Euroasian Health Journal

Artificial intelligence will not fully replace radiologists, but it will reshape their role—especially in image interpretation and patient care. Patients are often unsure how to respond to artificial intelligence related errors, while radiologists believe they must retain control and responsibility over diagnostic processes. Therefore, strategies for ethical accountability and stronger artificial intelligence education in medical training are essential. Collaboration between radiologists and IT specialists is crucial for patient-centered integration of these technologies. Objective. This study aimed to analyze physicians' perceptions of the use of artificial intelligence in radiology. A quantitative survey was conducted among 51 practicing physicians, including radiologists. The questionnaire explored issues such as patient data confidentiality, absence of human oversight, risk of skill loss, and interest in artificial intelligence applications. Results. The majority of respondents expressed positive attitudes towards artificial intelligence, highlighting its potential to enhance diagnostic speed and accuracy. However, concerns remain about loss of clinical skills, data privacy, and lack of human control. Over 60% of participants were interested in learning how artificial intelligence can be used in chest X-ray interpretation. Conclusion. Artificial intelligence is seen as a supportive tool, not a replacement for physicians. Successful implementation requires ethical guidelines, legal regulation, and the education of healthcare professionals to ensure safe and effective artificial intelligence integration. 

Cases of foodborne botulism are reported annually in the Kyrgyz Republic in the form of sporadic and group outbreaks. Botulism is a rare infectious disease and due to the specific clinical picture, presents great difficulties for clinicians to diagnosis. The aim of the study was to investigate the epidemiological and clinical characteristics of foodborne botulism. The case histories of 23 patients diagnosed with foodborne botulism hospitalised at the Republican Clinical Infectious Diseases Hospital between 2022 and 2023 were retrospectively analysed. As a result of analysing case histories, it was found that the transmission factor was mainly home-canned fruits and vegetables. In more than 60% of cases, there was a delay in patients seeking medical help. In 26.1% of cases, clinicians initially made erroneous diagnoses. Adults (87%) and predominantly males (61%) predominated among the patients. Recently, however, botulism has been registered among children. The analysis showed that the patients had typical clinical symptoms of botulism with the development of symmetrical descending paralyses of cranial nerves and symptoms of myoplegia. The results of laboratory research showed that in Kyrgyzstan botulism is caused predominantly by botulinum toxins type A, B, E, at the same time empirical approach in the treatment of botulism with anti-botulinum serum using monovalent sera of these types is reasonable. Thus, early diagnosis and treatment of foodborne botulism reduces the risk of fatal outcome and improves the prognosis of the disease. Increasing public awareness is a preventive measure for the disease.

This review analyzes the individual anatomical and radiological characteristics of the structure, blood supply, and innervation of the mandible. The mandible is a key craniofacial structure involved in chewing, speech, and facial aesthetics. Morphological features, including variations in bony canals, neurovascular bundles, and cortical bone relief, are of great clinical significance in dentistry and maxillofacial surgery. The article systematizes data from 35 scientific sources selected based on relevance, methodological quality, and originality.
Particular attention is given to modern imaging techniques – cone-beam CT, MRI, and radiography, which enable identification of individual anatomical variations: the presence of lingual canals, radiodensity of the incisive canal, and the course of the mandibular canal and its proximity to dental roots. The clinical relevance of these structures is discussed in the context of anesthesia, dental implantation, surgery, and treatment planning.
The review emphasizes the need for a personalized approach and in-depth understanding of mandibular anatomical variations to improve safety and efficacy in dental and surgical procedures.

Upper eyelid blepharoplasty is one of the most sought-after aestethic surgeries worldwide, especially among patients of Asian descent. However, the anatomical features of Asian eyelids, such as the absence of a distinct crease, the presence of subcutaneous fat tissue, and the specific structure of the orbital septum, require an individualized approach to selecting surgical techniques. The article presents a comparative analysis of the anatomical features of 50 patients of Asian and European descent, focusing on anatomical differences, clinical outcomes, and patient satisfaction.
The aim of the study is to examine and compare the effectiveness of various surgical techniques for blepharoplasty in patients of Asian and European descent, as well as to identify factors influencing patient satisfaction with the results of the surgery. All surgeries were performed at the "MaxClinic" for Plastic and Reconstructive Surgery. The study used standardized questionnaires, analysis of medical records, and pre- and post-operative photographs. Data were processed using SPSS software.
The relevance of this study for Kyrgyzstan is due to the growing demand for aesthetic surgeries, including blepharoplasty, among the population with predominantly Asian ethnic features. In a multi-ethnic country where both Asian and European anatomical features are present, it is important to develop adapted surgical approaches that take into account the specifics of the local population. Conducting such research will improve the quality of medical services, reduce the frequency of complications, and enhance patient satisfaction, which is particularly important in the absence ofstatistical data in Kyrgyzstan.
The results of the study can be used to develop recommendations for performing blepharoplasty in Kyrgyzstan, as well as to train surgeons in modern techniques that consider the ethnic characteristics of patients. 

