По данным литературы, распространенность нарушения обоняния различной этиологии составляет около 20%. Особенно актуален этот вопрос у пациентов после коронавирусной инфекции, распространенность нарушения обоняния у которых составляет 18–22%. В 4,7% случаев наблюдается стойкая не корректируемая медикаментозно поствирусная обонятельная дисфункция длительностью более 1 года, которая существенно влияет на качество повседневной жизни. В статье описывается клиническое наблюдение стойкой (более года) потери обоняния после перенесенной инфекции SARS-CoV-2. По данным идентификационных тестов у 20-летней пациентки диагностирована поствирусная аносмия со значительным снижением качества жизни согласно показателю опросника QOD-NS. МРТ головного мозга выявила двустороннюю атрофию обонятельных луковиц. Учитывая неэффективность медикаментозного лечения, пациентке проведен 6-месячный курс обонятельных тренировок с применением технологии виртуальной реальности. Контрольная оценка обоняния после курса тренировок с применением субъективных и объективных методов исследования показывает восстановление обоняния до нормосмии, увеличение размера обонятельных луко According to the literature, the prevalence of olfactory disorders of various etiologies is about 20%. This issue is especially relevant in patients after coronavirus infection, whose prevalence of olfactory impairment is 18–22%. In 4.7% of cases, persistent, drug- induced, post-viral olfactory dysfunction lasting more than 1 year is observed, which significantly affects the quality of daily life. The article describes the clinical observation of persistent (over a year) loss of sense of smell after undergoing SARS-CoV-2. According to identification tests, a 20-year-old patient was diagnosed with post-viral anosmia with a significant decrease in quality of life according to the QOD-NS questionnaire. An MRI scan of the brain revealed bilateral atrophy of the olfactory bulbs. Given the ineffectiveness of drug treatment, the patient underwent a 6-month course of olfactory training using virtual reality technology. A control assessment of the sense of smell after a course of training using subjective and objective research methods shows the restoration of the sense of smell to normosmia, an increase in the size of olfactory bulbs and confirms a clinically significant decrease in the negative impact of olfactory dysfunction on the patient’s quality of life.

Introduction. According to EPOS 2020, сhronic rhinosinusitis with nasal polypsis detected in 2–4.3% of the population, in Russia about 1.5 million people suffer from polyposis. In clinical practice, attention is most often paid to indicators of respiratory function. At the same time, the assessment of olfactory impairment characteristic of CRSwNP is carried out only by answering one of the 22 questions of the SNOT-22 questionnaire, and indicators of olfactory function are rarely taken into account when evaluating the results of objective research methods.Aim. To study the features of the clinical and functional state of the nose in patients with chronic rhinosinusitis and impaired sense of smell.Materials and methods. 50 patients with сhronic rhinosinusitis with nasal polypsis were examined. The study included an assessment of the sense of smell using Sniffin Stiks test-12, a study of respiratory function, performing a video endoscopy of the nose, computed tomography of the nose and paranasal sinuses. A comprehensive assessment of the condition was carried out using the SNOT-22 questionnaire.Results. The subjective assessment of the sense of smell by patients with CRSwNP does not always coincide with the results of identification tests. The results of the SNOT-22 questionnaire often depend on the degree of olfactory impairment. Patients with CRSwNP and anosmia are more likely to complain of postnasal congestion, thick nasal discharge and cough than patients with hyposmia, which is consistent with objective research methods.Conclusions. In patients with Ghronic rhinosinusitis with nasal polypsis and varying degrees of olfactory impairment, heterogeneity of the clinical and functional state of the nasal cavity and paranasal sinuses was noted. When interpreting the results of the SNOT-22 questionnaire, it is advisable to use factor analysis, taking into account the patient’s complaints. To plan individual management of patients with CRSwNP, a comprehensive assessment of the sense of smell is necessary, including identification tests, as well as an additional assessment of the results of computed tomography of the nose and paranasal sinuses and a video endoscopic picture of the nose according to generally recognized scales.

