Введение. Хронический фарингит (ХФ) является одной из наиболее часто встречающихся патологий ротоглотки. Многие из современных методов лечения не обеспечивают продолжительный эффект вследствие наличия лишь местного воздействия на измененную слизистую оболочку задней стенки глотки без учета изменений, вызванных нарушением трофических процессов в ткани. В статье представлены результаты применения мелкокапельного орошения слизистой оболочки задней стенки глотки маслом озонид в комбинации с низкоинтенсивным лазерным излучением на проекцию сосудов, осуществляющих кровоснабжение средних отделов ротоглотки. Цель. Повышение эффективности лечения пациентов с атрофическим фарингитом посредством применения озонотерапии и низкоинтенсивной лазеротерапии. Материалы и методы. Было проведено одноцентровое экспериментальное контролируемое рандомизированное открытое исследование 60 пациентов с АФ в возрасте от 18 лет (48,0 [39,0; 57,0] года), 50% мужчин и 50% женщин. При обследовании пациентов проводили сбор анамнеза, осмотр лор-органов, цитологическое и микробиологическое исследование слизистой оболочки задней стенки глотки, контактную эндоскопию слизистой оболочки задней стенки глотки, неврологический осмотр с пальпаторным исследованием мышц шеи. Для оценки жалоб и фарингоскопических признаков использовали 5-балльные визуально-аналоговые шкалы (ВАШ). Результаты. Полученные нами результаты показали статистически значимое улучшение качества жизни пациентов с АФ (p<0,001), улучшение фарингоскопической картины (р=0,006), а также свидетельствуют об улучшении микроциркуляции при воздействии озонотерапии и низкоинтенсивного лазерного излучения. Методика с применением озонотерапии и низкоинтенсивной лазеротерапии характеризуется бактерицидным и фунгицидным эффектом. Отмечается снижение общей обсемененности задней стенки ротоглотки патогенной и сапрофитной микрофлорой (отмечается статистически значимое снижение обсемененности задней стенки глотки сапрофитной и патогенной микрофлорой, р≤0,05). Методика с применением озонотерапии и низкоинтенсивной лазеротерапии обладает явным противовоспалительным эффектом, что выражалось в уменьшении проявления дискератоза и гиперкератоза. Заключение. Применение озонотерапии в сочетании с лазеротерапией открывает новые перспективы для патогенетически обоснованного и эффективного лечения АФ. Introduction. Chronic pharyngitis (CP) is one of the most common oropharynx pathologies. Most modern treatment methods do not provide a long-term effect because they are limited to a superficial local effect on the altered mucosa of the posterior pharyngeal wall without taking into account alterations caused by trophic disturbances in the tissue. The article presents results of fine-drop irrigation of the mucous membrane of the posterior pharyngeal wall with "Ozonide oil" in combination with low-intensity laser radiation on the projection of vessels supplying blood to the middle parts of the oropharynx. Purpose. To improve the effectiveness of atrophic pharyngitis patients treatment by using ozone therapy and low-intensity laser therapy. Materials and methods. A single-center experimental controlled randomized open-label study was conducted in 60 AP patients aged 18 years and older (48.0 [39.0; 57.0] years), of whom 50% were men and 50% were women. When examining patients, history collection, ENT organs inspection, cytological and microbiological testing of the mucous membrane of the posterior pharyngeal wall, contact endoscopy of the mucous membrane of the posterior pharyngeal wall, and neurological examination with neck muscles palpation were performed. 5-point visual analog scales (VAS) were used to assess complaints and pharyngoscopic signs. Results. Our results showed a statistically significant improvement in the quality of life of AP patients (p<0.001), and an improvement in the pharyngoscopic picture (p=0.006). The results obtained also demonstrated an improvement of microcirculation under ozone therapy and low-intensity laser radiation. Ozone therapy and low-intensity laser therapy technique is characterized by bactericidal and fungicidal effects. A decrease in the total contamination of the posterior wall of the oropharynx with pathogenic and saprophytic microflora was observed (a statistically significant decrease in the contamination of the posterior wall of the pharynx with saprophytic and pathogenic microflora was revealed, p≤0.05). Ozone therapy and low-intensity laser therapy technique has a pronounced anti-inflammatory effect, which was expressed in the reduction of dyskeratosis and hyperkeratosis. Conclusion. The use of ozone therapy in combination with laser therapy offers new prospects for pathogenetically substantiated and effective AP treatment.