Gigantomastia is a rare but clinically significant form of breast gland hypertrophy, characterized by excessive enlargement of breast volume, often accompanied by physical and psychoemotional complications. Patients diagnosed with this condition frequently report back and neck pain, postural disturbances, restricted physical activity, and psychological distress related to body image and social integration. In recent years, the frequency of gigantomastia diagnoses has been steadily increasing. This is attributed not only to improved diagnostic capabilities and wider access to specialized care but also to growing awareness among both physicians and patients. Several countries in Europe and Asia have accumulated considerable clinical experience in the management of giantomastia. In contrast, Kyrgyzstan faces a lack of reliable statistical data and insufficient focused research. This prospective study presents the clinical experience of treating 42 patients with gigantomastia in Bishkek between June 2022 and December 2023. A comprehensive approach was implemented, combining surgical intervention with elements of conservative therapy. The one-year follow-up demonstrated the safety and high effectiveness of the chosen treatment strategy for gigantomastia within the framework of Kyrgyzstan’s national healthcare system.

Despite the use of modern instrumental research at the present time, the diagnosis of acute appendicitis in the elderly and senile is a difficult task, and for a surgeon, a thorough collection of complaints, anamnesis of the disease and identification of the main clinical signs are key elements in the diagnosis of the disease. Despite the large number of research scales and systems in emergency surgery, the Alvarado scale is one of the most widely used definitions observing the main signs of acute appendicitis. The Alvarado score was developed by Alfredo Alvarado in 1986 as a diagnostic tool for acute appendicitis. The evaluation was based on a retrospective study of 305 patients admitted to Nazareth Hospital in Philadelphia, Pennsylvania, USA, with abdominal pain consistent with acute appendicitis. This article describes the features of the diagnosis of acute appendicitis in the elderly and senile, as well as the use of the Alvarado scale. Due to its simplicity, the Alvarado scale is easy to use and improves the diagnosis of diseases, more accurately determines the indicators available for hospitalization, and also prevents “unnecessary” operations. Objective of the study: Validation of the Alvarado scale in the diagnosis of acute appendicitis in elderly and senile individuals. Materials andmethods. The study included patients diagnosed with acute appendicitis over 60 years of age in the main group, as well as patients aged 18 to 60 years in the control group. Total number of patients 180. A retrospective study of the case histories of 180 patients who were diagnosed with acute appendicitis and who underwent surgical treatment was conducted. Results. When diagnosing acute appendicitis in elderly and senile individuals, if the Alvarado scale score is 8 points, this can be considered as an indication for surgery. Conclusion. According to the results of our study, the Alvarado scale is of great help in diagnosing acute appendicitis in elderly and senile individuals and determines the path of further treatment. 

Neurofibromatosis type 1 is one of the most common genetic diseases. It can be inherited in an autosomal dominant manner, but in almost half of the cases it occurs de novo. Neurofibromatosis type 1 is associated with café au lait spots, freckles in the inguinal and axillary areas, neurofibromas, Lisch nodules of the iris or choroidal anomalies, optic pathway gliomas and characteristic bone anomalies. In the world, the pathology occurs with a frequency of 1:3500 newborns. Mutation in the NF1 gene, which is located on chromosome 17 q11.2, leads to the inability to synthesize the cytoplasmic protein neurofibromin. This latter protein acts as a modulator of cell growth and differentiation, starting from intrauterine life, it is expressed by cells of the nervous system, endothelium and smooth muscles near blood vessels. The mutated protein and associated changes in the cellular environment lead to a very high risk of cerebrovascular changes. Deficiency of the NF1 gene leads to hyperactivation of RAS, which triggers the AKT/mTOR and Raf/MEK/ERK proliferation signaling pathways. As a result, benign neoplasms are formed - neurofibromas, which have a high tendency to malignancy. The gold standard for diagnosing neurofibromatosis type 1 is molecular genetic testing. The article provides information on the prevalence, clinical picture, diagnostic and treatment options for neurofibromatosis type 1, as well as our own clinical observation. The presented clinical case is interesting due to the progressive course of the disease in a child and  the formation of multiple plexiform neurofibromas. Currently, there are no methods for preventing this pathology, but early diagnosis and targeted therapy improve the quality of life of patients. Targeted therapy can have a great impact and slow the growth of neurofibromas. Selumetinib is a selective inhibitor of mitogen-activated protein kinase types 1 and 2 (MEK 1,2). It blocks MEK activity and the Raf/MEK/ERK signaling pathway, which helps suppress the proliferation of tumor cells in which this signaling pathway is activated.

This article presents the results of a retrospective analysis of the study of clinical and laboratory data of children with orbital complications of rhinosinusitis. The analysis showed that the greatest number of orbital complications occur in the younger group of children (1-7 years) - 72 (48%) patients, with acute sinusitis with complications, complaints were of increased body temperature, eyelid edema, headaches, and with chronic - chemosis and decreased vision prevailed. The most frequently detected growth of Staphylococcus aureus (45%). The analysis showed that timely initiation of treatment resulted in complete restoration of vision in almost all patients. In 1 patient with acute pansinusitis complicated by orbital phlegmon, vision in the right eye was not restored (the patient came on the 5th day after the onset of the disease). The effectiveness of the therapy conducted in rhinosinusogenic orbital complications depends on the correct etiotropic treatment. Determination of the species composition of microflora and its sensitivity to antibiotics is key. According to some authors, complex conservative treatment with the use of a lymphotropically sensitive antibiotic reduces surgical treatment of patients with rhinosinusogenic orbital complications. 