Polypous rhinosinusitis is a widespread disease, which, according to scientific publications, affects about 5% of the world's population. In Russia, the incidence of this disease is on average 4.9 per 10 thousand population. The identification of key risk groups, as well as regions that require closer attention from specialist doctors, is the basis for the prevention of the disease, and also leads to an improvement in the quality of life of patients with polypous rhinosinusitis. Purpose: to study the prevalence of polyposis rhinosinusitis among the population of the Samara region for the period from 2017 to 2021. Materials and methods. for a comparative assessment of the PRS of the population of the Samara region, a retrospective analysis of information on the number of diseases registered in patients living in the service area of a medical organization was carried out based on the data of the annual reporting form No. 12, No. 14 for 2017–2021. The results of the analysis showed that the number of patients with newly diagnosed polyposis rhinosinusitis decreased over the period from 2017 to 2021, with prevalence among the urban population. The most common form of the disease, nasal polyp, was identified, which is confirmed by the results of the analysis of statistical forms. Also the analysis made it possible to identify areas with the highest prevalence of pathology.

Introduction. According to statistics, about 20% of the population have olfactory disorders of various etiologies. Among the older age group, the prevalence of the symptom is significantly higher and ranges from 40% to 65%. Olfactory disorders are most often found in diseases of the nose and paranasal sinuses of viral and infectious genesis and traumatic brain injury. There are currently no approved schemes for the correction of olfactory disorders. However, in chronic rhinosinusitis, the role of endonasal surgical interventions, systemic and topical glucocorticoids, and biological targeted therapy has been substantiated. Olfactory training in patients with olfactory dysfunction of various etiologies may be a promising treatment method. Objective. To review olfactory training techniques in general clinical practice. Materials and methods. The search for publications in the PubMed and Web of Science databases for the period from 2009 to 2023 was carried out. Results. Olfactory training is an effective method of treating olfactory dysfunction of various etiologies. The proposed olfactory training schemes involve the use of various essential oils in a standard concentration, while the duration of training can vary from 3 to 8 months. The effect of training is characterized by improved indicators of discrimination and identification of odors. At the same time, the period of restoration of the sense of smell is determined both by the degree of severity of olfactory disorders and their duration and by the age of the patient. Shorter recovery periods of olfaction were observed in patients younger than 40 years, and longer periods, in patients older than 69 years. Discussion. The study of the prospects for the use of olfactory training in the correction of olfactory dysfunction involves the study of the role of polysensory stimulation in increasing their effectiveness. The most optimal is additional stimulation of the visual analyzer by immersing the patient in a virtual scenario.

Введение. По данным литературы, более 23% лиц в возрасте от 25 до 75 лет имеют различные варианты нарушения обоняния. В настоящее время существует ряд качественных и количественных методик оценки обоняния, применение которых в значительной степени трудоемко, требует специального оборудования и навыков. Большинство рекомендаций в международной практике относительно самооценки обоняния и влияния его нарушения на качество жизни касаются опросника Questionnaire of Olfactory Disorders – Negative Statements (QOD-NS). В то же время в России достоверных и надежных опросников самооценки обоняния недостаточно. Таким образом, разработка русскоязычных версий опросников самооценки обоняния имеет первостепенное значение. Цель. Перевод, адаптация и валидизация русскоязычной версии опросника QOD-NS (Questionnaire of Olfactory Disorders – Negative Statements Factor Analysis). Материалы и методы. Адаптация русскоязычной версии опросника QOD-NS проводилась в соответствии с международными стандартами. При помощи русскоязычной версии опросника QOD-NS на базе клиник ФГБОУ ВО «СамГМУ Минздрава России» проведено исследование с участием 100 человек в возрасте от 18 до 75 лет. Результаты. Каппа Коэна, по данным двукратного опроса пациентов методом «тест-ретест», для 78,4% утверждений варьировала от 0,76 до 0,99. Надежность внутреннего постоянства опросника QOD-NS (α Кронбаха) составила 0,947, общий коэффициент корреляции варьировал от 0,89 до 0,97, что свидетельствует о хорошей внутренней согласованности рускоязычной версии опросника QOD-NS. Суммарный балл QOD-NS был значительно выше у лиц с нормальным обонянием (43,8±7,2 балла), по сравнению с лицами, у которых выявлено нарушение обонятельной функции (31,2±0,2 балла) (p<0,05). Заключение. Результаты исследования показывают высокую надежность и валидность русскоязычной версии опросника QOD-NS, применение которого возможно во врачебной практике как для выявления нарушения обоняния, так и для определения уровня влияния данного состояния на качество жизни пациента. Introduction. According to the literature, more than 23% of people aged 25 to 75 years have various variants of olfactory disorders. Currently, there are a number of qualitative and quantitative methods for assessing the sense of smell, the use of which is largely labor-intensive, requires special equipment and skills. Most of the recommendations in international practice regarding the self-assessment of the sense of smell and the impact of its violation on the quality of life relate to the questionnaire Questionnaire of Olfactory Disorders – Negative Statements (QOD-NS). At the same time, there are not enough reliable and reliable questionnaires of self-assessment of the sense of smell in the Russian Federation. Thus, the development of Russian-language versions of olfactory self- assessment questionnaires is of paramount importance. Purpose. Translation, adaptation and validation of the Russian version of the questionnaire QOD-NS (Questionnaire of Olfactory Disorders – Negative Statements Factor Analysis). Materials and methods. The adaptation of the Russian-language version of the QOD-NS questionnaire was carried out in accordance with international standards. With the help of the Russian-language version of the QOD-NS questionnaire, a study was conducted on the basis of the Clinics of the Federal State Budgetary Educational Institution of the Ministry of Health of Russia of 100 people aged 18 to 75 years. Results. Cohen’s kappa varied from 0.76 to 0.99 for 78.4% of the statements, according to a two-time survey of patients using the "test-retest" method. The reliability of the internal consistency of the QOD-NS questionnaire (α Kronbach) was 0.947, the overall correlation coefficient varied from 0.89 to 0.97, which indicates good internal consistency of the QOD-NS questionnaire in Russian. The total QOD-NS score was significantly higher in individuals with normal sense of smell (43.8±7.2 points), compared with individuals with olfactory function impairment (31.2±0.2 points) (p<0.05). Conclusion. The results of the study show the high reliability and validity of the Russian- language version of the QOD-NS questionnaire, the use of which is possible in medical practice both to identify olfactory disorders and to determine the level of influence of this condition on the patient’s quality of life.

