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3/1997

Contents
3

Editorial

Original Papers

. . , . , . .

. . . -

W. J. Mann. OTORHINOLARYNGOLOGIC
MANIFESTATIONS
8
DURING PREGNANCY

. . ,. . ,. . , . . , . . ,
. . , . . .

L. A. Goryachkina, B. A. Chernyak, N. M.
Nenasheva,
I.
I.
Vorzheva,
A.
S.
Logvinenko,
M.
V.
Beda,
.
.
Mednikova.
CLINICAL
EFFICACY
OF
FLIXONASE
IN
TREATING
PER10
RENIAL ALLERGIC RHINITIS

. . . -

V. A. Grineva . CLINICAL AND MICRO


BIOLOGICAL ASPECTS IN DIAG
NOSIS AND TREATMENT OF
15
SPHENOIDAL SINUSITIS

. . .

19

. 3. , . . , . . , . . , . . .

. 3. , . . , . . .
XVI

3/1997

N. K. Sanzharovskaya. OSTEOMA OF
PARANASAL SINUSES
5. Z. Piskunov, V. S. Barsukov, F. N.
Zavialov, I. S. Piskunov, O. N.
Kuznetsova. PATHOGENESIS AND
MORPHOGENESIS OF ANTROCHOANAL POLYPS

22

G. A. Gadzhimirzaev, A. A. Gamzatova, Yu.


A.
Dzhamaludinov,
R.
G.
Gadzhimirzaev a. CRITICAL EVALUATION OF SOME CONCEPTS IN
SURGICAL TREATMENT OF NASAL
SEPTUM AND EXTERNAL NOSE
DEFORMITIES
Current Events

. . , . . , . .
, . . .

P. Van Cauwenberge, I. J. M. Dhooge. HISTAMINE AND NEUROPE-PTIDES

28

-JQ
Jy

Anniversaries 40

Meeting Calendar


,
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. 3. , 1997

3/1997

. ,
. .

(J. . Foreman, 1987).


1927 . . Lewis

. ,
. -IgE , . 15
,
, .
, ,
, ,
.
, (. Celander, . Folkov, 1953).
, SP, ,
CGRP NKA (J. . Foreman, 1987). ,
(VIP)
(P. J. Barnes, 1987).
NPY,
(J. S.
Lacroixetal., 1993).
(SP)
, ,
, . NK, SP- , (J. R. Carstairs, P. J. Barnes,
1986). SP ,
, (.
Van Cauwenberge et al., 1986; J. . Baraniuk et al.,
1991). , , , (J. . Foreman et al., 1983: P.
Van Cauwenberge et al., 1987).

VIP, 28 .
, VIP, -

12.018:577.175.824].08


(, )

(R. Uddman, R. Sundler, 1979). VIP


,
. VIP ,
(P. J. Barnes, 1987).
SP VIP ,
.


.
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10 : SP (50 /), VIP (50
/), 48/80 (/) (0,1 / ).
10 .
. 2
1 ,
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(
),
,
. .


J. . Foreman etal., (1983), , SP VIP
(- .
, SP VIP . -

* . . . . . .
3/1997

. . , . . . , 1997

. 1.
()

.

,
, .
:
( , 2-)
, -.

8 , SP, VIP
10 : 5, 50 100 / SP
VIP; 0,03, 0,15 0,3 / (P. van
Cauwenberge et al., 1987).
. 10 .

(-

).
. 1- . 2- 10 . 3-
300 2-- .
.
, 3-
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( ).

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, .
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SP VIP -:
.

- .

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(0,3 1,2 ). -

,
-, , 1 ,

. 2.
VIP, SP (|_:5
/ SP VIP 0,03 / ; :50 /
VIP SP 0,3 / ; :100 / VIP
SP 0,3 / ), ,- (-).
3/1997



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.

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,

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,
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0,2 (10, 20, 40
80 /). 30- . 3 13
.

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3, 13
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,
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, ,
.

, ,
SP , ,- . .
. : SP
,
. ,
3/1997

.
,
, : ,
, , .
SP VIP ? -
SP VIP , VIP .
, ,
SP
.
, SP
, NKA.
NK,- (. . Lee et al., 1982).
, ,
SP , (P. J. Barnes, 1987).
SP . , SP
, , ,
SP , , - , .

,
, SP VIP,
.
. ,

(. L. Mosimann et al., 1993),
, .