The sensation of a «lump in the throat», or «globus pharyngeus», is a common symptom that patients often describe as a feeling of a foreign body or pressure in the throat. It is most frequently associated with psychogenic factors, stress, or gastroesophageal reflux disease. However, in some cases, this sensation may be caused by organic pathologies that require careful diagnosis.
This article presents a clinical case in which persistent globus sensation was caused by hypertrophy of the lingual tonsil – a rare but clinically significant condition. The case emphasizes the importance of a comprehensive approach to patients with such complaints, including mandatory otolaryngological examination using modern imaging techniques.
This case highlights the need to rule out organic pathology when making a diagnosis and contributes to expanding the differential diagnosis for persistent globus sensation.

External nasal trauma is a common type of craniofacial injury, particularly in children and adolescents. Understanding its causes, anatomical structures involved, and clinical features is essential for timely diagnosis and effective treatment.
Objective: To analyze the etiology, morphological characteristics, clinical presentation, and treatment approaches for external nasal injuries.
Methods. The study involved clinical, otorhinolaryngological, ophthalmological, neurosurgical, radiological (including multi-slice computed tomography, magnetic resonance imaging, and conebeam computed tomography), and laboratory examinations. Patient medical records were analyzed to assess structural changes in the nasal bones, paranasal sinuses, orbits, and brain. Functional outcomes were evaluated using acoustic rhinometry; aesthetic results were assessed through photographic comparisons; and quality of life was measured using the Pediatric Quality of Life Inventory (PedsQL 4.0).
Results. The leading causes of nasal trauma were domestic accidents, sports injuries, and road traffic incidents. Fractures with nasal deformity were the most common type of injury, often requiring reposition. The optimal period for surgical intervention was found to be 5–10 days post-injury. A multidisciplinary approach significantly improved both functional and aesthetic outcomes.
Conclusion. Early diagnosis and timely management of external nasal trauma are critical for preventing complications and ensuring optimal functional and cosmetic results. A comprehensive, interdisciplinary evaluation is essential in managing such injuries effectively. 

The article presents a clinical case of the formation of a chain of auditory ossicles in the Medcenter.kg clinic of a patient with chronic purulent otitis media accompanied by a total defect of the tympanic membrane, destruction of the long process of the anvil and the head of the stapes. These pathologic changes led to significant hearing loss, which required surgical treatment tactics. During the surgical intervention the reconstruction of the auditory chain was successfully performed using boncement (bone cement), a modern biocompatible material, which allowed to restore the anatomical integrity of the anvil and the head of the stapes. Additionally, the formation of a new autotissue tympanic membrane from the patient's autofascia was performed, which ensured the tightness of the tympanic cavity and improved the functional outcome. The results of postoperative tonal threshold audiometry confirmed a significant improvement in sound conduction, indicating the success of the reconstruction. This clinical case emphasizes the effectiveness of boncement in otosurgery, especially for auditory ossicle defects. The use of this material allows achieving stable functional results, minimizing the risk of rejection and ensuring long-term hearing restoration. The observation demonstrates the prospect of such techniques in the treatment of chronic otitis media in patients with destruction of the elements of the sound conducting apparatus.

Summary. Objective: To provide an up-to-date review of the efficacy of honey and its potential applications in otorhinolaryngological practice.
Methods. A literature review was conducted using PubMed and Google Scholar databases. The analysis included publications concerning the pharmacological properties of honey and its clinical use in the treatment of ENT disorders.
Results. The antibacterial, anti-inflammatory, and regenerative properties of honey were examined, along with its mechanisms of action on the mucous membranes of the upper respiratory tract. The review included: 7 studies on the use of honey in pediatric otorhinolaryngology, 12 in rhinology, and 6 in otology.

Identified were 6 meta-analyses, 14 randomized controlled trials, 3 case reports, as well as animal model and in vitro studies.
Analyzed sources included: 11 articles on the antibacterial properties of honey, 2 on its use in ENT diseases, 5 related to tonsillectomy, 1 on angina, 1 on chemical burns of ENT organs, 11 on rhinosinusitis, 1 on functional endoscopic sinus surgery, 2 on cochlear implantation, 1 on mastoiditis, 2 on otitis externa, and 1 on otitis media.
Conclusion. The review demonstrates the high potential of honey in otorhinolaryngology. The collected data support the need for further randomized controlled trials to justify its broad clinical application.

The purpose of this work is to track and evaluate the effect of chitosan on tissue regeneration in post-traumatic eardrum perforation caused by mechanical damage, barotrauma, or infectious processes. Chitosan, a biopolymer with regenerative and anti-inflammatory properties, was used in the study. Since acute traumatic perforation of the eardrum may involve the structures of the middle and inner ear in the pathological process, it is advisable to use both subjective and objective methods to assess hearing dynamics. audiometry (a subjective technique) in adults is a routine method of assessing auditory function in cases of damage to both the sound-conducting and sound-receiving parts of the auditory system. In the article, the authors provide data on the use of chitosan gel for post-traumatic perforation of the eardrum, which is used for the first time in Kyrgyzstan as a method of tissue regeneration, which leads to its restoration, as well as the results of comparison with the control group. As a result of the study, it was noted that the use of chitosan in eardrum injury opens up prospects for the development of new treatment methods that promote rapid and safe tissue healing, as well as reduce inflammatory reactions and prevent complications.