Цель. Исследование пациентов, находящихся на стационарном и амбулаторном лечении с диагнозом новой коронавирусной инфекции, на предмет изменения обонятельной функции и его связи с тяжестью заболевания.Материалы и методы. Всего в исследовании участвовали 358 пациентов в возрасте от 18 до 95 лет. Всем пациентам была выполнена компьютерная томография (КТ) органов грудной клетки, взят мазок из носа и глотки ПЦР РНК COVID-19 (полимеразная цепная реакция с автоматической экстракцией рибонуклеиновой кислоты коронавирусной инфекции 2019 г.), проведено анкетирование на тему изменения обоняния и вкусовосприятия. Пациенты опрашивались дважды: в день выявления заболевания и через один месяц.Результаты. Существует прямая зависимость (r=0,87) между изменением обоняния и положительным результатом мазка на COVID-19 (коронавирусная инфекция 2019 г.). Также мы выявили зависимость между гипосмией/аносмией и низким процентом поражения легких (r=0,78, среди пациентов молодого возраста r=0,91).Заключение. Полученные данные могут использоваться врачами для выявления пациентов с бессимптомной и легкой формами COVID-19 для своевременной их изоляции и лечения. Purpose. To study patients undergoing inpatient and outpatient treatment with a diagnosis of a new coronavirus infection for changes in olfactory function.Materials and methods. A total of 358 patients aged 18 to 95 years participated in the study. All the patients underwent a computer tomography (CT) scan of the chest organs and a PCR of COVID-19 RNA (polymerase chain reaction with automatic ribonucleic acid extraction of coronavirus infection 2019) smear from the nose and pharynx, a questionnaire for changes in the sense of smell and taste perception. Patients were interviewed twice: on the day of detection of the disease and after one month.Results. It was found that there is a direct relationship (r=0.87) between the change in the sense of smell and the positive result of the smear on COVID-19 (coronavirus disease 2019). We also found a relationship between hypo-/anosmia and a low percentage of lung damage (r=0.78, among young patients r=0.91).Conclusion. The obtained data can be used to identify patients with asymptomatic and mild forms of COVID-19 for timely isolation and treatment.

