Vestnik otorinolaringologii最新文献

{"title":"[Current issues of diagnosis and treatment of paratonsillar and parapharyngeal abscesses].","authors":"A V Gurov, A A Lapchenko, M M Magomedov, D Z Khalifaeva","doi":"10.17116/otorino20269101155","DOIUrl":"10.17116/otorino20269101155","url":null,"abstract":"<p><p>Parapharyngeal abscess is a purulent inflammation of the tissue of the parapharyngeal space, often occurring as a complication of paratonsillar abscess. Parapharyngeal abscess refers to deep abscesses of the neck and is characterized by suppuration of loose tissue of the parapharyngeal space. The pathogenesis of the parapharyngeal abscess includes direct and lymphogenous spread of the inflammatory process from the primary focus. When a phlegmonous inflammatory process occurs in the parapharyngeal space, the patient experiences severe pain when swallowing, which radiates to the ear and increases when swallowing, and the patient's head is forced to tilt towards the pathological process. A painful lump appears in the angle of the lower jaw. Computed tomography is the \"gold standard\" for the instrumental diagnosis of parapharyngeal abscess. To date, there is no consensus on the optimal treatment strategy for patients with paratonsillar abscess complicated by parapharyngeal abscess. Certain issues, including the choice of surgical approach, remain controversial in clinical practice.</p>","PeriodicalId":23575,"journal":{"name":"Vestnik otorinolaringologii","volume":"91 1","pages":"55-63"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147322259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[First experience of using tezepelumab for the treatment of chronic rhinosinusitis with nasal polyps in the Moscow region].","authors":"V I Egorov, E Yu Savushkina","doi":"10.17116/otorino20269103146","DOIUrl":"10.17116/otorino20269103146","url":null,"abstract":"<p><p>Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory disease of the nasal mucosa and paranasal sinuses associated with severe nasal congestion, olfactory impairment, decreased quality of life, the need for repeated surgical interventions, and the use of systemic glucocorticosteroids. Real-world data on the use of tezepelumab in patients with severe relapsing CRSwNP remain limited.</p><p><strong>Objective: </strong>To describe the initial experience of tezepelumab application in real-world setting in patients with recurrent rhinosinusitis with nasal polyps and to evaluate early improvement of symptoms, quality of life, and tolerability of therapy based on available clinical data.</p><p><strong>Material and methods: </strong>We describe clinical observations of 8 patients with recurrent CRSwNP who received tezepelumab 210 mg subcutaneously every 4 weeks for 2 months. Patients were treated in a multidisciplinary day hospital. The total severity of symptoms was assessed using the visual analogue scale (VAS), quality of life - using the SNOT-22 questionnaire, the initial endoscopic picture - using the Lund-Kennedy score. In addition, peripheral blood eosinophils, treatment history, comorbidity and tolerability of therapy were evaluated. The primary assessment was performed at the baseline visit and approximately 2 months after the start of treatment. The analysis was descriptive.</p><p><strong>Results: </strong>The series included 8 patients, 6 of whom were women; the mean age was 54.2±9.0 years. All patients had recurrent CRSwNP and a history of surgical interventions. Bronchial asthma was described in 5 of 8 patients, and intolerance to nonsteroidal anti-inflammatory drugs or Samster's triad - in 4 of 8. Initially, the average score for VAS was 30.2±1.7, for SNOT-22 - 63.8±3.9. After 2 months, the mean VAS score decreased to 11.0±1.2, the average absolute change amounted to 19.2±1.5 points. The mean SNOT-22 score decreased to 30.1±5.8, with an average absolute change of -33.6±5.9 points. Improvement in VAS and SNOT-22 scores was observed in all 8 patients. The course of treatment was continued for all patients due to clinical improvement.</p><p><strong>Conclusion: </strong>In this small case series, tezepelumab was associated with an early reduction in symptom burden and improved quality of life in patients with severe recurrent rhinosinusitis with nasal polyps. The obtained observation results are preliminary. Confirmation in larger, systematically assembled cohorts with longer follow-up and standardized assessment of endoscopic, radiographic symptoms and safety indicators is needed.</p>","PeriodicalId":23575,"journal":{"name":"Vestnik otorinolaringologii","volume":"91 3","pages":"46-51"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Prevention of inflammatory diseases of the upper respiratory tract using herbal remedies].","authors":"V M Svistushkin, Zh T Mokoyan","doi":"10.17116/otorino202691041117","DOIUrl":"10.17116/otorino202691041117","url":null,"abstract":"<p><p>Violations of specific immune defense and weakening of nonspecific resistance of the body during inflammatory diseases of the upper respiratory tract necessitate a complex intervention using I eat drugs with immunomodulatory effects. For practicing doctors, immunomodulators are of particular interest. lators of natural origin obtained from active substances of medicinal plants.