Chronic pharyngitis (CP) is one of the most common diseases of the oropharynx. The number of referrals from patients with CP reaches 70% of the total number of referrals to an otorhinolaryngologist. The development of this disease is facilitated by the neuro-reflex factor and a violation of trophic and metabolic processes. It should be noted that of all forms of CP, the greatest impact on the quality of life is noted precisely in atrophic pharyngitis (AP), due to the presence of pronounced subjective sensations from the oropharynx. Many of the modern methods of treatment do not provide a lasting effect due only to the application, superficial local effect on the altered mucous membrane of the posterior pharyngeal wall, without taking into account the changes caused by a violation of trophic processes in the tissue. A promising direction in the treatment of atrophic pharyngitis is the use of a combined technique - ozone therapy and low-intensity laser therapy. The article presents the results of the application of fine-drip 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. OBJECTIVE:Improving the effectiveness of treatment of patients with atrophic pharyngitis through the use of ozone therapy and low-intensity laser therapy. MATERIAL AND METHODS:A single-center experimental controlled randomized open-label study of 90 patients with AP aged 18 and over was conducted. All patients were randomly divided into three groups depending on the treatment performed: group I - traditional treatment method (rinsing the oropharynx with antiseptic solutions, the use of tablets for resorption), group II - treatment with ozone therapy (fine drip irrigation of the mucous membrane of the posterior pharyngeal wall with Ozonide oil), group III - treatment with ozone therapy and laser therapy. During the examination of patients, anamnesis collection, examination of ENT organs, cytological and microbiological examination of the mucous membrane of the posterior pharyngeal wall, contact endoscopy of the mucous membrane of the posterior pharyngeal wall were performed. 5-point visual analogue scales (VAS) were used to assess complaints and pharyngoscopic signs. RESULTS:Our results showed a statistically significant improvement in the quality of life of patients with AP (p=0.012), an improvement in the pharyngoscopic picture (p=0.003). The results obtained by us indicate an improvement in microcirculation under the influence of ozone therapy and low-intensity laser radiation. The technique using ozone therapy and low-intensity laser therapy is characterized by a bactericidal and fungicidal effect. There is a decrease in the total contamination of the posterior wall of the oropharynx with pathogenic and saprophytic microflora (there is a decrease in the contamination of the posterior wall of the pharynx with saprophytic and pathogenic microflora (p≤0.05), the differences are statistically significant). The technique using ozone therapy and low-intensity laser therapy has a pronounced anti-inflammatory effect, which was expressed in a decrease in the severity of dyskeratosis and hyperkeratosis. Thus, the use of ozone therapy in combination with laser therapy opens up new prospects for pathogenetically sound and effective treatment of AP.

Hemangiomas of the nasal cavity are extremely rare in the practice of an otorhinolaryngologist and can be presented in various histopathological variants. Scientific data on hemangiomas of the sinonasal region are analyzed and systematized. The article describes the principles of diagnosis and choice of the method of surgical treatment of hemangiomas. An analysis of the literature data shows that with hemangiomas of the nasal cavity, a comprehensive examination of the patient is required, including collection of complaints and anamnesis, endoscopy of the nasal cavity and computed tomography of the paranasal sinuses, and with significant hemangiomas spreading to neighboring anatomical areas, magnetic resonance imaging with intravenous contrast.

Intraosseous vascular pathology of the turbinates is extremely rare in the practice of an otorhinolaryngologist and can be presented in various histopathological variants. The article presents two clinical cases in which an intraosseous cavernous hemangioma was hidden under the mask of a hypertrophied middle turbinate. The final diagnosis was established by the results of histological examination. The analysis of these clinical cases indicates that, despite the low prevalence, atypical clinical and CT picture, intraosseous formations of the nasal cavity can be of a vascular nature and certainly require a comprehensive examination, including CT, CT with contrast and/or MRI of the nose and paranasal sinuses. These clinical observations indicate that preliminary embolization of feeding vessels before surgical treatment is not required.

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.

Treatment of patients with fungal sinusitis, in some cases, does not lead to complete sinus sanitation, which may be due to insufficient surgical intervention and/or incorrectly selected antimycotic therapy. Treatment of such patients must necessarily include the complete removal of fungal masses from the affected sinus and the further use of antimycotics that ensure complete elimination of the pathogen. A clinical case of chronic fungal operated isolated sphenoiditis caused by the fungus Schizophyllum commune is presented. For extensive drainage of the sphenoid sinus, the patient underwent translamellar sphenoidotomy on the right with further antifungal therapy.