Despite numerous scientific studies and practical developments, the problem of chronic tonsillitis remains relevant. Angina and chronic tonsillitis occupy a leading place in the structure of diseases of adults and children. In chronic tonsillitis, a pathological process occurs with changes in both pathophysiological and pathomorphological terms. This is characterized by multifaceted disorders of all levels of humoral and cellular immunity, the presence of intoxication of the body, as well as a variety of local symptoms.
There are many types of surgical treatment for chronic tonsillitis. This paper presents the results of using the method of endoscopic minimally invasive radiofrequency tonsillolacunotomy in chronic tonsillitis in Kyrgyzstan in comparison with the traditional method. This method can be used as an alternative to laser, chemical and other types of treatment. The results described in the work clearly show that radio wave surgery can be used in outpatient settings, is accompanied by minimal bleeding, no necrosis and a pronounced reaction from the surrounding tissues, and, accordingly, an easier postoperative period.

Tinnitus – the perception of sound in the absence of actual external sound - is a symptom of an underlying condition rather than a separate disease. Its manifestations are often a sign of some neurological and vascular disorders. And unfortunately, tinnitus can significantly affect the quality of patient’s life, making social interaction and labor activity difficult. Treatments for tinnitus include pharmacotherapy, cognitive and behavioral therapy, sound therapy, music therapy, tinnitus retraining therapy, massage and stretching, and electrical suppression. According to six large population-based studies, the incidence of tinnitus among adults in different countries varies from 4.4 to 15.1% and from 7.6 to 20.1% in the age group over 50 years. Also, most of these patients tend to emotionally color their ear noise, and therefore the characteristics and degree of its influence on the quality of life are very individual. Tinnitus treatment includes pharmacotherapy, cognitive and behavioral therapy, sound therapy, music therapy, tinnitus retraining therapy, massage and stretching, and electrical suppression. Despite the prevalence of the problem, the question of the etiology and pathogenesis of tinnitus has not been fully studied at the moment. The search for new treatment methods is aimed not only at improving sound perception, but also at eliminating the accompanying noise, which can cause unbearable suffering to a person. In this work the authors tried to consider the characteristics, causes, mechanisms, and methods of treating tinnitus.

Tympanosclerosis is a chronic non-purulent disease of the middle ear, in which sclerotic changes occur in the structures of the tympanic cavity, including the eardrum and auditory ossicles. These pathological changes often lead to persistent impairment of the sound-conducting apparatus and hearing loss, especially in patients who have had recurrent or chronic otitis media. The article reviews current data on the epidemiology of tympanosclerosis, its pathogenesis and clinical manifestations. It is indicated that the disease is more common in adult patients, especially those over 40 years of age, but can also develop at a younger age in the presence of predisposing factors. Among the pathogenetic mechanisms, special importance is given to long-term inflammation, impaired microcirculation and fibrosis processes.

The authors focus on modern approaches to diagnostics, including otoscopy, audiometry, impedancemetry and imaging methods such as computed tomography of the temporal bones. However, it is emphasized that early diagnosis of the disease remains difficult, since its initial stages can be asymptomatic or disguised as other forms of hearing loss. This highlights the need for more sensitive diagnostic techniques.
Surgical treatments, including tympanoplasty and stapedoplasty, are also discussed, taking into account the severity of the auditory chain lesion. Finally, the importance of prevention is emphasized, especially in patients with frequent otitis, including the sanitation of foci of chronic infection and regular monitoring by an otolaryngologist.

Chronic tonsillitis is one of the most common ENT conditions, particularly prevalent among individuals aged 15 to 30. It involves inflammation of the palatine tonsils and presents withboth local (e.g., sore throat, bad breath) and systemic symptoms, such as joint, heart, or kidney complications due to chronic tonsillogenic intoxication. Accurate diagnosis and appropriate treatment - whether conservative or surgical - are essential, especially in cases resistant to medication.
One modern surgical approach, thermal welding, applies direct heat to dissect tissues with minimal thermal spread, reducing collateral damage. In a study involving 15 patients undergoing tonsillectomy using thermal welding, results demonstrated several advantages: shortened dissection time, reduced intraoperative blood loss, and a minimized risk of both early and late postoperative bleeding. Despite these benefits, patients experienced significant postoperative pain, with peak intensity observed on the seventh day after surgery.
Nevertheless, the method provided stable hemostasis, low need for analgesics, and a smooth recovery. These findings suggest that thermal welding is a viable and effective alternative to other tonsillectomy techniques. Its precision, safety profile, and comfort for both patient and surgeon support its broader adoption in clinical ENT practice.

