In children, chronic inflammatory diseases of the pharyngeal lymphoid ring are the most common chronic nasopharyngeal diseases. Available therapies are not always effective, associated with an increase in treatment duration and possible complications and recurrences. Laser therapy (LT) techniques have long been successfully used in ENT practice, but they still need to be optimized and standardized.OBJECTIVE:To analyze treatment outcomes in children with chronic inflammatory diseases of the pharyngeal lymphoid ring in out-patient settings using standard methods of LT (by localization, technique, and time of laser exposure) with different lasers.MATERIALS AND METHODS:A total of 214 patients aged 1-15 years with chronic inflammatory diseases of the pharyngeal lymphoid ring were included in the study. The patients were divided into three main groups (1-3) and received LT using different lasers on the Lasmik device and a control group without LT. Parameters of laser radiation sources (groups) were the following: Group 1 wavelength (λ) 635 nm, pulsed mode (PM), pulse width 100 ns, pulse power (PP) 5 W, mean power (MP) 0.04 mW; Group2 λ=904 nm, PM, PP=5 W, MP=0.04 mW; Group 3 λ=635 nm, continuous mode, MP=15 mW. The outcomes were assessed by clinical improvement.RESULTS AND CONCLUSION:A comparative analysis of the comprehensive treatment outcomes showed significantly better outcomes in the 1-3 groups compared to the control group. A higher efficiency of pulsed low-intensity laser radiation (LIRI) in comparison with a continuous mode, mostly red spectrum (λ=635 nm, PM, MP=5 W) was shown. This laser exposure results in faster improvement and allows performing LIRI exposure percutaneously without using light guides, which require sterilization and are quickly degrading.

Purpose: To increase the efficiency of treatment and rehabilitation of patients with chronic cicatricial stenosis of the larynx and trachea using laser light after reconstructive surgery on the larynx and trachea. Material and methods. 40 patients with chronic stenosis of the larynx and trachea were divided into two groups: Group I (main) – 20 patients who had laser therapy sessions in postoperative period and Group II (controls) – 20 patients who had no laser therapy. All patients were examined with laser Doppler flowmetry using laser analyzer LAKK 01 with a single-channel tissue probing option. Laser therapeutic apparatus Mustang 2000 with a laser head generating in the red spectrum (wavelength 0.63–0.65 μm, pulse-periodic mode, frequency 80 Hz) was used for laser sessions. Average energy density was 1.5–3.0 J/cm2 . Laser therapy course consisted of 8–10 sessions with average exposure time 5 minutes per irradiated zone; and in case of extensive wound defects, total exposure time was increased by irradiating several fields on the wound surface.

