Vol 31, No 1 (2025)

In recent years, medical professionals have shown increased interest in different advanced training courses using cadavers under the guidance of experienced and well-known mentors in the medical community. The medical profession requires ongoing improvement and readiness to learn new surgical techniques and use them in practice. This paper describes the role of cadaveric dissection hands-on workshops in improving professional skills. Diseases cause anatomical distortions or changes in structures that disrupt the function of organs and systems. For example, sclerosis of mastoid air cells in chronic otitis media or a lesion that immobilizes the otostapes in otosclerosis. Cadaver hand-on workshops allow to practice manual skills and study possible complications in a safe environment prior to using various techniques without risk to a patient. In addition, they improve the quality of operations due to training of confident actions of surgeons, discussion of clinical cases, and clear understanding of anatomical landmarks. Thus, the diagnosis and treatment analysis depend on the relationship between anatomy, physiology, pathology, radiology, and clinical sciences. The profession of a surgeon requires a deep knowledge of anatomy and surgical techniques, especially in cases of abnormal arrangement of anatomical structures. Hence, future physicians must have adequate knowledge of anatomy. Working on cadavers as a 3D model provides a unique opportunity to gain practical experience, which allows one to practice the skills required for safe and effective treatment.

Rhinitis is one of the most common conditions. Viruses are the main cause of inflammation of the nasal mucosa. In the development of the disease, bacterial infection joins or an opportunistic flora is activated. Therapeutic approaches include administration of antibacterial therapy if indicated (5–7 days for uncomplicated conditions, 10–14 days for complicated conditions), anti-inflammatory and mucolytic agents, non-steroidal anti-inflammatory drugs, decongestants, herbal drugs with proven anti-inflammatory effects. At the early stages, symptomatic therapy is indicated, including nasal irrigations with isotonic saline solution and both local and systemic decongestants. If there is purulent inflammation, local anti-inflammatory and antibacterial treatment can be added. One option is a silver solution. A 2% silver proteinate solution can be administered from early childhood as an antiseptic, disinfectant, and anti-inflammatory agent. The drug is effective in acute and chronic rhinitis, rhinosinusitis, and adenoiditis. Compliance with professional standards ensures effective treatment of acute inflammatory conditions of the nasal cavity and paranasal sinuses, reduces the risk of complications, and improves the quality of a patient’s life.

Background: Submucous cleft palate is an uncommon type of isolated clefts. Its diagnosis is not challenging: a triangular pit due to bone loss along the midline of the hard palate; a translucent mucosal duplication region in the midline soft palate, causing its muscle impairment, nasalizatio, and a bifid uvula. In case of the compensated submucous cleft palate and unclear clinical signs, diagnosis is challenging.

Aim: To determine clinical signs (markers) of X-ray computed tomography and magnetic resonance imaging for the diagnosis of submucous cleft palate.

Methods: A retrospective analysis of 21 medical records of patients with submucous cleft palate was conducted in 2019–2024. All patients underwent conservative and surgical treatment under the compulsory health insurance plan. All patients underwent X-ray computed tomography or magnetic resonance imaging.

Results: Magnetic resonance imaging showed a linear hypointense structure along the midline due to the intermittent levator muscles of the soft palate. X-ray computed tomography identified three typical markers of submucous cleft palate, including a triangular palate defect on a 3D reconstructed image of the skull; a palate defect in the frontal view and a shortened vomer; anterior displacement of the posterior nasal spine and a large nasopharyngeal space in the sagittal view. Patients seek medical help for upper airways infections from an otolaryngologist much earlier. Our study showed significant differences in the age of diagnosis of the submucous cleft palate by otorhinolaryngologists and other medical professionals (p = 0.015).

Conclusion: Otorhinolaryngologist can detect manifestations and effects of submucous cleft palate and suspect the defect much earlier than other medical professionals. A promising path in identifying submucous cleft palate is to use radiologic imaging methods in routine practice. Timely detection of the submucous cleft palate will allow earlier rehabilitation to improve the quality of life and speech.

Background: The female body is under the constant influence of sex hormones. In this case, the larynx is no exception—sex steroid hormone receptors are located on the vocal folds. Thus, during the menstrual cycle, the voice also experiences cyclical changes, which is particularly important for professional voice users. Today, the use of hormonal contraceptives is increasing; they suppress hormonal peaks and it may cause cyclical voice changes.

Aim: To analyse acoustic voice changes in women with a natural menstrual cycle and hormonal contraception users.

Methods: The voices of 15 females aged 21–28 years, including six females using hormonal contraception, were recorded at menstruation and late follicular and luteal phases. The menstrual cycle phases were determined using a calendar. Acoustic analysis was performed in the Praat software (6.4.21). The following parameters were studied: fundamental frequency, including the highest and the lowest pitch; voice intensity; perturbation measurements (jitter and shimmer); Harmonic-to-Noise-Ratio, and maximum phonation time.

Results: Women with a natural menstrual cycle had cyclical voice changes, including a lower voice quality during menstruation and a higher voice pitch in the late follicular phase. There are no voice changes in hormonal contraception users during the menstrual cycle.

Conclusion: The study proves the influence of sex hormones on acoustic voice parameters.

Traditionally, it was presumed that cholesteatoma of the external auditory canal and keratosis obturans were the same condition. Recent research has found that these are two distinct diseases. Cholesteatoma of the external auditory canal often presents as a unilateral lesion; whereas keratosis obturans is mostly a bilateral leasion, which is a critical aspect of differential diagnosis.

We have searched for literature on both nosologies and their conservative and surgical treatment approaches and studied a potential progression from keratosis obturans to cholesteatoma of the external auditory canal and their combination.

The paper describes a rare case of combination of these nosologies in a single patient, i.e. keratosis obturans in one ear and cholesteatoma of the external auditory canal in the other, observations and treatment of this condition over 25 years.

We confirmed the views of numerous Russian and foreign authors that long-term conservative treatment of keratosis obturans is both possible and effective. However, it requires high-quality follow-up and ear care accompanied by minimally invasive exenteration once in 4–6 months. Cholesteatoma of the external auditory canal requires different surgical treatment based on the disease’s progression.

Cholesteatoma of the external auditory canal may develop in one ear alongside keratosis obturans in the observed ear. Moreover, progression from keratosis obturans to cholesteatoma in the external auditory canal may be caused by ear injury, inappropriate care by the patient or a medical professional, especially in unfavorable environment and with contributing factors at play.