The problem of timely diagnosis and proper management of patients with cystic fibrosis is crucial not only in our country, but throughout the world. Experts of the Union of Pediatricians of Russia have considered various issues of etiology, pathogenesis, epidemiology, diagnosis, and treatment of this genetic disease in a modern light. Particular attention was paid to screening methods for early diagnosis of cystic fibrosis. The principles of complex therapy were justified, including rational use of antibacterial and mucolytic drugs and enzyme replacement therapy that significantly determine the disease prognosis.

Otosclerosis is one of the most common causes of progressive hearing loss, in particular in people of working age. The effectiveness of stapedial surgery largely determines the interest in studying the problems and prospects for the development of technologies, namely, the improvement of prostheses, surgical techniques, and assistance during interventions. It is worth noting that the main attention in the scientific literature is paid to the description of the clinic, the diagnosis of otosclerosis, as well as the methods of stapedoplasty. However, the question of the etiology and pathogenesis of this disease remains relevant and open for discussion, despite the many domestic and foreign works in this field. The emergence of new research methods, including molecular-genetic ones, contributed to the transition of research to a new level and the development of several new theories. Modern understanding of the pathogenesis of otosclerosis considers this disease as a multifactorial condition, in which many processes are involved, for example, genetic, hormonal, biochemical, and immunological. Likely, further study of the theory and hypothesis of the development of otosclerosis will find their justification, which will help answer many questions. The purpose of this article is to analyze and systematize data concerning various theories of the etiopathogenesis of the otosclerosis process, based on the study of modern domestic and foreign literature.

Introduction.Chronic nasal congestion caused by edema of inferior turbinate affect 20% of population and strongly influences their quality of life. Pharmacological treatment of chronic rhinitis is considered to be the first line therapy. However, if conservative treatment is not effective and clinical signs are not disappearing the question about relevant surgical treatment is arising. Nowadays there are many methods of exposure on mucosa of the inferior turbinate. Considering high incidence of the pathology surgical treatment is of current importance in modern otorhinolaryngology.Objective.Assessment of the effectiveness and comparison of the period of rehabilitation after submucosal laser destruction by laser beam with wavelength 1,56 and after submucosal destruction by radiosurgical instruments Ellman Surgitron with a frequency of 4 MHz in patients with chronic rhinitis.Methods.60 patients were included into the study aged from 18 to 80 years old with chronic rhinitis. All the patients were admitted to the department to perform surgical treatment. Semiconducted laser with wavelength 1,56 and radiosurgical instrument Ellman Surgitron with frequency of 4 MHz were applied to the treatment. We assessed SNOT20 score, endoscopic features, anterior active rhinomanometry and saccharin test results in all patients following the surgery.Conclusions.The data we have obtained provide the basis for choosing semiconductor laser as more effective and safe technique for the treatment of patients with chronic rhinitis.

Introduction. One of the most relevant areas of modern medicine is research affecting the assessment of the quality of life of a person. Hearing loss can significantly limit various areas of life, thereby affecting the overall quality of life and certain particular characteristics. One of the methods of surgical treatment of otosclerosis is stapedoplasty with the installation of a titanium prosthesis.Aim of the study. To assess the quality of life index in patients with otosclerosis and its dynamics depending on the surgical treatment performed.Materials and methods. The study involved 39 patients who underwent piston stapedoplasty with the installation of a titanium prosthesis. Quality of life was assessed at the preoperative and postoperative stages. We used a Russified version of the SPOT-25 questionnaire (Stapesplasty Outcome Test 25) with a range of results, where 0 is the minimum impact, and 100 is the maximum.Results. All patients successfully underwent stapedoplasty. The average score in the preoperative period was 58.8 ± 14.9, in the postoperative period – 29.4 ± 20.4. Statistical comparison revealed a statistically significant improvement in all separately assessed indicators (p < 0.001) and overall quality of life (p < 0.001).Conclusion. The introduction into practice of a new tool for assessing the patient’s condition through such a parameter as quality of life can influence the rationale for the methods and tactics of patient treatment, which can positively affect the quality of medical care provided.

Acute bacterial rhinosinusitis is about 0.5–2% of the total number of acute rhinosinusitis. Most often the etiological agents are Streptococcus pneumoniae, Moraxella Catarrhalis and Haemophilus Influenzae. Amoxicillin is most often used as antibacterial therapy of the first line. The growth of S. pneumoniae resistance to penicillins is increasing. Penicillin’s not working. It is necessary to find a viable alternative antibacterial treatment. It should be considered as an initial treatment of the third-generation cephalosporins, in particular Cefixime. A clinical case of patient treatment is presented sought medical care at the clinic of the ear, throat and nose diseases. The patient complained of а purulent nasal discharge, postnasal drip, hyposmia, unpleasant odor from the nose, temperature of 37.6 °C, discomfort in the projection of both maxillary sinuses, swelling in the area of the upper eyelid of the right eye. Аn additional examination was carried out and the diagnosis of “Acute bacterial rhinosinusitis” was established. The patient was on outpatient treatment. The initial antibacterial therapy was the Cefixime in the form of dispersed tablets 400 mg once a day for 7 days. Positive dynamics was already noted on the 3^rd day of treatment, the complete relief of clinical symptoms was achieved by the tenth day. On the NOSE scale, the patient scored 80 points on the day of circulation, on 3 days – 40 points, on the 7^th day – 20 points. The results of a microbiological examination were obtained seven days after the start of treatment. It detected the growth of S. Pneumoniae 10^6 sensitive to all antibacterial drugs. The presented clinical case demonstrates the high response of the outpatient medicine. The Cefixime can be recommended as the drug of choice in causal treatment of the acute bacterial rhinosinusitis, especially in the case of resistance or allergy to penicillin.

Introduction. Chronic rhinitis occurs more often in patients; it’s symptoms deteriorate their quality of life, affect sleeping, daily activity, and sometimes cause complications. The treatment depends on the clinical symptoms. In case of inefficiency of conservative therapy, surgery is indicated. Choosing an exact surgical instrument is still controversial.Objective. The aim of our study is to compare using semiconductor laser (wavelength 1.56 mkm) and radiofrequency (4 MHz) in patients with chronic rhinitis.Materials and methods. 60 patients with chronic drug-induced rhinitis aged 19–80 years were recruited and divided into two equal groups. All patients underwent surgical procedures: semiconductor laser (IRE-Polus) and radiofrequency (Ellman Surgitron) inferior nasal turbinate reduction. To assess and compare the healing process in two groups we used endoscopy and active anterior rhinomanometry. All patients filled out the SNOT-20 questionnaire. For the mucociliary clearance evaluation saccharin test was used. We observed patients during 12 months.Conclusion. Both, laser and radiofrequency, techniques are effective in patients with chronic rhinitis. In laser group shorter healing period was observed, what leads to rehabilitation shortening and life quality improvement.