Проблема лечения гнойного верхнечелюстного синусита (ГВС) остается актуальной, несмотря на широкое применение современных антибактериальных средств, противогрибковых препаратов, современных способов хирургии, включающих малоинвазивные эндоскопические лазерные, ультразвуковые и иные методы хирургического вмешательства в отношении верхнечелюстных пазух. Цель работы: повысить эффективность лечения острых и обострения хронических ГВС с помощью антимикробной фотодинамической терапии (АФДТ). Результаты. В течение 15 лет в клинических условиях 320 пациентам было проведено малоинвазивное лечение острого или обострения хронического ГВС с помощью АФДТ. Описываемый в статье способ первоначально применяли только в тех случаях, когда проведенное ранее лечение, включая хирургическое, не давало стойкого эффекта, или в тех случаях, когда у пациента была выражена аллергическая реакция на применение многих антибактериальных препаратов. Сеансы АФДТ ГВС проводили как в стационаре, так и в амбулаторных условиях. Для проведения АФДТ использовали только отечественный фотосенсибилизатор Радахлорин, отечественный лазерный медицинский аппарат Лахта-Милон и отечественные кварц-полимерные волокна для трансляции лазерного излучения в полость верхнечелюстной пазухи. После отработки методики АФДТ и получения положительных результатов данный метод стали применять как основной способ лечения первично диагностированного ГВС. Результаты многолетнего применения АФДТ показали, что она является эффективным способом лечения ГВС, но имеет и противопоказания к применению, а именно: одонтогенный ГВС полипозный ГВС и индивидуальная непереносимость Радахлорина и света. Применение АФДТ позволило добиться полного излечения, подтвержденного клиническими и микробиологическими результатами исследований у 288 (90) из 320 пациентов с ГВС. Background. The problem of purulent maxillary sinusitis (PMS) treatment remains relevant, despite the widespread use of modern antibacterial agents and antifungal drugs, introduction of modern methods of surgery, including minimally invasive endoscopic laser, ultrasound and others. Aim. To increase the efficiency of acute (catarrhal, purulent) and chronic (catarrhal, purulent, fungal) maxillary sinusitis treatment with the use of photodynamic therapy. Materials and methods. Within the last 15 years 320 patients with acute and chronic PMS underwent a minimally invasive treatment with APDT. The method described in the article was initially applied only in cases when the previous treatment, including surgical treatment, did not provide a stable effect, or in those cases when the patient had an allergic reaction to one of antibacterial drugs. The sessions of APDT were conducted both in hospital and in outpatient settings. Only Russian photosensitizer Radakhlorin, the domestic laser medical device Lakhta-Milon and domestic quartz-polymer fibers were used to produce laser irradiation of the maxillary sinus cavity. The APDT technique development and obtaining positive results allowed using it as the main method for primary PMS treatment. Results. The long-term results of APDT use showed its effectiveness for the treatment of PMS, but it also has contraindications, namely: odontogenic PMS polypous PMS and individual intolerance to Radachlorin and light. The use of APDT allowed to achieve a complete response, confirmed by clinical and microbiological data in 288 (90) of 320 patients with PMS.