1. Baranjuk J. ., Lundgren J. D., MullolJ et al. Substance P


and neurokinin A in human nasal mucosa // Am. J. Resp.
Cel. Molec. Biol. - 1991. - Vol. 144. - P. 228-236.
2. Barnes P. J. Neuropeptides in the lung: localisation, function,
and pathophysiologic implications // J. Allergy Clin.
Immunol. - 1987. - Vol. 79. - P. 285-295.
3. Carstairs J. R., Barnes P. J. Autoradiographic mapping of
substance P receptors in lung // Eur. J. Pharmacol. 1986.
- Vol. 127. - P. 295-296.
4. Celander O., Folkow B. The nature and the distribution of
afferent fibres provided with the axon reflex arrangement //
Acts Physiol. Scand. - 1953 . - Vol. 29. - P. 359-370.
5. Foreman J. C., Jordan C. C., Oehme P., RennerH. Structure
activity relationshi p for sone substance P-related peptides
that cause wheal-and-flare reactions in human skin // J.
Physiol. - 1983. - Vol. 335. - P. 449-465.
6. Foreman J. C. Neuropeptides and the pathogenesis of allergy //
Allergy. - 1987. - Vol. 42. - P. 1-11.
7. Lacroix J. S., Van Cauwenberge P., Lundberg J. M.
Peptidergic mechanisms in nasal hyperreactivity // Allergy.
- 1993. - Vol. 48 (Suppl. 16). - P. 21.
8. Lee C. M., Iversen I. L., Hanley M. R. et al. The possible
existance of multi pie receptors for substance P / / Naunym
SchmiedebergsArch. Pharmacol. - 1982. - Vol.318. - P.
1982.
9. Lewis T. The blood vessels of the human skin and their
responses. London: Shaw ans Sons, 1927.
10. Mosimann B. L., White M. V., HohmanR. J. etal. Substance P,
calcitonin gene-related peptide, and vasoactive intestinal


/
0,045

Saline I

Saline 2 820 840 VIP 20 \14 0,3 Ml,2 i 0,3

\2

. 3. ()

( -) (6). : ; Hi: .
5
,
10 ;

5 ;
10 .

m
m

/'/
3000

VIP 40 1,2

-S20

10

/'/
3000

20

. 4. ( ) SP ,
) 3 , ) 13 .

peptide increase in nasal secretions after allergen challenge in


atopic patients // J. Allergy Clin. Immunol. - 1993. Vol.92. - P. 95-104.
11. UddmanR., Sundler F. Vasoactive intestinal polypeptide
nerves in human upper respiratopy tract // ORL. 1979. Vol.41. -P. 221-226.
12. Van Cauwenberge P., Doyle W. J., SkonerD. F. Reactivity of
the nasal mucosa of the rhesus monkey to substance P, VIP,
compound 48/80 and histamine // Coyas A. (Ed.) Abstracts
of the II ERS Congress and 5th ISIAN. - Athens, 1986. - P.
10.
13. Van Cauwenberge P., Doyle W. J., RihouxJ.-P. etal. Effect
of cetirizine 2hcl and cimetidine on the rhesus monkey to
histamine, 48/80, substance P and vasoactive intestinal
polypeptide // Cetirisme Symposium Proceedings.
Brussels: UCB, 1987. - P. 17-22, 88-93.

P. Van Cauwenberge, I. J. M. Dhooge. HISTAMINE


AND NEUROPEPTIDES
In order to determine whether of not neurous system plays a
role in pathogenesis of inflammtory and allergic reactions the
authors investigated effects or neurotransmitters
substance P and VIP on human's and monkey's nasal
mucosa. Wheal and flare reactions caused by injection of SP
and VIP were considerably inhibited by Hl-blockers. Nasal
challenge with SP and VIP caused dosedependent
hypersecretion and histamine release in the nasal secretion in
monkeys. The challenge also produced increase of nasal
resistance in humans. These findings suggest involment of
neuropeptides in nasal allergy, which is a good example of
neurogenic inflammation.

28.12.96
3/1997


618. 3-06:616. 21/. 281-08

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1. Freche ., FontanelJ. P. (Eds). L'obstruction nasale. Paris:


1996.
2. Getchell . V., Doty R. L., Bartoshuk L. M., SnowJ. B. (Eds).
Smell and taste in health and disease. New York: 1991.
3. Mann W., JonasJ., Riede U. N., Beck Chl. A contribution to the
pathegenesis of otoscrerosis // Arch. Otorhinolaryngol. 1980.
-Vol.226. - P. 161.
4. Munker G. Tubenfunktionsmessung Habilitationsschrift.
Freiburg, 1972.
5. RosenburgB., Fikentscher R, Klinische olfactologie und gustologie.
- Leipzig: 1997.
6. Schiffmann S. Taste and smell in disease // New England Journal of
Medicine. - 1983. - Vol. 308. - P. 1337.
14.04.97

W. J. Mann. OTORHINOLARYNGOLOGIC MANIFESTATIONS DURING PREGNANCY


Various otorhinolaryngologic manifestations developing during
pregnancy, their diagnosis and treatment are described. The author
stresses importance and high incidence of the so-called "patulous
eustachian tube" in pregnant women, this entity is frequently
overlooked or unknown. Most ORL symptoms occuring during
pregnancy resolve spontaneously after parturition. Nevertheless
the lasting sequelae like conductive hearing loss due to
otosclerosis, persistent rhinosinusitis, allergy or some forms of
granulomas may require defi nit e treatment by
otorhinolaryngologist and are lasting witnesses of pregnancy.

