RU2281797C1 - Method of electrophoresis in lacunas of palatine tonsils - Google Patents

Abstract

FIELD: otolaryngology.

SUBSTANCE: in order to treat tonsillitis, ml of 1% solution of emoxipine is introduced into lacunas of palatine tonsils, after which the latter are exposed to helium-neon laser radiation with wavelength 0.63 μm, maximum output power 10-20 mW, light spot diameter 2-3 mm, and power flow density 35-60 W/cm², distal end of monofiber beamguide being introduced into lacuna cavity. Single dose ranges from 3.0 to 5.5 J/cm. Radiation exposition time is 2 min per 1 lacuna and full course consists of 5-7 procedures.

EFFECT: accelerated accumulation of required concentration of emoxipine in tissues of palatine tonsils so enhancing treatment efficiency.

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Description

The invention relates to medicine, namely to otorhinolaryngology, and is used to treat a compensated and decompensated form of chronic tonsillitis.

Known methods of intracavitary low-energy irradiation of the paranasal sinuses with a helium-neon laser (GNL) in rhinology (1).

Intracavitary laser physiotherapy was performed after washing the paranasal sinuses with a monofilament fiber, the distal end of which was inserted into the sinus (maxillary or frontal) through a catheter. Laser physiotherapy was carried out using commercially available GNL LG-38 with a wavelength of 0.633 μm and an energy exposure of 10 J / cm. As a light guide, a quartz-polymer monofilament in a protective polyethylene sheath with a diameter of a light-carrying core of 200 μm 1 m long with a fused distal end was used. The course of treatment ranged from 2 to 9 sessions (an average of 5).

The disadvantages of the analogue are:

1. The impact of intracavitary GNL is not effective enough without its simultaneous use with other drugs. Only against the background of the complex treatment of paranasal sinus disease the effect of laser physiotherapy will be most pronounced.

2. Normalization of biochemical parameters (lipid peroxidation and antioxidant protection) in patients with paranasal sinus disease will be a criterion for the effectiveness of laser therapy.

As a prototype, a method of the action of a helium-neon laser on the tissues of the middle ear in the presence of biological fluids and medical solutions was taken (2).

The depth of laser energy penetration into the mucous membrane and bone tissue taken from a rabbit’s drum bulla was experimentally studied in the aspect of substantiating the use of laser radiation in the conservative treatment of chronic purulent otitis media in order to stimulate reparative processes in the surgical wound in the early postoperative period. In the course of experimental studies, it was found that biological media, due to the high absorption coefficients of laser energy, impede its full access to the irradiated object. Transparent medical solutions, due to low absorption coefficients, have practically no attenuating effect when a laser beam passes through them. The penetration depth of laser radiation in them is 8-12 cm, which is hundreds of times greater than the depth of penetration into the blood, blood serum and thousands of times into the mucous membrane, bone and cartilage.

The disadvantages of the prototype are:

1. The effectiveness of intracavitary exposure to a helium-neon laser will not be effective enough if the wound exudate is preserved in the irradiated cavity.

2. Acceleration of reparative processes in the postoperative cavity with intracavitary exposure to laser radiation is most effective in combination with various drugs.

The aim of the present invention is a deeper penetration and faster absorption of the surface of the mucous membrane of the palatine tonsils of a drug having an antioxidant effect (1% solution of emoxipin) under the influence of a helium-neon laser in various forms of chronic tonsillitis.

This goal is solved by the fact that in the cavity of the gaps of the tonsils (6-8 gaps), pre-filled with a 1% solution of emoxipin in a volume of 3 ml, the distal end of the monofilament fiber is introduced. The exposure to a helium-neon laser is carried out using a laser physiotherapeutic installation "LA-2" with a wavelength of 0.63 μm, a maximum output power of 10-20 mW, the diameter of the light spot ranges from 2 to 3 mm, the power flux density is 35-60 W / cm ² , a single dose is from 3.0 to 5.5 J / cm. The action of a helium-neon laser is carried out using the distal end of the monofilament fiber connected to the laser unit. The exposure time of laser radiation is 2 minutes per 1 lacuna. The technique of laser phoresis of emoxipin is carried out by the course for 5-7 days directly in the viewing room.

Concrete example

Under observation were 15 children aged 9 to 17 years with a compensated and decompensated form of chronic tonsillitis, who had previously repeatedly washed the lacunae of the tonsils with 0.2% solution of furacilin in combination with 5% solution of ascorbic acid.

