RU2253384C1 - Method for surgical treatment of exudative otitis - Google Patents

Abstract

FIELD: medicine, otorhinolaryngology.

SUBSTANCE: one should introduce an endoscope connected with video camera into patient's auditory canal and apply two metal tubes, perform incision in posterior-lower quadrant under endoscopic control. Then tympanic membrane should be washed to remove pathological content due to applying antiseptic solution in one tube and aspiration - through another one. After complete sanitation it is necessary to introduce the endoscope into incision of tympanic membrane to control its state, then it should be introduced into auditory canal to apply shunt under its control. The method enables to shorten period of operation and perform constant control for the process of tympanic sanitation.

EFFECT: higher efficiency of therapy.

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Description

The invention relates to medicine, otorhinolaryngology, and can be used to treat exudative otitis media.

A known method for the surgical treatment of exudative otitis media, including anesthesia, an incision in the anteroposterior or anterior-inferior quadrant and adequate drainage of the middle ear cavity, aspirating the exudate from the tympanic cavity, administering drugs and installing a shunt.

The disadvantage of this method is the lack of direct visual control over the condition of the tympanic cavity during rehabilitation and the inability to control the effectiveness of its implementation.

The objective of the proposed method is to increase the efficiency of surgical treatment of exudative otitis media and reduce the time of the operation.

This object is achieved in that in a method of surgical treatment of exudative otitis media, including anesthesia, an eardrum section, aspiration of pathological contents, administration of a drug solution and installation of a shunt, it is new that an endoscope connected to a video camera is inserted into the external auditory canal before control of which in an immersion medium, cut the tympanic membrane in the posterior-lower quadrant, then wash the tympanic cavity through two metal tubes, Formation into the ear canal, by introducing an antiseptic solution in one tube and aspirating pathological content via another tube and then installing the shunt under control of the endoscope.

Surgical treatment of exudative otitis media under the control of an endoscope connected to a video camera allows the surgeon to examine the eardrum in detail before and after the incision, remove the pathological contents, evaluate the effectiveness of rehabilitation and establish the quality of the shunt.

The process of introducing a solution of antiseptic and removing pathological contents occurs simultaneously, which increases the efficiency of sanitation of the tympanum.

The method is as follows.

Under general anesthesia, a direct view, with a diameter of 1.9 mm, a length of 110 mm, is inserted into the external auditory canal and two metal tubes are installed to inject the antiseptic solution into one tube and aspirate the pathological contents through another, after which an immersion medium is created in the auditory canal.

After examining the eardrum in an immersion medium with a paracentesis needle, an incision is made in the posterior-lower quadrant, then the tympanic cavity is washed to remove pathological contents. After complete debridement, an endoscope is inserted into the section of the eardrum to monitor the condition of the tympanic cavity, then the endoscope is displayed in the external auditory meatus and a shunt is installed under its control.

Example 1

Patient M., 4 years old, was admitted to the hospital with a diagnosis of Chronic bilateral exudative otitis media. Under general anesthesia, after processing the external auditory canal with a 96% alcohol solution, a direct viewing endoscope with a diameter of 1.9 mm and a length of 11 cm was inserted into the external auditory canal, a tube system was installed to inject an antiseptic solution and remove pathological contents. After they are connected, an immersion medium is created in the external auditory canal. In the immersion medium, after examining the eardrum with a paracentesis needle, an incision was made in the posterior-lower quadrant. Under pressure, a large amount of thick exudate was released through the incision. By irrigation, the tympanum is washed through the incision and the pathological contents are removed along with the antiseptic solution. After washing through an incision, an endoscope was inserted into the tympanic cavity, and a control examination of the mucous membrane of the tympanic cavity was performed. The mucous membrane of the tympanic cavity is swollen, the exudate is completely removed. Under the control of the endoscope, a shunt was installed at the incision site of the eardrum. Turunda with ointment “Levomekol” was installed in the external auditory meatus.

Example 2

Patient S., 10 years old, was admitted to the hospital with a diagnosis of Chronic right-sided exudative otitis media. Under general anesthesia, treatment of the external auditory canal with a 96% alcohol solution, a direct viewing endoscope with a diameter of 1.9 mm and a length of 11 cm was inserted into the external auditory canal. A tube system was installed to inject the antiseptic solution and remove pathological contents, after connecting them to the external The ear canal creates an immersion environment. In the immersion medium, after examining the eardrum with a paracentesis needle, an incision was made in the posterior-lower quadrant. Pathological contents not received. By irrigation, the tympanum is washed through the incision, and a scanty amount of mucopurulent clots is obtained. After washing through an incision, an endoscope was inserted into the tympanic cavity, and a control examination of the tympanic cavity was carried out. The mucous membrane of the tympanic cavity is swollen, in the lower sections thick jelly-like mucus is determined. A repeated washing of the tympanic cavity was carried out until the pathological contents, which were visually controlled using an endoscope in an immersion medium, were completely removed. After complete rehabilitation, a shunt is installed in the section of the eardrum. A turunda with ointment “Levomekol” was installed in the ear canal.

The positive effect of the proposed method for the treatment of exudative otitis media is that in the immersion medium there is no need for periodic removal of the endoscope from the external auditory meatus in order to wipe the end part of the endoscope, which is contaminated with the removed pathological contents during the operation. This reduces the duration of the operation and allows continuous monitoring of the process of rehabilitation of the tympanic cavity.

Claims (1)

A method for surgical treatment of exudative otitis media, including anesthesia, an eardrum incision, aspiration of pathological contents, the administration of a drug solution and the installation of a shunt, characterized in that an endoscope connected to a video camera is inserted into the external auditory meatus, under the control of which an erectile incision is performed the membranes in the posterior-lower quadrant, then rinse the tympanic cavity through two metal tubes installed in the external auditory meatus, pu em administration antiseptic solution in one tube and aspirating pathological content via another with the subsequent installation of the shunt under control of the endoscope.