Fungal flora is one of the causes of inflammatory, including polypous, processes in the nasal cavity. In this regard, studies aimed at reducing the effect of fungal sensitization (FS) on the course of chronic polypous rhinosinusitis (CPRS) are relevant. The objective of the study was to evaluate the effect of various treatment options on the clinical course of the disease in patients with chronic polypous rhinosinusitis against the background of sensitization to fungi. The study included 90 patients with chronic polypous rhinosinusitis in combination with FS. The patients were divided into two groups – the first clinical group (G1) and the second clinical group (G2). G1 patients received allergen-specific immunotherapy (ASIT) according to the scheme. G2 patients received basic treatment. Evaluation of the clinical efficiency of ASIT was made based on complaints, assessment of symptom severity on a visual analog scale (VAS), and rhinoendoscopic examination. The treatment outcomes were evaluated on a 4-point scale, with excellent results (4 points) – complete remission of the disease during the follow-up period (6–12 months); good (3 points) – exacerbation of the disease 1-2 times a year, in mild form and removed by expectant treatment; satisfactory (2 points) – the number of exacerbations did not decrease. The use of ASIT therapy is pathogenetically justified and leads to a significant improvement in the clinical condition of patients with CPRS with FS.

Congenital anomalies of the ossicular chain are a rare condition in clinical practice. In literature described different variants of the ossicular chain anomaly from stapes footplate ankylosis to complete aplasia of the ossicular chain, oval, and round window. Possible congenital ossicular chain anomaly should be suspected in case of non-progressive conductive hearing loss with a normal ear drum during an otoscopic examination, without a history of previous ear infections or trauma. In this article, we described the clinical case of congenital ossicular chain anomaly presented as fixed incus. Stapes was presented as single, straight, broad crus that were attached to the central part of the footplate. Stapedius tendon was absent. The footplate was completely mobile. Exploratory tympanotomy was performed to confirm a diagnosis of congenital ossicular chain anomaly. The ossicular chain was reconstructed with PORP titanium prosthesis. Furthermore, a literature review was done, conclusions presented.

Serous otitis media is a serosal inflammation of the mucous membrane of the auditory tube and the tympanic cavity which develops on the background of Eustachian tube dysfunction. It is characterized by the presence of seromucous exudate in the tympanic cavity. The disease occurs more often in children than adults. The objective of the research was to compare the effectiveness of different methods of treating serous otitis media. Materials and methods. The study included 46 patients with serous otitis media at the age of 22-55 years. There were 26 females and 20 males who were treated as inpatients and outpatients in the department of microsurgery of ENT-organs in Ivano-Frankivsk Central City Clinical Hospital during 2012-2016. Disease duration ranged from 10-15 days to 1 month. In all the patients, serous otitis media developed on the background of persistent allergic rhinitis. All the patients underwent comprehensive examination: their complaints as well as anamnestic data were analyzed, ENT examination including the endoscopic examination of the nasal cavity and the nasopharynx, otoscopy, audiometry, impedancemetry and laboratory investigations was performed. All patients were divided into 2 groups: Group I included 21 patients receiving conservative therapy for allergic rhinitis and serous otitis media; Group II comprised 25 patients receiving conservative therapy for allergic rhinitis and treatment of serous otitis media applying myringotomy and bypass surgery of the tympanic cavity.Results. The analysis of the study revealed that in 9 patients of Group I, an improvement in hearing occurred on the third-fourth days after treatment. In 12 patients, treatment was ineffective. 14 patients of Group II who underwent myringotomy with the evacuation of the fluid from the tympanic cavity and subsequent injection of glucocorticoids into the tympanic cavity noted an improvement in hearing immediately after the procedure or the day after. In 11 patients of Group II, a thick mucous exudate was obtained during myringotomy. These patients underwent bypass surgery. The shunt was removed after a thorough cleaning of the tympanic cavity as well as the restoration of the auditory tube function. Conclusions. Myringotomy is more effective and rational method of treating serous otitis media. Myringotomy with subsequent bypass surgery is recommended for patients with a thick mucous exudate in the tympanic cavity in order to prevent chronic adhesive otitis as well as to perform a complete sanation of the tympanic cavity and to restore the auditory tube function.

The paper presents modern competency-based approach to teaching otorhinolaryngology using new technologies that will improve the assimilation of new material considering each student’ knowledge, skills, and experience. The competency-based approach can be successfully implemented based on active learning, introducing elements of professional activity in the educational process. While analyzing clinical cases, business and learning games, the student becomes a specialist and future’s team member. The quality of education should be improved through an effective organization and informatization of the educational process, the introduction of the latest research results in teaching practice, the provision of high-quality teaching and the development of modern learning and teaching base.

Diagnosis and treatment of patients with complaints of the “lump in the throat” remain a complex multidisciplinary problem. This is due to the polyetiology of factors causing similar symptoms and an empirical approach to the treatment. “Lump in the throat” is one of the clinical manifestations of upper respiratory tract paresthesia. According to the literature data, there is the reason for referral to an otolaryngologist in 4.1 to 5.0% of cases. The objective of the research was to optimize and improve the diagnosis and pathogenetic approach to the “lump in the throat” treatment. Materials and Methods. To achieve the specified objective, a comprehensive examination of 38 patients who sought an otolaryngologist’s medical advice, complaining of a “lump in the throat” at the age of 18-45 years (26 women and 12 men), was performed. For the purpose of optimal diagnostics, general clinical examination, examination of ENT organs, endoscopic examination of the nasal cavity and nasopharynx, microlaryngoscopy were performed; the condition of patients’ psycho-emotional status was assessed (consultation of psychologist and psychiatrist). Results. A comprehensive clinical study of 38 patients with complaints of the “lump in the throat” at the age of 18-45 years was performed. Psychosomatic disorders were detected in 26 patients; ENT organ diseases were present in 12 patients. All patients received treatment depending on the diagnosed somatic, otorhinolaryngological and psychosomatic pathology.