Introduction. There is an abundance of various methods of surgical treatment in the world, which include: classical tonsillectomy (TE), shaver TE, unipolar and bipolar bilateral TE, laser TE, palatine tonsil coblation, etc. However, there is still a risk of recurrence of chronic tonsillitis after TE there is a need for a study in the late postoperative period.Purpose of the study. Improving the efficiency of surgical treatment of patients with chronic tonsillitis based on the analysis of five main methods of surgical treatment of chronic tonsillitis according to clinical and laboratory criteria.Materials and methods. Patients were divided into 5 study groups depending on the method of tonsillectomy: The first group consisted of 60 patients after classical tonsillectomy. In the second group there were 55 patients after palatine tonsil coblation. The third group included 48 patients after laser tonsillectomy. The fourth group consisted of 64 patients after tonsillectomy using the surgitron apparatus. The fifth group consisted of 58 patients after microdebrider tonsillectomy.Results. By analysis, it was found that the best results were obtained in patients of the 1st group, who underwent classical tonsillectomy. In this group, there are fewer cases of subjective and objective clinical symptoms (sore throat, signs of subatrophic pharyngitis, hypertrophy of the lateral folds of the pharynx, remnants of the lymphoid tissue of the palatine tonsils, as well as postoperative cicatricial changes). In a laboratory study, patients of the 1st group had the lowest values of the indicators (ASL-O titer, CRP and DNase B levels, negative results of the Streptatest).

Introduction. The problem of the development of acute post-traumatic otitis media has not lost its relevance. Long-term preservation of the defect of the tympanic membrane contributes to the development of chronic inflammation in the middle ear and a deterioration in the quality of life of patients.Objective. To study the effect of blood plasma enriched with platelet growth factors on the regeneration of the tympanic membrane tissues in patients with acute post-traumatic perforation.Materials and methods. Patients with acute post-traumatic perforation of the tympanic membrane were divided into the main (24 people) and control (19 people) groups. Patients of the main group in the area of perforation of the tympanic membrane were injected once by application with a clot of autoplasma, enriched with platelet growth factors. The control group patients underwent dynamic observation of the processes of natural regeneration of the tympanic membrane tissues. On the 5, 10 and 15th days, the tissue regeneration of the tympanic membranes was assessed subjectively (patient complaints, audiometry) and objectively (otoscopy with the calculation of the dynamics of the relative perforation area, otoacoustic emission).Results. A single application of blood plasma enriched with platelet growth factors to the perforation area was significantly more often accompanied by closure of the tympanic membrane perforation (p ≤ 0.01) and a decrease in the average relative area of the tympanic membrane perforation on days 10 and 15 of the study (p ≤ 0.01). The dynamics of the average relative area of the tympanic membrane perforation reflected a high rate of closure of the tympanic membrane defect in the main group. Better healing of the tympanic membrane in patients of the main group was accompanied by an improvement in the auditory function of the affected ear. The quality of hearing was, on average, significantly better in the patients of the main group than in the patients of the control group, both on the 10th and 15th days of observation (p ≤ 0.01).Conclusion. Clinical use of blood plasma enriched with platelet growth factors has a beneficial effect on the rate, intensity of closure of the tympanic membrane perforation and hearing.

Introduction. The high incidence of chronic tonsillitis (CT), as well as the high risk of complications, make research in this area very relevant. The ambiguity of approaches to conservative therapy determines the need to search for new, reasonably effective, chemotherapy regimens.Objective. To carry out a comparative characteristic of various options for conservative therapy of chronic tonsillitis of toxicallergic form (TAF) I degree (CT TAF I).Materials and methods. The study included patients with CT TAF I according to the classification of B.S. Preobrazhensky and V.T. Palchun. The patients were divided into three clinical groups, depending on the therapy. Patients of the first group underwent a course of washing the lacunae of the tonsils with 1% dioxidine solution. Patients of the second group were prescribed antibiotic therapy with a retard form of clarithromycin. Patients of the third group underwent complex treatment – washing the lacunae of the palatine tonsils and simultaneously taking antibiotic therapy. The effectiveness of treatment was assessed by comparing the dynamics of changes in complaints, pharyngoscopic symptoms of CT, regional lymph nodes, and laboratory parameters.Results. Complex conservative therapy of CT TAF I provides early relief of patients’ complaints (in 93.2% of patients on the 7th day from the start of treatment), the maximum decrease in the severity of local CT symptoms (up to 1 point on the VAS at the end of treatment, with the exception of the Zak sign — 1.4 points) and the greatest positive dynamics of laboratory parameters.Conclusions. The analysis showed that for patients with CT TAF I, complex therapy, including a course of washing the lacunae of the palatine tonsils with 1% dioxidine solution and simultaneous administration of antibacterial therapy with a retard form of clarithromycin, is the most optimal therapeutic tactic that allows to achieve an earlier and stable reduction in the severity of symptoms HT, patient complaints, as well as the normalization of laboratory parameters.

