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The aim of the study was to improve the efficiency of diagnosis of various forms of chronic hyperplastic laryngitis, which is referred to as precancerous conditions of the larynx, video laryngostroboscopy was performed in 249 patients. All patients have occupational hazards: increased voice load, smoking, working capacity in a hospital state during acute respiratory viral infections, laryngitis, bronchitis. In case of detection of areas of dyskeratosis of mucous membrane of vocal folds (leukoplacia, hyperkeratosis) biopsy followed by histological examination was carried out. The results of a histological study of leukoplakia showed the presence of metaplasia of stratified squamous epithelium in 100% of the examined. Among patients with vocal fold hyperkeratosis, metaplasia of stratified squamous epithelium was detected in 20,8%, grade II and III dysplasia – 15,1% of observations. 64,1% of patients were diagnosed with laryngeal cancer. The video laryngostroboscopic picture of the larynx in various forms of chronic hyperplastic laryngitis was studied. According to the results of the study, pathological changes in the mucosa of the vocal folds with possible malignation include hyperkeratosis. During video laryngostroboscopy, asymmetric, irregular, mucous waves oscillate in the hyperkeratosis area in 60,4% of patients, and in 39,6% of patients the absence of vibrations of the vocal fold in the area of hyperkeratosis is diagnosed.

The article discusses the use of Bayesian methods for statistical inference as an alternative to the traditional method of testing hypotheses based on the significance level. Illustrative examples of solving traditional statistical problems of hypothesis testing in otorhinolaryngology based on the calculation and interpretation of the Bayes factor are presented. As two tasks for illustration, we used the tasks of assessing the impact of sauna visits on indicators of nasal flow in patients with allergic rhinitis and the task of assessing the association of the season of the year and the frequency of birth of children with hearing impairment. Although in the form of an article it is impossible to fully describe and explain all the mathematical terms and their origin for understanding the logic of Bayesian methods, we tried to explain what they mean without reference to the mathematical manuals. As Bayesian methods are increasingly used in statistical applications, a basic understanding of how to calculate them should be part of the toolkit of every medical researcher, and how to interpret it, of every practitioner who is interested in modern results of clinical trials. All calculations used in the article are accompanied by an R-code, so they can easily be reproduced, the text of the article can be used as step-by-step instructions for their implementation.

To conduct a retro- and prospective analysis of the clinical characteristics and results of surgical treatment of patients with congenital temporal bone cholesteatoma.On the basis of the SPb Scientific Research Institute of ENT of the Ministry of Health of Russia 23 patients were diagnosed with congenital temporal bone cholesteatoma for the period from 2011 to 2018. There were 11 men (47.8%), 12 women (52.2%), the age of patients - from 2 to 44 years. The M.J. Levenson criteria were used to verify congenital middle ear cholesteatoma. (1986). According to intrasurgery findings, we identified congenital cholesteatoma of the middle ear stages according to the ChOLE classification. Other types of congenital temporal bone cholesteatoma included the patients with congenital atresia of the external auditory opening, combined with congenital temporal bone cholesteatoma; we found a patient with exostoses obstructing the external auditory canal combined with congenital cholesteatoma of the middle ear; and a patient with congenital cholesteatoma of the temporal bone pyramid.An increase in the incidence of congenital temporal bone cholesteatoma was noted, which is probably due to increased awareness of specialists and the wider use of imaging research methods. A relationship was revealed between the stage of congenital cholesteatoma according to the ChOLE classification and the necessary volume of surgical intervention. Of the total number of cases of congenital temporal bone cholesteatoma, 26.1% were the patients with anomalies in the development of the outer and middle ear.All patients with suspected congenital temporal bone cholesteatoma require a temporal bone MSCT and middle ear MRI in DWI mode.Провести ретро- и проспективный анализ клинических особенностей и результатов хирургического лечения пациентов с врожденной холестеатомой височной кости.На базе ФГБУ «СПб НИИ ЛОР» Минздрава России за период с 2011 по 2018 г. у 23 пациентов была диагностирована врожденная холестеатома височной кости. Мужчин было 11 (47,8%), женщин — 12 (52,2%), возраст больных — от 2 до 44 лет. Для верификации врожденной холестеатомы среднего уха были использованы критерии M. Levenson (1986 г.). Согласно интраоперационным находкам, для врожденной холестеатомы среднего уха нами были выделены ее стадии согласно классификации ChOLE. К другим видам врожденной холестеатомы височной кости были отнесены пациенты, имеющее врожденную атрезию наружного слухового прохода, сочетанную с врожденной холестеатомой височной кости; пациент с обтурирующими наружный слуховой проход экзостозами, сочетанными с врожденной холестеатомой среднего уха; пациент с врожденной холестеатомой пирамиды височной кости.Отмечено увеличение встречаемости врожденной холестеатомы височной кости, что, вероятно, связано с повышением информированности специалистов и более широким применением визуализирующих методов исследования. Выявлена связь между стадией врожденной холестеатомы по классификации ChOLE и необходимым объемом оперативного вмешательства. Из общего числа наблюдений врожденной холестеатомы височной кости 26,1% составили пациенты с аномалиями развития наружного и среднего уха.Всем пациентам с предполагаемой врожденной холестеатомой височной кости необходимо проведение МСКТ височных костей и МРТ среднего уха в DWI-режиме.