3/1997


616.211 -002-0563-085.218.2/.3-036.8-07

10

. . , . . , . . , . . . ,
. , . . , . .


, 10
20% (. Okuda, 1988; P. A. Pedersen, E.
R. Weeke, 1981).

() (. Sibbald, 1995).
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1987; C. Svensson, M. Andersson, G. G. A. Passonetal,
1990).
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, .

1.
. . ., 1996, 4, . 2641.
2. Bentley A. M. Immunohistology of the nasal mucosa in
allergic rhinitis: increases in activated eosinophils and
epithelial mast cells. J. Allergy Clin. Immunol., 1992, 89,
877-883.
3. Boner A. L. A double blind comparison of fluticasone
propionate aqueous nasal spray (FPANS), 100 mkg given
once daily, FPANS 200 mkg given once daily, and placebo
aqueous nasal sprey given once daily, in the treatment of
seasonal allergic rhinitis in children aged 411 yrs.
Allergy, 1992,12, 173 (Abstract).
4. Boner A. L., Sette L. Rhinitis in children: efficacy and
safety of anew intranasal corticosteroid. Eur. Resspir. Rev.,
1994,4,20,271-273.
5. Eradding P., Feather I. H., Wilson S. Immunolocalization
of cytokines in the nasal mucosa of normal and perennial
rhinitis subjects. J. Immunol., 1993, 151, 3853-3865.
. S. S., Barrows A. A., DeCotiis B. A., Settipane G.
A., Corrao W. M. Airway hyperresponsiveness in
allergic rhinitis. A risk factor for asthma. Chest, 1987, 91,
671-674.
7. Brydon M. Look up more noses. // Paper presented at
3/1997

asthma plus rhinitis meeting. London, 1993.


8. Hording S. M. The Human pharmacology of fluticasone
propionate. Respir. Med., 1990, 84, 25 - 59.
9. Juniper E. F., Guyatt G. H. Development and testing of a
new measure of health status for clinical trials in
rhinoconjunctivitis. Clin. exp. Allergy, 1991, 21, 7783.
10. Meltzer E. O. Is the successful control of perennial rhinitis
achievable? Eur. Resspir. Rev., 1994, 4, 20, 266-270.
11. Mercer M. J,, VarNic Kerk C. H. Clinical characteristic
of childhood asthma. S. Afr. Med. J.,1991, 79, 77-79.
12. Okuda M. Allergic rhinitis. Asian med. J. Japan, 1988,31, 2,
108-111.
13. Orgel H. A., Meltzer E. O., Bierman W. Intranasal
fluocortin butyl in patients with perennial rhinitis: a 12month efficacy and safety including nasal biopsy. J.
Allergy Clin. Immunol.,1991, 88, 257-264.
14. Pedersen P. A., Weeke E. R. Allergic rhinitis in Danish
general practice. Allergy,1981, 36, 375-379.
15. Phillipps G. H. Structure-activity relationshiips of
topically active steroids: the selection of fluticasone
propionate. Respir. Med., 1990, 84, 19-23.
16. Pipkorn U,. Proud D., Lichnenstein L. M., Kagey S. A.,
Norman P. S., NaclerioR. M. Inhibition of mediator
release in allergic rhinitis by pretreatment with topical
glucocorticosteroids. N. Engl. J. Med.,1987, 316, 15061510.
17. Prieto J. L., Gutierrez V., Berto J. M., Camps B.
Sensitivity and maximal response to methacholine in
perennial and seasonal allergic rhinitis. Clin. Exp.
Allergy, 1996, 26, 61-67.
18. Proctor D. F., Adams G. K. Physiology and pharmacology of
nasal function and mucus secretion. Pharmacol. Ther.
Bull., 1976,2, 493-509.
19. Settipane R. J . , Hagy G. W., Settipane G. A.
Development of new asthma and allergic rhinitis in 23year follow-up of college students. J. allergy Clin. Immunol.,
1991,87,232.
20. Sibbald ., Rink E. Epidemiology of seasonal and
perennial rhinitis. Clinical presentation and medical
history. Thorax, 1991,46, 859-901.
21. Sibbald B. Epidemiology of rhinitis // Management
update in rhinitis & Nasal polyposis. A symposium report.
Lisbon, Portugal, 1995, 6-11.
22. Svensson C., Andersson M., Parsson G. G. A., VengeP.,
Alker U. Albumin, bradykinins, and eosinopil cationic
protein on the nasal mucosa surface in patients with hay
fever during natural allergen exposure. Allergy Clin.
Immunol, 1990, 85, 828-833.
15.03.97.
L. A. Goryachkina, B. A. Chernyak, N. M. Nenasheva, I.
I. Vorzheva, A. S. Logvinenko, M. V. Beda, . .
Mednikova. CLINICAL EFFICACY OF FLIXONASE IN
TREATING PERRENIAL ALLERGIC RHINITIS The
paper reports data on the clinical trial of Flixonase
(fluticasone propionate 0,05% aqueous nasal spray - FPANS) in
treatment of 28 patients with severe and moderate symptoms of
perrenial allergic rhinitis. The patients received FPANS in a
daily dose 200 ug during 8 weeks. Complete control of all
rhinitis symptoms (nasal blockage, rhinorrhea, itching and
sneezing) was obtained in 79% of the patients. In cases of
severe allergic symptoms daily dose of 400 ug was effective.
High topical anti-inflammatory activity of FPANS provided
effective symptoms control by the end of the first week of
treatment. Even in most severe cases monotherapy with FPANS
was reliable and spared them the necessity of using
antihistamines and decongestants. FPANS was well tolerated
by the patients and in 3 (11%) cases only slight irritation of
nasal mucosa was noticed, but in no case did it become a
reason for reducing the dose or discontinuance of the treatment.