The relevance of the problem under study is conditioned upon insufficient information on the prevalence and clinical course of fractures of the paranasal sinuses in Astana. The purpose of the study is to conduct a retrospective analysis of these injuries and to identify the prevalence and epidemiological features of fractures of the paranasal sinuses in the city of Astana. Initially, the study included the medical histories of patients for 2018-2023 of both sexes aged 8 to 84 years (a total of  314 people) who were diagnosed with a fracture of the paranasal sinuses. Out of the 314 cases, 293 met the inclusion and exclusion criteria. The medical records of these 293 cases (including medical histories and records of clinical examinations, medical images such as X-ray pictures, computerized tomography scans, and their reports) were thoroughly examined. Men aged 13-35 were the most frequently affected, and traffic accidents and motorcycle accidents were the most common causes of fractures. Nearly half of the patients (n = 160, 54.6%) received surgical treatment. Open reposition and internal fixation were performed in 87 patients (29.7%). 11% of patients had no treatment. The most frequent complication was an infection of a postoperative wound or tissue near a metal structure. The presented data have potential significance for the development of new strategies for injury prevention and the identification of patients at risk of postoperative complications.

Purpose of the study: to increase the functional effectiveness of tympanoplasty options using a biocompatible polymer. Materials and methods of research: using this method, 35 patients were operated on at the medical center “Medcentre.kg”. Results and discussion. This method ensures the achievement of 10 dB of bone-air gap in approximately 50% of cases, 20 dB in 70%-80% of cases. The method is carried out as follows: Under local anesthesia + neuroleptanalgesia, the mobility of the auditory ossicular chain is checked. If erosion of the long process of the incus is observed with the malleus manubrium and stapes superstructures intact, all mucosa is removed from the bony surfaces and allowed to dry. Next, a biocompatible self-polishing acrylic mixture is applied with point movements to the remaining part of the long process of the incus. The eroded area of the long process of the incus is increased with a biocompatible self-polishing acrylic mixture, allowed to dry, and the mobility of the incus-stapedial joint is checked. The wound behind the ear is sutured in layers. Aseptic dressing. Conclusions. The method of hearing restoration is much cheaper than previously known analogues, such as the use of partial prostheses of the auditory ossicles, does not require a two-stage surgical intervention, and does not contain the risk of displacement of the chain of auditory ossicles, as with the use of prostheses. The biocompatible self-polishing acrylic mixture is easy to work with and hardens within 5 minutes into any desired shape, making it a reasonable alternative for repairing ossicular chain defects without causing any allergic reaction.

Facial nerve injury is a common complication during surgical interventions on the middle ear and skull base, particularly in cases of cerebellopontine angle and temporal bone tumors. When proximal nerve reconstruction is not possible, hypoglossal-facial anastomosis is considered one of the most effective methods for reinnervation. This study presents a retrospective analysis of 36 surgical procedures involving end-to-end hypoglossal-facial anastomosis in patients with facial nerve injury of various etiologies. The effectiveness was assessed using the House–Brackmann scale and facial muscle electromyography over a 12-month postoperative period. The results demonstrated gradual recovery of facial muscle function, especially in the orbicularis oculi and frontalis regions, with positive dynamics in 77.4% of cases. Complete facial symmetry was restored in nearly half of the patients. However, the technique is associated with potential complications such as hemiglossal atrophy and speech difficulties. The findings support the rationale for early anastomosis - within 12 months of injury—and highlight the need for further optimization of surgical and rehabilitative strategies.

The article presents a clinical case of a rather rare disease such as glomus tumor of the middle ear. The tumor was localized in the tympanic cavity, which led to mixed hearing loss of grade 3. This tumor cytologically refers to benign tumors, but according to the clinical course it can be considered aggressive, which can spread to vital structures of the body (internal carotid artery, brainstem). Radiation methods of examination, such as computed tomography of the temporal bones and magnetic resonance imaging make it possible to see the localization of the soft tissue formation and its prevalence beyond the temporal bone, which allows us to plan the volume of the upcoming operation. Given this feature of the tumor, embolization of the vascular stroma of the tumor, microsurgical removal of the tumor and sometimes various types of radiation therapy are used for treatment. A classification of glomus neoplasms of the temporal bone is also presented.
Thus, the diagnosis of glomus formations has some peculiarities, as practice shows, there is noise in the ears without changes in the otoscopic picture, which primarily suggests damage to the auditory nerve. Patients without additional studies can receive various methods of conservative therapy until the glomus protrudes from the tympanic cavity into the external auditory canal and causes bleeding.

The aim of the study was to conduct a comparative analysis of two approaches to the treatment of mixed hearing loss developed against the background of chronic suppurative otitis media (CSOM). The research was conducted at the Tashkent Pediatric Medical Institute from January 2019 to January 2023, with the participation of 70 patients. The patients were divided into two groups: Group 1, where hearing-improving surgeries were combined with hearing aid use, and Group 2, where only hearing-improving surgeries were performed. Patients in group 1 experience significantly fewer symptoms, such as ear discharge, pain, congestion, tinnitus, and headaches. They also have a more satisfactory hearing condition and fewer problems with speech intelligibility, both in normal conditions and in noisy environments. The psychological condition of patients in group 1 is also better, with less fear and a smaller impact of the disease on their quality of life. The overall score, which takes into account all aspects of the disease, also shows better results in group 1 compared to group 2. The results showed that the combined approach with hearing aids in Group 1 demonstrated a more pronounced improvement in hearing, both in terms of audiometric results and quality of life indicators (COMOT-15). Group 1 also showed more significant improvements in reducing symptoms such as pain, ear congestion, and hearing functions, as well as in the psychological state of the patients.

