The beginning of the development of otorhinolaryngology in Kazan should be considered 1925 - the time of the opening of the otorhinolaryngological department and clinic at the Faculty of Medicine of Kazan University. Its creation was carried out by prof. V.K. Trutnev.

The experience of the treatment of acute and chronic purulent otitis media by the meatotympanal injection of medicinal agents, the use of laser energy and ozone is given. The method of the functional diagnosis of chronic tonsillitis — rheoteonsillography, as well as the stages of intensive therapy of acute laryngotracheitis in children are described. The data of the use of laser irradiation in combined treatment of mycoses of the ear and upper respiratory tracts are given.

The investigation of the dynamics of the content of IgA, IgM, IgG and antibodies to DNA in blood serum and perilymph of 30 patients with otosclerosis, in 20-th active stage and in 10-th nonactive one, shows the plausible increase of the levels of IgG and antobodies to DNT, more pronounced in the active stage of the disease relative to the nonactive stage. The inverse correlation between immunologic characteristics and ear levels is found: namely, the decrease of IgG levels and antibodies to DNA in perilymph of patients with otosclerosis and hence, the decrease of the process activity is accompanied by the auditory function suppression in the form of the increase of perception theresholds of osteoconductive sounds on vocal and high rates.

The true and quasineurosensory hypoacusis is well-founded, the possibilities to distinguish the neurosensory hypoacusis with the presence of vestibular pathology and without it are considered. The basic regulations of differentiation of the sudden and acute neurosensory hypoacusis are given.

HLA-A-B-C phenotypes in 105 patients with otosclerosis, verificated during operation and correlated with the results of histoiden- tification of 113 healthy persons are determined. It is suggested that the ethnic sign does not influence the formation of the peculiarities of HLA polymorphism. The patients were devided into two groups: with familial predisposition to otosclerosis (33) and without it (72). A2, В12, Bx, Cx antigens are more frequent among them and A28, В18, B27, B40 and Cwl are less common. The associations, intending among the patients, are absent in patients with familial agrégation. The conclusions are made of the absence of the HLA-association of familial forms of otosclerosis and the existence of the gene, determinating the stability to the development of otosclerosis (HLA-B40). It is not inconceivable that genes exist, predisposing to the development of infamilial form of the disease (B12).

It is advisable to perform cautious radical operations at the same time with plasty elements. The early surgicai sanation of the middle ear is recommended allowing to preserve its elements, to increase the possibilities of reconstruction and consequently, to decrease a potential danger for acoustic function of a patient as well as for his life as a whole.

On the basis of the archival material of the Kazan otolaryngologic clinic, the comparative analysis of intracra-nial rhinogenic and otogenic pathology is performed by stages. In the presence of a general decrease of the intracranial complications rate during the last 20 years in this pathology structure the combined lesions prevail, which determines the high level of lethality. Computer tomography and particularly MRT-tomography allow to reveal the infection focus in the skull cavity and to define the adequate surgical tactics.

In unsuccessful conservative therapy it is advisable touse the original method of surgical intervention: a cryoprobe point is brought into the submucous space of the inferior turbinated bone and after preliminary process of freezing it is removed with freezing soft tissue block. Positive results are obtained in 90% of the patients.

It is necessary to use the current possibilities of the diagnosis, namely, the computer tomography and endoscopic methods of the surgical treatment in providing service to patients with orbital complications of sinusitis.

The endoscopic interventions into the nose cavity and on the accessory nasal sinuses with high functional effect are used for the treatment of 182 patients. Particular attention has been given to the postoperative follow-up of such patients in connection with the danger of cicatricial obliteration of the median nasal passage in early and remote postoperative periods.

As many as 447 patients with primary gout are examined. Biochemical investigations show the disorders of ferrçiental, lipid, carbohydrate, protein metabolism in patients with gout. The decrease of the absorptiondischarge function of parenchymatous cells of the liver is revealed in dynamic scintigraphy. The increase of the liver size, focal hypo- and hyperechogenic formations at the expense of cysts and calcificators are found. Cholelithiasis is revealed in 57 patients.

