К ВОПРОСУ ОБ АЛГОРИТМЕ ЛУЧЕВОЙ ДИАГНОСТИКИ ПЕРЕЛОМОВ СРЕДНЕЙ ЗОНЫ ЛИЦА, СОПРОВОЖДАЮЩИХСЯ ПОВРЕЖДЕНИЕМ ВЕРХНЕЧЕЛЮСТНОЙ ПАЗУХИ

The X-ray and spiral computed tomography pictures of patients with zygomatico-orbito-maxillary coplex fractures accompanied by damage of the maxillary sinus walls were analyzed. Residual displacement and emergence of hemosinus after close reduction and after open reduction with internal fixation were compaired. Radiography could be used as a screening for detection of indication for surgery. Computed tomography should be a regular method of postoperative diagnostic to evaluate sinus pneumatisation and anomalies of ostio-meatal unit.Изучены данные лучевой диагностики у пациентов с переломом скуло-орбитально-верхнечелюстного комплекса, сопровождающимся повреждением верхнечелюстной пазухи. Проведен анализ качества сопоставления костных отломков, а также частоты возникновения гемосинуса после закрытых и открытых методов хирургического лечения переломов по данным рентгенографии и компьютерной томографии. Сделан вывод о возможности использования рентгенографии в качестве скрининга для выявления показаний к хирургическому лечению и необходимости выполнения компьютерной томографии в послеоперационный период для оценки пневматизации верхнечелюстной пазухи и состояния остио-меатального комплекса

КОМПЬЮТЕРНАЯ ДИАГНОСТИКА В ЛЕЧЕНИИ ПАТОЛОГИЙ РИНОСИНУСОТУБАРНОЙ ЗОНЫ

This article presents the capabilities of computer tomography in the diagnosis and treatment algorithm combine pathology (acute sinusitis, acute otitis media, Eustachian tube dysfunction).В статье представлены возможности компьютерной томографии в диагностике и алгоритм лечения патологии риносинусотубарной зоны

ВОЗМОЖНОСТИ ЭЛЕКТРОМАГНИТНОЙ НАВИГАЦИОННОЙ СИСТЕМЫ В ЭНДОСКОПИЧЕСКОЙ ХИРУРГИИ ОСТЕОМ ЛОБНЫХ ПАЗУХ

The article presents the possibility of an electromagnetic navigation system during endoscopic endonasal removal of the frontal sinus osteomas, the possibility of intraoperative monitoring of doing surgery, and postoperative analysis.В статье представлены возможности электромагнитной навигационной системы при эндоскопическом эндоназальном удалении остеомы лобной пазухи, возможности интраоперационного контроля ведения оперативного вмешательства, а также анализ послеоперационных данных

КОМПЬЮТЕРНАЯ ТОМОГРАФИЯ В ДИАГНОСТИКЕ ОСТЕОМ ОКОЛОНОСОВЫХ ПАЗУХ

The article presents the possibility of 3D-computer tomography in the diagnosis of the paranasal sinuses osteoma, the results of surgical treatment in 34 patients.В статье представлены возможности 3D-компьютерной томографии в диагностике остеом околоносовых пазух, представлены результаты оперативного лечения у 34 пациентов

RHINORRHEA: SYMPTOM OF MANY DISEASES!

Rhinorrhea is a term for abundant mucous (watery) discharge from the nasal cavity, which originated from the Greek word «rhoia» (flow, discharge). Rhinorrhea is usually a symptom of acute diseases. However, less pronounced manifestations can be a sign of various chronic diseases not only of the nasal cavity, but of other organs and systems. In order to identify the causes for rhinorrhea, you may need to take an additional examination and a detailed history of occupational diseases, medications taken, etc. The patients should receive symptomatic treatment while awaiting the laboratory test results and identification of the causes for the disease