This study was conducted with the aim of comparing the effectiveness of closed sanitizing surgeries with and without the use of endoscopic assistance in chronic suppurative otitis media (CSOM). The study included 39 patients who underwent closed surgeries, including atticotomy, tympanoplasty, and other methods. The patients were divided into two groups: in the first group, surgery was performed using both a microscope and an endoscope, while in the second group, only a microscope was used. The results showed that the use of an endoscope significantly improved the visualization of hard-to-reach areas of the middle ear, such as the anterior attic, facial sinus, and others. This reduced the risk of residual cholesteatoma development, particularly in children.
Postoperative audiological results showed no significant differences; however, in the group with endoscopic assistance, the recurrence rate of cholesteatoma was lower (10% versus 30%). The study's conclusions confirm that combining a microscope and an endoscope increases the effectiveness of sanitizing surgeries, reduces the risk of recurrence, and improves the restoration of middle ear anatomy. Endoscopy, especially in pediatric practice, offers a valuable alternative to traditional microscopic techniques, ensuring more complete and stable recovery.

A cochlear implant is a device used in severe to profound hearing loss where hearing aids are inadequate. These hearing losses may be congenital or acquired. Our goal in the management of hearing loss in children with congenital hearing loss should be to detect hearing loss early and start using hearing aids in the first 6 months. Cochlear implants can be applied starting at 9 months of age, depending on the country. Ideally, the implant should be applied as close as possible to the age of 1. The later the implant is applied in children with congenital hearing loss (especially after the age of 5), the less effective the device will be. It is very important to apply cochlear implants to both ears in order to provide sound depth and to determine the direction of the sound. In addition, if for any reason one of the implants experiences a temporary failure, traumatic damage or infection-related dysfunction; having a working implant in the other ear is also very important in the management of the process. The benefits of cochlear implantation not only include improved hearing and increased ability to develop speech and language skills, but also improved academic success, a better quality of life, and improved employment.

This study examines emergency care-seeking patterns for acute еar, nose, and throat diseases among children in Bishkek, a major urban center. Combining retrospective analysis of patient data from the Emergency Medical Center with the author’s clinical observations, the research highlights key epidemiological trends. Seasonal peaks during winter months were linked to climatic factors, respiratory infection outbreaks, and urban environmental conditions. Young children exhibited heightened vulnerability due to anatomical and physiological characteristics of their airways. A considerable proportion of cases required hospitalization, primarily for complicated disease forms, underscoring the need to strengthen outpatient care. Systemic challenges, such as delayed care-seeking and widespread self-medication, emphasized the urgency of parental education initiatives. Recommendations include telemedicine integration, preventive campaigns, and enhanced primary healthcare resources. The study advocates for a multidisciplinary approach to reduce emergency service burdens and improve pediatric care quality. By addressing both clinical and socio- environmental factors, the findings contribute to strategies for mitigating healthcare disparities in urban settings.

During the heating season, the condition of the atmospheric air in densely populated cities becomes unsuitable for breathing, causing harm to the condition of the respiratory tract, including the olfactory analyzer. The purpose of this study is to study the condition of the olfactory analyzer under conditions of atmospheric air pollution in the city of Bishkek. The study included 150 healthy participants who underwent olfactometry to assess their olfactory function. The results showed that the level of air pollution has a negative impact on the condition of the olfactory analyzer, with the most pronounced impairments observed in the cold season. These data emphasize the importance of understanding the impact of the environmental situation on public health, especially in a city with high pollution levels. To prevent further deterioration of the olfactory analyzer and, possibly, other health aspects, it is necessary to take measures to reduce the level of air pollution in Bishkek. Such interventions can include both environmental initiatives and educating citizens about the importance of protecting the environment for maintaining health. The study draws attention to the importance of an integrated approach to solving the problem of air pollution and its impact on human health, which in the future can lead to an improvement in the quality of life of city residents.

Objective. To determine the evidence-based indications and contraindications for performing septoplasty in children, taking into account age-related anatomical and physiological characteristics and current clinical protocols.
Materials and Methods. A review of domestic and international literature, analysis of current clinical guidelines, and a comparative assessment of clinical cases were conducted.

Results. Indications and contraindications for pediatric septoplasty were systematized. Key aspects of treatment strategy selection were identified, emphasizing the importance of a comprehensive approach in cases of combined pathologies.
Conclusions. Septoplasty in children is an effective method for restoring nasal breathing in cases of nasal septal deviation. A minimally invasive surgical approach through a skin incision in the mobile part of the septum allows for preservation of the mucosal lining. Due to the biomechanical properties of the perichondrium in children, spontaneous cartilage realignment is often achieved after elevating the mucoperichondrial flap from the concave side, with additional cartilage incisions if necessary. Silicone splints are recommended to prevent postoperative complications.
In the presence of concomitant dentoalveolar anomalies (narrowing, shortening, or retroposition of the maxilla), the optimal age for surgical intervention is 6–8 years, which helps reduce the need for subsequent orthodontic treatment.
In children under 12 years of age, additional crestotomy (removal of the nasal crest) is performed; in those over 12 years — crestosuturotomy (removal of the nasal crest with osteotomy of the median palatine suture), which reduces the risk of recurrent dentoalveolar anomalies observed in 43% of cases after isolated orthodontic treatment without prior otorhinolaryngological intervention (septoplasty). In combined surgical cases, referral to an orthodontist is recommended on the 7th postoperative day.