616.216.23-002-078]-08

. .



- (. . - .,
1982). ,
,
1,5 2% (. 3.
, . 3. , 1991).

,
.
.
(. . , 1994; . 3.
., 1995). ,

(. A. Shugar et al., 1981; . .
., 1991).


, , , , , IV . . (. VanJohnson et al., 1988; D. P. Dooley et al., 1992; M. R.
McGinnisetal., 1992).
, . . (. . . , 1989)
, 66% . , 88% , . . .
.
, .
. . (1989)
.

.

(. J. Carrazana et al., 1991).

. . , 1997


,
, (. I. Lana-Peixoto et al., 1992).

1993-1996 . - - 432
. 98
(22, 7%)
.
,
- . . ,
( 4200591 18.02.94).
-
, ,
, . , ""
5% .

. , -.
.



: (25,5%), (21,4%),
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(6,1%) (. 1).

(72,3%). ,
. - 3/1997

21,4%

1. , .

9,5%

4,8%

Candida
Penicillium
Aspergillus

3,8%
Alternaria . 2. ,

61,9%


- (34%)
- (25%).
21 .
14 67 , 15,
6.
1 15 . , 66,7%
Candida, 23,8% Penicillium.
,
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, . 41,1% , 35,3% 17,6% . 3/1997

4
. .
.
(71,4%), , .
(61,9%
),
(57,1%), (42,8%),
(33,3%).
(50%)
(35,7%) .

(14,3%). 28,6%

. 3.
.
60%
"".

, " ".
,


. ,
,
.
- 85,7% .
38%
, 43%, 19%.
,
.

, . , (52,4%)

. , (. 3).
Candida. ,

. 4. .
.

.
28,6% (. 4). , . , Penicillium. -,
.
19% .

. .
.
, ,
. . , 0,1%

. -

0,5% .


,
, in vitro. 3/1997


-.
() 0,63
10 15
./2
. 3
7.

,
Candida,
Penicillium
.
5 6 . 87,5% 7 9-
. 2 ( , )
. . 4,8% .

1.
: (25,5% ); (21,4%) - (47%).
2. 66,7%
Candida.
3. ,


.

.
4.
,

.
5. 0,1%
87,5%
.

1. . ., . ., . .

// . . - 1991. - 3. - . 81-83.
2. , . .
., 1989.
3. . . 3/1997

// . . 1994. 2.
- . 62-63.

4. . ., . ., . . . ., 1982.
5. . 3., . ., . . /./ .
. - 1995. - 2. - . 41.
6. . 3., . 3.

. . ., 1991.
7. Carrazana E. J., Rossitch E. Jr., Morris J. Isolated central
nervous system aspergillosis in the acquired
immunodeficiency syndrome // Clin. Neurol. Neurosurg.
-1991. - Vol. 93, N 3. - P. 227-230.
8. Dooley D. P., Hollsten D. A., Grimes S. R., Moss J. Jr.
Indolent orbital apex syndrome caused by occult
mucormycosis //J. Clin. Neuroophthalmol. 1992.
Vol. 12, N4. - P. 245-249.
9. Johnson C. D., Brandes W. Invasive aspergillosis of the
sphenoethmoidal sinuses in an immunocompetent host / /
J. Amer. Osteopathol. Ass. - 1992. - Vol. 92, N 8. - P.
1047-1051.
10. Lana-Peixoto M. I., Lana-Peixoto M. A. Aspergilose
invasiva do seio esfenoidal e paralisia do sexto nervo / /
Arg. Neuropsiquiatr. - 1992. - Vol. 50, N 1. - P. 110-115.
11. McGinnis M. R., Campbell G., Gourley W. K., Lucia H.
L. Phaeohyphomycosis caused by Bipolaris spicifera: an
informative case. // Eur. J. Epidemiol. 1992. Vol. 8,
N3. - P. 383-386.
12. Sugar M., Mortgomery W., Hyslop N. Alternaria sinustis //
Ann. Otol. (St. Louis). - 1981. - Vol. 90. - P. 251-254.
13. Van-JotmsonE., line L. ., Julian . A., GarciaJ. H.
Bilateral cavernous sinus thrombosis due to mucormycosis //
Arch. Ophthalmol. - 1988. - Vol. 106, N8. - P. 10891092.