Spontaneous cerebrospinal fluid (CSF) leak is one of the types of non-traumatic CSF leaks in which the etiologic factor is unknown. Skull base defects transnasal endoscopic plasty is the initial method of surgical repair of spontaneous cerebrospinal fluid leaks. METHODS: Forty-five patients with spontaneous CSF leaks were managed using multilayer transplant technique. The basic choice criteria of endoscopic transnasal surgical approach and materials to reconstruction of skull base defects were the size of defect and its localization. In all cases pediculated flaps in combination with free graft were used. RESULTS: In 43 (96%) cases CSF leaks was successfully managed in primary surgery, which indicates high efficiency of the described surgical interventions.Спонтанная назальная ликворея является одним из видов нетравматической назальной ликвореи, при которой неизвестна первичная причина происхождения заболевания. Основным методом хирургического лечения спонтанной назальной ликвореи считается эндоназальная эндоскопическая пластика дефектов основания черепа. Пациенты и методы. В данном исследовании представлен опыт применения многослойных трансплантатов у 45 пациентов со спонтанной назальной ликвореей. Основными критериями выбора способа пластики дефектов основания черепа и материалов были локализация и размер ликворной фистулы. Во всех случаях в качестве трансплантатов применялись питаемые мукоперихондриальные и мукопериостальные лоскуты в комбинации со свободными аутотрансплантатами. Результаты. У 43 (96%) пациентов назальная ликворея была купирована после первого хирургического вмешательства, что свидетельствует о высокой эффективности описанных методик пластики дефектов основания черепа.

Inverted papilloma (IP) is a benign sinonasal lesion that has a known propensity for recurrence, local aggressiveness and an association with transformation to squamous cell carcinoma. Due to the high rate of recurrence, association with malignancy and a tendency of multicentricity, the surgical approaches to treatment are controversial. Over the years there has been a slow evolution from aggressive (en bloc) resection by lateral rhinotomy to endoscopic techniques. This progress corresponds to the advances that have been made in endoscopic sinus surgery over the past 15 years. Technological advances have allowed the detection of sinonasal IP before its extension beyond the sinonasal region, thus enabling minimally invasive techniques to be used in the treatment of selected cases of IP. In terms of aetiology there is certain evidence that the presence of HPV in IP could be predictive of malignant transformation. Parameters such as hyperkeratosis, squamous epithelial hyperplasia and a high mitotic index are negative prognostic indicators, which could be useful in the future follow-up of patients with IP.

Chronic suppurative otitis media (CSOM) remains one of the main causes of severe hearing loss in children and people of working age, which makes it socially significant. According to domestic and foreign authors, the prevalence of this disease in global population is 1,5 to 4%.