The problem of chronic tonsillitis remains one of the urgent problems of modern otorhinolaryngology. The article discusses the statistics and complications of chronic tonsillitis, provides indications for tonsillectomy and its main complications.OBJECTIVE:Generalization and systematization of data on the impact of surgical treatment on the quality of life of patients with chronic tonsillitis.MATERIAL AND METHODS:Search for literary sources, carried out using the search engines of the RSCI, PubMed, Web of Science, and eLibrary.RESULTS:A review of literature sources demonstrates a significant improvement in the quality of life of patients after tonsillectomy; however, data from some studies show a trend towards a decrease in the number of planned tonsillectomies and an associated increase in the detection of local purulent-septic complications.

The relevance of the problem of chronic inflammatory diseases of the pharynx is due to the significant prevalence of this pathology. Among all forms of chronic pharyngitis, the most adverse effect on the quality of life is observed in chronic athrophic pharyngitis. According to the literature, in this category of patients there are no clear criteria for assessing the functional state and morphological picture of the mucous membrane of the posterior pharyngeal wall. Most of the described signs of atrophic pharyngitis are insufficienyly informative, which necessitates further improvement of existing and possible search for new diagnostic methods. Many of the modern methods of treatment do not provide a lasting effect due to the presence of only a local effect on the altered mucous membrane of the posterior pharyngeal wall, without taking into account the changes that are caused by a violation of trophic processes in the tissue, which necessitates the search for new effective methods of treating this disease.The review article outlines modern ideas about the methods of diagnosis and treatment of chronic pharyngitis, presents promising areas in the treatment of patients with atrophic pharyngitis. In foreign countries, the term «chronic tonsillopharyngitis» is most often used. Due to the existing difference in terminology, the predominant part of the material on the problem of chronic pharyngitis is presented by domestic literature sources.

INTRODUCTION Chronic tonsillitis is a multifactorial immunopathological process that contributes to the development of tonsillitis-associated pathology. In turn, this tonsillitis-associated pathology potentiates and aggravates the course of chronic tonsillitis. In the literature, there are data on the possible influence of oropharyngeal loci of focal chronic infection on the body as a whole. One of such foci that can aggravate the course of chronic tonsillitis and maintain sensitization of the body are periodontal pockets formed during the inflammatory process in periodontal tissues. Highly pathogenic microgranisms of periodontal pockets secrete bacterial endotoxins, stimulating the immune response of the human body. Bacteria and their waste products cause intoxication and sensitization of the whole organism. A vicious circle is formed, which is quite difficult to break. OBJECTIVE To study the effect of chronic inflammatory process in periodontal disease on the course of chronic tonsillitis. MATERIAL AND METHODS 70 patients with chronic tonsillitis were examined. Together with a dentist-periodontist, an assessment of the state of the dental system was carried out, according to the results of which all patients with chronic tonsillitis were divided into 2 groups: with and without periodontal diseases. RESULTS In patients with periodontitis, highly pathogenic flora is found in periodontal pockets. When examining patients with chronic tonsillitis, it is important to assess the condition of the dental system, to calculate dental indices, the key of which are periodontal and bleeding index. It is necessary to recommend comprehensive treatment for patients with CT and periodontitis by otorhinolaryngologists and periodontists. CONCLUSION It is necessary to recommend comprehensive treatment by otorhinolaryngologists and dentists to patients with chronic tonsillitis and periodontitis.

В статье представлен аналитический обзор публикаций, касающихся течения новой коронавирусной инфекции (COVID-19) у пациентов с полипозным синуситом. Приведены современные данные о влиянии полипозного синусита на течение COVID-19. Подробно описаны потенциальные факторы, влияющие на риск заражения SARS-CoV-2 и течение COVID-19 при разных фенотипах/эндотипах синоназального воспаления.

The article is devoted to the study of chronic tonsillitis from the point of view of the clinical and morphological picture of the disease, histological changes in the palatine tonsils in various forms of CT. The authors raise the question of studying the assessment of the effect of conservative therapy on the morpho-functional state of the palatine tonsils. The article focuses on the study and influence of extratonsillary oropharyngeal loci of focal infection, such as periodontopathies, on the course of chronic inflammation of the palatine tonsils. The association of periodontitis with CT and various somatic diseases has been demonstrated. The necessity of further study of the cause-and-effect relationships of CT and periodontal diseases, as well as a more in-depth study of the morphological picture in CT using immunohistochemical methods of research, which will allow us to develop new principles for the diagnosis and treatment of this disease, is justified.

Laryngeal and pharyngeal mucosa of 50 patients with malignant (n=56%) and benign (n=44%) laryngeal and pharyngeal tumors was examined with autofluorescent spectroscopy using nitrogen laser LGI-505 (337,1 nm). It was found that autofluorescent spectrum of malignant tumors is significantly less intensive than relevant spectrum of healthy mucosa and benign tumors.