06.02.97

V. A. Grineva. CLINICAL AND MICROBIOLOGICAL ASPECTS IN DIAGNOSIS AND


TREATMENT OF SPHENOIDAL SINUSITIS

Clinical study which included indwelling catheterization of


sphenoidal sinus via its natural ostium and cytologic and
oacteriologic examination of the sinus content as well as
contrast enhanced X-rays demonstrated inflammation in
sphenoidal sinus in 22.7% of patients with chronic and
recurrent sinusitis. Among the patients with spenoidal
sinisitis bacterial infection was revealed in 25.5% of the
cases, fungal and bacterial-fungal associations - in 21.4%
and 47% respectively. Candida species were isolated in
66.7% of the cases of fungal and bacterial-fungal
sphenoidal sinusitis. The study demonstrates correlation
between isolation of Candida species and atrophic
degeneration of sphenoidal and nasal mucosa on the one
hand and between isolation of Penicillium species and
hyperplasia of the mucosa on the other. Systemic antifungal
treatment as well as local administration of Pimafucin
and local laser therapy provided effective management
of sphenoidal sinusitis.


616.216.23-006.34.03

. .


.
,

.
,

.
,
.
Z. Manollidis . (1970),
51% ,
22%,
3,1%,
1,7%, 0,9%.

, (. .
. . , 1972).

.
. .

. "" ,
(. . , . . , 1973).
.
. . (1980), . . .
(1990), . . . (1991)
,
,
. ,
(. . .
1971; . . , 1972; . . . 1984).
,
,
,
. , . . (1968) . .
(1969, 1970, 1994) , . . (1967)
. . (1970) .
. X. (1975)
, . . , . .
(1972) . . .
. (1989), . . .
(1987)
, . .
(1982) , . . (1990)
, . . .
(1994)
.
:
, . ,
. (. . . (1994).
. , . . (1973)
. . , 1997

12000 23 , .
30-
62
. 54, 8.
15 68 .
:
34 , 14 (23%) ,
3 (5%) .
11 (18%)
: 6 (10%) , 3 (5%) , ,
, 2 (3%)
(. .).
,
. , -,
, . (7 )

,
.
, . , , .
, ,
.
,
, .
, , , .

, .
,

33 .
52
1990 16 ,

.
1957
:
.
, , .
.
. 1990 ,
3/1997

20

15-20

,
,

,
,

2 1-30

31 -40

11

41 -50

51

34

14

16

17

14

62

33 ,
,
. , , ,

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, .
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.
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.
. , 55 ,
,
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,
. , , , ,
, .
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.
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.
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"" 6 (.
), 3/1997

.
. ,
.
,
, . , "" ,
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.
, 2 2
. . , .
.
,
.
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, (, , ), , .
,
.
,
. ,
.

1. . . // , - , 1972. -.
9, . 192-197.


21

""
. (
).

2. . . ,
// . . 1969. . 3., .
48-51.
3. . . , // . . 1970. 4. .
29-36.
4. . ., . 3.
// .
., . . . - 1987. - 1. - . 59-61.
5. . . ,
// . . 1994. 2. - . 98-99.
6. . . , // . . - 1968. - 11. - . 88.
7. . ., . . ( ). .,
1972.- 90.
8. . .
// . . 1972. 4. . 104 106.
9. . . ,
// . 1967. 6. . 461-462.
10. . .
// . ., .
. . - 1990. - 3.- . 78.
11. . ., . .
//
. . - 1990. - 1. - . 74-76.
12. . ., . ., . ., . ., . . // . 1994. 3. .
11-14.
13. . ., . ., . .
,
// . ., . . . 1989. 6. -.
59-60.
14. . ., . .
, // . . - 1984. - 6. - . 87-88.
15. . . //
. . - 1972. - 10. - .72-73.

16. . ., . .
//
. . - 1973. - 2. - . 83.
17. . ., . ., . .
,
// . .,
. . . - 1991. - 5. - . 81-82.
18. . ., . . // . . 1994. ( 2), .
93-94.
19. . .
,
// , . 1982.
6. - . 69-70.
20. . .
14 // . 1970. 4 . - . 99-101.
21. . ., . ., . .
// . ., . . .
1971. - 5 . -. 112-113.
22. . X.
// , 1975.- . 5. - . 96-98.
23. . ., . . / /
, . - 1972. - 1. - . 92-93.
24. Manclidis L. Danulidis J. Komplication bei nasenbenhohlen
osteomen // Z. Laryngol. Rinol. - 1970. Bd. 49, N 12. - S.
833-836.
6.02.97

