RU2308992C1 - Method for complex therapy of chronic highmoritis - Google Patents

Abstract

FIELD: medicine, physiotherapy, otorhinolaryngology.

SUBSTANCE: beforehand after catheterization of antrum of Highmore through artificially applied anastomosis one should wash antral cavity with furacillin solution, then antral cavity should be filled in with 0.5%-dehydroquercitin solution; into solution one should introduce a distal edge of a flexible light guide of light diode AFS/S apparatus, at wave length of 0.45 mcm, radiation power of 120 mW, the diameter of light spot ranged 3-5 cm, exposure of 5 min, therapeutic course should last for 5 min. The innovation enables to enhance antioxidant action of 0.5%-dehydroquercitin solution due to affecting the mucosa of antrum of Highmore cavity with blue light spectrum.

EFFECT: higher efficiency of therapy.

1 ex, 2 tbl

Description

The invention relates to medicine, namely to a physiotherapeutic method of treating chronic sinusitis using LED phototherapy in combination with an antioxidant in otorhinolaryngology.

Known methods of intracavitary low-energy sinus irradiation with a helium-neon laser (GNL) (1).

Intracavitary laser physiotherapy was performed after washing the paranasal sinuses using a monofilament fiber, the distal end of which was inserted into the sinus (maxillary or frontal) through a catheter, as well as into the nasal cavity and nasopharynx. 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. The course of treatment ranged from 2 to 9 sessions (an average of 5).

The disadvantages of the analogue are:

1. The effect of an intracavitary helium-neon laser is not effective enough without its simultaneous use with antibiotics, sulfonamides, desensitizing agents, antioxidants, and other means.

2. With laser physiotherapy, a later normalization of blood biochemical parameters in patients with chronic sinusitis was noted as a criterion for effective treatment.

The method of LED phototherapy is taken as a prototype in the treatment of diseases of the ear, throat and nose (2). We performed LED therapy with the AFS apparatus in the treatment of allergic rhinitis, both using projection techniques for exposing the skin of the external nose and the projection area of its sinuses and endonasal, irradiating the mucous membrane of the nasal cavity and nasopharynx.

The disadvantages of the prototype are:

1. The effect of radiation from the LED device of the AFS of various wavelengths on the skin of the projection region of the maxillary sinus is practically not possible due to the powerful barrier to LED radiation in the form of its bone front wall.

The aim of this invention is to enhance the antioxidant effect of a 0.5% solution of dihydroquercetin by exposing the blue light spectrum to the mucous membrane of the maxillary sinus cavity using LED phototherapy with an APS / C device.

This goal is solved by the fact that after performing an endonasal maxillary sinusotomy and applying an artificial anastomosis in the lower nasal passage connecting the maxillary sinus cavity with the nasal cavity, in the early postoperative period, the maxillary sinus cavity was washed with furacilin solution and its subsequent filling with 0.5% dihydroquercet solution into the solution of the distal end of the flexible fiber of the AFS / C LED device with a wavelength of 0.45 μm, a maximum output radiation power of 120 mW, the diameter of the light spot t 3 to 5 cm to enhance the antioxidant effect of a 0.5% solution of dihydroquercetin on the mucous membrane of the maxillary sinus under the influence of the blue emission spectrum of LED phototherapy, the exposure duration is 5 minutes, the treatment course was 5 sessions.

Concrete example

Under observation were 12 patients aged 23 to 52 years with various forms of chronic sinusitis.

Example. Patient P., 52 years old, was hospitalized in the ENT department of AOKB with a diagnosis of Chronic left-sided sinusitis, purulent form. After the examination, the patient underwent surgery - left-sided endonasal sinusotomy with the imposition of an artificial anastomosis in the lower nasal passage connecting the maxillary sinus cavity with the nasal cavity, through which the sinus was rinsed with furacilin solution and the cavity filled with 0.5% dihydroquercetin solution with the introduction of distal cavity the end of the flexible fiber of the AFS / S LED device with a wavelength of 0.45 μm, a maximum output radiation power of 120 mW, the diameter of the light spot is from 3 to 5 see, the solution of dihydroquercetin and the mucous membrane of the maxillary sinus was illuminated, the exposure time was 5 minutes, the treatment course was 5 sessions. The procedure is carried out in the position of the patient lying on the left side in the dressing room.

Simultaneously with the LED phototherapy of the maxillary sinus cavity, a study of biochemical blood parameters was carried out to assess the effectiveness of the treatment in comparison with patients who underwent intracavitary LED phototherapy of the maxillary sinus (Table 1).

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

Table 1 Indicators in nmol / l Indicators before treatment in nmol / l Intracavitary LED therapy Intracavitary LED therapy + dihydroquercetin Lipid hydroperoxides (normal - 28.5 ± 0.6) 33.11 ± 0.12 29.52 ± 0.12 28.87 ± 0.11 Diene conjugates (norm - 29.98 ± 0.61) 32.69 ± 0.10 30.79 ± 0.11 30.17 ± 0.13 Malondialdehyde (normal - 5.79 ± 0.12) 7.63 ± 0.09 6.31 ± 0.11 5.81 ± 0.11

Dihydroquercetin and LED phototherapy reduced the inflammatory process in the maxillary sinus, which was confirmed by inhibition of lipid peroxidation and increased the level of antioxidant protection of tissues (Table 2).

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

table 2 The indicators in mcg / ml Indicators before treatment in mcg / ml Intracavitary LED therapy Intracavitary LED therapy + dihydroquercetin Tocopherol acetate (normal - 22.05 ± 0.55) 19.23 ± 0.08 21.12 ± 0.07 21.61 ± 0.08 Ceruloplasmin (normal - 22.0 ± 0.37) 20.05 ± 0.07 21.49 ± 0.08 21.81 ± 0.09

Information sources

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

2. Nasedkin A.N., Grachev S.V., Abrahamyan J.N. et al. Comparison of clinical indicators of the effectiveness of the use of laser therapy and LED phototherapy in the treatment of diseases of the ear, throat and nose // Health and medical equipment. - 2005. - No. 8 (22). - S. 45.

Claims (1)

A method for the complex treatment of chronic sinusitis, characterized in that after catheterization of the maxillary sinus through artificially imposed anastomosis, the sinus cavity is rinsed with a solution of furatsillin, then the sinus cavity is filled with a 0.5% solution of dehydroquercetin, the distal end of the flexible light guide of the AFS / LED device is introduced into the solution C, with a wavelength of 0.45 μm, a radiation power of 120 mW, a diameter of the light spot from 3 to 5 cm, an exposure of 5 minutes, a course of treatment of 5 minutes.