Introduction. Тo study the microscopic picture of the tissues of the perforated tympanic membrane after the introduction of blood plasma enriched with platelet growth factors into the perforated area of the tympanic membrane in the experiment.Materials and methods. 36 rats (72 tympanic membranes) were examined. The animals were divided into 2 groups, the main and the control. The tympanic membrane was perforated in rats of both groups using sterile play. Animals of the main group were injected with a single application of autoplasm of blood enriched with platelet growth factors into the area of perforation of the tympanic membrane. The animals of the control group underwent only dynamic observation. The rats were withdrawn from the experiment in batches of 6 individuals on day 5, 10, 15 after the tympanic membrane perforation, then a histological assessment of the tissue regeneration of the tympanic membranes was performed. Results. In animals of the main group on the 5th day after perforation of the tympanic membrane, edema and disorganization of connective tissue were significantly less frequently recorded than in animals of the control group (p ≤ 0.05). Fibroblastic infiltration of tympanic membrane tissues was significantly more often observed in rats of the main group compared with rats in the control group (p ≤ 0.05). In rats of the main group on the 10th day after perforation of the tympanic membrane, edema and disorganization of the connective tissue of the tympanic membranes were noted significantly less frequently than in rats of the control group (p ≤ 0.05). Signs of fibroblastic infiltration and neoangiogenesis at the same time in animals of the main group were revealed significantly more often, in contrast to rats in the control group (p ≤ 0.05). In animals of the main group, on the 15th day after perforation of the tympanic membrane, fibroblastic infiltration and neoangiogenesis were revealed in all cases of observation, which significantly exceeded the corresponding indicators in the control group, and leukocyte infiltration in rats of the main group, in contrast to the previous stages of the study, was noted significantly less frequently. than in rats of the control group (p ≤ 0.05).Conclusion. Earlier and complete regeneration of damaged tissues of the tympanic membrane under conditions of its traumatic perforation was noted in rats of the main group under the influence of PCOTFR. In rats of the main group, more organized collagen fibers, the presence of basophilic leukocytes, signs of neoangiogenesis, and extensive fields of fibroblasts were visualized.

Introduction. According to different authors, 4 to 40% of the child and adult population suffer from chronic tonsillitis (СT), with many authors noting an increase in the number of cases and no tendency to decrease the frequency of this pathology.Objective. To optimize diagnostics and treatment tactic of taking patients with chronic tonsillitis (CT) using our own clinical and laboratory data and morphological data as well as literature data.Materials and methods. Аt the first stage of work, 166 patients were examined. They were divided into 4 categories (experimental groups) depending on clinical CT classification according to B.S. Preobrazhensky and V.T. Palchun. We also formed a group of patients who did not have CT symptoms. All patients underwent tonsillectomy or tonsillotomy. All tissue samples of palatine tonsils we got were investigated using immunohistochemical markers and default histological colorings. At the second stage, the dynamics of complaints, clinical symptoms and laboratory parameters were assessed in 247 patients diagnosed with CT Toxic-Allergic Form I (CT TAF I) before conservative treatment and 3 months after conservative treatment. Patients were divided into 3 groups depending on the conservative treatment regimen: a course of flushing the lacunae of the tonsils; antibiotic therapy with a retard form of clarithromycin; complex treatment combining the first two options.Results. Тhe chronic inflammatory process in the palatine tonsils changes their cytoarchitectonics. At the same time, there is a direct correlation between the presence and severity of changes with the clinical classification of chemotherapy according to B.S. Preobrazhensky and V.T. Palchun.Conclusion. With CT TAF II, the palatine tonsil not only loses its importance as an organ of the immune system, but also becomes a hotbed of infection in the body, which can cause severe complications. Only tonsillectomy can effectively protect the patient from these complications. At the stage of CT TAF I, the formation of metatansillar complications occurs. Patients with this form of CT require special attention, and correctly conducted conservative therapy can protect patients from local and general complications of CT. A variant of such conservative therapy that gives a lasting effect is complex therapy with washing the lacunae of the palatine tonsils with an antiseptic solution and simultaneous antibiotic therapy with 14-membered macrolides that can accumulate in the lymphadenoid tissue.

The purpose of the work is to study the current state of the problem of diagnosing and treating fungal adenoiditis and tonsillomycosis in children. This article summarizes the literature data on the predisposing factors and characteristics of the occurrence of fungal infections of adenoid vegetations and tonsils in children. The works present modern approaches to the diagnosis and treatment of children with fungal adenoiditis and tonsillomycosis, depending on the selected genus and the type of fungus. Based on the conducted research, performed on the basis of "The Sverzhevskiy Otorhinolaryngology Healthcare Research Institute", we found that the incidence of fungal adenoiditis in children is 16.4%, and the incidence of tonsillomicosis in children with chronic tonsillitis is 21.5%. The most frequently detected strain in this pathology is C. albicans. In the presented study, a justification of the chosen treatment regimen was made on the basis of the data obtained during microbiological (bacteriological and mycological) studies.