Despite the abundance of studies focused on the clinical, diagnostic, and therapeutic aspects of nasal septal deviation, data on the cellular composition and biomechanical characteristics of its structures remain limited and fragmented.
Objective. To summarize and standardize existing data on the microstructure and biomechanics of nasal septal tissues based on a review of literature and internet sources, and to identify priority directions for further research aimed at improving surgical treatment and reducing the risk of postoperative complications.
Materials and Methods. A review of national and international scientific literature, current clinical guidelines, and a comparative analysis of clinical cases was conducted.

Results and Conclusions. The nasal septum, in our opinion, consists of seven layers, each playing a crucial role in maintaining its anatomical integrity and functionality. Knowledge of the anatomical and histological features of these layers and their clinical relevance in septoplasty is essential for modern rhinologic surgery. These aspects are currently underrepresented in educational and scientific literature, and there are no dedicated monographic publications on the topic.
Preservation of the perichondrium and periosteum – structures that ensure the nutrition of cartilage and bone – is a fundamental principle of septoplasty. Understanding the biomechanics of the septal cartilage contributes to the optimization of surgical techniques, helps preserve nasal function, and reduces the risk of postoperative complications.
Thus, awareness of the layered structure and biomechanical properties of the nasal septal cartilage is critical to achieving optimal functional and aesthetic outcomes in septoplasty.

The aim of this study was to develop and evaluate the effectiveness of a comprehensive rehabilitation program - including physiotherapy, cognitive behavioral therapy, and nutritional support - for reducing the severity of tic hyperkinesias in children after tonsillectomy. These disorders significantly impair quality of life, hinder social adaptation, and require a multidisciplinary treatment approach.

Tonsillectomy is one of the most commonly performed surgical procedures in pediatric otorhinolaryngology, especially for chronic tonsillitis. However, in some cases, neurological complications such as tic hyperkinesias may develop postoperatively, highlighting the need for subsequent rehabilitation. The proposed program included physiotherapeutic procedures and nutritional support aimed at restoring nervous system function and improving overall health status. The study included children diagnosed with postoperative tic disorders who underwent a rehabilitation course lasting 3, 6, or 9 months. The effectiveness of the intervention was assessed using tic severity scales as well as neurological and psycho-emotional evaluations.
The results demonstrated a statistically significant reduction in tic severity among participants in the rehabilitation program compared to the control group. The most pronounced improvements were observed in patients who underwent rehabilitation for six months or longer. Thus, the implementation of a comprehensive rehabilitation program following tonsillectomy enhances neurological and behavioral outcomes in children and reduces the risk of chronic tic disorders.

Over the past decade, dentistry has undergone significant technological advancements that have transformed diagnostics, treatment planning, therapy, and preventive care. This paper provides an overview of ten major innovations that have found widespread clinical application: 3D printing, digital dentistry (including CAD/CAM technologies), intraoral scanners, laser technologies, minimally invasive procedures, stem cell-based regeneration, navigation systems in implantology, artificial intelligence, advanced dental biomaterials, and telemedicine.
Each of these technologies has significantly improved the precision and quality of dental care, reduced the invasiveness of procedures, and enhanced patient outcomes. Special attention is given to the rise of personalized treatment, enabling practitioners to tailor therapeutic strategies based on individual anatomical and clinical features. AI's role in radiographic analysis and treatment automation, and the increased accessibility of care via telemedicine, are also explored.
Comparative tables and visual data illustrate the effectiveness and degree of integration of these technologies into daily dental practice. Based on analysis of 15 recent and authoritative sources, the study concludes that continuous education and interdisciplinary collaboration are critical for maintaining high standards in modern dental care.

Pathology of the oral mucosa is one of the most common forms of dental disease in both children and adults, requiring timely diagnosis and multidisciplinary treatment. Traditional methods aimed solely at local symptom relief often prove insufficiently effective due to the multifactorial nature of these conditions - including infectious-inflammatory, allergic, immune, and reactive processes. As a result, relapses occur, the process becomes chronic, and patients’ quality of life declines. This paper examines a comprehensive approach to diagnosing and treating oral mucosal diseases, with an emphasis on advanced techniques developed by various authors to enhance therapeutic efficacy. Modern diagnostic methods - such as digital screening - allow for more accurate and timely detection of pathological changes. In treatment, agents with antiseptic, antiviral, and immunomodulatory properties are actively employed. The aim of the study was to improve the effectiveness of diagnosis and treatment of oral mucosal diseases in children and adults. Materials and methods were based on the aggregated data of three authors concerning oral mucosal pathology. The results demonstrated a high prevalence of viral stomatitis, followed by allergic forms, while candidal and aphthous stomatitis were encountered much less frequently.

