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Improvement of therapeutic tools is one of topical issues in modern otorhinolaryngology. The article is devoted to the study of the stimulating effect of physical therapy on the concentrations of secretory IgA in nasal secretions, from the entries of auditory tubes and nasopharynx in the patients suffering from adenoiditis, rhinosinusitis, and exacerbation of chronic otitis media. The increase in clinical and immunological efficiency when using low-frequency ultrasonic cavitation therapy in combination with photochromotherapy in combined treatment of these conditions was evaluated in dynamics by measuring concentrations of secretory immunoglobulin levels in nasal secretions using enzyme immunoassay technique (Vector-Best, Russia). The purpose of this study was to improve clinical and immunological effectiveness of treatment of patients with chronic adenoiditis, sinusitis and exacerbation of chronic purulent otitis media when using low-frequency ultrasound cavitation and photochromotherapy in complex therapy. The study involved 54 patients. The control group consisted of 25 patients who received conventional treatment (topical and systemic antibacterial and anti-inflammatory drugs, unloading and elimination procedures, symptomatic and restorative therapy) and the main group of 29 people who, in addition to etiotropic therapy, received low-frequency ultrasound cavitation irrigation of the nasal cavity followed by a course of photochromotherapy. Evaluation of the effectiveness of treatment was carried out by studying the barrier state of the nasal mucosa by the levels of secretory IgA concentration by the method of enzyme immunoassay. The low-frequency ultrasound cavitation in combination with photochromotherapy as an adjunct to etiotropic treatment in patients with adenoiditis, rhinosinusitis and exacerbation of chronic otitis media promotes an earlier increase in secretory IgA concentration of nasal mucosa and entry of the auditory tube when compared to standard treatment methods. The trend to IgA increase by 14 days reached maximal values and was slightly decreased month later. An early increase in the concentration of secretory IgA in nasal secretions and the entry of auditory tube, and positive clinical results of treatment are observed when low-frequency ultrasound cavitation is used in etiotropic therapy in combination with photochromotherapy in patients with adenoiditis, rhinosinusitis and exacerbation of chronic otitis media. The results substantiate the opportunity of introducing these physical methods of physical therapy into complex etiotropic therapy, as a non-invasive and effective method.

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Introduction. According to the literature, oxidative stress is described as one of the main factors in the pathogenesis of chronic suppurative otitis media, supporting the inflammatory process at the local level. The transition of inflammatory mediators to the systemic level is associated with the risk of developing ear purulent-destructive complications. The study of the products of lipid peroxidation in comparison with morphological changes in the structures of the temporal bone will justify the tactics of the operation.Aim. Comparison of the levels of lipid peroxidation products at the local and systemic levels in chronic suppurative otitis media, depending on the nature of pathomorphological changes in the structures of the temporal bone.Materials and methods. A prospective study of 130 patients with chronic suppurative otitis media at the age of 20-62 years with a verified diagnosis of chronic suppurative otitis media, admitted for surgical treatment, was carried out. To study the indicators of oxidative stress at the systemic level, the blood serum of patients was used; at the local level, the bone biomaterial obtained from patients during the surgical treatment of chronic suppurative otitis media was used. The quantitative determination of the primary, secondary and final products of peroxidation was carried out in the groups of patients with separate registration of lipoperoxides in the heptane and isopropanol phases of the lipid extract by spectrophotometry.Results and discussion. In the observation of patients with morphological signs of purulent destruction of the temporal bone, not only a local level of inflammation activity, but also a systemic level of an unfavorable outcome was revealed in two variants: osteoproliferation or osteonecrosis of the bone tissue of the temporal bone in chronic purulent otitis media with a constant threat to the patient's life due to intracranial purulent complications.Conclusion. The appearance in low concentrations of lipid peroxidation products in serum in patients with chronic purulent otitis media substantiates the need for a behind-the-ear approach in reconstructive-sanitizing otosurgery even with minimal clinical manifestations and CT scan data, since at the preclinical level it confirms the osteonecrotic type of bone remodeling with the risk of delayed death.

BACKGROUND: The negative effect of impulse noise and vibration when using small arms on the auditory analyzer in athletes is less investigated and justifies the need for an extended study of volunteers with normal hearing. The study of the initial characteristics of the impulse noise and vibration effects of sports weapons on the auditory analyzer will make it possible to determine the early risk factors for the occurrence of high-frequency hearing loss in shooters by the number of shots from sports weapons and the recovery time of auditory function. AIMS: To conduct a comparative analysis of the effect of impulse noise and vibration exposure depending on the technical characteristics of small arms on volunteers with normal hearing and, based on the results obtained, unify the methods of forecasting and prevention. MATERIALS AND METHODS: At the Department of Otorhinolaryngology of the South Ural State Medical University of the Ministry of Health of Russia, 30 fifth-year students were examined following continuous recruitment of volunteers between September 2022 and November 2022. All interviewed participants gave voluntary written consent to participate in the survey and to the test level of impulse noise. Based on the current regulatory documents, all volunteers were surveyed and underwent audiological and vestibulometric studies, the technical characteristics of noise and vibration exposure as a risk factor for the early development of presbycusis were determined, and ways of preventing hearing loss through lifestyle were proposed. RESULTS: The comparative analysis of the influence of impulse noise and vibration effects showed a dependence on the weight of the small arms cartridge, number of shots, and adaptation time of the auditory analyzer in volunteers with normal hearing considering the changes in the high-frequency spectrum of increasing audiometry thresholds from the average value of indicators. CONCLUSIONS: The use of active explanatory propaganda among young people on a careful attitude to the physiological state of the cochleovestibular apparatus avoids the risk of early presbycusis development.