Vol 76, No 1 (1995)

The beginning of the development of otorhinolaryngology in Kazan should be considered 1925 - the time of the opening of the otorhinolaryngological department and clinic at the Faculty of Medicine of Kazan University. Its creation was carried out by prof. V.K. Trutnev.

The investigation of the dynamics of the content of IgA, IgM, IgG and antibodies to DNA in blood serum and perilymph of 30 patients with otosclerosis, in 20-th active stage and in 10-th nonactive one, shows the plausible increase of the levels of IgG and antobodies to DNT, more pronounced in the active stage of the disease relative to the nonactive stage. The inverse correlation between immunologic characteristics and ear levels is found: namely, the decrease of IgG levels and antibodies to DNA in perilymph of patients with otosclerosis and hence, the decrease of the process activity is accompanied by the auditory function suppression in the form of the increase of perception theresholds of osteoconductive sounds on vocal and high rates.

HLA-A-B-C phenotypes in 105 patients with otosclerosis, verificated during operation and correlated with the results of histoiden- tification of 113 healthy persons are determined. It is suggested that the ethnic sign does not influence the formation of the peculiarities of HLA polymorphism. The patients were devided into two groups: with familial predisposition to otosclerosis (33) and without it (72). A2, В12, Bx, Cx antigens are more frequent among them and A28, В18, B27, B40 and Cwl are less common. The associations, intending among the patients, are absent in patients with familial agrégation. The conclusions are made of the absence of the HLA-association of familial forms of otosclerosis and the existence of the gene, determinating the stability to the development of otosclerosis (HLA-B40). It is not inconceivable that genes exist, predisposing to the development of infamilial form of the disease (B12).

On the basis of the archival material of the Kazan otolaryngologic clinic, the comparative analysis of intracra-nial rhinogenic and otogenic pathology is performed by stages. In the presence of a general decrease of the intracranial complications rate during the last 20 years in this pathology structure the combined lesions prevail, which determines the high level of lethality. Computer tomography and particularly MRT-tomography allow to reveal the infection focus in the skull cavity and to define the adequate surgical tactics.

It is necessary to use the current possibilities of the diagnosis, namely, the computer tomography and endoscopic methods of the surgical treatment in providing service to patients with orbital complications of sinusitis.

The improvement and normalization of the characteristics of humoral and cellular immunity and nonspecific organism protection correspond to the good and excellent results of immunotherapy, whereas in unsatisfactory and satisfactory results the pathologic ships in immune system are conserved,, ov the insignificant positive dynamics of immunologic characteristics is observed. The presence ot immune disorders after the immunotherapy course by bacterial allergens is an indication for the following extension without regard to the clinical results obtained up to, the normalisation and improvehent of immunologic characteristics.

As many as 159 children aged 9 to 14 are examined for the clinical assessment of theefficacy of local application of 15% water solution of dimephosphone in acute and chronic purulent maxillary sinusitis. The normalization of the rhinoscopic picture in acute maxillary sinusitis in patients of the basic group is observed in 5—7 days, in chronic — in 7—8 days, in the conrol group treated with 1% solution — in 11 —12 and 12—14 days, respectively. The terms of normalization of the roentgenologic picture are approximately the same as the rhinoscopic one. The comparison of results of the effect of dimephosphone on the course of maxillary sinusitis with results of the treatment with dioxidine reveals more pronounced local antiinflammatory action of dimephosphone on the mucosa of maxillary sinuses and nose cavity.

The connection between the formation of vocal fold nodes and change of normal tonus of external larynx muscles is found. In dys- phonias the true vocal folds mucosa is traumatized in friction of tightened folds (hypertonus dysphonia) as well as weakened folds (hypotonus dysphonia) resulting in the formation of vocal fold nodes.

The vegetative characteristic are studied in 45 patients after craniocerebral injury of medium gravity. The peculiarities of the vegetative nervous system functioning in the remote period are the different background characteristics in cardiovascular system, the decreased vegetative reactivity, the complex nature of provision of physical and mental activity. The effect of sex and age of patients, traumatic substrate lateralization and social adaptation nature on the nature of vegetative disorders is shown.

The microcirculation state in 48 patients with unilateral and bilateral deforming coxarthrosis of I—III stages and in 34 healthy persons aged 26 to 63 is studied using biomicroscopy method of bulbar conjunctiva vessels. It is established that the pronounced microcirculating disorders depend on the disease gravity and pathologic process occurrence. The most constant signs of microhemo- circulation disorder are intravescular and vascular changes.

Thanks to advances in cofosurgery, a significant number of patients with otosclerotic hearing loss have improved hearing. Nevertheless, many problems of this disease continue to remain relevant at the present time. Among them, the pathogenesis of otosclerosis, as well as the mechanism of inhibition of the activity of the otosclerotic process, should be distinguished, especially in those cases when the otosclerotic rearrangement captures the cochlear region of the ear labyrinth.

The influence of two methods of forming a conjunctival flap on the hypotensive efficiency of operations and the outflow of intraocular fluid in the long-term follow-up was studied. Operated on 2 groups of patients - 150 people (150 eyes). In group 1 (76 patients), operations were performed with an incision of the conjunctiva at the site of its attachment along the limbus for 5 - 6 mm, followed by its separation by 3 - 4 mm upward.

96 patients with allergic rhinitis aged from 24 to 40 years were under our supervision at the Republican Center of Clinical Immunology. Patients (40 men and 56 women) were followed regularly for 5 years. The duration of the disease did not exceed 10 years. The diagnostic program aimed to establish the signs of "atopic phenotype" and specific hypersensitivity in patients with allergic rhinitis. It included an allergic history, skin testing, provocative nasal tests, test of inhibition of natural emigration of leukocytes (TTEL) with histamine, determination of the number of eosinophils in peripheral blood, assessment of humoral and cellular immunity, HLÂ-typing.

To assess the effectiveness of conservative treatment of patients with chronic tonsillitis, a group of children from 4 to 14 years old (50 people) was selected, registered in the children's cardiac dispensary. Before and after treatment, the microflora of the mucous membrane of the palatine tonsils was determined.

This work presents the results of treatment of patients with functional diseases of the larynx by phonopedic voice correction using various methods. From 1991 to 1993 we treated 2421 patients

The experience of the work of the interrepublican ear-improving centre giving medical and consulting service to patients with ear diseases for a period of 30 years is presented. The structure and directions of the polyclinic department of the ear-improving centre are given, and the clinical examination using monitoring observation of the ear and vestibular function state of patients after surgical rehabilitation should be given consideration.

The lesions of upper respiratory tracts are diagnosed in 37,6% of the examined persons depending on the age and length of work. The direct dependence of professional hypoacu- sis on the length of work is stated in 31% of the workers.

In August 1994, it was 90 years since the birth of the Honored Scientist of the RSFSR, Professor Nikolai Nikolaevich Lozanov. Nikolai Nikolaevich was born in 1904 in Saratov. After graduating from the Saratov Medical Institute in 1927, N. N. Lozanov was accepted as a junior researcher at the Saratov Research Institute of Physiology of the Upper Respiratory Tract, where from 1930 to 1932 he was engaged in graduate school. Over the years, his fulfillment of a number of original works on embryohistology of the pharyngeal lymphadenoid ring, as well as on professional traumatization of the ear under conditions of noisy production, was the basis for his approval in 1932 as an associate professor of the clinic of social health (department of ear, nose and throat) at the Leningrad Institute physical culture them. Lesgaft. Working fruitfully, he summarized here his scientific research on the physiology of the vestibular analyzer and in 1936 successfully defended his doctoral dissertation.