Original research New Possibilities of Surgical Treatment of Chronic Stenosis of the Larynx and Cervical Trachea
Daykhes NA, Reshulskiy SS, Vinogradov VV, Akopyan KV, Karneeva OV
The aim of the study is to improve the efficiency of surgical treatment of patients with advanced cicatricial stenosis of the larynx and cervical trachea. The paper presents the experience of treatment of patients with cicatricial stenosis of the larynx and cervical trachea having sidewalls laringotraheostomy deficit after the first stages of reconstructive operations. A comparative analysis of treatment outcomes of patients with such pathology different in the choice of used reconstructive material (autocartilage, allocartilage, xenomaterial material based on polytetrafluoroethylene) has been performed. There is given a comparative assessment of the material used for the reconstruction of the side and front walls of the larynx and cervical trachea. There are described complications and ways to overcome them in the performance of reconstructive operations of the said anatomical area.
Received: 2014-11-25
Published online: 2017-01-05
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VIEWS 3946
Review Modern View on Mucociliary Clearance Regulation: a Literature Review
Laberko EL, Bogomilsky MR
The article presents a literature review of recent data on the functioning of mucociliary clearance. The main unresolved up today and still in dispute questions about the mechanisms of work's regulation, identification of a key link and the formation of pathological changes in the process are given. Also there are described the continued at the present time works and perspective studies of the possibility of positive influence on the functioning of mucociliary clearance. The data obtained in the future will lead to the development and implementation in practical health of the techniques to improve the affected transport function of ciliated epithelium in a number of diseases.
Received: 2014-11-21
Published online: 2017-01-05
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VIEWS 3859
Original research Condition of the Middle Ear and Hearing Function in Patients with Congenital Cleft Lip and Palate in Different Periods of Childhood
Bogoroditskaya AV, Sarafanova ME, Radtsig EYu, Prityko AG
Cleft lip and palate (CLP) take 86.9 % of all congenital face malformations. Often the conductive hearing loss develops due to the otitis media with effusion in children with this pathology. There are not enough data about the state of the middle ear and hearing function in children with CLP in different periods of childhood. The aim of the study was to evaluate these indicators in children operated on for CLP in the first year of life in different periods of childhood. As a result of a comprehensive survey of 28 children it was found that the problem with the middle ear was preserved in that group of patients, despite the early stages of surgical treatment of the congenital malformation and the courses of the conservative therapy aimed at restoring the function of the auditory tube. It was made a conclusion about the necessity for the dynamic observation by a physician otolaryngologist of such patients in different periods of childhood, even in the absence of complaints from the middle ear and good results in the study of the state of the tympanic cavity and hearing at the time of another scheduled inspection.
Received: 2014-10-21
Published online: 2017-01-05
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VIEWS 3953
Original research The Role of Endoscopy in Diagnostics of Adenoiditis in Children with Allergic Diseases
Polunin MM, Klendar KV, Zaitseva OV
Nasal endoscopy investigation in children aged from 2 till 14 years was made by various endoscopes (flexible — in infants and rigid — with an angle of view of 0° and 30° in older children). At survey the attention was paid to the change of color, hypostasis, a hypertrophy of a mucous cavity of a nose, degree of adenoids, their prelying to choana or prolapse in posterior parts of the nasal cavity, obstruction of pharyngeal mouths of auditory tubes. The conclusion was made that timely diagnostics including nasal endoscopy allows to determine the causes leading to the development of an adenoiditis and to choose the optimum personalized scheme of treatment in each case.