Цель работы повысить эффективность репаративных процессов в слизистой оболочке носа после одномоментной септопластики и подслизистой вазотомии нижних носовых раковин путем воздействия на нее 0,9-ного раствора хлорида натрия (NaCl), кавитированного низкочастотным ультразвуком, в сочетании с фотохромотерапией (видимый синий свет, -450 нм). Материал и методы. В исследование были включены 108 пациентов с искривлением перегородки носа и вазомоторным ринитом, которым одномоментно были выполнены септопластика и подслизистая вазотомия нижних носовых раковин (читать в дальнейшем после операции ). В контрольной группе было произведено стандартное послеоперационное лечение: антибиотикотерапия, орошение полости носа изотоническим раствором NaCl, туалет носа. Пациентам основной группы кроме вышеперечисленной терапии, начиная со 2-х суток после операции, проводили физиотерапевтическое лечение, причем в зависимости от применения методов физиотерапии пациенты основной группы были разделены еще на 3 подгруппы: А, В и С. Пациенты подгруппы А получали только орошение полости носа 0,9-ным раствором NaCl, кавитированным низкочастотным ультразвуком, пациенты подгруппы В только фотохромотерапию (-450 нм), а пациенты подгруппы С получали оба из вышеперечисленных методов физиотерапии. Результаты. Оценку состояния слизистой оболочки носа проводили на 2-е и 14-е сутки после операции с помощью эндоскопического осмотра, определения транспортной, выделительной и всасывательной функций слизистой оболочки носа, цитологического исследования, а также по результатам передней активной риноманометрии. Было показано, что к 14-м суткам после операции эндоскопическая картина полости носа быстрее пришла в норму у пациентов подгруппы С по сравнению c группой контроля. Восстановление транспортной, выделительной и всасывательной функций слизистой оболочки носа также протекало интенсивнее у больных подгруппы С, чем у больных в контрольной группе. Так, через 2 недели после операции полное восстановление транспортной и выделительной функций слизистой оболочки носа наблюдали у большей части пациентов подгруппы С (51,85 и 55,6 соответственно), в то время как в контрольной группе эти функции нормализовались только у 3,7 больных. Всасывательная функция слизистой оболочки носа к 14-м суткам после операции пришла в норму у 88,89 пациентов подгруппы С, а в контрольной группе эта функция к 14-м суткам восстановилась только у 37,04 больных. Цитологическое исследование показало, что к 14-м суткам после операции регенеративный тип риноцитограмм приобрели 85,19 пациентов подгруппы С, что на 37,04 было больше по сравнению с группой контроля. По данным передней активной риноманометрии, у пациентов подгруппы С через 2 недели после операции средний показатель суммарного объемного потока составил 610117,45 см3/с, что на 43,44 было выше аналогичного показателя в контрольной группе (p0,05). Выводы. Полученные результаты позволили сделать заключение, что сочетанное применение 0,9-ного раствора NaCl, кавитированного низкочастотным ультразвуком, и фотохромотерапии (-450 нм) способствует повышению эффективности репаративных процессов в слизистой оболочке носа у больных после одномоментного выполнения септопластики и подслизистой вазотомии нижних носовых раковин. Лидирующее место в плановой хирургии оториноларингологических заболеваний принадлежит коррекции перегородки носа и нижних носовых раковин. От 13 до 31 больных оториноларингологических отделений госпитализируются в плановом порядке для хирургического лечения искривления перегородки носа 1, 2. Несмотря на постоянное совершенствование ринохирургической техники 3 и развитие послеоперационной фармако- и физиотерапии 48, сроки реабилитации пациентов после септоплатики и подслизистой вазотомии нижних носовых раковин составляют от нескольких недель до нескольких месяцев. Такой длительный восстановительный период ведет к снижению качества жизни пациентов и значительным экономическим потерям 9. Поэтому остается актуальным вопрос поиска новых методов для стимуляции репаративных процессов слизистой оболочки носа после септоплатики и подслизистой вазотомиии нижних носовых раковин. Одним из широко используемых физических методов лечения различных заболеваний ЛОР-органов является ультразвук (УЗ) 10, 11. В терапевтических целях все большее распространение The aim of this work is to increase the efficiency of reparative processes of the nasal mucosa after septoplasty and submucous vasotomy of the inferior turbinates by exposure 0.9 sodium chloride solution cavitated by lowfrequency ultrasound in combination with photochromotherapy (visible blue light, -450 nm). The study included 108 patients with septum deviation and idiopathic rhinitis, whom were simultaneously performed septoplasty and submucosal vasotomy of the inferior turbinates. In the control group, standard postoperative treatment was performed: antibiotic therapy, irrigation of the nasal cavity with isotonic sodium chloride solution. In addition to the above therapy, patients from the main group received physiotherapeutic treatment starting from 2 days after the operation, and, depending on the application of the methods of physiotherapy, the patients of the main group were divided into three subgroups: A, B and C. Subgroup A patients received irrigation of the nasal cavity with 0.9 sodium chloride solution, cavitated low-frequency ultrasound, in subgroup B we used photochromotherapy (-450 nm), in subgroup C - combination of this two methods of physiotherapy (AB). Assessment of the nasal mucosa was performed on the 2nd and 14th day after the operation by obtaining endoscopic examination, determination of transport, excretory, suction functions of the nasal mucosa, cytological examination, and anterior active rhinomanometry We found that by the end of 14th day after the operation the endoscopic picture of the nasal cavity quickly recovered in patients of subgroup C, in comparison with the control group. Recovery of transport, excretory and absorption functions of the nasal mucosa also proceeded more intensively in patients in subgroup C. So, two weeks after the operation, a full recovery of the transport and excretory functions of the nasal mucosa was observed in the majority of patients in subgroup C (51.85 and 55.6, respectively), while in the control group these functions were normalized only in 3,7 of patients. The suction function of the nasal mucosa came back to normal in 88.89 of patients of subgroup C to the end of 14-th day after the operation, and in the control group this function was restored only in 37.04. Cytological study showed that by the 14th day after operation, 85.19 of the patients in subgroup C had a regenerative rhinocytogram type, which was 37.04 more compared to the control group. According to the data of anterior active rhinomanometry two weeks after the operation for patients in subgroup C the average total volumetric flow was 610 117.45 cm3/s, which is 43.44 higher than in the control group (p0.05). The results us obtained made it possible to conclude that the combined using of 0.9 sodium chloride solution cavitated with low-frequency ultrasound and photochromotherapy (-450 nm) promotes efficiency of reparative processes of the nasal mucosa in patients after the simultaneous septoplasty and submucous vasotomy of the inferior nasal turbinates.

