Topicality: In recent years, ideas about the mechanisms of action of a local lysozyme containing antiseptic have been significantly expanded. Data on the availability of antiviral drugs and a positive effect on regeneration processes have been obtained. Objective: In order to further study the properties of the drug, its effect on the mechanisms of inflammation in a clinical setting and model of inflammation in an animal experiment was investigated. Material and methods: Clinical and immunological studies were conducted in 22 children aged 9-12 years, of which 10 people represented a group of healthy donors. 12 people with exacerbation of chronic catarrhal pharyngitis received the drug Lizak in the form of monotherapy according to the instructions. The oropharyngeal secretion was studied, where the pro-inflammatory cytokine interleukin-1β (Cytokine, RF), lactoferrin (Vector Best, RF), as well as the macrophage inflammatory protein MIP-1b (Hucaltbiotecknolgy, Netherlands) were determined by the ELISA method. As an analyzer, a Lab line reader (Austria) was used. The studies were carried out at two points: before the start of therapy and a day after its completion. Under the experimental conditions, a model of caraginan edema of rat paws was used, which, prior to the introduction of phlogogen, received per os drug lizak. The degree of edema was determined using a special installation with an installed micrometer for measuring the thickness of the feet in the time interval from 0 to 24 hours. In addition, the levels of proinflammatory cytokine interleukin-1β and anti-inflammatory interleukin-10 were determined in the blood serum of animals at the same time intervals. Statistics were carried out using the ‘t’ –Student criterion. Results: Under monotherapy with the drug Lysak in children with acute pharyngitis, a decrease in the content of proinflammatory factors, interleukin-1β and Mip-1b, in the oropharyngeal secretion is shown. When studying the effect of the drug on the development of aseptic inflammation (stage of exudation) in the foot of rats, it was found that the drug Lizak had an inhibitory effect on the development of edema in the range of 1-4 hours, after which its effect was not detected (24 hours). In the control group and the “pure” control group, inflammatory edema was detected compared to the initial level (p=0.02) at 4 hours and was not detected after 24 hours. The drug Lysac has the ability to inhibit the development of aseptic local inflammation in the initial stages of its development. Confirmation of the systemic nature of the action of the drug is to reduce the level of pro-inflammatory cytokine-interleukin-1 in the blood serum of animals by 4 hours from the onset of the inflammatory process. Conclusions: The drug Lizak actively reduces the levels of pro-inflammatory cytokines both systemically and with local use and has a pronounced decongestant effect.

Introduction: In recently ears factors of innate immunity both cellular and humoral have been paid considerable attention as they are a protective barrier of a fast response and that is why they are largely concentrated at the intersection of the digestive tract and airways. The data concerning the activity level of factors of innate immunity in the upper airways affected by nonspecific inflammatory processes is insufficient and sparse and therefore the purpose of this research was to study the content of humoral factors of innate immunity in the oropharyngeal secretion (ORS) of patients with chronic infectious inflammatory diseases of the upper airways in remission. Materials and Methods: There was an examination of 16 patients with chronic rhinosinusitis (CRS) of bacterial genesis (15-40 years old), 12 patients with rhinopharyngitis of post-viral genesis (8-16 years old), 12 people with scleroma from 30 tо 52 years of age (atrophic form), 10 patients with chronic tonsillitis in remission (from 10 to 33 years of age) and 11 patients of a control group (practically healthy donors from 12 tо 40 years of age). The content of MIP-1b, defensin-1β, lactoferrin, lysozyme, α-interferon was studied in the nonstimulated OPS. Statistics were carried out using Mann-Whitney U-test. Results: The greatest number of deviations in the decrease in the content of the examined nonspecific protective factors was found in cases of scleroma, chronic tonsillitis and chronic rhinosinusitis (p<0,05). The lack of protective humoral factors of innate immunity can be evidence of local immunodeficiency even in remission, which is a pathophysiological component of the maintenance of chronic inflammation. Conclusion: The decrease int he quantitative composition of factors of innate immunity in the oropharyngeal secretion of patients with chronic infectious inflammatory diseases of the airways is an objective ground not only for a replacement therapy, but also for the use of immune response modifiers from photo-immune modulators to “genuine immune modulators” controlling the state of the factors of both innate immunity and immunoglobulins, primarily of secretory type, the level and functionality of various groups of immunocompetent and accessory cells.

