the formation of professional competencies and readiness for independent work among residents.

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Treatment of inflammatory pathology of the nasal cavity at the present stage requires a doctor to clearly understand the physiological mechanisms that implement the main functions of the mucous membrane of the nasal cavity and upper respiratory tract. One of the most important processes that ensure the normal functioning of the respiratory tract is mucociliary clearance. Violations of its work leads to stagnation of mucus and the development of inflammation not only in the nasal cavity, but also in the lower respiratory tract and middle ear cavities. The authors of the article consider the main etiological factors and mechanisms of the pathogenesis of inflammatory diseases of the nasal cavity, discuss approaches to the treatment of these conditions. The authors conclude that in conditions of acute and chronic inflammation of the nasal mucosa, accompanied by the secretion of thick viscous mucus, the most effective topical use of the combined preparation, which includes acetylcysteine, tuaminoheptane and sodium hyaluronate. This combination has both mucolytic, vasoconstrictive and protective effects, which increases the effectiveness of the drug and the adherence of patients to therapy.

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Inflammatory pathology of the oropharynx, which does not lose its relevance, is a problem that is of interest to doctors of various specialties. As one of the main causes of inflammatory diseases of the pharynx, the influence of microorganisms, primarily viruses, on the mucous membrane of the upper respiratory tract is indicated. The authors of the article emphasize the importance of preserving the indigenous microbiota, which provides a barrier function and prevents the adhesion and colonization of pathogenic microorganisms. In this regard, the most effective and safe is local microbiocenosis-regulatory therapy using lysozyme, a natural peptide that has antiseptic, anti-inflammatory and immunoregulatory effects. As such a drug, the authors recommend the combined drug Lorolizin, which can be used in the treatment of acute pharyngitis, acute tonsillitis, and adenoiditis.

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Purpose of the study. Generalization of data on the value of alternative and additional treatment of acute infectious rhinitis with Korizalia. MATERIAL AND METHODS: The material of scientific publications included in the Cochrane Library, information bases of the RSCI, MEDLINE, PubMed was used as a data source. The choice of material was carried out using the key words: colds, acute rhinitis, herbal medicine, homeopathic remedies. RESULTS: Analysis of published clinical trial descriptions suggests the potential value of homeopathic medicines, in particular Korizalia, in improving the effectiveness of the treatment of acute rhinitis. The use of Korizalia in acute infectious rhinitis was more effective in relation to the main symptoms of ARI compared with placebo. CONCLUSION: The lack of optimal drugs for the etiotropic treatment of viral acute respiratory infections determines the relevance of alternative and complementary methods of treatment using drugs of natural origin. The drug Korizalia can be used for acute respiratory infections (acute infectious rhinitis) as an alternative drug or in combination with other drugs.

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THE AIM OF THE STUDY: Was to summarize data on the role and place of herbal remedies, in particular, the extract from the roots of Pelargonium sidoides (EPs 7630) in the treatment of acute sinusitis. MATERIAL AND METHODS: Materials of scientific publications included in the Cochrane Library, information bases of the RSCI, MEDLINE, PubMed were used as a data source. The choice of material was carried out according to the keywords: epidemiology of acute sinusitis, modern treatment of acute sinusitis, colds, herbal remedies, Pelargonium sidoides. RESULTS: Analysis of published clinical trial data demonstrates evidence that EPs 7630 is significantly superior to placebo in reducing the duration and severity of symptoms of acute respiratory infection and indicates the advisability of including an extract from Pelargonium sidoides (EPs 7630) roots in OS treatment protocols. The high safety profile and clinically significant efficacy of this drug make EPs 7630 an important component of drug therapy for acute sinusitis.

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The article covers the problems of diagnosis and treatment of inflammatory diseases of the oropharynx. The authors consider the main nosological forms of focal inflammation in the throat, discuss the role of ß-hemolytic streptococcus group A in the genesis of angina and chronic tonsillitis and their complications. The authors discuss the influence of irritants - smoking, alcohol, cold air, gastroesofareal reflux on the development of chronic inflammation of the oropharynx mucosa. Leading clinical symptoms in oropharyngeal diseases and the main methods of their treatment are presented. The authors conclude that the most effective treatment of focal inflammation in the throat is the use of combined topical drugs. As a choice for local therapy of pharyngeal diseases, the authors offer a combined drug Doritiricin, effectively and safely relieving pain syndrome and local inflammatory response.

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The article presents a modern approach to the diagnosis and treatment of inflammatory diseases of the outer ear. The authors consider the main predisposing factors that determine the development of external otitis: traumatic injury, water ingress, use of in-the-ear headphones, occupational hazards and others. The role of various microorganisms, including Pseudomonas aeruginosa, Staphylococcus aureus, bacteria of Enterobacteriaceae family and fungi of genera Aspergillus, Candida, Penicillium, Mucor in the genesis of inflammatory pathology of the outer ear is discussed. For the purpose of effective treatment of external otitis the authors suggest to use a local combined preparation Candibiotic, which contains antibacterial, fungicidal, hormonal and analgesic components that affect the main factors of pathogenesis of the disease.