In many cases, tooth loss is associated with periodontal diseases, particularly periodontitis, which has a very high prevalence worldwide. Periodontitis is accompanied by an inflammatory process affecting progressively deeper layers of periodontal tissues, including the destruction of the ligamentous apparatus and resorption of the alveolar bone, ultimately leading to tooth extraction if timely treatment is not provided. Treatment of periodontal diseases must be comprehensive, including orthopedic measures that aim to unite mobile and more stable teeth into a single block to evenly distribute the masticatory load across the dental arch.
Our study focused on analyzing dental prosthetic constructions fabricated in dental clinics of Osh city and Osh region. The analysis of the prosthetic structures produced in this region showed that primarily single crowns, stamped-soldered fixed bridges, partial removable plate dentures, and complete removable dentures were used.
Splinting-type prosthetic constructions-such as soldered crowns, bridge prostheses with multiple abutment teeth, and modified clasp (bugel) dentures – were not fabricated according to the reports from the dental clinics of Osh city and Osh region.

A retrospective study was conducted to assess the utilization of dental services by the adult population of Bishkek in municipal dental polyclinics No. 2, 3, 4, 5, and 6 for periodontal diseases during the period from 2020 to 2024. Additionally, prosthetic dental care was analyzed based on reporting data for the study period, specifically from 2018 to 2022.
The results of the study showed that in 2020, a very small number of adults sought dental care for periodontal diseases, which was presumably due to the impact of the Covid-19 pandemic. In the following years, there was a noticeable change in the number of visits. This can be attributed to the absence of specialized periodontal offices, standardized treatment protocols, and proper reporting systems.
Regarding the analysis of the prosthetic departments of the five municipal dental polyclinics during the study period, the following can be stated: Among the total number of fabricated prostheses, the majority were single crowns made of metal-ceramic, metal, or plastic materials. However, all of them were of unjoined (non-splinted) construction, which does not meet the specific requirements for the treatment of periodontal diseases. Most of the fixed dental bridges were stamped-soldered or metal-ceramic, but were also not adapted to the conditions of periodontal pathology.
Among removable prostheses, the most frequently produced were partial and complete acrylic (plate) dentures. Cast metal (bugel) dentures represented the lowest share in terms of quantity - accounting for only 1.63% of all fabricated removable prostheses.

Periodontitis remains one of the serious public health problems due to its high prevalence, which subsequently leads to tooth loss, negative impact on aesthetics and chewing function, and can be a source of social inequality and deterioration in the quality of life of patients, the severity of which increases with age. Pathology of the periodontium requires timely diagnosis and comprehensive treatment. Today, the development of new methods of treatment of periodontal diseases and improvement of traditional treatment schemes is a rather urgent issue. In this article, the methods of treatment of periodontitis with the use of modern drugs, aimed at improving traditional methods of treatment, are considered. Drugs with antiseptic, bactericidal, fungicidal and antiviral effects are actively used in the treatment of periodontal diseases. The purpose of this study was to evaluate the effectiveness of low-intensity laser therapy in combination with miramistin-based nanomatrices in the treatment of periodontal diseases. The results of the study showed that the combined use of the drug containing miramistin with low-intensity laser therapy in the complex therapy of patients with chronic generalized periodontitis significantly improves the condition of periodontal tissues, which is confirmed by the indicators of clinical indices and a decrease in thenumber of periodontopathogenic  microorganisms.

Artificial intelligence is increasingly used in dentistry, helping to improve diagnostic accuracy, optimize treatment processes, and automate routine procedures. Thanks to machine learning algorithms, artificial intelligence is able to analyze X-ray and CT images with high accuracy, identifying pathological changes in the early stages of disease development. Modern artificial intelligence models are actively being introduced into various areas of dentistry - from cariesology and clinical endodontics to periodontology and assessment of alveolar bone loss. This opens up new possibilities for digital planning, modeling and production of restorations with a high degree of precision and functionality. Additionally, artificial intelligence programs are capable of predicting the development of pathologies and prioritizing risk factors, which improves the quality of clinical decision-making. This article examines aspects of clinical application of artificial intelligence in dental practice. The analysis is based on data from the White Dent clinic in Semey (Abai region). A content analysis of clinical cases and statistical forms of electronic medical records was conducted. Electronic medical records of patients, cone-beam computed tomography data and digital scannedimages of the oral cavity were used to assess the effectiveness and accuracy of the use of artificial intelligence in various dental areas.

This article is devoted to sorbents, a group of drugs widely used in dental practice. It examines in detail the mechanisms of their therapeutic action on periodontal tissues. The article presents the results of periodontitis therapy using the carbon sorbent shungite. Among the examined patients, chronic catarrhal gingivitis was detected in 17 people (29.8%), generalized mild periodontitis - in 16 (28.0%), and moderate - in 24 patients (42.1%). The effectiveness of treating periodontal diseases using shungite paste was assessed in comparison with the use of shungite plates and traditional hardening dressings for gums. The most pronounced prolonged therapeutic effect was noted when using shungite paste. The clinical effectiveness of the local sorption therapy method for catarrhal gingivitis and periodontitis of mild and moderate severity is confirmed by positive dynamics of microbiological, cytomorphological and immunological indicators. As a result of comparing the therapeutic effectiveness of two forms of local sorption therapy, it was established that the optimal form of shungite for the treatment of patients with catarrhal gingivitis, as well as mild to moderate periodontitis, is 70% paste. In the treatment of mild and moderate periodontitis using 70% shungite paste, 6 months after treatment, disease remission was observed in 84.2% and 70% of cases. After 12 months, it was noted in 81.1% and 63.4% of patients.