Example. Patient V., 16 years old, was outpatient in the ENT department of the AODKB with a diagnosis of chronic tonsillitis, decompensated form. Surgical treatment of the patient was not performed due to the pathology of the blood coagulation system and possible bleeding after surgery. A child has a history of relapses of angina up to 2-3 times a year with an increase in body temperature to 37.3-38.5 ° C, frequent colds. Previously, the patient was washed lacunae of the tonsils with a solution of furatsillina and 5% solution of ascorbic acid in courses up to 10 times. Against the background of the treatment, the number of relapses of tonsillitis did not decrease, caseous masses remained in the gaps of the tonsils, regional lymph nodes were increased to 1.0 cm in diameter.

To eliminate the chronic process of inflammation in the tonsils, the technique of laser phoresis of a 1% solution of emoxipin was used.

In the cavity of the gaps of palatine tonsils (6-8 gaps), pre-filled with a 1% solution of emoxipin in a volume of 3 ml, the distal end of the monofilament fiber was introduced. The helium-neon laser was applied using the LA-2 laser physiotherapeutic unit with a wavelength of 0.63 μm, a maximum output power of 10-20 mW, the diameter of the light spot ranged from 2 to 3 mm, and the power flux density was 35-60 W / cm ² , a single dose ranged from 3.0 to 5.5 J / cm. The action of a helium-neon laser was carried out using the distal end of a monofilament fiber connected to a laser system. The laser exposure time was 2 minutes per 1 lacuna. The technique of laser phoresis of emoxipin was carried out by the course for 5-7 days directly in the viewing room.

Simultaneously with laser phoresis, a study of blood biochemical parameters was carried out to assess the effectiveness of treatment in comparison with patients who underwent traditional therapy (Table 1).

This method of laser phoresis contributes to the rapid accumulation of the required concentration of the drug in the tissues of the tonsils, which helps to increase the effectiveness of the treatment.

A helium-neon laser promotes deeper penetration of a solution of emoxipin into the tissues of the tonsils, being its conductor.

The antioxidant helps inhibit the processes of lipid peroxidation in tissues and increases the level of antioxidant protection, which is very important to eliminate chronic inflammation in the tonsils and restore their immunological function.

The dynamics of lipid peroxidation after treatment (table 1).

Table 1. Indicators in nmol / l Traditional therapy Conventional Therapy + Emoxipin Lipid hydroperoxides (normal - 28.5 ± 0.6) 28.95 ± 0.31 28.51 ± 0.23 Diene conjugates (norm - 29.98 ± 0.61) 30.42 ± 0.81 29.98 ± 0.42 Malondialdehyde (normal - 5.79 ± 0.12) 6.20 ± 0.27 5.80 ± 0.21

The dynamics of antioxidant defense after treatment (table 2).

Table 2. Indicators in mcg / ml Traditional therapy Conventional Therapy + Emoxipin Tocopherol acetate (normal - 22.05 ± 0.55) 21.21 ± 0.11 22.04 ± 0.19 Ceruloplasmin (normal - 22.0 ± 0.37) 21.12 ± 0.27 21.99 ± 0.16

Information sources

1. Pluzhnikov MS, Lopotko A.I. Low-energy laser radiation in rhinology // Russian rhinology. - 1995. - No. 3-4. - from. 42-47.

2. Mishenkin N.V., Tikhomirov V.V., Krotov Yu.A. The effect of the energy of a helium-neon laser on the tissues of the middle ear in the presence of biological fluids and medical solutions // Herald of Otorhinolaryngology. - 1990. - No. 5. - p. 18-21.

Claims (1)

A method for the treatment of tonsillitis, including the introduction of a drug and subsequent exposure to a helium-neon laser, characterized in that as a drug is injected into the lacunae a 1% solution of emoxipin in a volume of 3 ml, after which they are exposed to laser radiation with a wavelength of 0, 63 microns, with a maximum output power of 10-20 mW, a light spot diameter of 2-3 mm, a power flux density of 35-60 W / cm ² , a single dose of 3.0-5.5 J / cm ² and an exposure of 2 minutes per 1 lacuna moreover, the distal end face of the monofilament fiber lead into the cavity of the gaps, the course of 5-7 treatments.