N. . Sanzharovskaya. OSTEOMA OF PARANASAL


SINUSES
The author presents a series of 62 cases of paranasal sinuses
osteoma. There were 54 male and 8 female patients aged 1568. The tumor affected frontal sinus in 34 (54%) patients,
ethmoidal and maxillary sinuses - in 14 (23%) ana 3 (5%)
patients respectively. In 11 (18%) cases osteoma occupied
several sinuses: in 6 (10%) - ethmoidal and frontal, in 3 (5%) all sinuses and nasal cavity on one side, in 2 (3%) - nasal
cavity only. Clinical presentations, diagnosis and surgical
technique are described. Two unique cases are presented by
observation of osteoma growth during 33years and multiple
giant "dead" osteoma which occupied several sinuses.

3/1997


616.215/.216. 1-006.5-002-072.1

'22

. 3. , . . , . . , . . , . .




- (.
3. , 1995; . . ., 1997; .
Stammberger, 199I; Z. Crampette etal., 1995).

,
() ,
().

72
10 58
9 . 12 .
,
-,
. 4 ; 4 .

() , ,
,

.

,
,
.

'

..

JgA

. 30
,
JgA .

( )
.

,

,
, . ,
10% . 710
-.

"Karl
Storz" ( 0, 30, 70)

.
.
,
,
{. 1).
, ,

. ,

.

,
.
.
. ,
, , ,
.

,
.
-

. 1. ., 27 . 1/4 .

3/1997

, 1997

4,
10.

, ,
.

,
(. 2, , 6, , ).

, .
, -

. 2. -
().
.

.
,
.

,
,
, , ,
-

3/1997

.

IgA.

0,1 0,2 /, 0,2 0,5 /, 0,5 2,3 /.
IgA 3,4 5,6 /. ,
IgA .

, , , . , ,
, .

4 , 2 - .

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(PC-), ,
. 10
. 42
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, .


, .

,
, .
3/1997


: , (. 3),
, , (.
4). , ,

(. 2, , ).
,
:
,


.
10 (. 2, ),
. 2
, .



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-
(. 5, , ). ,

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,
,
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.
. , , , .


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, ,
.
.

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.
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; "" (
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.
,

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, .

. 4. ., 23 .
, - , .
.

. 5.

() (). -. . 200, . 120.


. 6. . -. . 120.

.
(. 7)
.

,
,
.

, .
Zuckerkaudl 1893 .
,
A. Onodi (1922).
. ,


.
,
,
3/1997

. 7. . -.
. 120.

. , (
18
25920 ),
, . , .

. Bachert (1986) U. Ganzer (1989), ,
, ,
.
, ,
,
.
.


,


.

,
. ,
,



.
(. . , 1967; R. Aust, . Drettner,
1974).

.

, ,
.

,
,
. ,
, , ""
,
.
,

.
.

. I
,
.
(. 3). II

.
(. 4).
,
.
III , , (.
1).
, ,
III .

1.

,

.
2.
,
,
.
3.
,
,
.
4. : I , ;

II ,
; III
.
5. , .
6.
,
, ( ,
, ).

1. . .
( ) . 1993.
2. . ., . ., . . // . 1997. 1. . 812.
3. . 3. .
// XV . .. - 1995.- . 87-90.
4. . . . ., 1967.
5. . ., . . ( ) ., 1981.
6. Aust R., Drettner . Oxygen in the human maxillary sinus during
normal and pathological conditions // Acta Otolaryngol.
1974.- Vol. 78.- P. 264-269.
7. Bachert C. Experimented Untersuchungen zur Auswirkung der
Nasenatmungsbeuhinderung auf die Ventilation der
Kieferhohle// Laryngol. Rhinol. Otol. - 1986. - 65, N5. -S.
250-255.
8. Bachert C., Gauzer U. Experimental studies of relationship
between maxillary sinus ventilation and various obstructions of
the nose and nasopharynx // Rhinology. 1989. Vol. 27,
N 1 , - P. 37-43.
9. CrampetteZ. , MondainM,, RombauxPh. Sphenochoanal polyp in
children. Diagnosis and treatment. Rhinology. 1995. Vol.
33, NN. -P. 43-45.
10. Onodi A. Die topographische Anatomie der Nasenhohle und inrer
Nebenhohlen // Katz L., Blumenfeld F. Handbuch der
speziellen chirurgic des ohres und obenen Zuftwege.Leipzig.,
1922. -S. 61-134.
11. Stammberger H. Functional endoscopie nasal and paranasal
sinus surgery. The Messerklinger technique. Toronto
Philadelphia, 1991.
12. Zuckerkandl E. Normal und pathologische Anatomie der
Nasenhohle und ihren pneumatischen Anhange. Wien, 1893.
21.05.97