Laryngitis is one of the commonest causes of dysphonia in the subjects engaged in the voice and speech professions. This condition can be either associated with the professional activities or related to voice fatigue. It is a common practice to distinguish between acute and chronic forms of occupational laryngitis. The main factors responsible for development of both conditions include the non-observance of directions concerning the protection and hygiene of the speaking and singing voice. The present study included 478 (100%) subjects engaged in the voice and speech professions presenting with the diagnosis of acute or chronic occupational laryngitis who applied for medical assistance to our Phoniatric Care Department. The clinical state of their larynx was evaluated with the use of the videoendostroboscopic technique. Acute laryngitis was diagnosed in 103 (21.5%) of the examined subjects while the remaining 375 (78.5%) ones presented with chronic laryngitis. A characteristic feature of acute occupational laryngitis documented in 38 (36.9%) examined professional voice users with this condition (practically healthy in all other respects) was the development of this disorder as a result of overloading the speech organs. On the contrary, viral and/or bacterial laryngitis revealed in 65 (63.1%) of the patients was preceded by acute respiratory symptoms. A total of 62 (16.5%) patients suffered from chronic occupational laryngitis attributable to overloading of the organs of speech during protracted periods. The remaining 313 examined professional voice users were found to present with various forms of chronic laryngitis including catarrhal laryngitis in 175 (46.7%) of them, edematous-polypoid and atrophic forms in 32 (8.5%) and 19 (5.1%) subjects respectively. The main etiological factors underlying the development of all the tree forms of chronic laryngitis were smoking, chronic tonsillitis, gastroesophageal reflux disease, bronchial asthma, and diabetes mellitus.Одной из частых причин дисфоний у лиц голосо-речевых профессий являются ларингиты, которые могут быть обусловлены профессиональной деятельностью или не быть связаны с голосовой нагрузкой. Выделяют острую и хроническую формы профессиональных ларингитов. Основной причиной их развития является несоблюдение правил охраны и гигиены певческого и речевого голоса. Было обследовано 478 (100%) профессионалов голоса с диагнозом 'острый или хронический ларингит', обратившихся в фониатрическое отделение. Клиническое состояние гортани оценивали с использованием метода видеоэндостробоскопии. Острый ларингит диагностировали у 103 (21,5%) пациентов, хронический - у 375 (78,5%) больных. Характерным для острого профессионального ларингита, выявленного у 38 (36,9%) человек, являлось его развитие после большой голосовой нагрузки на фоне полного здоровья. Напротив, вирусному или вирусно-бактериальному ларингиту у 65 (63,1%) пациентов предшествовали острые респираторные явления. Хроническим профессиональным ларингитом страдали 62 (16,5%) пациента, которые испытывали длительные голосовые перегрузки. У остальных 313 больных выявлены различные формы хронического ларингита: катаральная в 175 (46,7%) случаев, гиперпластическая - в 87 (23,2%), отечно-полипозная - в 32 (8,5%), атрофическая - в 19 (5,1%). Основными этиологическими факторами развития этих форм были курение, хронический тонзиллит, гастроэзофагеальная рефлюксная болезнь, бронхиальная астма, сахарный диабет.

The article provides data about benign tumors of nasal cavity (inverted papillomas), considering the principles of this disease etiology and incidence. The work focuses on the diagnostics of neoplasms of other nasal cavity tumors, in particular, CT and MR diagnostics. The methods for surgical treatment of the nasal cavity inverted papilloma are provided. A separate paragraph of the work is devoted to the observations, providing the data of the disease symptoms. The authors describe an example of nasal cavity inverted papilloma treatment from endonasal endoscopic access and its late result.

Osteoma is a benign neoplasm consisting of highly differentiated bone tissue cells. Frontal sinus is the most frequent localization of the bone neoplasms. The only treatment of the frontal sinus osteomas is surgical intervention. There are several surgical approaches to excision of frontal sinus osteomas. Transnasal endoscopic approach is applied rather seldom, however it has a number of advantages. The article describes the experience of transnasal endoscopic approach in excision of the frontal sinus osteomas.

Lipid peroxidation and antioxidant system were studied at hospital admission, on postoperative day 1, 3 weeks and half a year after surgery in 86 patients with different stages of laryngeal cancer. A correlation is stated between lipid peroxidation disturbances and the defects in the protective antioxidant system. Low-frequency laser irradiation of autoblood produced a clinically beneficial effect and stabilized biochemically the relations between lipid peroxidation and antioxidant systems.

YAG-ND laser contact surgery in combination with tracheal puncture jet ventilation of the lungs were used in managing 128 patients with laryngeal cancer (T1-T2) and 129 patients with benign lesions of the larynx. A complete response was achieved in 97.3% of stage I and 94.4% of cancer stage II patients. The recurrences occurred in 7 out of 129 patients with benign lesions.

Basing on the results obtained in 129 patients with benign and 135 ones with malignant laryngeal tumors the author provides theoretical and practical grounds for introduction of high-energy YAG laser under contact regimen in endolaryngeal microsurgery of relevant tumors. Advantages of the method, indications and contraindications to its application are considered in detail.