Received: 2014-11-28
Published online: 2017-01-05
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VIEWS 3692
Original research Reasons for the Decrease in Visual Acuity in Patients after Surgery for Rhegmatogenous Retinal Detachment, According to Optical Coherence Tomography
Avanesova TA, Kozhukhov AA, Zhavoronkov SA, Merzlikin MD, Yugay SA, Totikova AR
Visual acuity after vitrectomy for rhegmatogenous retinal detachment depends on the type of foveal microstructural changes. The purpose of the research — the study of the relationship between visual acuity and foveolar microstructure investigated by means of optical coherence tomography in patients after the treatment of rhegmatogenous retinal detachment. There were investigated 32 patients, the time of observation was 12 months. The defects of the junction between internal and outer segments were registered in 17 eyes (53.1 %), external limited membrane defects were found in 5 eyes (15.6 %). There was a negative correlation between the presence of those defects and the maximum correctable visual acuity (r= –0.39, p <0.05; r = –0.65, p <0.05 respectavely). Remains of epiretinal membrane without traction component were identified in 17 cases (53.1 %), macular edema — in 4 eyes (12.5 %), there was no correlation between those findings and maximum correctable visual acuity. There was a negative correlation between the remoteness of rhegmatogenous retinal detachment and the maximum correctable visual acuity (r = –0.49, p <0.05). It was concluded that the main changes affecting the maximum correctable visual acuity were located in the outer parts of the fovealar area.
Received: 2014-12-12
Published online: 2017-01-05
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VIEWS 3739
Clinical case Modern Hybrid Revascularization Surgery for Crural Arteries (Clinical Observation)
Matyushkin AV, Lobachev AV, Tischenko IS, Mamaeva DA
The article on the clinical case justified a new approach in the surgical treatment of patients with atherosclerosis obliterans of lower limb arteries. Hybrid operation allows to reduce the number of postoperative complications and overall mortality. Own experience of revascularization with distal lesions indicate the need for additional procedures when performing distal anastomosis using a synthetic prosthesis for improving remote patency of bypass grafts. This clinical case reflects the modern approach to surgical reconstruction of the leg arteries in patients with obliterating atherosclerosis of lower limb arteries.
Received: 2015-04-03
Published online: 2017-01-05
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VIEWS 3835
Method Efficiency of Epidural Analgesia in Newborns with Surgical Diseases
Sichkar SYu, Afukov II, Koshko OV, Emirbekova SK, Eliseeva NV
The purpose of the study was to evaluate the efficiency of epidural analgesia (EA) with local anesthetic Ropivacain in newborns suffering from various surgical diseases during intra- and postoperative period. From 2012 till 2014 about 60 cases of epidural analgesia were observed. Patients included children with congenital diaphragmatic hernia (n = 14), bowel obstruction (n = 21), bowel perforation (n = 4), anal atresia (n = 7) and others (n = 14). We used 20G epidural catheter and Ropivacain (2 mg/ml) in a dose of 2 mg/kg during operations. In postoperative period we practiced various ways to administer the local anesthetic into epidural space. It was proved that epidural analgesia with Ropivacain allowed to achieve the proper pain relief effect without any hemodynamic failures or toxic effects of local anesthetic.
Received: 2015-03-02
Published online: 2017-01-05
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VIEWS 4320
Review Prophylaxis and Treatment of Deep Vein Thrombosis of Lower Extremities at Total Hip Replacement: a Literature Review
Ershov DS, Kopenkin SS, Skoroglyadov AV
This article discusses the principles of prevention and treatment of deep vein thrombosis of the lower extremities during total hip replacement (THR). Prevention of venous thromboembolism after THR should be carried out with modern drugs. Patients with hip fracture should be carried out prevention from the moment of the injury before surgery using unfractionated heparin or low molecular weight heparins. The duration of prevention after surgery should be at least 28–35 days. The combination of pharmacological and mechanical methods of prophylaxis to the most extent reduces the risk of deep vein thrombosis after THR. No need to be monitored, oral and direct mechanism of action not associated with the concentration of antithrombin III give the advantage to the new oral anticoagulants (dabigatran, rivaroxaban, apixaban) in comparison with injected low-molecular-weight heparins and unfractionated heparin. Rivaroxaban and dabigatran may be used for the treatment of deep vein thrombosis, which is also an advantage of these drugs. Performing ultrasonic angioscanning during the first 5 days after the surgery, is most likely justified for patients with decreased locomotor activity, venous thromboembolic complications or a history of abuse prevention protocol. Deep vein thrombosis after THR is secondary, so long-term treatment for several months seems unjustified.
Received: 2015-02-06
Published online: 2017-01-05
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VIEWS 3888