Background/Objectives: Emergency airway management is a critical skill for healthcare professionals, particularly in life-threatening situations like “cannot intubate, cannot oxygenate” (CICO) scenarios. Errors and delays in airway management can lead to adverse outcomes, including hypoxia and death. Cognitive aids, such as checklists and algorithms, have been proposed as tools to improve decision-making, procedural competency, and non-technical skills in these high-stakes environments. This systematic review aims to evaluate the effectiveness of cognitive aids in enhancing emergency airway management skills among health professionals and trainees. Methods: A systematic search of MEDLINE, Embase, CINAHL, Cochrane Library, Scopus, Web of Science, and ClinicalTrials.gov was conducted from February to March 2024. Studies examining the use of cognitive aids, such as the Vortex method, the ASA difficult airway algorithm, and visual airway aids, in emergency airway scenarios were included. Outcomes assessed included decision-making speed, procedural success rates, and non-technical skills. Data were extracted using standardized protocols, and the quality of included studies was appraised. Results: Five studies met inclusion criteria, encompassing randomized controlled trials, controlled studies, and mixed-methods research. Cognitive aids improved decision-making times (reduced by 44.6 s), increased procedural success rates, and enhanced non-technical skills such as teamwork and crisis management. Participants reported reduced anxiety and improved confidence levels (self-efficacy scores increased by 1.9 points). The Vortex method and visual cognitive aids demonstrated particular effectiveness in simulated scenarios. Conclusions: Cognitive aids significantly enhance emergency airway management skills, improving performance, reducing errors, and increasing provider confidence. Integrating cognitive aids into training programs has the potential to improve patient safety and outcomes. Further research is needed to validate these findings in clinical settings and optimize cognitive aid design and implementation.

Introduction: A diagnostic pathway to detect aspiration is challenging and usually requires a multidisciplinary approach and a variety of tests. Lipid-laden macrophage index (LLMI) was first described in 1985 by Corwin and Irwin as a promising tool to detect aspiration. Information in the literature as well as physicians’ opinions about the clinical value of the LLMI remains controversial. Objectives: To assess the clinical value and possible limitations of LLMI as a diagnostic marker for detecting aspiration in children. Methods: Based on the available literature we thought to answer the following questions: 1. Is there a reliable cutoff value of LLMI to detect aspiration? 2. What are the limitations of LLMI? We queried 8 electronic databases: Medline, Embase, CINAHL, Cochrane, Global Health, Web of Science, Africa Wide Information, and Global Index Medicus. Studies were selected based on established study criteria. Search was limited to publications in English language including human and animal studies. Authors reviewed 2900 articles and identified 21 relevant to the studied subject. Results: Research reveals different proposed cutoff values for aspirators ranging from 85 to 200 macrophages. LLMI reliability has several limitations including: inter- and intraobserver variability among pathologists scores, inability to differentiate between exogenous and endogenous lipid content, inconsistencies in the definition of the term “aspiration” in various publications. Also, studies in animal models have shown that the nature of the disease, frequency of aspiration, and the time frame when bronchoalveolar lavage (BAL) is performed, could all contribute to the overlap in LLMI in aspirators versus non-aspirators. Discussion: Our research demonstrates the limitations of LLMI in distinguishing between aspirators and non-aspirators. We believe based on these findings that airway teams should audit their local data as to the value of BAL in detecting aspiration in their patient population.

