RU2491895C1 - Laser apparatus for nasal breathing recovery - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to otorhinolaryngology. A heated distal flat end of a light guide of ATKUS-15 semi-conductor laser is used to excise a cicatrical diaphragm in a contact continuous mode. Laser radiating power is 8.5-9 Wt. An exposure length is 30 to 60 seconds. That is followed by introducing 1% emoxipin 1 ml into a formed coagulation necrosis. The necrotic areas are exposed to LA-2 physiotherapeutic laser apparatus. The therapeutic course makes 7 days.

EFFECT: method provides the nasal breathing recovery, prevents any possible recurrences.

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Description

The invention relates to medicine, namely to otorhinolaryngology.

Known methods for surgical treatment of atresia of the entrance to the nose (1).

The operation consists in excising excess tissue in anticipation of the nose and covering the wound surface with a thin skin flap on a feeding leg, taken from the nearest area of the face. The flap is fixed with hair sutures and tampons or with an elastic rubber tube, which should not put pressure on the flap, otherwise it will die, but only keep it in contact with the underlying wound surface.

The disadvantages of the analogue are:

1. In more than 85% of cases, recurrence of atresia of the vestibule of the nose develops.

2. An additional scar on the face.

3. Drying and rejection of the transplanted flap.

As a prototype, a method of laser excision of synechiae in the nasal cavity using Nd: YAG and a semiconductor laser was taken (2). After performing application anesthesia in contact mode, the oblique synechia in the nasal cavity is dissected by the oblique distal end of the fiber. A narrow zone of coagulation necrosis is formed without a zone of corbonization. The power at the output of a monofilament of 6-8 W is used with an exposure of 0.1-1 s.

The disadvantages of the prototype:

1. When excising synechiae, as a rule, nearby sections of the mucous membrane of the lateral and medial walls of the nasal cavity can be burned.

2. The use of this method of excision of synechia in the nasal cavity there is a need for repeated laser excisions.

The aim of this invention is the laser excision of the cicatricial diaphragm in anticipation of the nose forming its atresia with the introduction of an antioxidant solution into the coagulation necrosis zone, followed by the photophoresis technique with a helium-neon laser.

This goal is solved by the fact that after infiltration anesthesia of soft tissues in anticipation of the nose and scar tissue forming its atresia with a 1% lidocaine solution using the heated distal end of the fiber of the ATKUS-15 semiconductor laser in a continuous contact mode with a laser radiation power of 8.5- 9 W, laser exposure time from 30 to 60 seconds was performed excision of the scar diaphragm from all the walls of the vestibule of the nose, followed by injection into the subcutaneous layer of the wings of the nose, septum and the bottom of the vestibule nasal nasal congestion in the area of the formed coagulation necrosis of a 1% emoxipin solution and illuminating these areas with the distal end of the monofilament fiber of a helium-neon laser using a LA-2 physiotherapeutic laser with a wavelength of 0.63 μm, a maximum output power of 20-30 mW, and a diameter a light spot from 0.5 to 0.8 cm, a power flux density of 50 W / cm ² , a single dose from 5.5 to 6.5 J / cm. The exposure time of laser radiation was 2 minutes per zone of coagulation necrosis of the nasal septum, wing of the nose, bottom of the vestibule of the nose, with a course of treatment of 7 days directly in the viewing room.

Concrete example

Under observation, there were 3 patients aged 18 to 37 years with unilateral atresia of the vestibule of the nose, the main complaint of which was the complete absence of nasal breathing on the one hand, previously all patients were injured in the outer nose with damage to the skin of the vestibule and the wings of the nose.

Example. Patient S., 37 years old, was on outpatient treatment with a diagnosis of Atresia of the vestibule of the nose on the left. He suffers from this disease for 3 years. Previously, the patient suffered an external nose injury with the subsequent formation of a lack of nasal breathing and entry into the nasal cavity on the left. With anterior rhinoscopy, a cicatricial diaphragm was completely determined to completely block the entrance to the nasal cavity. Given the presence of a cicatricial diaphragm and the possibility of its re-formation, the patient was recommended an operation - Laser excision of the cicatricial diaphragm of the vestibule of the nose.

After infiltration anesthesia of soft tissues in anticipation of the nose and scar tissue forming its atresia with a 1% lidocaine solution using the heated distal end of the ATKUS-15 semiconductor laser fiber in a continuous contact mode with a laser radiation power of 8.5 W, laser exposure time of 60 seconds excision of the cicatricial diaphragm from all the walls of the vestibule of the nose was performed, followed by injection into the subcutaneous layer of the wings of the nose, septum and the bottom of the vestibule of the nose in the area of the formed coag of ulcerative necrosis of a 1% solution of emoxipin and coverage of these zones with the distal end of a monofilament fiber of a helium-neon laser using a physiological laser apparatus "LA-2" with a wavelength of 0.63 μm, a maximum output power of 20-30 mW, a light spot diameter of 0, 5 to 0.8 cm, power flux density 50 W / cm ² , a single dose from 5.5 to 6.5 J / cm. The exposure time of laser radiation was 2 minutes per zone of coagulation necrosis of the nasal septum, wing of the nose, bottom of the vestibule of the nose, with a treatment course of 7 days directly in the viewing room (Fig. 1).

Information sources:

1. Babiyak VT. Clinical otorhinolarynology. - SPb .: Hippocrates. - 2005. - p. 315.

2. Conservative and surgical methods in rhinology / ed. M.S. Pluzhnikov. - SPb.: "Dialogue." - 2005 .-- 352-353.

Claims (1)

The method of laser excision of the scar diaphragm in anticipation of the nose forming its atresia, characterized in that after infiltration anesthesia of soft tissues in anticipation of the nose and scar tissue forming its atresia with a 1% lidocaine solution using the heated distal end of the optical fiber of the semiconductor laser in a continuous mode with with a laser radiation power of 8.5-9 W, a laser exposure time of 30 to 60 s, excision of the scar diaphragm from all the walls of the vestibule of the nose, followed by injection the introduction of a subcutaneous layer of the wings of the nose, septum and the bottom of the vestibule of the nose in the area of the formed coagulation necrosis of a 1% solution of emoxipin and illuminating these areas with the distal end of the monofilament fiber of a helium-neon laser with a wavelength of 0.63 μm, with a maximum output power of 20-30 mW , with a light spot diameter from 0.5 to 0.8 cm, a power flux density of 50 W / cm ² , a single dose from 5.5 to 6.5 J / cm, where the exposure time of laser radiation is 2 minutes per zone of coagulation necrosis nasal septum, nose wing, the bottom of the vestibule of the nose, the course of treatment is 7 days.

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