</p><p><strong>Purpose of the review: </strong>To analyze the effectiveness of the clinical use of the drug Tonsilgon N for chronic infections. tions of the upper respiratory tract in adult and pediatric patients and its impact on the prevention of exacerbations.</p><p><strong>Material and methods: </strong>A search of publications was carried out in the databases PubMed, Embase, Cochrane Library, ClinicalTrials.gov, eLibrary.ru, Google Scholar. The results of randomized and non-randomized controlled trials were analyzed.</p><p><p>observational studies for 2000-2026.</p><p><strong>Results: </strong>The review included information from 20 studies. The collected data showed the ability of the drug Tonsilgon N increases immunological resistance and prevents the development of exacerbations of chronic infections tions. Analysis of published works indicates the high preventive effectiveness of the drug Tonsilgon N: its use statistically significantly reduces the incidence of acute respiratory viral infections, helps relieve local manifestations of inflammation, reduces the average duration of exacerbations. Decrease noted the need for antibiotic therapy when using the drug Tonsilgon N in children of different age groups and in adults.</p><p><strong>Conclusion: </strong>The research results have convincingly proven the effectiveness of the drug Tonzilgon N in relation to cupping prevention of exacerbations and prevention of relapses of chronic upper respiratory tract infections.</p>","PeriodicalId":23575,"journal":{"name":"Vestnik otorinolaringologii","volume":"91 4","pages":"117-124"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A cloud-based system for automatic diagnostics of dysphonia via acoustic parameters using artificial intelligence models].","authors":"D I Kurbanova, S G Romanenko, O G Pavlikhin, E V Lesogorova, O V Eliseev, E N Krasilnikova, V A Zemlyanov, E A Teplykh, Kh Z Khaybulaev","doi":"10.17116/otorino20269104178","DOIUrl":"https://doi.org/10.17116/otorino20269104178","url":null,"abstract":"<p><p>The diagnosis of voice disorders remains a persistent challenge in otorhinolaryngology, as the analysis of complex data demands specialized clinical expertise. A promising approach involves the implementation of artificial intelligence (AI) and machine learning methods, which can automate the analysis of acoustic voice parameters, objectively differentiating between norm and pathology. The creation of user-friendly, secure and accessible cloud-based platforms utilizing environments like Google Drive and Colaboratory reduces the need for expensive infrastructure. This is a critical prerequisite for the successful integration of AI into clinical practice.</p>","PeriodicalId":23575,"journal":{"name":"Vestnik otorinolaringologii","volume":"91 4","pages":"78-80"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Internal validation of a novel risk classification system for juvenile nasopharyngeal angiofibroma involving the skull base: a comparative analysis of the Fisch-Andrews and UPMC staging systems].","authors":"N S Grachev, I N Vorozhtsov, E Yu Yaremenko","doi":"10.17116/otorino20269104140","DOIUrl":"https://doi.org/10.17116/otorino20269104140","url":null,"abstract":"<p><strong>Objectives: </strong>To develop and internally validate a new prognostic classification system for juvenile nasopharyngeal angiofibroma (JNA) involving the skull base, aimed at improving risk stratification for massive intraoperative blood loss and tumor recurrence. The model's performance was compared with two established systems: Fisch-Andrews and UPMC (University of Pittsburgh Medical Center).</p><p><strong>Material and methods: </strong>Using multivariable logistic and Cox regression analyses, we created a point-based risk model (GVV score) incorporating three clinical and radiological parameters: (1) Tumor volume, scaled using a coefficient of 0.055; (2) Growth pattern: tumour extension limited to the nasal cavity, nasopharynx, pterygopalatine fossa and/or paranasal sinuses (1 point); involvement of the infratemporal fossa and/or orbit without intracranial extension (2 points); presence of intracranial extension (3 points), destruction of the greater wing of the sphenoid bone (2 points), destruction of the pterygoid process (1 point), and post-pterygopalatine extension (1 point); (3) Vascularization: complete embolization (-1 point), history of prior intervention (+1 point). Patients were stratified into three risk groups based on total score: I stage (<2.0), II stage (2.0-5.79), III stage (≥5.8). For recurrence: low (<5.0), intermediate (5.0-6.99), high risk (≥7.0). Internal validation included AUC analysis, Brier score, Hosmer-Lemeshow test, 10-fold cross-validation, and Net Reclassification Improvement (NRI). Predictive performance was compared with the Fisch-Andrews and UPMC systems.