Introduction. According to global statistics, secretory otitis media (SOM) ranks first among middle ear infections. This pathology is believed to be characteristic of the pediatric population; however, recent global statistics indicate an increase in the percentage of SOM cases among the adult population. Information about adult-onset SOM varies, with no consensus on the causes of its occurrence. Diverse clinical presentation of the condition, often unsatisfactory treatment outcomes, and a high percentage of recurrences have necessitated a more in-depth study of the etiological factors associated with adult-onset SOM. The objective of the research was to determine clinical and morphological parallels in the etiopathogenesis of adult-onset SOM as well as to establish the relationship between the clinical, otoscopic, and endoscopic presentations and pathomorphological changes in the tubal tonsils in these patients. Materials and Methods. Sixty-eight (38 men and 30 women) patients with SOM at the age of 18 to 65 years were examined. Fifty-three patients were diagnosed with unilateral pathological process, while in 15 individuals, bilateral SOM was observed. All the patients underwent a comprehensive assessment of their complaints, collection of their medical history, and a full ear, nose, and throat examination using conventional methods, optical techniques, video endoscopy of the nasopharynx and tubal tonsils, and otomicroscopy. In 15 patients, to exclude a malignant process, tissue samples from the tubal tonsils were taken for pathological examination. Results. One of the causes of adult-onset SOM could be pathomorphological changes in the tubal tonsils, specifically their inflammation, hypertrophy, and in some cases, tumours. The clinical course and stages of SOM development depend on the duration of auditory tube obstruction. Inflammation of the tubal tonsils usually results in catarrhal and serous SOM, while hypertrophy or hyperplasia of the tubal tonsils is observed in patients with mucous SOM. Conclusions. Pathomorphological changes in the tubal tonsils have been established as one of the reasons for developing SOM in adults. Both the clinical presentation of SOM and the stage of its progression depends on the type of pathomorphological changes, their localization (upper or lower pole), and the duration of auditory tube obstruction. A prolonged, recurrent, and treatment-resistant course of SOM may be associated with hypertrophy of the tubal tonsil or tumours. Clinical and morphological parallels identified by us will enable timely utilization of effective etiopathogenetic treatment of SOM and prevent the occurrence of complications.

The problem of hearing pathology is relevant as we have seen the number of those patients increasing yearly. According to the literature, about 30% of all cases of hearing loss are related to middle ear pathology. The cause of the development of many forms of hearing loss is the dysfunction of the Eustachian tube which can lead to retraction of the tympanic membrane, development of secretory otitis media or even adhesive otitis media that can be the reason for constant conductive hearing loss, and require surgical intervention to restore mechanism of sound conduction. Prevention and treatment of hearing disorders is not only a medical, but also a social-economic problem. In our researches, we’ve decided to study the peculiarities of hearing impairment in patients with secretory otitis media in different stages of its development, depending on the condition of the tubal tonsils and lymphoid tissue around the orifice of the Eustachian tube. The aim. Study the relationship between the state of auditory function and pathomorphological changes of the tubal tonsils and lymphoid tissue around the orifice of the Eustachian tube in patients with secretory otitis media in different stages of its development. Material and methods. There were examined 89 patients, age between 18 and 65 years old, with secretory otitis media. All patients were performed a detailed collection of complaints, disease anamnesis, examination of the ENT-organs – by a routine method and with the help of endoscopic and microscopic equipment, as well as pure-tone audiometry and tympanometry. Patients were divided into III groups. Group I – 21 patients with catarrhal stage of secretory otitis media, group II – 38 patients with serous stage, group III – 30 patients with mucous stage. The results. When examining patients with secretory otitis media during nasopharyngeal endoscopy, the changes in the tubal tonsils and surrounding area in the form of inflammation, hypertrophy, or hyperplasia were found. The form of these changes affects the nature of the disease stage. According to pure-tone audiometry, the average hearing thresholds at speech frequencies by air conductivity in all patients were significantly increased. At the same time, in patients of group III with mucous exudate in the middle ear space, average hearing thresholds by bone conduction were slightly increased, which is associated with significantly restricted or absent movement of the tympanic membrane and ossicular chain in the presence of thick mucous exudate. Conclusions. Analyzing the patients’ complaints, clinical picture, data of otoscopy, endoscopy of the nasal cavity and nasopharynx, data of pure-tone audiometry and tympanometry – there was determined a cause-and-effect relationship between the condition of the tubal tonsils, the stage of secretory otitis media and, accordingly, hearing impairment in the examined patients. The performed studies indicate that one of the reasons for the development of secretory otitis media in adults may be pathomorphological changes in the tubal tonsils and lymphoid tissue surrounding the orifice of the Eustachian tube, namely their pathomorphological changes: inflammation, hypertrophy, or hyperplasia. Inflammation of the tubal tonsils, as a rule, is the cause of the development of the catarrhal and serous stage of secretory otitis media, and their hypertrophy or hyperplasia leads to the long-term dysfunction of the Eustachian tube, which in turn is the cause of the mucous stage of secretory otitis media. The problem of hearing pathology is relevant as we have seen the number of those patients increasing yearly. According to the literature, about 30% of all cases of hearing loss are related to middle ear pathology. The cause of the development of many forms of hearing loss is the dysfunction of the Eustachian tube which can lead to retraction of the tympanic membrane, development of secretory otitis media or even adhesive otitis media that can be the reason for constant conductive hearing loss, and require surgical intervention to restore mechanism of sound conduction. Prevention and treatment of hearing disorders is not only a medical, but also a social-economic problem. In our researches, we’ve decided to study the peculiarities of hearing impairment in patients with secretory otitis media in different stages of its development, depending on the condition of the tubal tonsils and lymphoid tissue around the orifice of the Eustachian tube. The aim. Study the relationship between the state of auditory function and pathomorphological changes of the tubal tonsils and lymphoid tissue around the orifice of the Eustachian tube in patients with secretory otitis media in different stages of its development. Material and methods. There were examined 89 patients, age between 18 and 65 years old, with secretory otitis media. All patients were performed a detailed collection of complaints, disease anamnesis, examination of the ENT-organs – by a routine method and with the help of endoscopic and microscopic equipment, as well as pure-tone audiometry and tympanometry. Patients were divided into III groups. Group I – 21 patients with catarrhal stage of secretory otitis media, group II – 38 patients with serous stage, group III – 30 patients with mucous stage. The results. When examining patients with secretory otitis media during nasopharyngeal endoscopy, the changes in the tubal tonsils and surrounding area in the form of inflammation, hypertrophy, or hyperplasia were found. The form of these changes affects the nature of the disease stage. According to pure-tone audiometry, the average hearing thresholds at speech frequencies by air conductivity in all patients were significantly increased. At the same time, in patients of group III with mucous exudate in the middle ear space, average hearing thresholds by bone conduction were slightly increased, which is...