Introduction: Among a large number of immunomodulation agents, a special role belongs to herbal medicines. They differ in relative harmlessness and high efficiency, both with system and local use. Clinical and immunological efficacy of Esberitox phytopreparation (Schaper&Brummer, Germany) in a number of diseases of viral and microbial origin has been shown. This report presents data on the effect of Esberitox on the factors of local immunity of the oral cavity in patients with chronic pharyngitis, tonsillitis and periodontitis with systemic use of Esberitox in monotherapy. Methods: The oropharyngeal secret of 10 patients with chronic tonsillitis (CT), 11 patients with chronic pharyngitis (CP), (all patients after tonsillectomy), 10 patients with chronic periodontitis was investigated. Patients were given monotherapy with «Esberitox» for 10 days (CP), according to the manufacturer's instructions for use of the drug. In addition, 9 practically healthy persons (K) of the same age (18-50 years) were examined. The ELISA method was used to determine the class A immunoglobulins (secretory and monomeric), IgG, α-interferon, interleukin-1β, levels of immune complexes. Statistics: Mann-Whitney U-test. Results: Studies have shown that in patients with chronic inflammatory diseases of the oral cavity there is a decrease in the protective factors of local immunity – the level of secretory IgA, antiviral factor – α-interferon and an increase in the level of pro-inflammatory cytokine – interleukin-1β, monomeric form of IgA and the number of immune complexes. The use of «Esberitox» as a monotherapy was accompanied by an increase in the concentration of class A secretory immunoglobulin, the «normalization» of the α-interferon content (increase in concentration) and interleukin-1β (decrease in content). Conclusion: The resulting positive effects from the use of esberitox allow us to recommend the drug as part of the complex therapy of chronic diseases of the oropharynx, and in the form of monotherapy.

Stylohyoid syndrome (Eagle Sterling syndrome) – a complex of symptoms caused by the change in the position, shape and size of the styloideus process and (or) calcification of the stylohyoideus and submucosal ligaments, resulting in irritation of the dorsal and posterior process and muscle structures. As a rule, this disease is not diagnosed because of the low awareness of practitioners. Patients with different diagnoses are treated by different specialists: dentists, ENTs, neurologists, and prolonged symptomatic treatment is ineffective. In patients with the presence of Eagle Sterling syndrome impaired performance is present and dramatically reduced quality of life, which determines the social significance and relevance of problem of diagnosis and treatment of this disease. Materials and methods: During the period from 2009 to 2020 in the department of inflammatory diseases of ENT-organs of the State Institution «O.S. Kolomiychenko Institute of Otolaryngology of National Academy of Medical Sciences of Ukraine» 13 persons with this pathology (10 men and 3 women) aged from 25 to 60 years, who turned to our institution after unsuccessful treatment by a neurologist, dentist and specialists of other related specialties, were examined and operated. 3 people were diagnosed with a stylo-carotid and in 10 – stylopharyngeal type of SHS. Surgical removal of styloideus process of the temporal bone, depending on the anatomical features of the styloideus process, was performed by external access at the anterior edge of the nodding muscle (10 patients) or transoral access (3 patients). Results: No patients were observed in the postoperative period, the wounds healed with primary intention. The disappearance of the pain syndrome a few days after surgery was noted in 7 patients, in others complaints it persisted up to 1 month, while there was a positive trend, and only 1 patient remained the intensity and nature of the pain syndrome. Thus, patients with the Eagle’s syndrome have a high effect of surgical treatment and relatively short postoperative rehabilitation, which significantly improves their quality of life.

