Inflammatory diseases of ENT organs and purulentseptic intracranial complications associated with them in the Kabardino-Balkarian Republic

Actuality. The growth of inflammatory diseases of ENT organs and associated purulent-septic intracranial complications is an urgent problem of modern otorhinolaryngology. Severe complications associated with sepsis and inflammatory lesions of the membranes and brain matter are life-threatening conditions for otorhinolaryngological patients.Objective. To study the epidemiological situation of inflammatory diseases of the ENT organs and associated purulent-septic intracranial complications in the Kabardino-Balkarian Republic.Materials and methods. Data of official statistics, electronic databases, statistical reports of the Ministry of Health of the KabardinoBalkan Republic, data of outpatient’s medical records and hospital medical records of multidisciplinary medical and preventive institutions, data on the prevalence of diseases of ENT organs in the Kabardino-Balkarian Republic from 2011 to 2018 among adults and children.Results and conclusions. The results obtained reflect a significant increase in inflammatory diseases of the ENT organs in the Kabardino-Balkarian Republic from 2011 to 2018. both in the number of reported cases and in the primary incidence. Despite the decrease in the number of inpatient ENT beds in the Republic in 2013, the number of patients treated increased. The reduction of ENT beds entailed an increase in hospital mortality, which is represented exclusively by ENT-associated intracranial complications. Today, the Republic has a rather high level of ENT-associated intracranial complications associated with low prevention and diagnosis of inflammatory ENT diseases, which dictates the importance of using a multidisciplinary approach (ENT doctor, neurologist, ophthalmologist, resuscitator, therapist, neurosurgeon), the need for review management tactics, development of algorithms for the diagnosis and optimal treatment of patients with ENT-associated HFD

Predictors of poor outcome in treatment of patients with pyoinflammatory otogenic and rinosinusogenic intracranial complications

OBJECTIVE. The authors would like to reveal preoperative and intraoperative predictors of lethal outcome in patients with otogenic and rhinosinusogenic pyoinflammatory intracranial complications. The study assessed an efficacy of specialized medical care of this category of patients. MATERIAL AND METHODS. Тhis research included 303 patients (199 (65,68 %) men and 104 (34,32 %) women) aged from 39,3 ± 17,4 years on average who underwent operation concerning intracranial pyoinflammatory oto- and rinosinusogenic complications in multidisciplinary hospitals of different subjects of the Russian Federation at the period from 2000 to 2014. RESULTS. Multiple logit regression analysis of predictors of lethal outcome showed the presence of higher number of factors and errors which influenced on treatment during preoperative period. These factors and errors caused an extension of preoperative period and increase of unfavorable outcome. CONCLUSIONS. While planning the management of primary and specialized care, doctors should take into account the identified predictors for patients of this category

CLINICODIAGNOSTIC FEATURES OF OTORHINOSINUSOGENIC INTRACRANIAL PYOINFLAMMATORY DISEASES COMPLICATED BY SEPSIS

The authors analyzed 60 clinical cases of follow-up study of patients aged 14 to 76 years old with otorhinosinusogenic intracranial complications and sepsis. Diseases of ENT organs were as the primary foci of infection-inflammatory processes. There were noted otitis media in 24 (40%) patients, rhinosinusitis - in 19 (31,7%) patients, combined purulent lesions of the middle ear and paranasal sinuses - in 17 (28,3%) patients. Purulent meningitis was diagnosed in 22 (46,7%) cases, purulent meningoencephalitis - in 38 (63,3%) patients. All treated patients were diagnosed with sepsis, including severe sepsis with multiple organ failure in 27 (45%) patients. The lethality consisted of 44,5% in group of patients with severe sepsis. The early diagnostics of systemic inflammatory response, sepsis, organosystemic disorders, practical application of modern algorithm of diagnostics and treatment, medico-economic standards of sepsis are necessary in order to start specialized intensive treatment on time. The patients should be transferred to septic center. Modern surgical and therapeutic methods must be applied. These approaches to treatment have a direct impact on the prognosis and outcome in each clinical case

AN ALGORITHM OF MEDICAL CARE FOR PATIENTS WITH OTOGENIC AND RHINOSINUSOGENIC PURULENT INTRACRANIAL COMPLICATIONS

The article highlights a retrospective study of 303 cases of completed clinical management of patients treated for ENT pathology complicated by purulent intracranial inflammatory diseases and sepsis, admitted to multi-specialty hospitals of the RF subjects during the period 2000–2014. To evaluate the condition of patients and changes in course of the disease, the integral and quantifying scores to assess the severity of the systemic inflammatory response syndrome were used: SOFA, which allows to evaluate the level of organ dysfunction, the APACHE  II severity of disease score and the Glasgow coma scale. The outcome is directly dependent on early comprehensive diagnosis of injury to the vital organs and systems of the body, timely initiation of specialized treatment