Nasopharyngeal cysts are typically benign, congenital lesions filled with fluid and encapsulated from surrounding tissues. Both children and adults may present with clinical signs. The aim of the study was to improve the efficiency of diagnostics and treatment of nasopharyngeal cysts in adults based on the differential diagnosis. Materials and Methods. The study was carried out at the Department of Otolaryngology with the Course of Head and Neck Surgery, Ivano-Frankivsk National Medical University, Ukraine, and encompassed both outpatient and inpatient-to-outpatient observations. Fifteen (9 females, 6 males) patients with nasopharyngeal cysts at the age of 28 to 51 years were examined. All patients underwent a comprehensive assessment, including a thorough evaluation of their medical history, a standard examination of the ears, nose, and throat (ENT) using conventional and optical techniques, alongside computed tomography (CT) of the nasopharynx and paranasal sinuses, complemented by a general physical examination. Results. Fifteen patients with nasopharyngeal cysts were examined and treated. In nine (60%) cases, the cyst appeared as a round mass with a dense wall, partially or completely obstructed by the excretory duct and containing dense content, localized in the central region of the nasopharynx. In four (26.6%) cases, the cyst ruptured. Cysts were localized laterally, originating from the fossa of Rosenmüller in three (20%) cases. All patients underwent minimally invasive surgery. Conclusions. Endoscopic examination, CT, and magnetic resonance imaging are the most informative diagnostic methods for nasopharyngeal cysts. A definitive diagnosis can be made based on pathomorphological examination. The treatment of choice for nasopharyngeal cysts is endoscopic endonasal surgery with a microdebrider and laser coagulation.

The paper assessed and systematized the primary causative factors, clinical progression, and diagnosis of secretory otitis media in adults through bibliographic and structural-logical analyses. The global significance of this issue has been assessed based on international and national research. The study aimed to analyze the primary causative factors, clinical course, and diagnosis of secretory otitis media in adults, as well as their significance in selecting the most effective treatment methods. Material and Methods. Bibliographic and structural-logical analyses were used to investigate secretory otitis media in adults as a medical and social issue. Results. Recent studies have challenged previous beliefs of a single etiology for secretory otitis media, identifying multiple potential causes and variations in disease progression influenced by their combination and predominance. Conclusions. The analysis revealed that, despite the wealth of data available on the etiology, pathogenesis, diagnosis, and treatment of SOM, it remains one of the leading causes of hearing loss in adults. Ongoing research into the causative factors and their systematization will enable improved functional outcomes and reduced recurrence rates by applying pathogenetically-based treatments. Keywords: Secretory Otitis Media; Etiology; Pathogenesis; Diagnosis; Hearing Los