</p><p><strong>Results: </strong>We analyzed 143 patients treated surgically between 2014 and 2024. The new model showed superior performance for predicting massive blood loss (AUC=0.761 vs. 0.597 and 0.574), transfusion (0.739 vs 0.669 and 0.662), and blood loss >15% of circulating volume (0.776 vs 0.726 and 0.675), compared to Fisch-Andrews and UPMC. Recurrence prediction was comparable (AUC=0.713). The model also demonstrated lower Brier scores and more accurate classification of patients without adverse events. High-risk patients had a 6.6-fold greater risk of recurrence (<i>p</i>=0.001).</p><p><strong>Conclusion: </strong>This novel classification system provides more accurate and clinically interpretable risk stratification for JNA than current staging systems. External validation in independent cohorts is warranted to support its broader clinical use.</p>","PeriodicalId":23575,"journal":{"name":"Vestnik otorinolaringologii","volume":"91 4","pages":"40-49"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Determination of significant parameters of the pyriform aperture in functional and surgical aspects. Part 2: reference range of parameters in the pyriform aperture region].","authors":"D S Pshennikov, V I Popadyuk","doi":"10.17116/otorino20269104181","DOIUrl":"https://doi.org/10.17116/otorino20269104181","url":null,"abstract":"<p><p>In medicine, a reference range (RR) is a range of values considered normal for physiological parameters in healthy individuals, with parameters within the RR considered within the normal range. A reference limit is a value mathematically derived from a reference distribution, defined such that a specified proportion of reference values lie above or below it. Currently, there are no established standards for reference ranges and limits for the parameters of the pyriform aperture region.</p><p><strong>Objective: </strong>To determine the reference ranges and limits of the parameters of the pyriform aperture region.</p><p><strong>Material and methods: </strong>The reference range and limits of the present study were determined for the following parameters of the piriformis width measured using cone beam computed tomography data in 577 individuals of the Central European type of Caucasian race (≥18 years, 273 men and 304 women) divided into age groups (18-44, 45-59, 60-74, ≥75 years): maximum width of the pyriform aperture (WPA), width of the nasal cavity at the level of the attachment of the anterior bony end of the inferior nasal turbinates (WNCp), width of the pyriform aperture in the projection of the attachment of the anterior bony end of the inferior turbinates (WPAp), length of the pyriform ridge (LPR) and angle of the pyriform ridge (APR). The lower reference limits (LRL), calculated in mm as <i>μ</i> (mean value) ± 1.96<i>σ</i> (standard deviation) and <i>μ</i>±3<i>σ</i>, were used as an anatomical reference for the relative and absolute narrowness of the parameters of the width of the pyriform aperture region.</p><p><strong>Results: </strong>For men, regardless of age, the LRLs are respectively: WPA - 20.82 and 19.06; WNCp - 19.15 and 17.18; WPAp - 19.28 and 17.34. For women, regardless of age, the LRLs are respectively: WPA - 19.34 and 17.57; WNCp - 18.74 and 16.78; WPAp - 18.79 and 16.96. For women in the younger age group (18-44 years), the LRLs are respectively: WPA - 18.29 and 16.32; WNCp - 17.7 and 15.6; WPAp - 17.88 and 15.92. The reference range for the length and angle of the piriformis ridge is written as the lower and upper reference limits for men and women, respectively: LPR in mm ([0; 4.36] and [0; 4.22]), APR in degrees ([70.8; 113.05] and [69.76; 108.69]).</p><p><strong>Conclusions: </strong>The results of the study should be used in a possible surgical algorithm for the treatment of chronic nasal obstruction as a reference range and limits for the parameters of the piriformis region.</p>","PeriodicalId":23575,"journal":{"name":"Vestnik otorinolaringologii","volume":"91 4","pages":"81-87"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A historical review of cortical auditory evoked potentials].","authors":"E S Shcheglova, G Sh Tufatulin","doi":"10.17116/otorino202691041103","DOIUrl":"https://doi.org/10.17116/otorino202691041103","url":null,"abstract":"<p><p>Long-latency (or cortical) auditory evoked potentials (LLAEP/CAEP) reflect the cortical processing of acoustic signals. This method is currently utilized in audiological, neurological and neurolinguistics research. LLAEP were first discovered serendipitously in 1939 during neurophysiological investigations of cortical bioelectrical activity. Subsequent studies established the reliability of LLAEPs as a biomarker for the maturation of central auditory system in individuals with normal hearing and those with hearing impairment, as well as in users of hearing aids or cochlear implants. LLAEP have also been investigated as a method for assessing cognitive auditory processing, such as speech discrimination abilities. This review outlines the history of LLAEP research, the principal trends in its investigation across different periods, and the specific contributions of Russian scientists to the field.