Prospects for using herbal preparation in combination with physical methods in complex therapy of chronic adenoiditis

Introduction. Importance of the search effective methods of treating chronic adenoiditis in children is associated with a high incidence and risk of developing complications. Treatment of chronic adenoiditis are described in the literature, but the advantages of any of them are inconclusive, which leads to the search for additional more progressive methods.Objective. To increase the effectiveness of the treatment of chronic adenoiditis using complex therapy of non-drug methods in combination with the herbal preparation Tonsilgon N.Materials and methods. Biochemical changes in lymphoid tissue were studied on biopsy material in 111 children with chronic adenoiditis, grade 3 adenoid hypertrophy, directed to planned surgical treatment. In the preoperative period, patients were divided into 4 groups: Group 1-control group, patients who received conventional methods of treatment; 2-study group, patients who additionally used low-frequency ultrasound irrigation of the nasal cavity and nasopharynx with photochromotherapy; The third group, patients who received the herbal preparation tonsilgon N (drops) as preoperative therapy; The fourth group study underwent low-frequency ultrasound irrigation of the nasal cavity and nasopharynx in combination with photochromotherapy and took the drug Tonsilgon N in an age-related dosage.Results and discussion. When comparing the results of biochemical studies, an increase in the products of lipid peroxidation was noted in patients of the first group, which was regarded as a factor in the protracted course of the disease. The use of targeted phytoniring drugs in combination with low-frequency ultrasonic cavitation and photochromotherapy in complex therapy significantly modulates the processes of lipid peroxidation and can potentiate the antioxidant protection of cells.Conclusion. Objective data were obtained for the first time on biochemical changes in lymphoid tissue for various methods of therapy indicate the prospects of using non-drug methods in combination with a herbal preparation in the complex therapy of chronic adenoiditis

Personalized prediction of the results of reconstructive surgery for chronic otitis media

Introduction. The goal of the surgical treatment of patients with chronic otitis media is to eliminate the consequences of the inflammatory and destructive disease while preserving the anatomy of the middle ear and improving auditory function. According to the literature, the outcome of middle ear reconstructive surgery for the surgeon and the patient in most cases remains unpredictable. The development of an integrated approach to predicting the results of reconstructive sanitizing surgery will make it  possible to select the most effective surgical tactics in terms of treatment time and type of surgical intervention.Aim. To develop a methodology for personalized prediction of the result of operations on the temporal bone in patients with chronic otitis media and substantiate the choice of optimal surgical tactics, taking into account clinical and functional parameters.Materials and methods. A retrospective study was carried out to compare the data of patients with the use of the author’s personalized prognosis method: “A method for predicting the result of tympanoplasty” and “A method for predicting the degree of  hearing loss in otosurgery for chronic otitis media” with the results of surgical treatment of 263 patients with chronic otitis media, operated on in hospitals in Moscow. Chelyabinsk in 2018–2020.Results and discussion. In the observation, the patients were divided into two groups according to the sum of points, which determined the volume, type and timing of the operation. The sum of points less than or equal to 20 was assessed as a favorable prognosis for reconstructive debridement surgery. The sum of points in the range from 21–40 was assessed as the possibility of carrying out onestage surgery for the purpose of sanitation and reconstruction, but the patient should be informed about the unfavorable prognosis for the restoration of hearing. A score greater than 40 is assessed as an unfavorable prognosis, with an indication for separate-stage surgery, indicating a socially significant hearing loss in the postoperative period in patients with chronic otitis media.Conclusion. A personalized approach to predicting the results of surgical treatment forms groups of patients with chronic suppurative otitis media and helps in choosing surgical tactics in terms of the type, volume and timing of one-stage or separatestage reconstructive surgery and the need for reoperation for a period of one year

Opportunities for correction of individual links of the pathogenesis of allergic rhinitis and bronchial asthma with assessment of the quality of life of patients

