The relevance of the study is due to the need for an extended search for information on the current state of the problem of acute otitis media in adults based on the experience of Ukrainian and foreign authors. The aim of our research: To analyze the world experience on the etiology, pathogenesis and diagnosis of acute otitis media in adults. Materials and methods: 125 modern literature sources of electronic databases PubMed, EMBASE, MED-LINE, U.S. National Library of Medicine Clinical Trials, Research Gate and Cochrane Library. Introduction: The problem of otitis media as a component of the problem of inflammatory diseases of the upper respiratory tract remains relevant in modern medicine, based on its incidence and prevalence in the structure of otolaryngological diseases. Despite the achievements of modern medical science, these indicators remain consistently substantial, which determines the relevance of further research to improve diagnosis and treatment. Results: By conducting a bibliographic method of research it was found that most scientific articles are devoted to the problem of acute otitis media in children, while the problem of acute otitis media in adults is not sufficiently studied. Clinical and experimental studies have established that the function of immune protection of the middle ear is present at almost all physiological levels from epithelial cells to intracellular nuclear factor. This function is realized through the messengers of the cytokine network. Among the pool of cytokines, IL-1, IL-6 and TNF-α are important for the pathogenesis of acute otitis media. One of the features of the immune defense is a clear succession of stages of inflammation with its own features at each stage. It is shown that each of the links of immune defense (including cytokines) is able to detect (in case of discrepancy in strength and time) a negative effect with the maintenance or intensification of inflammation. The data of experimental analysis of pathomorphological changes in the middle ear depending on the duration of the disease are presented. It is also shown that the issue of complicated course (in particular mastoiditis) is still relevant. The role of acute otitis media in the deveopment of intracranial complications (meningitis) has been established. The significance of comorbidity for the pathogenesis of acute otitis media and the role of diabetes mellitus in the structure of comorbidity was proved. The main factors of reducing the effectiveness of diagnosis and treatment of acute otitis media are convincingly outlined: the multifactorial nature of the etiology, the peculiarities of immune protection and the tendency of otopathogens to evade the host's immune response, the importance of comorbid pathology in adult pat ients with ENT diseases. A certain number of literature sources are devoted to the features of the course of acute otitis media in diabetes mellitus. The shortcoming identified by the results of the analysis of literature sources: the lack of research on the peculiarities of the clinic and diagnosis of acute otitis media in adults, especially in the setting of comorbid pathology, primarily type 2 diabetes mellitus, indicates the relevance of further research on this problem.

ABSTRACT. Worldwide, there are about 466 million people (6.1%) with hearing loss and approximately 34 million of them (7%) are children, two-thirds of whom live in developing countries. In the course of research, it has been proven that in 60% of cases, sensorineural deafness is combined with vestibular disorders, which can be both obvious (rarely in children) and hidden. Timely detection of vestibular disorders in young children, especially hidden ones, prevents delay in the child’s motor development and significantly reduces the risk of vestibular dizziness development in older age. The aim of the article was to study modern instrumental methods of balance function research in children based on scientific analysis of contemporary literary data. Materials and methods: A comprehensive search of relevant literature sources was conducted in December 2021 using electronic databases RubMed, EMBASE, MEDLINE, U.S. National Library of Medicine Clinical Trials, Research Gate and Cocharane Library. The results: Despite highly developed technological diagnostic capabilities of present-day medicine, the study of etiology, prevention and correction of various balance and hearing disorders in children of different ages is one of the most acute issues to be solved by modern medical community. Up-to-date improvements in the diagnostic methods of the auditory and vestibular analyzer expand the possibilities of interpreting their results and allow a deeper understanding of the degree of the stato-acoustic analyzer damage. To investigate the vestibular function, vestibulometry and otoneurological examinations are usually carried out, which are the same tests that are used in adults. However, such examinations require more patience from the child and they should be conducted in a playful manner. Detection of hidden vestibular dysfunctions ought to be comprehensive, in particular, using instrumental methods, one of which is static computer stabilometry, that creates an opportunity to determine translational and motor disorders. The conclusion. Long-term problems with balance in children can lead to a delay of motor functions development, which can further slow down the child's achievement of age-appropriate psychomotor stages and have a negative impact on school performance, and in general, on social, speech and intellectual development. Therefore, detection of vestibular dysfunction at an early age is of great medical and social importance. Acute otitis media is currently a curable disease in most cases, if undesirable consequences are prevented during the period of examination and treatment. Vestibular function can be adequately assessed using reliable instrumental tests. In this sense, static stabilometry is a very useful method for the objective determination of vestibular deficits in children, regardless of the presence or absence of any subjective complaints.