Antibiotic of choice for exacerbation of tonsillitis

The article analyzes an approach to the choice of antibiotic therapy in the treatment of tonsillitis. Traditionally, β-hemolytic streptococcus is eradicated with penicillins. Underestimating the role of microorganisms causing exacerbation of tonsillitis can lead to ineffective antibiotic therapy. Staphylococcus aureus plays an important role in the recurrence of tonsillitis. Unprotected β-lactam antibiotics are not effective in the treatment as these bacteria produce β-lactamase. Amoxicillin in combination with clavulanic acid has bactericidal action and is effective against Staphylococcus aureus as a pathogen of frequently recurring tonsillitis

A modern approach to the combination treatment of allergic rhinitis

Allergic rhinitis is a common disease that significantly worsens the patient’s quality of life. In some cases, the disease can be life threatening. Severe attacks of bronchial obstruction may occur in patients with allergic rhinitis. The widespread prevalence of allergic rhinitis in adults and children, consistent increase in disease incidence constitutes a great medical and social issue. Treatment for allergic rhinitis should be aimed at reaching increased remission duration, preventing the exacerbation of the disease and educating patients to maintain control over the symptoms of the disease. A challenge that otolaryngologists and allergists face is to restore nasal breathing in patients with allergic rhinitis. The updated approach to the challenge is to suggest treatment that takes into account the pathophysiological mechanisms that occur not only in the mucous membrane of the nasal cavity, but throughout the body, in particular, in the intestine

Transsphenoidal endoscopic appro ach in the treat ment of spontaneous cerebrospinal fluid (CSF) leak

Introduction. Spontaneous nasal liquorrhea is a pathological condition associated with defect between nasal cavity and intracranial structures that lead to the expiration of the CSF from the nasal cavity.The objective is to evaluate the effectiveness of endoscopic endonasal approach in the CSF leak treatment.Material and methods. For the period from 2008 to 2018, 38 patients with spontaneous nasal liquorrhea were examined and treated in Pavlov First Saint Petersburg State Medical University, the clinic of neurosurgery of Kirov Medical Institute and Almazov National Medical Research Centre. All patients underwent plastic surgery of the CSF fistula by endoscopic endonasal aproach.Results. Only in 4 cases, there was a large defect, the failure of the closure of which required repeated surgical intervention in 1–2 weeks after the initial operation.Conclusion. The use of autologous tissues (muscle or fat autograft) is the method of choice for repeated surgical plastics of the cerebrospinal fluid fistula or in a large size defect (more than 5 mm)

ГРИБКОВЫЕ ПОРАЖЕНИЯ ВЕРХНЕЧЕЛЮСТНЫХ ПАЗУХ: КТ-ДИАГНОСТИКА

The report is dedicated to the fungal rhinosinusitis. The article describes the role of three-dimension computed tomography in diagnostic and planning maxillary sinus approach in case fungus ball.Статья посвящена грибковым поражениям околоносовых пазух. Описана роль цифровой объемной компьютерной томографии в диагностике и планировании хирургического доступа при наличии грибкового тела верхнечелюстной пазухи

Peculiarities of the acute sinusitis course in patients with chronic vasopathy

This article deals with a modern view of the pathophysiology and the course of acute inflammatory diseases of the paranasal sinuses, complicated by the presence in a patient of chronic rhinitis of vasomotor etiology. The article covers various clinical situations and factors predisposing to chronic angiopathy, special emphasis is placed on differential diagnostics of chronic vasomotor and allergic rhinitis, as well as on the need for adequate and science-based selection of pathogenetic therapy. The article provides a detailed clinical picture of chronic rhinitis, including chronic vasomotor rhinitis with the indication of characteristic symptoms. We also offer the algorithm for treatment of acute inflammatory diseases of paranasal sinuses, complications of chronic vasomotor rhinitis tested in our clinic. During 2016 under our supervision there were 42 patients with chronic vasomotor rhinitis and acute sinusitis. The patients were divided into 2 groups. Each patient received as etiotropic therapy antibiotics of the protected penicillins group, as a basic system component of pathogenetic therapy – a blocker of histamine receptors, a gentle diuretic herbal tea and Afobazol. Additionally, patients received local therapy: in the experimental group – Otrivin® Complex spray; in the control group – a hypertonic solution of sea water in the form of a spray