Introduction. One of the antileukotriene drugs for the treatment of bronchial asthma and allergic rhinitis with and without polyposis is montelukast. The presented article presents the  results of  the analysis of  the effectiveness, safety and impact on the quality of life of patients, the use of the singular, in various forms of allergic rhinitis and associated comorbid conditions.Aim of the study. To assess the impact on the quality of life of patients, the effectiveness and safety of the use of montelukast in the complex therapy of patients with allergic rhinitis and comorbid diseases.Materials and methods. A simple, blind, randomized, controlled clinical trial involved 97 patients divided into 4 groups: patients with moderate allergic rhinitis; allergic rhinitis of moderate severity and bronchial asthma; severe allergic rhinitis and bronchial asthma; severe allergic rhinitis, bronchial asthma and polypous rhinosinusitis. In parallel with the comparison of drug tolerability, safety and clinical symptoms (rhinorrhea, nasal congestion, itching, sneezing, bronchopulmonary manifestations), the quality of life was assessed using a special SNOT-22 questionnaire.Results. The use of the antileukotriene drug montelukast in the complex therapy of allergic rhinitis and related comorbid conditions significantly improved the clinical symptoms and quality of life of patients over the entire period of treatment in all groups. There was an increase in the suppression of leukotriene-mediated effects when using montelukast, more in the group of people with allergic rhinitis and bronchial asthma, such as symptoms of the allergic triad, mucus hypersecretion, bronchospasm, eosinophilia, increased vascular permeability, etc.Conclusion. In the treatment of patients with allergic rhinitis and morbid conditions, Singular has demonstrated an inhibitory effect on cysteinyl leukotrienes, high bioavailability, good tolerability and safety

Oxidative protein modification of the temporal bone tissue in chronic otitis media

Aim. To study the role of oxidative protein modification of bone tissue proteins in the formation of destruction of temporal bone structures in chronic otitis media. Methods. The study included 139 patients aged 16-75 years with a verified diagnosis of chronic otitis media, who are candidates for surgical treatment. Depending on the method of surgical treatment, patients are divided into four groups (by nosology and complications and reoperations): patients with tubotympanic otitis media and epitympanic antral otitis, without complications and with local or intracranial complications, after reconstructive sanitizing ear surgery. The state of the processes of oxidative modification of proteins was evaluated in the bone tissue of the middle ear cavities, obtained intraoperatively, by the content of carbonyl products with the use of spectrophotometry. The data were processed by descriptive statistics and were presented in the form of a median and a range between quartiles with an estimate of the reliability of the intergroup differences by the Mann-Whitney U-criterion. Results. A comparison of the indicators characterizing the oxidative modification of bone tissue proteins of the temporal bone in patients with complicated and recurrent forms of chronic otitis media demonstrates a greater degree of free radical destruction of proteins, primarily markers of early stages of protein damage and an increase of aldehyde products, both at the basal level and in response to induction in a complicated course of the disease. Conclusion. The obtained data allow drawing a conclusion about a high level of oxidative stress in bone tissue in destructive forms of chronic otitis media accompanied by relapses and complications, and about the perspectives of antioxidant pre-operative use taking into account the features of oxidative stress in bone tissue in patients with chronic otitis media

Motivation of the patient to perform aesthetic rhinosurgical intervention, topical issues in identifying the true reasons: A review

From time immemorial, people have sought to improve their body and appearance by resorting to various medical, non-drug and surgical interventions. The most advanced direction in this context has been and remains facial cosmetic surgery, which, being a kind of standard that allows you to achieve perfection, encourages people to change their appearance in an operative way, which is not always justified. The most common and sought after desire of people when visiting a plastic surgeon is to change the shape of the nose. The main motive for rhinoplasty is low self-esteem, dissatisfaction with the shape and size of the nose, which, in their opinion, prevents them from achieving success in their personal lives, building a career, etc. As a rule, most of these people are people of ethnic groups who seek to “Europeanize” their nose and face according to modern aesthetic canons, people with dysmorphophobia, young girls and boys. Often there are cases when patients, having not received the desired result, make claims to surgeons and embark on litigation. Therefore, when planning rhinoplasty, it is necessary to find out several important questions: the main psychological reasons that motivated rhinoplasty; whether the patient has mental deviations what are the external influences and internal deviations. Patients presenting with the following features are at high risk and should give surgeons reason to reconsider their rhinoplasty