The objective of the work is to improve the efficacy of the reparative processes of the nasal mucosa after septoplasty and submucosal vasotomy of inferior turbinates by applying 0.9% sodium chloride solution cavitated by a low-frequency ultrasound. The study involved 50 patients with septum deviation and vasomotor rhinitis. In all cases, septoplasty and submucosal vasotomy of the inferior turbinates were performed simultaneously. In the control group, we used standard postoperative treatment: antibiotic therapy, irrigation of the nasal cavity with seawater isotonic solution, nasal toilet. The nasal cavity of the main group patients was irrigated with 0.9% sodium chloride solution, cavitated by low-frequency ultrasound, starting from the 2nd post-operative day. Assessment of the nasal mucosa condition was performed on the 2nd and 14th days after the surgery by means of endoscopic examination, determination of transport, excretory, absorbent functions of the nasal mucosa, cytological examination, and anterior active rhinomanometry. In the course of the study, it has been found that irrigation of the nasal cavity with 0.9% of sodium chloride, cavitated by low-frequency ultrasound, provides stimulation of the reparative processes in the nasal mucosa and, as a result, shortens the rehabilitation period.

Backgroun d: In the last 10 years, the use of computer-assisted navigation systems (CANS) in endo-nasal endoscopic surgery of the paranasal sinuses and skull base in adults has been well studied. In pediatric practice, isolated cases of the use of this method have been described, with most of patients suffering from various types of sinusitis. Aim: To improve efficacy of the transnasal surgery for sinonasal, nasopharyngeal and skull base neoplasms in pediatric patients. Materials and methods: 77 patients aged from 22 days to 18 years with various nasal, nasopharyngeal, paranasal and skull base neoplasms were divided into two groups depending on the surgical technique. The main group included 40 patients in whom CANS guided surgery was used and the control group comprised 37 patients operated without CANS. Each group was divided into two subgroups based upon the complexity of the intervention (in subgroup 1, it was a biopsy and in subgroup 2, tumor excision). Results: There were no significant differences between 1st subgroups of both groups in the intervention duration, intra-operative blood loss, number of post-operative days in the hospital. Compared to the patients from the subgroup 2 of the control group, in those from the subgroup 2 of the main group the duration of intervention decreased by 60 minutes (p = 0.038, Mann-Whitney U-test), intra-operative blood loss decreased by half (p = 0.044, Mann-Whitney U-test), duration of hospital stay, by 2 days (p = 0.02, Student's t-test). The rates of radical excision was higher in the main group (p = 0.02, Fischer's exact test). Conclusion: The use of CANS in endonasal surgery allows for reduction of the intervention time and anesthesia duration, minimizes blood loss, is associated with earlier post-operative rehabilitation of children.

Investigation of the structure, incidence, and concentration of the microorganisms vegetating on the lacunal mucosa of the palatine tonsils was carried out. Based on the data obtained, the priority pathogenes were determined: Streptococcus (group D) and E. faecalis. Studying the degree of lacunal mucosa sowing with microorganisms enabled elaboration of criteria to assess efficiency of the treatment applied.

