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The authors studied the age-related features of the vascular organization of the adenoid tissue. A total of 46 subjects (n=46) were examined; they were divided into two groups one of which included subjects at the age from 7 to 12 years (n=25) whereas the other group was comprised of 21 subjects at the age from 18 to 42 years (n=21). 29 participants of the study were men (63%) and 17 (37%) women. The histological examination of the adenoid tissue revealed the characteristic changes in the adenoid vasculature in the subjects of either age-group. The subjects above 18 years of age were shown to have developed sclerosis and hyalinosis of the vascular walls with the formation of cavernously dilated plethoric veins having the thickened rigid walls. The morphological changes in the connective tissue (basal) layer were documented responsible for the manifestation of the phenomenon of 'immersion' of the lymphoid tissue with the well developed microcirculatory bed. It is concluded that the results of the histological examination can serve as one of the indicators for the use of electrophysical methods to perform adenotomy in the patients older than 18 years.

The objective of this review is to summarize and systematize the data concerning the modern laser and laser-based systems, their characteristics, and possible applications in various spheres of medicine including otorhinolaryngology. The application of laser technologies in medical practice gains ever increasing popularity. Lasers have been successfully used during a long period for the diagnostic and therapeutic purposes. At present, they are just as actively applied in different fields of the surgical practice. Otorhinolaryngology makes the most extensive use of neodymium, CO2, and holmium lasers. The latter has the most universal characteristics and is operated in a relatively short wavelength range (λ=2.01 mcm); moreover, its radiation penetrates as deep as 0.4 mm into the biological tissues. In other words, the holmium laser not only combines the advantages of the CO2 and neodymium lasers but is also devoid of their shortcomings. The holmium laser is considered to be the most promising source of laser radiation for the application in otorhinolaryngological surgery with a potential encompassing the most wide spectrum of surgical manipulations needed to treat pathological changes in the ears, nose, and throat. The application of this instrument in medical practice opens up new prospects for the development of otorhinolaryngology.

научно-исследовательский клинический институт оториноларингологии им. Л.И. Свержевского» департамента здравоохранения москвы, москва, россия; 2 ГБоУ впо «российский национальный исследовательский медицинский университет им. н.И. пирогова» минздрава россии, москва, россия Цель-изучить распространенность хронического кистозного верхнечелюстного синусита и частоту применяемых хирургических доступов к пораженной пазухе при лечении данной патологии. Материал и методы. проанализирован архивный материал, включающий 12 094 истории болезни пациентов, проходивших хирургическое лечение в пяти крупных Лор-клиниках москвы в течение 2014 г. Результаты. Установлено, что за год было проведено 659 хирургических вмешательств по удалению кисты верхнечелюстной пазухи, что составляет 34,1% от общего числа операций по поводу хронического верхнечелюстного синусита и 4,1% от общего числа хирургических вмешательств на Лор-органах. применялись следующие хирургические доступы: эндоназальный (через средний носовой ход)-в 188 (28,5%) наблюдениях, экстраназальный (через переднюю стенку пазухи)-у 454 (68,9%) пациентов, комбинированный-в 17 (2,6%) случаях. Вывод. отмечена целесообразность разработки рекомендаций по выбору оптимального хирургического доступа при кистах верхнечелюстной пазухи. Ключевые слова: киста верхнечелюстной пазухи, хронический гайморит, медицинский стандарт лечения.