Relevance: Thyroid surgery is dangerous and can lead to damage RLN. The frequency of nerve damage varies widely and this is due to the fact that not always immediately after surgery and subsequent examination of the larynx. This leads to late start of treatment. Purpose of this research is estimate the frequency of transient and permanent immobility of the vocal folds after thуroid surgery. Materials and methods: It was prospective cohort monocenters investigate. 1364 patients were examined. We developed “voice passport of the patient” to improve the diagnosis and treatment. It included data of examination and treatment. All patients in the preoperative and postoperative periods were examination: laryngoscopy, laryngeal videoendoscopy, voice spectral analysis and Voice Handicap Index (VHI-30 modified version) by Jacobcon. Results and discussion: Postoperative disorders of motion vocal folds were in 132 (9.7%) patients. Recovery of motion vocal folds were observed in 123 patients, which were 93.2% of the total number of cases of damage RLN (132) and 9.1% of the total number of surgical interventions (1364). Lack of recovery of motion vocal folds more than one year (laryngeal paralysis) was observed in 9 patients, which was 6,8% of the total number of cases of damage RLN (132) and 0.6% of the total number of surgical interventions (1364). Conclusions: Studying the frequency of paresis and paralysis of the larynx depending on the type of surgery and predicting the risks of PGN depending on the scope of the intervention before its implementation allows to reduce the number of postoperative complications and optimize management tactics in cases where nerve injury can’t be avoided.

Topicality: Blockage of hemorrhage due to vascular damage is the leading role of the clotting cascade of the hemostasis system. Recently, two types of such damage have become highly relevant. The first of them is caused by viral damage to the endothelium, which leads to uncontrolled cascade activation of the descending system. The second type is caused by aquabarotrauma and associated hydrodynamic shock. Both types of damage lead to the development of thrombotic-fibrous complications of the circulatory system due to the formation of long fibrin deposits. Such deposits are resistant to the action of the fibrinolytic system due to their irregular and chaotic structure. This, in turn, leads to severe functional complications. Aim: Systematize data on molecular and cellular features of systemic damage to the endothelium. To compare the clinical material of persons who suffered from or died of COVID-19. To compare the functional disorders of the hearing organs in persons who have experienced akubarotrauma or who have become ill with COVID-19. Results and discussion: The clinical material of persons who suffered from COVID-19 or died as a result of it is presented. The functional disorders of the hearing organs in persons who have experienced acubarotrauma or who have become ill with COVID-19 are considered. The reasons for the resistance of thrombotic-fibrous deposits in vessels with systemically damaged endothelium are discussed. Possible methodical approaches to overcoming the considered functional complications are discussed.

One of the most serious complications in thyroid surgery is damage to the recurrent laryngeal nerve, which can significantly worsen the patient’s quality of life, so predicting the course of the disease is very important, as it contributes to timely and targeted aid to patients and the determination of optimal treatment tactics. Objective — construction of the prognostic model of the absence of larynx motility recovery in unilateral lesions of the recurrent laryngeal nerve in thyroid surgery Materials and methods. In the years 2018 — 2021, a prospective single‑center study was conducted at the Ukrainian Scientific and Practical Center of Endocrine Surgery, Transplantation of Endocrine Organs and Tissues of the Ministry of Health of Ukraine. Investigation involved 164 patients after thyroidectomy with unilateral motility disorder of the larynx. The investigated patients are divided into two groups: the main group (n = 33) included patients with unilateral paralysis of larynx (the mean age 49.7 ± 11.1 years), and control group consisted of 131 patients with unilateral paresis of larynx (the mean age 43.2 ± 14.6 years). Results. Prognostication of disease was conducted by means of three methodologies. The method of statistical analysis of Wald was conducted taking into account the most meaningful informing laryngoscopy signs with their gradations (9 laryngoscopy signs and 1 sign that is related to age), that were distinguished by us in previous prognostic research. Diagnostic coefficients and information measures of Kullback J of selected features were determined and a special template was developed using the MS Excel program to automate diagnostic analysis. Method of binary logistic regression allows the expectation of dependence of binary initial variable (present/absent paralysis) after influence of factor variables. Three factor signs that remained after recalculation have been investigated. To ensure quick and convenient execution of calculations, a corresponding template has also been created in the MS Excel program. The prognostic express test, which enabled us to build an easy‑to‑use test based on the most significant two predictors and their gradations, which were converted into ranks. A comparison of the occurrence of paresis/paralysis of the larynx was made for different sums of ranks. Conclusions. The diagnostic method based on the sequential Wald analysis, despite good performance in the case of a definite result, gave about 25 % indeterminate results and therefore needs further improvement based on a more representative sample. The diagnostic model built using binary logistic regression led to good results, but working with it requires a personal computer and an appropriate template for calculations in the Excel program. The prognostic express test, which is based on the consideration of only two predictors, is convenient, does not require complex calculations and provides an acceptable level of sensitivity and specificity, which can be widely used in the clinical practice of first‑line otorhinolaryngologists for a timely decision on further conservative or surgical treatment.