The objective of the present article was to report the current literature data concerning the significance of and prospects for the application of the CT-navigation systems in transnasal endoscopic surgery of neoplasms localized in the nasal cavity, nasopharynx, paranasal sinuses, and the base of the skull in the children.

The objective of the present study was to enhance the effectiveness of the treatment of the patients presenting with various forms of chronic tonsillitis (CT) by means of antimicrobial photodynamic therapy (APDT). The study included 48 patients at the age from 18 to 55 years divided into three groups; all of them suffered from various forms of CT. Group 1 was comprised of 12 patients given a course of traditional conservative therapy. Group 2 consisted of 17 patients treated by APDT while group 3 included 19 patients in whom a course of antimicrobial photodynamic therapy was preceded by the treatment of the mucous membrane of the palatine amygdalae with a lidase solution. The microbiological testing was performed on days 5, 12, and 24 after APDT and also within the next 6-9 months. The results of the microbiological and clinical studies give evidence of the possibility to improve the effectiveness of the treatment of chronic tonsillitis by means of antimicrobial photodynamic therapy with the use of the preventive treatment of palatine tonsillar mucosa with a lidase solution. Such treatment was found to facilitate degradation of theintercellular matrix of the biofilm and reduced its resistance to the photodynamic impact.

The objective of the present work was to overview current concepts of epidemiology and clinical picture of a rare benign neoplasm, lipoblastoma, known to occur in the children, to report an original observation of one case of this condition, and to discuss specific features of its surgical treatment in the patient presenting with a rare localization of the tumour in the neck region extending onto certain vitally important anatomical features. Diagnosis of lipoblastoma of rare localization on the neck was verified in a 20-month old child. The necessity of differential diagnostics of lipoblastoma from other tumours (including malignant ones) in the neck region is substantiated along with the approaches to its surgical treatment bearing in mind the difficult of access localization of the tumour. It is concluded that the benign character of this neoplasm predetermines the favourable outcome of its treatment; however, there is a risk of incomplete dissection of the tumour and its relapse.

Photodynamic therapy (PDT) was given to 61 patients with recurrent cancer of the tongue, oral mucosa, lower lip, oro- and nasopharynx, larynx. Photosensitizers photogem and photosens of Russian produce were employed. The radiation was given twice with the interval 24 and 48 hours, the exposure to light 3 to 30 min. The impact was external, through the instrumental canal of the fibroscope, by intracavitary and interstitial techniques. The response was assessed within 4-6 weeks after the PDT course. The effect was observed in 95.1% patients. Its duration ranged from 4 months to 5 years. Complete resorption of the tumor was achieved in 57.4%. The treatment failed in 4.9% patients.

Clinical trials have been conducted of a new therapeutic semiconductor laser from the Mustang series which generates laser radiation in red light range (0.63-0.65 mcm) in impulse mode. Laser therapy was given to 75 patients with different ENT diseases with good effect. A surgical laser unit CTH-10 (YAG-Ho laser, 2.09 mcm) has undergone pilot tests with good results in 12 patients with pain maxillofacial syndromes. Photodynamic therapy was used in upper respiratory tract cancer in 27 patients, the results are analysed.

The paper describes experimental and clinical results obtained with application of laser radiation (wave length 1.54 microm). The source of the radiation was a new surgical laser unit Glasser. The techniques and advantages of the above radiation treatment are characterized.

We examine thermal effect of a 2.1 micrometer Holmium laser on the internal stress and shape of cartilage. For 2.1 microns radiation, the absorption depth is more by an order of magnitude than that, for 10 micrometer radiation. We have studied the influence of laser intensity, pulse duration, pulse repetition rate, and of cartilage thickness on its shaping conditions. Spatial and temporal locality of Ho laser radiation as well as the bulk character of the heating allow us to produce the stress relaxation without overheating of the surface irradiated and to prevent undesirable effects of tissue carbonization and destruction.