S. Z. Piskunov, V. S. Barsukov, F. N. Zavialov, I. S.


Piskunov, O. N. Kuznetsova. PATHOGENESIS AND
MORPHOGENESIS OF ANTROCHOANAL POLYPS
CT, nasal and maxillary sinus endoscopy, bacteriologic
and virologic studies as well as examination of SIgA level in
nasal and sinus content was performed in 72 patients with
antrochoanal polyps (ACP). The polyps removed during
sirgery and mucosa of maxillary sinus located in vicinity
or the polyp attachment were studied by means of light
microscopy. Presence of pathogenic bacteria and viruses on
the mucosa and dramatic decrease of SIgA were revealed.
There exists a strong body of opinion that ACP is a
specific form of maxillary sinusitis related to
anatomical abnormalities of middle turbinate and
nasopharynx which lead to increase of expiratory air stream
volume in the posterior part of middle meatus.
Pathomorphological study confirmed presence of local
chronic inflammation and mucoid degeneration of
submucous layer resulted in a pseudocyst and a polyp
formation.
3/1997


616.212.5-007.24-089

28

. . , . . ,
. . , . .

,
. ,
,
,

.
, ,
.
,


, . . 1618 .

.
,
- -
, ,

. , (140 )

500 , 27% .
72%
.

,
, , , .
,

" ", " ". ""
.
, ,
() () . , .

,
, 3/1997

.

. ,
, ,
.


.

,
.


,
,

,
.

-
,
. -'
,
.
, 5% , .
,
.
, ,
.
, . ,
.

- .

.
,
, ,

. 1997


.
.

, ,
.
.
,

,
16 18 , ,

. ,
,
, - (. , 1971 .).
,



( ,
, ), .

.

,
16 18
. ,
(. 3. , 1990; . . , 1993
.),
.

4 5- , . 3.
(1990),


.



.
.


.

( , , -

29

.).

,
, . ,
,

.


.
.
- .
.


, ,
. ,

.

1. . . // . . 1993.
1. - . 36.
2. . . . .
. - 1971.
3. ..
, // , 6-. . , 1990. . 128
130.
24.02.97

G. A. Gadzhimirzaev, A. A. Gamzatova, Yu. A.


Dzhamaludinov, R. G. Gadzhimirzaeva. CRITICAL
EVALUATION OF SOME CONCEPTS IN
SURGICAL TREATMENT OF NASAL SEPTUM
AND EXTERNAL NOSE DEFORMITIES
Some princi pies of surgical treatment of nasal septum
and external nose deformities in different age groups
are described. This is the authors opinion that early
correction of the deformities in pediatric age group is
indicated and probability of face deformities after such
surgery in patents under 16 years is exaggerated. Correct
preoperative treatment and general anestesia
considerably reduce risk of complications in patients
with concomitant respiratory allergic diseases. Presence
of nasal trauma as a possible etiologic factor must be
revealed preoperatively because correction of
osttraumatic nasal septum deformities should be done
an experienced surgeon exclusively.
3/997


XVI

2-7 1997

(-)
XVI


.
82

,
,
,
, , ,
. 1928
.
,
.

. , , ,
, .
,
, , , . " ".
.
,


.

1996 .
, .
. ,
:
.
:
. . 3. ,
, ; . . . ,
,
; . . ,
- ( ); . . .
( -
); . . (- ); . , .
. ; . . (
, ).
: . . . ,
,
3/1997

616.21/28:061.3(100)

. . . ; .
.
.
,

. . , ; .
. ( ),
. .

,
.
.
.
-
William Deane. , IFOS . ,
,
. Gerard McCafferty
, . IFOS
Peter Alberti ,
, IFOS.
, . Rodney Williams
25 , . .
. . .

, ,
. .
" ".

. .
,

.
, .
. 350 .
,
262 .

. . .
.
. .

, 1997



.

Ellman
Internation Inc. . 3,8 .
, .
, .

,
, --,
, , ,
, .
10%.
.
, . , , . .
100 .
500 .
.
45 , -
.

Daily Congress News.

.
7.15
. ,
, 8.30
18 .
. ,
, ,
.

,
400 ,
.
, .

. .

.
7 () 2,8 100000 . ,

. -

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,
. . .

( , ,
). -

.
.

, .
.
. . .
Okuda D. Passali 31 .
10 40% .
.
1955 1981 4 19,7
1000 . 12
.

1,5 .
. -
. .
,
. . 5 ,
7 , 6
. 1995
.

34 ,
.
1948
1990 - 17 142.
.
. ,
, . , ,
, . . ,
1, , 8. 5,
3/1997


32 .

60%,
2%, 6%, 35%.
.
2 ,
10 12 .
.
: ?
. Tos () .
Stammberger () :

/ . , -,
. U. Lund () ,
,

- . ,
.
4
12 .
.
. . D. Passali () ,
.


. .

.
3 .
.
:
.
,

, , . L.
Malm ()
20
.
.
.
. per os . .

.

,

.
- 3/1997

.
, .
. 3. .
" " 1 1997 .

,
.