Introduction: Studies of the clinical status, production of antibodies to hemagglutinins of influenza A and B viruses and the content of immune complexes in patients with chronic inflammatory diseases (CID) of the upper respiratory tract (URT) before and within 36 weeks of vaccination after parenteral vaccination Vaxigrip leads to a short-term (~ 6 months) increase in anti-influenza hemagglutinin t itres. According to modern ideas about the mechanisms of antiviral protection, in addition to humoral, mainly due to antibodies, antiviral protection is largely due to the activation of innate immune factors, both systemic and local. Aim: to evaluate in the dynamics of observations the influence of a single parenteral influenza vaccination on the factors of innate immunity in patients with chronic inflammatory diseases of the upper respiratory tract. Material and methods: Among the factors of innate immunity a significant role is played by interferons, the activity of natural cytolytic cells (NK) of various histogenesis, phagocytic cells and non-specific proteins such as defensins, elafins. Therefore, quantitative and functional characteristics of NK-cells, phagocytic absorption activity of polymorphonuclear leukocytes (PMN), systemic content of γ-interferon (IFN-γ) were studied in patients at the systemic level. At the local level, the concentrations of defensin-β and α-interferon were studied in mucosa secretes (MS) according to modern ideas about the state of the mechanisms of innate antiviral immunity. From the autumn-winter period of 2019 to November 2020, 32 donors (control group) and 32 patients with CID of both sexes were examined, 11 of whom were diagnosed with chronic rhinosinusitis, 9 with chronic tonsillitis, and 12 with chronic pharyngitis. No vaccinations were given 1 year before the study. Samples of venous serum and oropharyngeal secretes of all clinically healthy patients, as well as persons with CID were obtained at the initial examination. After parenteral vaccination with Vaxigrip (SANOFI PASTEUR, S.A., France), blood and MS were tested twice more in vaccinated patients: 12 and 36 weeks after vaccination. The obtained samples of experimental material were stored at a temperature of -20 C◦ until the simultaneous determination of innate immune factors (interferons), in particular with the help of reagents from Cytokine, Hema Medica (RF), defensin-β (Hucalt-bio, the Netherlands). Measurements were performed on a microplate enzyme-linked immunosorbent assay "STAT FAX 2100 (USA). Statistical processing was performed using the non-parametric criterion "U" - Mann-Whitney or Fisher's exact method. Differences were considered statistically significant at p <0.05. The results were given in the form of arithmetic mean (M), median (Me) and percentiles (P25-P75). Results: In determining the role of innate immunity factors in vaccination with influenza vaccine, we conducted clinical and immunological examination of patients with chronic inflammatory diseases of the upper respiratory tract, which included systemic determination of γ-interferon, quantitative and functional activity of natural cytotoxic cells, phagocytosis activity at the stage of attraction and capture. Levels of α-interferon and defensin-β in oropharyngeal secretion (MS) were studied. It was found that before influenza vaccination in patients with chronic inflammatory diseases of the upper respiratory tract found an increased content of γ-interferon and decreased phagocytic activity of polymorphonuclear leukocytes. Decreased α-interferon and defensin-β concentrations were detected in MS patients before vaccination. After vaccination, there were positive changes in the direction of increasing the concentration of nonspecific local immunity factor – defensing 1β and partly in the observation period of 3 months after vaccination- α-interferon. Сonclusion: Among the factors of innate immunity in patients with CІD at the systemic level, decreased cytolytic activity of NK, increased levels of γ-interferon and decreased phagocytic function of neutrophils. Decreased concentration of α-interferon and defensin-1β is determined in the saliva of patients with CID. Vaccination of patients with chronic inflammatory diseases of the upper respiratory tract with influenza vaccine has a positive effect on the state of innate immune factors of local and systemic level: concentration of γ-interferon, phagocytic activity of neutrophils and enhancing the functional activity of natural killer cells, increase in saliva of defensin-1β.