</p>","PeriodicalId":23575,"journal":{"name":"Vestnik otorinolaringologii","volume":"91 4","pages":"103-108"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The influence of physical, respiratory, and vocal exercises on the acoustic characteristics of the voice of professional vocalists].","authors":"V A Samsonov, I V Kastyro, V I Popadyuk, A N Kovalenko, S G Dragunova, V V Malakhovskiy, E V Orlova, I K Kalmykov, A S Pereverzeva","doi":"10.17116/otorino20269104167","DOIUrl":"https://doi.org/10.17116/otorino20269104167","url":null,"abstract":"<p><p>The article examines the impact of functional tests on the acoustic characteristics of professional singers. Particular attention is paid to an objective analysis of changes in the main acoustic parameters before and after performing exercises.</p><p><strong>Objective: </strong>To identify and characterize changes in the acoustic parameters of the voice of professional vocalists following physical, respiratory, and vocal loading.</p><p><strong>Material and methods: </strong>The study involved 82 professional vocalists aged 18 to 65 years. Voice recordings were obtained from each vocalist to extract acoustic parameters before and after loading. Squats, respiratory loading, and vocal exercises were used as the loading conditions.</p><p><strong>Results: </strong>Vocal exercises led to an increase in fundamental frequency (<i>p</i><0.036) and a decrease in Jitter (<i>p</i><0.04), while Shimmer showed no significant change. Physical exercise caused a pronounced decrease in Jitter (<i>p</i><0.024), whereas breathing exercises had no significant effect on any of the acoustic voice parameters of the professional vocalists.</p><p><strong>Conclusions: </strong>The use of loading in the context of voice production significantly contributes to the improvement of acoustic voice characteristics and an increase in vocal endurance. The combined use of exercises of various orientations possesses high rehabilitation potential for restoring vocal function.</p>","PeriodicalId":23575,"journal":{"name":"Vestnik otorinolaringologii","volume":"91 4","pages":"67-72"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Justification of a personalized approach to the treatment of patients with recurrent chronic rhinosinusitis with nasal polyps based on cytokine-induced Th2 inflammation (interleukin-4, interleukin-13)].","authors":"R M Pestova, L F Aznabaeva, E E Savelieva","doi":"10.17116/otorino20269102143","DOIUrl":"10.17116/otorino20269102143","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the features of cytokine-induced Th2 inflammation (IL-4 and IL-13) in patients with recurrent chronic rhinosinusitis with nasal polyps (CRSwNP) in order to improve therapeutic effectiveness.</p><p><strong>Material and methods: </strong>A total of 74 patients with recurrent CRSwNP and 30 healthy individuals (control group) were examined. Based on the characteristics of sinonasal mucus, patients were divided into two groups: Group I - with liquid mucus (<i>n</i>=39) and Group II - with dense mucus (<i>n</i>=35). Dense mucus was associated with tissue remodeling within the inflammatory focus, an increased risk of intraoperative complications, frequent recurrences, and resistance to standard therapy. Concentrations of IL-4 and IL-13 in lavage fluids were measured using enzyme-linked immunosorbent assay (ELISA).</p><p><strong>Results: </strong>Patients with dense mucus exhibited significantly higher concentrations of IL-4 and IL-13 than those with liquid mucus (<i>p</i><0.05). Elevated IL-13 levels were pathogenetically significant and correlated with the severity of clinical manifestations (<i>p</i><0.05). High clinical efficacy was observed with dupilumab, a monoclonal antibody that blocks the shared <i>α</i>-subunit of the IL-4 and IL-13 receptor (IL-4R<i>α</i>) (<i>p</i> = 0.0077).</p><p><strong>Conclusion: </strong>Assessment of key Th2-related cytokines (IL-4 and IL-13) demonstrated their pathogenetic relevance in patients with recurrent CRSwNP and dense mucus. Elevated IL-13 levels were associated with more severe clinical manifestations and mucus densification. Dupilumab therapy showed significant clinical efficacy. Thus, dense mucus may be considered a clinical marker of IL-13-driven pathology and a potential criterion for a personalized approach to targeted biologic therapy.</p>","PeriodicalId":23575,"journal":{"name":"Vestnik otorinolaringologii","volume":"91 2","pages":"43-49"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147875891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Methods of evaluating the functional state of the mucous membrane of the maxillary sinuses (literature review)].","authors":"M M Magomedov, Sh Yu Avkaeva, O N Rozhdestvenskaya, T N Zhogoleva","doi":"10.17116/otorino20269101170","DOIUrl":"10.17116/otorino20269101170","url":null,"abstract":"<p><p>The literature review presents the currently known methods of assessing the functional status of the maxillary sinus, based on data from domestic and foreign sources. It describes the research methods and the results of studies on the normal state and pathology of the maxillary sinus.</p>","PeriodicalId":23575,"journal":{"name":"Vestnik otorinolaringologii","volume":"91 1","pages":"70-75"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147322224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}