Introduction. A large increase in the incidence of catarrhal rhinosinusitis determines the search for new methods of treating these patients. In this regard, the use of herbal preparations for relieving the symptoms of this nosology is of increasing interest. The article discusses the problems of using drugs based on Cyclamen europaeum (CE ) in the treatment of acute catarrhal rhinosinusitis.Purpose of the study. Evaluation of the effectiveness of CE extract in the complex treatment of acute catarrhal rhinosinusitis.Materials and methods. A randomized controlled study was carried out to study the efficacy of cyclamen europaeum extract in outpatients with an established diagnosis of acute catarrhal rhinosinusitis (the presence of 2 or more symptoms of acute rhinosinusitis, the presence of radiological signs of acute catarrhal rhinosinusitis.Results. The results of the study showed that the intranasal use of drugs based on CE in acute catarrhal rhinosinusitis helps to reduce headache, reduces the abundance of nasal discharge, promotes the early restoration of nasal breathing, as well as smell and taste.Discussion. The study objectively confirmed that the use of drugs based on CE has a positive effect on the dynamics of the course of acute catarrhal rhinosinusitis, promotes the early restoration of the epithelium of the nasal mucosa, olfactory function, and also has a positive effect on the restoration of gustatory function.Conclusions. Based on the results of this study, it can be concluded that it is advisable to use drugs based on CE in the treatment of acute catarrhal rhinosinusitis.

Spatial and speech characteristics of hearing are needed to monitor the rehabilitation of sensorineural hearing loss in patients of older age groups. Using the created «Program for the assessment of speech, spatial and qualitative characteristics of hearing using virtual reality» increases the level of hearing diagnostics using a computerized audiovisual script. The purpose of the study is a comparative analysis of the speech, spatial and qualitative characteristics of hearing before and after using virtual reality in patients of older age groups. The results of the study showed that with good tolerance of virtual reality in 48.3% of patients, the answers to the questions of the SSQrus-12 questionnaire for assessing the spatial and speech characteristics of hearing became more objective. The developed methodology supplemented the group of modern diagnostic methods for spatial and verbal hearing by immersing the patient in a virtual environment in the created audiovisual scenario.

Introduction. One of the characteristic manifestations of COVID-19 is a disorder of smell, which, according to the literature, occurs in 61.2% - 85.6% of patients with COVID-19. The article discusses the problems of post-viral dysosmia in COVID-19 convalescents. Purpose of the study. Evaluation of olfactory disorders in patients after coronavirus infection and the possibility of obtaining additional benefits from prescribing bioregulatory medicine drugs.Materials and methods. The assessment of the severity of olfactory disorders in patients, taking into account the age according to self-assessment data using a visual analogue scale, as well as an objective assessment of odor identification using the Sniffin ‘Sticks Screening 12 Test. The possibility of increasing the efficiency of recovery of olfactory disorders by prescribing complex preparations of bioregulatory therapy (main group) was studied.Results. The percentage of persons who fully restored the olfactory function in the main group was 56.5%, while in the patients of the control group only in 6.6%. Faster (on the 7th day) dynamics of identification testing using SST-12 in patients taking complex preparations of bioregulation therapy was noted. On the 3rd day of therapy, there was a significant decrease in anxiety in patients treated with bioregulatory drugs.Discussion. The conducted study objectively confirmed that the olfactory disorder is present in the vast majority of patients with ARS. The appointment of bioregulatory therapy contributes to the early restoration of the olfactory function.Conclusions. Based on the results of this study, it can be concluded that it is advisable to use bioregulatory drugs.

Objectives to assess the efficiency of using a comprehensive hearing test, including a questionnaire survey and determination of hearing thresholds using the "Automated system of primary hearing assessment" web application, in comparison with tone threshold audiometry in elderly people. Material and methods. We examined 138 patients of the Samara Regional Clinical Hospital for War Veterans who were over 60 years old. The group included 67 women and 71 men with the average age of 71.6 6.4 years. The patients underwent ENT endoscopy, an online survey on hearing self-assessment, hearing thresholds study using the Automated Primary Hearing Assessment web application, and tone threshold audiometry. Results. The prevalence of hearing impairment in the group was 76.1% according to the online questionnaire on hearing self-assessment. When comparing the general results of the on-line test questionnaire and the study of hearing thresholds, the on-line test data were confirmed when conducting tonal threshold audiometry in 75.0% of people with normal test indicators, in 25.0% of people an in-depth study showed some hearing loss. According to an online survey of patients with hearing complaints, 89.1% had a certain degree of hearing loss. Hearing parameters according to the web application were comparable in terms of both hearing threshold values and the degree of hearing loss with the data of tonal threshold audiometry. The maximum difference was 3.9 and 3.5 dB at 1 and 2 kHz for the right ear and 7.2 dB at 4 kHz for the left ear. Low agreement of mean hearing thresholds was observed in patients at frequencies of 1 and 4 kHz on the right ( = 0.24 and = 0.3, respectively) and at a frequency of 4 kHz - on the left ( = 0.14), which may be due to high-frequency hearing loss in this group of patients and more significant fluctuations of indicators. The discrepancies in the data of the web application and in the values of the hearing thresholds when taking into account the comorbid status were minimal in persons with diabetes mellitus and amounted to 2 dB at a frequency of 8 kHz, the maximum deviations were observed in patients with occupational risk factors of 7.2 dB at a frequency of 4 kHz. Conclusion. The comprehensive study that includes an online survey on hearing self-assessment and the hearing function evaluation in the Automated System for Primary Hearing Assessment web application is a convenient and simple tool for screening hearing impairment in outpatients and clinical examination, as well as at the stage of monitoring, treatment, and rehabilitation of patients with various degrees and types of hearing loss, especially in the elderly people.