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The article discusses the problems of the comorbid course of purulent-inflammatory diseases of the ENT organs and diabetes mellitus. The authors consider the main immunological factors of systemic and tissue immunity, which make it possible to detect immunodeficiency in conditions of purulent inflammation - immunoglobulins A, M, G, phagocytosis parameters, lysozyme, lactoferrin, general bactericidal activity, antibody affinity, determined in blood serum and saliva. In the course of the work, results were obtained that characterize a decrease in the systemic and tissue immune reactivity, which correlate with the degree of compensation of diabetes mellitus, which is a predictor of the occurrence and development of focal suppurative inflammation in the ENT organs. The authors conclude that rational antihyperglycemic therapy is necessary to maintain a satisfactory level of glycemia.

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BACKGROUND: The interrelationship of thyroid pathology and ENT organs is one of the least studied aspects of iodine deficiency diseases. Diseases of this localization are distinguished by a variety of their causes, high prevalence, a tendency to prolonged and chronic process, resistance to drug therapy and a negative effect on the quality of life of patients. AIM: To study the state of ENT organs in hypothyroidism in the iodine-deficient region of Eastern Siberia (Irkutsk Region). MATERIAL AND METHODS: The main group consisted of 302 patients with hypothyroidism, and the control group - 116 people without thyroid pathology. All patients who participated in the study were on replacement therapy (Levothyroxin). An objective study of the ENT organs was performed using an endoscope and a microscope. The SF-36 questionnaire was used to study the indicators of quality of life. A questionnaire was used to assess the symptoms of rhinitis, which provided clarification of the severity of symptoms on a visual analogue scale. RESULTS: Among patients with thyroid dysfunction, various changes characteristic of chronic pathology of the pharynx, larynx, and ear were found with almost the same frequency as among those examined without thyroid pathology. Chronic rhinitis in hypothyroidism is characterized by manifest edematous-hypertrophic changes in the turbinate, intense hyperemia of the nasal mucosa, the presence in the nasal passages of viscous, thick mucous discharge. The most important integral indicators of health components are physical (PH) and psychological (MH) patients with chronic rhinitis were reduced (50.6±1.96 and 53.0±2.08 respectively). CONCLUSION: The symptoms of rhinitis are leading in the structure of the pathology of the upper respiratory tract in hypothyroidism and have a significant negative impact on the patient's quality of life indicators.

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This article was designed to describe the history of the establishment and development of the research divisions based at the Department of Otorhinolaryngology of the Faculty of General Medicine, N.I. Pirogov Russian National Research Medical University, including laser, vestibulogical, and audiological laboratories. The authors present an overview of the main research activities and achievements of the Department with special reference to the management of Meniere's disease, cochlear-vestibular disorders associated with sensorineural hearing loss, injuries to the organs of hearing, and diseases of the central nervous system. Also discussed are the peculiarities of the laser-assisted medical care and the possibilities for the application of therapeutic and surgical lasers for the purposes of the practical otorhinolaryngological work.

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This article is focused on the peculiar features of the ENT microbial paysage in the patients presenting with diabetes mellitus. We have examined a total of 310 patients including 145 suffering from the pyoinflammatory ENT diseases and concomitant diabetes mellitus. The study has demonstrated that the microbial biocenoses of the ENT organs in the diabetic patients are dominated by the potentially pathogenic and transitory microflora whereas the saccharolytic microflora and the non-fermentative bacteria (pseudomonades) concentrate in the foci of ENT inflammation. The spectrum of microorganism that occur in the areas of inflammation are shown to depend on the quality of compensation of diabetes mellitus.

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The objective of the present study was to determine the leading clinical and pathogenetic factors determining the clinical course of the pyoinflammatory ENT diseases in the patients with diabetes mellitus (DM) and to develop the algorithm for the rational therapy of these conditions. A total of 145 patients presenting with pyoinflammatory ENT diseases and concomitant diabetes mellitus were available for the examination that included the microbiological and biochemical studies, determination of the total lipid spectrum, glycated hemoglobin (HbA1c) level, and glycemic profile. Also, the body mass index of the patients was estimated along with the type and severity of obesity. Moreover, the character of antibacterial and hypoglycemic therapy was evaluated. The mathematical analysis of the data obtained revealed the clinical and biochemical parameters determining the clinical picture of the pyoinflammatory ENT diseases in the patients with diabetes mellitus. These were localization of the pyogenic process in the larynx, abdominal obesity, fasting hyperglycemia in excess of 8.3 mmol/l, and dyslipidemia accompanied by the reduction in the amount of high density lipoproteins to below 40 mg/100 ml and the increase of low density lipoproteins to above 155 mg/100 ml. The results of the study were used to develop the differentialalgorithm for the combined treatment of pyoinflammatory ENT diseases in the patients with diabetes mellitus based on the proposed original scale for the prediction of pyogenic complications.

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