Thanks to advances in cofosurgery, a significant number of patients with otosclerotic hearing loss have improved hearing. Nevertheless, many problems of this disease continue to remain relevant at the present time. Among them, the pathogenesis of otosclerosis, as well as the mechanism of inhibition of the activity of the otosclerotic process, should be distinguished, especially in those cases when the otosclerotic rearrangement captures the cochlear region of the ear labyrinth.

Hearing loss as a result of the otosclerotic process in the labyrinth capsule is diagnosed in 0.1 - 1% of the total population, thus being an important medical and social problem. To date, many methods have been developed for surgical correction of otosclerotic hearing loss and pathogenetic drug action on the otosclerotic focus in the labyrinth capsule [10]. Of the various hearing-improving interventions, stapedectomy and stapedoplasty are the most widespread. Less commonly, such methods of operations as monocrural transposition, stapediolysis, interposition technique, etc. are used. Due to the existing variety of methods, the otosurgeon has the opportunity to choose a surgical intervention that is rational for the patient, taking into account the individual options for the structure of the middle ear and visual assessment of the developmental features of the otosclerotic process. To date, the technique of hearing-improving surgery is approaching, it can be considered, to the ideal level and provides maximum functional efficiency and social rehabilitation of patients in 80 - 95% of cases [10 12].

The influence of two methods of forming a conjunctival flap on the hypotensive efficiency of operations and the outflow of intraocular fluid in the long-term follow-up was studied. Operated on 2 groups of patients - 150 people (150 eyes). In group 1 (76 patients), operations were performed with an incision of the conjunctiva at the site of its attachment along the limbus for 5 - 6 mm, followed by its separation by 3 - 4 mm upward.

In recent years, cases of serous meningitis with influenza have become more frequent. Here is our observation. Sh., 12 years old, was admitted to the clinic on November 22, 1993 with purulent discharge from the right ear for a long time and discharge with an unpleasant odor and itching in the left ear. The child has a history of frequent pneumonia, acute respiratory viral infections, goimoritis and purulent otitis media. In Î98é he underwent adenotomy. In February 1990, a radical operation was performed on the right ear for otogenic meningitis.

96 patients with allergic rhinitis aged from 24 to 40 years were under our supervision at the Republican Center of Clinical Immunology. Patients (40 men and 56 women) were followed regularly for 5 years. The duration of the disease did not exceed 10 years. The diagnostic program aimed to establish the signs of "atopic phenotype" and specific hypersensitivity in patients with allergic rhinitis. It included an allergic history, skin testing, provocative nasal tests, test of inhibition of natural emigration of leukocytes (TTEL) with histamine, determination of the number of eosinophils in peripheral blood, assessment of humoral and cellular immunity, HLÂ-typing.

It is known that in chronic tonsillitis caseous plugs are formed mainly in the lacunae of the first order, in their wide part, closer to the exit. The reason for the formation of stagnant pathological secretions and plugs in the lacunae is the difficulty of evacuation from them due to the narrowness of the mouth or its deformation after repeated inflammatory processes.

A clinical assessment of the combination of inhalation therapy with phytopreparations and agents affecting the immune system was carried out. The study included 60 patients with chronic tonsillitis aged 15 to 45 years with a disease duration of 2 to 20 years. Patients, in addition to clinical examination, underwent sowing of flora from the depths of the lacunae to detect microbes or fungi, followed by determination of sensitivity to antibiotics, and skin allergological tests with microbial allergens were performed.

This work presents the results of treatment of patients with functional diseases of the larynx by phonopedic voice correction using various methods. From 1991 to 1993 we treated 2421 patients

With the help of ultrasound and NMR tomography, the diagnosis of stones in the biliary tract has improved significantly. In this regard, the number of patients who want to get rid of stones, the existence of which they did not even suspect before the examination, is growing significantly. The low trauma of laparoscopic cholecystectomy (LCE) is captivating, and there is a danger of expanding the indications for this, already quite common operation. But the removal of the organ necessary for digestion excludes the possibility of new painful disorders.

The experience of the work of the interrepublican ear-improving centre giving medical and consulting service to patients with ear diseases for a period of 30 years is presented. The structure and directions of the polyclinic department of the ear-improving centre are given, and the clinical examination using monitoring observation of the ear and vestibular function state of patients after surgical rehabilitation should be given consideration.