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Цель. Cоздание упрощенного макета барабанной полости, соответствующего основным анатомическим ориентирам, для отработки процедуры постановки поршневого стапедиального протеза. Материалы и методы. Для изготовления макета-тренажера использовался шприц объемом 5 мл, который всегда доступен и обладает низкой рыночной стоимостью и в то же время соответствует основным анатомическим параметрам смоделированной барабанной полости. В эксперименте принимали участие 13 человек – ординаторы и врачи, которые не имели опыта подобных хирургических вмешательств. Результаты. По результатам проведенного исследования все участники эксперимента при апробации макета для стапедопластики успешно справились с поставленной задачей. Среднее количество времени, затраченного на установку поршневого протеза, составило 1 мин. 55 сек. При выполнении задания участникам давалось 5 попыток установки стапедиального протеза с соблюдением времени отдыха в количестве 2 минут между подходами. Использование созданного макета экономически более выгодно, удобно для понимания процедуры стапедопластики начинающими специалистами, эффективно в развитии микрохирургических мануальных навыков, которые в перспективе положительно отражаются на результатах при работе с кадаверным материалом животных и живой хирургии стремени. Заключение. По результатам проведенного исследования созданный макет барабанной полости соответствует всем анатомическим параметрам и может успешно применяться в учебной практике для отработки процедуры постановки стапедиального протеза. Purpose. To create a simplified prototype of the tympanic cavity, corresponding to the main anatomical parameters, for practicing the technique of piston stapedial prosthesis placement. Materials and methods. A 5 ml syringe was used to make the model, which is always available and has a low market value, corresponding at the same time to the basic anatomical parameters of the simulated tympanic cavity. The experiment involved 13 participants: residents and doctors having no experience of such surgical interventions. Results. According to the results of the study, all participants successfully coped with the task of testing the stapedoplasty model. The average time spent on placing the piston prosthesis was 1 min. 55 sec. When performing the task, the participants were given 5 attempts to place the stapedial prosthesis with a rest time of 2 minutes between approaches. The use of the created prototype of tympanic cavity is more cost-effective, convenient for understanding the stapedoplasty technique by novice specialists, effective in developing microsurgical manual skills, which in the long term have a positive effect on the results when manipulating cadaveric animal material and in live stapes’s surgery Conclusion. According to the results of the study, the created model of the tympanic cavity corresponds to all anatomical parameters and can be successfully used in educational practice to work out the technique of stapedial prosthesis placement.

The article presents the results of the study of thioldisulphide system by amperometric titration method in the patients with chronic diseases of the upper respiratory tract with the concomitant coeliac disease. The study involved 48 patients with genetically confirmed diagnosis of celiac disease, aged 19 to 45 years. We observed a significant reduction of thioldisulphide index (the ratio of the concentration of SH-and-SS-groups of blood serum), which indicates the resistance tissue disorder and the intensification of free radical oxidation in these patients. The change of TDI may serve as a diagnostic criterion of the efficacy of the therapy.

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Surgical training of specialized specialists in clinical residency requires the development of a wide range of general professional abilities for the possibility of further provision of qualified medical care. Competent mentoring plays an important part in the adaptation of a young doctor and contributes to their preparation for professional tasks. Training surgical skills is an integral part of the educational process in otorhinolaryngological practice. Previously, human cadaveric material was used to practice manual skills, but nowadays its use has heavy restrictions. The possibility of using animal cadaver material for practicing surgical skills led by a mentor in otorhinolaryngology was considered in the experimental and clinical work. Dissection of two heads of rams, three heads of rabbit, and two heads of pig was performed. The anatomical structure of experimental samples was studied in detail, using multispiral computed tomography with subsequent surgical dissection of the cadaver material. An endoscopic tube and a stationary binocular microscope were chosen as methods of optical visualization of the surgical field. Considering the peculiarities of the structure of the anatomy of animals, the optimal list of practicing surgical skills in practical otorhinolaryngology was determined, including paracentesis of the tympanic membrane, shunting of the tympanic cavity, mastoidectomy, ossiculoplasty, septoplasty, and sinusotomy.