. . : "
1997 ?".
.
.
.
-
.
, . W. Draf ()

79 14 .

.
I. Y. Park () ,
,
. .
. , . I. Y. Park .

Rudert ().
, , . Sethi
()
120 . 19 , 9 ,
.
D. Kennedy ()
.
, .
I. Park ()
. , ,
. YAG -

__________________
.
,
.
Mackay () , .
0,5 3%.
,
.
. Brennan ()
(
), .

.
.

.
. YAG-.

. . . .

. , .
.

, 1015 ,
, , ,
,
.

. ,
,

,


,
,
.
,

.


.


.


,
, XIV
.
,
, ( , ) (, ).
.
. (1
Tarabishi Mahmoud)
37% .

60% .

.
(J. Spratley et al., ).
().
. (J. .
. Engel et al.)
( 2
): (),
, ( ),
, (, ,
), , ,
. (5060%)
6 12 . ,

9
.
,
4
12 (J. Kari, Kvaerner et al.,
).

, (.
Karmody; H. Valtonen; . Carlos Ruah et al.), ,

. , ,
, .
2
, .
, "" ,
.

. Goro Mogi ()
,
. IgG , 3/1997


streptococcus pneumoniae
haemophilus influenze,
, IgG. (,
, )

.

. ,

,

.


( IL-P, IL-6, IL-8) .

-.

.

IgA
. , IgA,


,
.
P. J. Robb et al.) 346 4 . 24%

. 75%

IgA
.

.
60%
7% . 95%

,

(A. Golz et al., ). (Paul
. van Cauwenberge et al.) ,
,
,
( 20% ).
.

30 (
)
.

.
,
, (. Luotonen

3/1997

et al.)
, ,
.

.

67%, 33% .
94% , 6%. , .
(Mow Ming Hsu, ).
, ,
,
, .
(P. Bonding)
.
50% .
.
(Jens Thomsen et
al.)

, , 2
3 , .


- .
(Rui S. Penha, Carlos . Ruah) 30 ,

. ,

.

(Ying-Chia Huang). , ,
,
7 14 .

.
(Gristwood, Dr. Ronald)

8,1% :

. :
; , ; , , , ;

; ;
. .
(Matthew M. W. Yung) -

. - ______ ____ __

,
,
, , .
(recess supratubal), (anterior epitympanic

space), (Prussak's space)
,
.
,
.
, , 2- .
.
,
( 10 , 100 ), - .
,
1,4 , 14 (. Seldmaier, ). .


,
(. Yamasaki et al.).

,
(Tolsdorff, Peters ).
, .
, -
(). - pars tensa , - ,
.
, . . , , , (tympanic
- isthmus). ,
, ,
- .
. , ()
, - (
(Ramsay Hans .). ),
. ,
. Troltsch, Politzer,
Prussak, Helmhols and Hammar 10 . . .

, 60- ,
.
- .
, : ,
, , .
. , , 51 , ,
, - . - ,
- ,
. - ( )
: (- .

, ),

,
, .
, ,
. , -
,
. .
, - ,
( 28% 4%).
.



3/1997

__________________
36 . -



.
, (S. Spiric P. Spiric)

.
( .) .

.
4000
, 1986 1994 ,
7 .
. ,
(Due Minh Bui, ).
.

,

.

.
2,7
,
.
Karhuketo Tapio et al. ()
. 1,7
(
)
: , , ,
.

. -
(F. Bernard) ,
-

.
,

. .
Stancovic et al. () ,


.
,
. 44%
74% . 76%
3/1997

88% . ,

67%
,
100% . 14%
.
: , 30% ,
, ""
.
R. Wielgosz et al. () 40 (15300 )
, , .
,
(),

. 1 , 2 3
.
(Robert A. Goldenberg), (Ph. Bordure et al.), (Dr. Brace Black),
(Reck, Ralf)

.

. ,
.
, ""
.
.

, .
, .
.

.
(Helmi Abdullah, ), -
. ,

(
).


N. Naude ( )
.
.


.
,
,
.


. (Atsushi Shinkava, Makoto Sakai) ,
.
() .

71,3% .

90,0%.
- (F. Legent et al.).



- ,
. ,
.



(sulcus tympanicus) .

.
.
N. A. Mahmoud, S. I. Malki ()



.
83,8% .
, , . .
, Dr. Paul Pagan () , , ,
.


.
,
.
,
( ) (Paul van den
Broek, ). R. Gomez Ullate
() .,
, . "" ,
.
, ,
. .,
. ,

,
.
J. Muller et al. ()
6488 , 1988
1996 . . 80%
. - 206 80% .
. Wing
Yuen ()
. -
10
38% . - 30 ,
(100%).


91% , 9%

,
,
.
(Georg G. Browning)
,
,
- ,
.
"
". : 1 , 2 , 3 . 2 ,
1 .
.
. 3/1997


, 13 60% ,

, .
,
,
.

, , ,
.
(D. A. Moffat)


.

-
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