RU2432921C1 - Method of partial laser resection of nasal turbinates in case of chronic rhinitis - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to method of high-energy laser partial resection of lower nasal turbinate in case of chronic rhinitis in otolaryngology. Contact partial laser resection of free end of lower nasal turbinate with cavernous venous plexuses is performed. Laser resection is carried out with pendulum-like movements of distal butt end of light conductor of high-energy semiconductor laser "ATKUS-15" with 0.4 mm diameter along entire length of nasal turbinate from its anterior end towards the posterior one. Impact is performed with laser radiation power 8.5 W and wavelength 0.83 mcm in continuous mode. Duration of laser impact constitutes 30-40 seconds. Procedure is performed one time from two sides. Efficiency of said impact performance was evaluated by a number of clinical factors: absence of nasal bleeding and necessity of nose tamponade, reduction of edema of mucous membrane of lower nasal turbinates, recovery of breathing function of nasal cavity, reduction of transport function of ciliated epithelium.

EFFECT: method makes it possible to recover nasal breathing in case of chronic rhinitis.

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Description

The invention relates to medicine, namely to a method of high-energy partial laser resection of the lower turbinate in chronic rhinitis in otorhinolaryngology.

Known methods for treating chronic rhinitis by radiocauterization of the lower nasal concha with a bipolar electrode with a Surgitron apparatus with an exposure time of 10 seconds and with the Coagulation mode and a power of 3.0-5.0 units (1).

The disadvantages of the analogue are:

1. After radiocauterization of the lower nasal concha is performed, nasal bleeding may develop, entailing tamponade of the nasal cavity for 1-2 days.

2. For a long time, 8-9 days, after radiocauterization of the lower nasal concha, crusts remain in the nasal cavity.

3. Nasal breathing after radiocauterization of the lower turbinates is restored only to 8.9 ± 1.1 days.

4. The effectiveness of treatment reached 86%.

As a prototype, a method of partial resection of hypertrophied nasal concha - conchotomy is taken. Scissors for conchotomy perform a partial resection of the free edge of the lower nasal concha from its anterior end to the posterior, followed by tamponade of the nasal cavity for 1-2 days to stop bleeding (2).

The disadvantages of the prototype are;

1. The duration of the operation and the need for tamponade of the nasal cavity for 1-2 days.

2. Long-term formation of crusts and cicatricial adhesions in the nasal cavity between the lower nasal concha and the nasal septum.

4. The development of atrophic rhinitis in the long-term postoperative period.

3. The effectiveness of treatment reaches 83%.

The aim of this invention is the restoration of nasal breathing in chronic rhinitis with a high-energy semiconductor laser by partial laser resection of the lower turbinate.

This goal is achieved by the fact that after infiltration anesthesia of 5 ml of a 1% solution of lidocaine of the inferior nasal concha, a partial laser resection of the free edge of the inferior nasal concha was performed with cavernous venous plexus pendulum-like movements of the distal end of the fiber of the ATKUS-15 high-energy semiconductor laser with a diameter of 0.4 mm the entire length of the nasal concha from its anterior end to the posterior with a laser radiation power of 8.5 W and a wavelength of 0.83 μm, in continuous mode, the duration l grain exposure was 30-40 seconds, the procedure was carried out once with the two sides. The effectiveness of treatment 1 month after its implementation in patients reached - 93%.

Concrete example

Under observation were 15 patients aged 18 to 43 years with allergic, vasomotor, hypertrophic rhinitis.

Example. Patient Z., 26 years old, was treated in the ENT department of AOKB with a diagnosis of Chronic vasomotor rhinitis, an allergic form with polypoid hypertrophy of the lower nasal concha. After a preliminary examination of the patient and infiltration anesthesia of 5 ml of 1% lidocaine solution of the inferior nasal concha, a partial laser resection of the free edge of the inferior nasal concha was performed with cavernous venous plexus pendulum-like movements of the distal end of the ATKUS-15 high-energy semiconductor laser with a diameter of 0.4 mm on the entire length of the nasal concha from its anterior end to the posterior with a laser power of 8.5 W and a wavelength of 0.83 μm, continuously In the normal mode, the duration of the laser exposure was 30 seconds; the procedure was performed once on both sides.

The effectiveness of the performed partial partial laser resection of the free edge of the inferior nasal concha with cavernous venous plexuses was determined by a number of clinical factors.

1. There was no nosebleed.

2. There was no need for nasal tamponade.

3. Swelling of the mucous membrane of the lower nasal turbinates decreased by 10 days after partial laser resection.

4. The respiratory function of the nasal cavity was restored in full by 10 days after surgery.

5. The transport function of the ciliated epithelium of the nasal cavity was restored by 10 days of the postoperative period.

Information sources

1. Shakhova E.G. The effectiveness of surgical treatments for chronic rhinitis // Russian rhinology. - 2005. - No. 2. - S. 61.

2. Palchun V.T., Preobrazhensky N.A. Diseases of the ear, throat, nose. - M.: Medicine, 1978.- 487 p.

Claims (1)

A method of partial laser resection of the lower turbinates in chronic rhinitis by exposure to laser radiation, characterized in that the partial resection of the free edge of the lower turbinate and cavernous venous plexuses was carried out by laser radiation along its entire length from its front end to the back in the form of pendulum-like movements by the distal end of the fiber high-energy semiconductor laser with a diameter of 0.4 mm with a laser radiation power of 8.5 W and a wavelength of 0.83 μm, in continuous mode, the length The laser exposure was 30–40 s; the procedure was performed once on both sides.