RU2260460C1 - Method for applying laser radiation to tympanic cavity structures in the cases of chronic purulent middle otitis - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: method involves applying direct laser irradiation to tympanic cavity structures at wavelength equal to 0.67 mcm, power of 15 mW in continuous mode during 2 min. Direct tympanic cavity laser irradiation is carried out beginning from the first day of postoperative period. Direct tympanic cavity laser irradiation is carried out with flexible light guide. Wavelength is equal to 0.63 mcm, power of 1,0 mW, duration is 10 min per one session. The number of sessions is 10.

EFFECT: accelerated treatment course.

Description

The invention relates to medicine, namely to otorhinolaryngology. One of the most effective methods of treating patients with chronic purulent otitis media is a method of laser irradiation of the tympanic cavity during a sanitizing operation on the temporal bone (Svistushkin V.M., Bezchinskaya M.Ya., Morozova S.V., Makeeva N.S. Vestnik of otorhinolaryngology, 1992, N1, pp. 16-18). The method includes the use of a helium-neon laser system LTM-01 with a wavelength of 0.63 μm, a power of 1.0 mW. Laser irradiation of the tympanic cavity through the eardrum is performed after surgery on the temporal bone. Treatment begins from 7-8 days of the postoperative period after removal of tampons from the postoperative cavity. A flexible light guide is introduced into the external auditory meatus to a depth of 1-1.5 cm. The exposure time is 10 minutes. The number of sessions is 7-12.

The disadvantage of this method is the long incapacity for work.

The technical result of this invention is to reduce the period of disability.

The method is as follows. During surgery on the temporal bone in patients with chronic purulent otitis media, laser irradiation of the mucous membrane of the tympanic cavity and the mouth of the auditory tube is performed using a flexible laser fiber inserted through the surgical wound into the tympanic cavity. The irradiation time is 2 minutes, the wavelength is 0.67 μm, and the power is 15 mW in a continuous mode.

When the facial nerve is involved in the inflammatory process, a section of the facial nerve in the fallopian canal is exposed and then laser irradiated. For this, a flexible laser fiber is inserted through the surgical wound into the tympanic cavity directly to the exposed area of the facial nerve. The irradiation time is 2 minutes, the wavelength is 0.67 μm, and the power is 15 mW in a continuous mode.

When carrying out tympanoplasty, laser irradiation of a neotympanal flap is performed. To do this, after laying the non-tympanal flap on the remnants of the eardrum, the flexible laser fiber is inserted through the surgical wound into the tympanic cavity directly to the folded flap. The irradiation time is 2 minutes, the wavelength is 0.67 μm, and the power is 15 mW in a continuous mode.

At the end of the operation, a disposable sterile light guide is inserted into the tympanic cavity through the surgical wound, the second end of which is removed through the postoperative wound behind the ear, the surgical wound is sutured, the postoperative cavity is plugged. Treatment begins from the first day of the postoperative period. For this, a disposable sterile optical fiber installed in the tympanic cavity is connected to a laser apparatus. The exposure time is 10 minutes, the wavelength is 0.63 microns, and the power is 1 mW. The course of treatment is 7-10 sessions, one session per day.

The reduction of the period of incapacity for work is achieved by direct exposure to laser radiation with a wavelength of 0.67 μm, a power of 15 mW in continuous mode for 2 min on the structures of the tympanic cavity during surgery on the temporal bone and direct laser irradiation of the tympanic cavity starting from the first day of the postoperative period.

Example 1

Patient A., 52 years old, with a diagnosis of left-sided chronic purulent otitis media, a sanitizing operation was performed on the right temporal bone. During the operation, the tympanic cavity and the mouth of the auditory tube were irradiated using a Mustang laser device, model 024, with a wavelength of 0.67 μm, a power of 15 mW in continuous mode, the irradiation time was 2 minutes. Then, a disposable sterile light guide is installed in the tympanic cavity, the second end of which is removed through the behind the wound, the surgical wound is sutured, and the postoperative cavity is plugged. From the first day of the postoperative period, the patient was irradiated with a drum cavity using a helium-neon laser apparatus ALOK-1 with a wavelength of 0.63 μm and a power of 1.0 mW. For this, the withdrawn end of a disposable sterile fiber installed in the tympanic cavity was connected to the ALOK-1 laser apparatus. The duration of the irradiation session is 10 minutes. The course of treatment was 7 sessions. After a full course of treatment, 7 days, the patient’s postoperative cavity is epidermized, there are no inflammatory phenomena. The period of incapacity for work was 14 days.

Example 2

Patient S., 37 years old, was diagnosed with chronic suppurative otitis media, peripheral paresis of the facial nerve on the right, a sanitizing operation was performed on the right temporal bone with decompression of the facial nerve. After exposure of the facial nerve in the fallopian canal, it was irradiated using a Mustang laser model 024, with a wavelength of 0.67 μm, a power of 15 mW in a continuous mode, the irradiation time was 2 min. Then, a disposable sterile light guide is installed in the tympanic cavity, the second end of which is removed through the behind the wound, the surgical wound is sutured, and the postoperative cavity is plugged. From the first day of the postoperative period, the patient was irradiated with a tympanic cavity and facial nerve using an ALOK-1 helium-neon laser apparatus with a wavelength of 0.63 μm and a power of 1.0 mW. For this, the withdrawn end of a disposable sterile fiber installed in the tympanic cavity was connected to the ALOK-1 laser apparatus. The duration of the irradiation session is 10 minutes. The course of treatment was 10 sessions. After a full course of treatment, 10 days, the patient has no symptoms of peripheral paresis of the facial nerve, there are no inflammatory phenomena from the postoperative cavity. The period of incapacity for work was 15 days.

Example 3

Patient D., 28 years old, with a diagnosis of left-sided chronic purulent otitis media, performed a sanitizing operation on the right temporal bone with tympanoplasty. After laying a non-tympanal flap on the remains of the eardrum, it was irradiated using a Mustang laser device, model 024, with a wavelength of 0.67 μm, a power of 15 mW in continuous mode, the irradiation time was 2 minutes. Then, a disposable sterile light guide is installed in the tympanic cavity, the second end of which is removed through the behind the wound, the surgical wound is sutured, and the postoperative cavity is plugged. From the first day of the postoperative period, the patient underwent irradiation of the tympanic cavity and neotympanic flap using a helium-neon laser apparatus ALOK-1 with a wavelength of 0.63 μm, a power of 1 mW. For this, the withdrawn end of a disposable sterile fiber installed in the tympanic cavity was connected to the ALOK-1 laser apparatus. The duration of the irradiation session is 10 minutes. The course of treatment was 10 sessions. After a full course of treatment, 10 days, the patient noted complete engraftment of a neotympanic flap, there are no inflammatory phenomena from the postoperative cavity. The period of incapacity for work was 14 days.

According to the proposed method, 29 patients were treated. The duration of the period of disability of patients with chronic suppurative otitis media decreased by an average of 32%.

Claims (1)

A method for laser irradiation of the structures of the tympanic cavity in chronic suppurative otitis media, including laser irradiation of the tympanic cavity after surgery on the temporal bone with a wavelength of 0.63 μm, a power of 1.0 mW, for 10 minutes per session, the number of sessions up to 10, using a flexible optical fiber, characterized in that, in addition, during surgery on the temporal bone, direct laser irradiation of the structures of the tympanic cavity with a wavelength of 0.67 μm, a power of 15 mW in a continuous mode, for 2 minutes, and starting from Vågå postoperative day perform direct laser exposure of the tympanic cavity.