Objectives - to analyse the complex solutions for rehabilitation of sensorineural hearing loss in adults and elderly people. Material and methods. We reviewed 27 articles on the problem, published in the recent 5 years, presented in the international databases PubMed, Scopus and E-library. Conclusion. The rehabilitation procedure for chronic SNHL is quite clearly regulated and defined at the state level only for the person with hearing disabilities. While determining the needs of the disabled person in rehabilitation, the recommended rehabilitation approaches are described. However, in the normative documents, there is no clearly defined rehabilitation algorithm, taking into account the patient's individual characteristics. A high index of multimorbidity in adults with SNHL, including anxiety-depressive disorders and cognitive deficit, determines the need for inclusion of the auditory training in the rehabilitation process. The use of various options for auditory training along with electro-acoustic correction of hearing or cochlear implantation is an essential component of an individual rehabilitation program.

Цель - провести анализ комплексных решений по реабилитации слуха для взрослых пациентов с хронической сенсоневральной тугоухостью и лиц старшей возрастной группы. Материал и методы. Проведен обзор 27 статей по данной тематике, представленных в международных базах данных PubMed, Scopus и E-library, за последние 5 лет. Заключение. Процедура реабилитации при ХСНТ регламентирована и определена на государственном уровне только для инвалидов по слуху. В определении потребности инвалида в мероприятиях по реабилитации прописаны возможные реабилитационные подходы, носящие рекомендательный характер. Четко обозначенного алгоритма реабилитации с учетом индивидуальных особенностей пациента в документах нет. Высокий индекс мультиморбидности у взрослых лиц с ХСНТ, включая тревожно-депрессивные расстройства и когнитивный дефицит, определяет необходимость включения в реабилитацию слухового тренинга. Использование различных вариантов слухового тренинга наряду с электроакустической коррекцией слуха или проведением кохлеарной имплантации является обязательным компонентом индивидуальной программы реабилитации.

Цель – изучить пороги слуха на высоких частотах у пациентов пожилого и старческого возраста с учетом возрастной нормы и наличия коморбидных заболеваний. Материал и методы исследования. В процессе проведения скрининга было обследовано 111 пациентов в возрасте от 50 до 97 лет (средний возраст составил 70,5±2,1 года) с учетом их возраста, слуховой функции, сопутствующих заболеваний. Результаты. Сравнение средних порогов слуха на высоких частотах с возрастными нормами слуховой чувствительности выявило, что у 12,6% пациентов имеются недооцененные потери слуха. Наличие сопутствующих заболеваний оказывает существенное влияние на процесс развития хронической сенсоневральной тугоухости в каждой возрастной группе. Заключение. Аудиометрия в расширенном диапазоне частот у пациентов старшей возрастной группы с сопутствующими заболеваниями может дополнить алгоритм обследования пациента в плане оценки состояния слуха.

The article presents the results of study of regional demographic data of principal age groups taking into account the territorial distribution in 2014–2016. The authors carried out a comparative analysis of data of total morbidity and morbidity by the classes of ≪ear and mastoid diseases” and ≪respiratory diseases≫ in dynamics for the period 2014–2016 with an emphasis on hearing pathology. The authors carried out an analysis of the structure of ENT pathology and comorbid conditions in patients of the older age group of Samara Regional Clinical Hospital for War Veterans (SOKGVV). As a result, a stable growth of elderly and senile people in the population of the region was noted, peculiarities of the structure of ENT pathology in SOKGVV patients were revealed and their comorbid profile was studied.